Ability of optical coherence tomography to detect caries beneath commonly used dental sealants.
Ability of optical coherence tomography to detect caries beneath commonly used dental sealants.
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DOI：
10.1002/lsm.20963
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发表时间：
2010-10
影响因子：
2.4
通讯作者：
Wilder-Smith, Petra
中科院分区：
文献类型：
--
作者：
Holtzman, Jennifer S.;Osann, Kathryn;Pharar, Jessica;Lee, Kenneth;Ahn, Yeh-Chan;Tucker, Travis;Sabet, Sharareh;Chen, Zhongping;Gukasyan, Ripsik;Wilder-Smith, Petra
早期蛀牙的发生和发展通常可以通过牙科密封剂来预防。然而，偶尔腐蚀在密封剂下面进行。目前的技术不允许监测潜在的病变进展或停止。牙齿密封剂本身掩盖了识别早期蛀牙的视觉线索，X光照片也不够敏感。因此，临床医生可能不愿意使用牙科密封剂。本离体研究的目的是评价牙医使用光学相干断层扫描（OCT）成像检测常用牙科密封剂下的龋齿的能力。40颗拔除的牙齿被分为相等的龋和非龋牙齿组，通过目视检查确定。在X线片和OCT成像后，随机分配牙齿，使用四种常用牙科密封剂之一进行密封剂放置：Clinpro™、Fuji Triage™、Embrace Wet Bond™和Delton™。在密封剂放置后，对牙齿进行X线摄影，OCT成像，切片，组织学检查，并评分为健康/不健康。分别对OCT和放射学图像进行评分。金标准是连续切片的组织病理学诊断。计算所有指标的Cohen Kappa、敏感性、阴性预测值和阳性预测值。经过90分钟的培训后，标准化前的牙医能够使用OCT比视觉或X线检查更准确地检测蛀牙。使用OCT的检测在密封剂放置之前比之后稍好。这种影响的大小取决于所使用的密封剂的类型。在密封剂放置后，放射学诊断也不太准确。在四种牙科封闭剂中，Delton提供了极好的阳性预测值和最佳的封闭剂后阴性预测值。在这项体外研究中，牙医能够根据OCT图像检测四种常用牙科密封剂下的蛀牙。目前正在进行临床研究，以确定这种方法在体内的有用性。
The onset and progression of early tooth decay is often preventable with dental sealants. However, occasionally decay progresses underneath the sealant. Current technology does not permit monitoring of potential lesion progression or arrest. Dental sealants themselves mask the visual cues that identify early tooth decay, and radiographs are not sufficiently sensitive. Therefore clinicians can be reluctant to use dental sealant. The objective of this ex vivo study was to evaluate the ability of dentists to detect decay beneath commonly used dental sealants using Optical Coherence Tomography (OCT) imaging. Forty extracted teeth were divided into equal groups of carious and non-carious teeth, as determined by visual inspection. After radiographs and OCT imaging, teeth were randomly assigned for sealant placement with one of four commonly purchased dental sealants: Clinpro™, Fuji Triage™, Embrace Wet Bond™, and Delton™. Following sealant placement, teeth were radiographed, imaged with OCT, sectioned, examined histologically, and scored as healthy/not healthy. OCT and radiographic images were scored separately. The gold standard was histopathological diagnosis from the serial sections. Cohen’s Kappa, sensitivity, negative predictive value and positive predictive value were computed for all measures. After 90 mins training, pre-standardized dentists were able to detect tooth decay more accurately using OCT than with visual or radiographic examination. Detection using OCT was somewhat better prior to sealant placement than afterwards. This effect varied in size depending on the type of sealant used. Radiographic diagnosis was also less accurate after sealant placement. Of the four dental sealants, Delton provided excellent positive predictive value and the best post-sealant negative predictive values. In this ex vivo study, dentists were able to detect tooth decay beneath four commonly used dental sealants based on OCT images. Clinical investigations are now underway to determine the usefulness of this approach in vivo.
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影响因子：
3.5
作者：
Ko, ACT;Choo-Smith, LP;Cleghorn, B
通讯作者：
Cleghorn, B
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