IN VITRO EVALUATION OF EARLY CARIES DETECTION TECHNIQUES AND INTERVENTIONS

该项目将包括三个阶段，将确定各种实验诊断技术测量釉质脱矿早期变化的能力，评估各种干预措施，并验证临床研究中脱落牙齿的临床诊断。待评估的诊断技术是定量光诱导荧光（QLF）、电导率（ECM）、红外光荧光（IR）和传统的视觉评估。第一阶段将验证原发性和继发性龋样病变，这些病变将在釉质标本中产生，并测量初始组织变化。偏振光显微镜（PLM）的金标准。标准的化学缓冲溶解系统将用于产生光滑的表面损伤，而微生物龋齿模型（丰塔纳et al.，1996）将用于评估继发性龋。在这种情况下，将使用硅胶和树脂修复材料。假设QLF、ECM和IR在检测矿物质含量的最小变化方面即使不比标准诊断更好，也会表现良好。该项目的第二阶段和更长的阶段将确定早期干预在初级和二级模型中的功效。早期干预将用于帮助预防病变形成或进展以及增强再矿化。原位模型系统将用于确定氟化物治疗、矿化剂和激光治疗对光滑表面龋的疗效。这种模式允许宿主、微生物群落、饮食和干预措施之间的相互作用。丰塔纳的体外继发性龋齿模型还将评估早期干预如CHX清漆、氟化物、激光等预防、阻止和/或逆转继发性龋齿病变形成的能力。这些研究将调查使用的树脂，玻璃离子，复合材料作为修复材料。据推测，早期干预将防止需要手术干预的明显病变形成。第三阶段包括使用PLM作为金标准来确定脱落牙齿中病变形成的程度。这些牙齿将在项目II和II中收集，并送往爱荷华州进行评估。还将使用PLM对继发性龋齿模型中使用的牙齿进行评价，并与CFSM进行比较。实验室和临床数据将通过生物统计学核心进行关联。

This project will consist of three phases which will determine the ability of various experimental diagnostic techniques to measure early changes in enamel demineralization, to evaluate various interventions and to validate clinical diagnosis on exfoliated teeth from clinical studies. The diagnostic techniques to be evaluated are quantitative light-induced fluorescence (QLF), electrical conductivity (ECM), infrared light fluorescence (IR), and traditional visual evaluation. Phase I will validate both primary and secondary caries-like lesions that will be created in enamel specimens and measured for initial tissue changes. The gold standard to be used as polarized light microscopy (PLM). A standard chemically buffered, dissolution system will be used to create smooth surface lesions, while the microbial caries model (Fontana et al., 1996) will be used to evaluate secondary caries. In this case, both amalgram and resin restorative materials will be used. It is hypothesized that the QLF, ECM and IR will perform as well if not better than standard diagnosis in detecting minimal changes in mineral content. The second and longer phase of this project will determine the efficacy of early interventions in both the primary and secondary models. The early interventions will be used to help prevent lesion formation or progression as well as to enhance remineralization. In situ model systems will be used to determine the efficacy of fluoride treatments, remineralization agents and laser treatments on smooth surface caries. This model allows interaction between host, microflora, diet and interventions. The in vitro secondary caries model of Fontana will also evaluate the ability of early interventions such as CHX varnishes, fluorides, lasers, etc. to prevent, arrest and/or reverse secondary caries lesion formation. These studies will investigate the use of amalgram, glass ionomer, and composite as restorative materials. It is hypothesized that early intervention will prevent overt lesion formation that requires operative intervention. The third Phase consists of using PLM as the gold standard for determination of the extent of lesion formation in exfoliated teeth. These teeth will be collected in Projects II and II and sent to Iowa for evaluation. Teeth used in the secondary caries model will also be evaluated with PLM and compared to CFSM. The laboratory and clinical data will be correlated by the Biostatistics Core.