Development of QLF Handpiece for Early Caries Detection

描述：尽管在过去的25年里，在美国观察到龋齿的患病率显著下降，但龋齿仍然是最常见的牙齿疾病，需要采取额外的措施来预防和控制这种疾病。在发育的早期阶段检测龋齿的能力将显著促进制定更有效的措施来预防和控制这种疾病，并在牙科实践中加以应用。传统的视觉触觉放射检查方法无法检测到蛀牙过程，直到蛀牙进展到300-500微米的牙釉质，而且这种病变很难通过经常需要的修复程序逆转/再矿化。过去十年的研究表明，一种新的技术，定量光荧光（QLF）不仅能够更早地检测龋病过程，而且能够量化矿物含量的变化，即脱矿和再矿化，因为它们发生在原位。这种能力将使牙科医生能够：1)在空化之前识别反映龋齿风险的早期病变；2)实施适当的干预措施，在较早阶段扭转疾病进程，取得更有效的结果；3)监测应用干预措施的成功（或失败）。然而，用于研究的QLF仪器在临床牙科实践和临床研究中常规使用是相当麻烦和不可接受的。第一阶段申请建议重新设计QLF手机，并进行必要的实验室验证测试，以确保持续检测早期病变的能力。为了实现这些目标，工程师和牙科临床医生团队将重新设计和重建QLF系统的手件组件，以：a)减少其体积，重量和形状，以便于在后牙上使用；b)替换当前的镜面附件，以防止起雾并提高图像质量；c)提高照明水平，以防止阴影；D)更换/修改笨重的视频电缆和导光系统；E)增加获取白光图像的能力；f)添加脱水系统以允许临床医生确定检测到的病变的活动性。然后将在实验室中对所得的原型手件进行评估，以验证其在QLF检查中的功能能力。

DESCRIPTION: In spite of the remarkable decline in the prevalence of Dental caries observed in the U.S. during the past 25 years, Dental caries continues to be the most common Dental disease and additional measures for the prevention and control of this disease are needed. The ability to detect Dental caries at an earlier stage of development would markedly facilitate the development of more effective measures for the prevention and control of this disease and their use in Dental practice. Conventional visual-tactile-radiographic procedures for caries detection are unable to detect the caries process until it has progressed through 300-500 microns of enamel and such lesions are difficult to reverse/remineralize with restorative procedures frequently required. Research during the past decade has demonstrated that a new technology, Quantitative Light Fluorescence (QLF) is not only capable of detecting the caries process much earlier but is able to quantify changes in the mineral content, i.e., demineralization and remineralization, as they occur in situ. This capability will allow Dental practitioners to: 1) identify early lesions reflecting caries risk prior to cavitation; 2) implement appropriate interventions to reverse the disease process at an earlier stage with more efficient outcomes; and 3) monitor the success (or failure) of the applied intervention measures. Nevertheless, the QLF instrumentation used for research is quite cumbersome and unacceptable for routine use in clinical Dental practice and in clinical research. This Phase I application proposes to redesign the QLF handpiece and conduct the necessary laboratory validation tests to assure the continued ability to detect very early lesions. To achieve these goals a team of engineers and Dental clinicians will redesign and reconstruct the hand-piece component of the QLF system to: a) reduce its bulk, weight, and shape in order to facilitate its use on posterior teeth, b) replace the current mirror attachment to prevent fogging and improve image quality, c) improve the level of illumination to prevent shadows; d) replace/revise the cumbersome video cables and light guide system; e) add the capability of obtaining white light images; and f) add a dehydration system to permit the clinician to determine the activity of the detected lesions. The resultant prototype hand-piece will then be evaluated in the laboratory to verify its functional ability for QLF examinations.