IN VITRO EVALUATION OF EARLY CARIES DETECTION TECHNIQUES AND INTERVENTIONS

该项目将包括三个阶段，这三个阶段将确定各种实验诊断技术的能力，以测量牙釉质脱矿的早期变化，评估各种干预措施，并从临床研究中验证对剥脱牙齿的临床诊断。需要评估的诊断技术有定量光诱导荧光(QLF)、电导率(ECM)、红外光荧光(IR)和传统的目测评价。第一阶段将验证将在牙釉质标本中创建的原发和继发龋样病变，并测量初始组织变化。用作偏振光显微镜(PLM)的金标准。一个标准的化学缓冲溶解系统将被用来创造光滑的表面损伤，而微生物龋病模型(Fontana等人，1996)将被用来评估继发性龋齿。在这种情况下，将同时使用AMALGRAM和树脂修复材料。据推测，QLF、ECM和IR在检测矿物含量的微小变化方面将表现得与标准诊断一样好。该项目的第二阶段和更长阶段将确定早期干预措施在初级和次级模型中的效果。早期干预将被用来帮助防止病变的形成或进展，以及加强再矿化。将使用原位模型系统来确定氟化物治疗、再矿化剂和激光治疗光滑表面龋病的疗效。该模型允许宿主、微生物区系、饮食和干预措施之间的相互作用。Fontana的体外继发性龋病模型还将评估CHX清漆、氟化物、激光等早期干预措施预防、阻止和/或逆转继发性龋损形成的能力。这些研究将调查amalgram、玻璃离子和复合材料作为修复材料的使用情况。假设早期干预将防止需要手术干预的显性病变的形成。第三阶段包括使用PLM作为金标准来确定牙齿剥脱的病变形成程度。这些牙齿将被收集在项目II和II中，并被送往爱荷华州进行评估。在继发性龋齿模型中使用的牙齿也将用PLM进行评估，并与CFSM进行比较。生物统计核心将把实验室和临床数据联系起来。

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.