Development of QLF Handpiece for Early Caries Detection

描述(由申请人提供)：在过去的40年里，由于氟化物在公共卫生项目中的广泛使用，如公共用水加氟、牙科实践和口腔卫生产品，龋齿患病率显著下降。尽管如此，龋齿仍然是最常见的牙病。众所周知，传统的视觉-触觉临床龋病检查程序只有在病变进展到难以用氟化物等措施逆转的阶段才能发现病变。对龋齿过程的了解已经远远超出了将龋齿的证据限制在E2(仅限牙釉质的龋齿)或D3(釉质和牙本质的龋齿)空洞水平的程度。仅在空化水平记录病变不再被接受(ICCCT，2002)。定量光荧光(QLF)是一种已被证明在早期阶段(空化前)检测和量化病变进展的技术。这项技术将使牙科医生能够：(A)在空化之前识别反映龋齿风险的早期釉质脱矿；(B)实施适当的干预措施，在更早的阶段扭转疾病过程，取得更有效的结果；以及(C)监测所应用的干预措施的成功或失败。该计划的总体目标是开发一个用于临床牙科实践的QLF研究系统。第一阶段计划成功地克服了研究手持设备的限制，允许常规临床使用。第二阶段计划寻求进一步完善仪器硬件和用户软件，使该技术在临床实践中实用。这项应用的具体目标是：(1)改进仪器，使其更符合人体工程学，并便于实用的感染控制程序；(2)验证重新设计的仪器检测早期龋齿和监测实验室变化的能力；(3)开发与现有软件兼容的用户友好的计算机软件界面，供牙科专业人员使用；(4)开发适当的培训材料；(5)通过临床调查验证系统的有效性。这项研究的结果应该通过确定患龋齿风险较高的牙科患者来改善普通人群的牙齿健康，并导致实施干预措施，扭转这一过程，减少或防止修复的需要。

DESCRIPTION (provided by applicant): During the past 40 years there has been a remarkable decline in the prevalence of dental caries due to the widespread use of fluoride in public health programs, such as communal water fluoridation, dental practice and in oral hygiene products. In spite of this, dental caries continues to be the most prevalent dental disease. It is known that the traditional visual-tactile clinical caries examination procedure cannot detect lesions until they advance to the stage where they are difficult to reverse with fluorides and other measures. The understanding of the caries process has progressed far beyond the point of restricting the evidence for dental caries at the E2 (caries in enamel only) or D3 (caries in enamel and dentin) levels of cavitations. Recording lesions only at the cavitation level is no longer acceptable (ICCCT, 2002). Quantitative Light Fluorescence (QLF) is a technology that has been shown to detect and quantify the progress of lesions at an early stage (pre-cavitation). This technology will allow dental practitioners to: (a) identify early enamel demineralization reflecting caries risk prior to cavitation; (b) implement appropriate interventions to reverse the disease process at an earlier stage with more efficient outcomes; and (c) monitor the success or failure of the applied intervention measures. The overall goal of this program is to develop a QLF research system for use in clinical dental practice. The Phase I program successfully overcame the limitations of a research hand-piece to permit routine clinical use. The Phase 2 program seeks to further refine the instrument hardware and user software to make the technique practical within clinical practice. The specific aims of this application are to: (1) refine the instrument to make it more ergonomic and facilitate practical infection control procedures; (2) verify the ability of the redesigned instrument to detect early caries and monitor changes in a laboratory; (3) develop user-friendly computer software interfaces that are compatible with the existing software for use by dental professionals; (4) develop appropriate training materials; (5) verify efficacy of the system through a clinical investigation. The results of this research should improve dental health of the general population by identifying dental patients at greater risk of developing dental caries and result in the implementation of interventions to reverse the process and reduce or prevent the need for restorations.