目的:本研究比较了目视检查的诊断结果(VI),数字比特翼射线照相术(BWR),和近红外光透射照明(NIR-LT,Diagnocam,KaVo,比伯拉赫,德国)用于咬合龋齿的检测和评估。
方法:本研究包括203名患者(平均年龄23.0岁)。所有个人都获得了细致的VI。此外,收集BWR和NIR-LT图像。盲目评估所有BWR和NIR-LT图像是否存在釉质龋齿病变(ECL)和牙本质龋齿病变(DCL)。描述性统计分析包括频率的计算,交叉表格,并使用皮尔逊卡方检验进行成对比较。
结果:在这个低风险的成年人群中,大多数ECL/DCL是通过VI检测到的。ECL/DCL的额外诊断结果为5.0%(BWR)和6.8%(NIR-LT)。VI/NIR-LT或VI/BWR的组合使用确定了咬合面上所有ECL/DCL的95.7%和94.4%,分别。
结论:这项比较诊断研究表明,VI检测到大多数咬合龋病变。两种额外的方法显示出有限的益处。由于NIR-LT的宝贵功能,即,X线游离度和临床实用性,这种方法可能优于基于X射线的方法.然而,在诊断出填充物不足或多个(深)龋齿病变或需要评估与牙髓相关的龋齿扩展的临床情况下,应规定BWR。
结论:VI必须被理解为在低风险成人人群的咬合面上选择的龋齿检测方法,这可能有助于避免多种诊断测试,过度诊断,和过度治疗。
OBJECTIVE: This study compared the diagnostic outcomes of visual inspection (VI), digital bitewing radiography (BWR), and near-infrared light transillumination (NIR-LT,
DIAGNOcam, KaVo, Biberach, Germany) for occlusal caries detection and assessment of posterior teeth.
METHODS: This study included 203 patients (mean age 23.0 years). All individuals received a meticulous VI. Additionally, BWR and NIR-LT images were collected. All BWR and NIR-LT images were blindly evaluated for the presence of enamel caries lesions (ECLs) and dentin caries lesions (DCLs). The descriptive statistical analyses included calculation of frequencies, cross tabulations, and pairwise comparisons using Pearson chi-square tests.
RESULTS: The majority of ECLs/DCLs were detected by VI in this low-risk adult population. The additional diagnostic outcomes in terms of ECLs/DCLs amounted to 5.0% (BWR) and 6.8% (NIR-LT). The combined usage of VI/NIR-LT or VI/BWR identified 95.7 and 94.4% of all ECLs/DCLs on occlusal surfaces, respectively.
CONCLUSIONS: This comparative diagnostic study showed that VI detected the majority of occlusal caries lesions. Both additional methods showed limited benefits. Due to the valuable features of NIR-LT, i.e., X-ray freeness and clinical practicability, this method might be preferred over X-ray-based methods. Nevertheless, BWRs should be prescribed in clinical situations where insufficient fillings or multiple (deep) caries lesions are diagnosed or where there is a need to assess the caries extension in relation to the pulp.
CONCLUSIONS: VI has to be understood as caries detection method of choice on occlusal surfaces in low-risk adult population which may help to avoid multiple diagnostic testing, overdiagnosis, and overtreatment.