本文選題：窩溝齲　切入點：早期齲　出處：《華西口腔醫(yī)學雜志》2016年06期

【摘要】：目的比較光學相干斷層成像技術(OCT)與臨床探視診對人牙窩溝早期釉質齲的檢出效能。方法獲取77顆人離體恒磨牙面的97個可疑早期齲位點OCT二維圖像,由3位臨床醫(yī)師雙盲法分別通過OCT圖像和探視診方法對這些位點進行評分,以偏光顯微鏡獲取的組織學圖像為金標準,評估OCT、臨床探視診檢出早期窩溝齲的敏感度(SE)、特異度(SP)、陽性預測值(PPV)、陰性預測值(NPV)及其與組織學評分結果的相關性;采用Kappa檢驗分析檢測者間評分結果的一致性,采用非參數(shù)法Z檢驗比較受試者工作特征(ROC)曲線下面積(AUC)。結果對于脫礦局限于釉質表層外1/2的窩溝早期齲,OCT檢出率(14/25)明顯優(yōu)于探視診(3/25)。OCT檢出窩溝早期釉質齲的SE、SP、PPV、NPV(0.83、0.64、0.87、0.57)均高于探視診(0.79、0.60、0.85、0.50)。OCT與探視診檢測窩溝早期齲的AUC(95%CI)分別為0.737(0.569~0.822)、0.696(0.614~0.859),二者間差異無統(tǒng)計學意義。OCT評分與組織學評分呈正相關(r=0.559,P0.05),檢測者間檢測結果的一致性為中等。結論 OCT能夠敏感、無創(chuàng)、有效地檢出早期窩溝齲,具有輔助臨床探視診檢出早期窩溝齲的應用潛能。
[Abstract]:Objective to compare the efficacy of optical coherence tomography (Oct) and clinical visits in the detection of early enamel caries of human teeth. Methods OCT images of 97 suspected early caries sites in 77 human permanent molars were obtained. These loci were scored by the double blind method of three clinicians by OCT images and visiting and diagnosis methods respectively. The histological images obtained by polarizing microscope were taken as the gold standard. To evaluate the sensitivity, specificity, positive predictive value and negative predictive value of Kappa and the correlation between the sensitivity, specificity, positive predictive value and histological score of early lacunae caries, and to analyze the consistency of the results by Kappa test, and to evaluate the correlation between the positive predictive value and the histological score, and to evaluate the correlation between the positive predictive value (PPVV) and the negative predictive value (NPV). The area under the operating characteristic curve was compared by non-parametric Z test. Results the Oct detection rate of early caries and sulcus caries with demineralization confined to 1 / 2 of the enamel surface was significantly better than that of SESPPPVNPV0.83V0.840.57). The mean value of Oct was 0.737 / 0.5690.569 / 0. 8696 / 0.614 / 0.859, respectively. The difference between Oct score and histologic score was not statistically significant, and the consistency of the test results was moderate. Conclusion OCT can be sensitive, and the correlation between Oct score and histologic score is positive, and the correlation between Oct score and histologic score is moderate. Conclusion OCT can be sensitive, and there is no significant difference between Oct score and histological score, and the consistency of the test results between the two groups is moderate. Conclusion OCT can be sensitive, and there is no significant difference between Oct score and histological score, and the correlation between Oct score and histological score is moderate. Conclusion OCT can be sensitive. Noninvasive and effective detection of early lacunae caries has the potential to assist clinical visits to detect early lacunae caries.
【作者單位】： 天津市口腔醫(yī)院中心實驗室;天津市口腔醫(yī)院牙體牙髓病科;
【基金】：國家自然科學基金(30770597)~~
【分類號】：R781.1

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