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

【摘要】：目的比較光學(xué)相干斷層成像技術(shù)(OCT)與臨床探視診對(duì)人牙窩溝早期釉質(zhì)齲的檢出效能。方法獲取77顆人離體恒磨牙面的97個(gè)可疑早期齲位點(diǎn)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(duì)這些位點(diǎn)進(jìn)行評(píng)分,以偏光顯微鏡獲取的組織學(xué)圖像為金標(biāo)準(zhǔn),評(píng)估OCT、臨床探視診檢出早期窩溝齲的敏感度(SE)、特異度(SP)、陽(yáng)性預(yù)測(cè)值(PPV)、陰性預(yù)測(cè)值(NPV)及其與組織學(xué)評(píng)分結(jié)果的相關(guān)性;采用Kappa檢驗(yàn)分析檢測(cè)者間評(píng)分結(jié)果的一致性,采用非參數(shù)法Z檢驗(yàn)比較受試者工作特征(ROC)曲線下面積(AUC)。結(jié)果對(duì)于脫礦局限于釉質(zhì)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(zhì)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(cè)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(wú)統(tǒng)計(jì)學(xué)意義。OCT評(píng)分與組織學(xué)評(píng)分呈正相關(guān)(r=0.559,P0.05),檢測(cè)者間檢測(cè)結(jié)果的一致性為中等。結(jié)論 OCT能夠敏感、無(wú)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(yīng)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(shí)驗(yàn)室;天津市口腔醫(yī)院牙體牙髓病科;
【基金】：國(guó)家自然科學(xué)基金(30770597)~~
【分類號(hào)】：R781.1

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