光学相干断层成像检出早期窝沟龋效能的体外评估

发布时间：2018-03-24 02:32

本文选题：窝沟龋　切入点：早期龋　出处：《华西口腔医学杂志》2016年06期

【摘要】：目的比较光学相干断层成像技术(OCT)与临床探视诊对人牙窝沟早期釉质龋的检出效能。方法获取77颗人离体恒磨牙面的97个可疑早期龋位点OCT二维图像,由3位临床医师双盲法分别通过OCT图像和探视诊方法对这些位点进行评分,以偏光显微镜获取的组织学图像为金标准,评估OCT、临床探视诊检出早期窝沟龋的敏感度(SE)、特异度(SP)、阳性预测值(PPV)、阴性预测值(NPV)及其与组织学评分结果的相关性;采用Kappa检验分析检测者间评分结果的一致性,采用非参数法Z检验比较受试者工作特征(ROC)曲线下面积(AUC)。结果对于脱矿局限于釉质表层外1/2的窝沟早期龋,OCT检出率(14/25)明显优于探视诊(3/25)。OCT检出窝沟早期釉质龋的SE、SP、PPV、NPV(0.83、0.64、0.87、0.57)均高于探视诊(0.79、0.60、0.85、0.50)。OCT与探视诊检测窝沟早期龋的AUC(95%CI)分别为0.737(0.569~0.822)、0.696(0.614~0.859),二者间差异无统计学意义。OCT评分与组织学评分呈正相关(r=0.559,P0.05),检测者间检测结果的一致性为中等。结论 OCT能够敏感、无创、有效地检出早期窝沟龋,具有辅助临床探视诊检出早期窝沟龋的应用潜能。
[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.
【作者单位】：天津市口腔医院中心实验室;天津市口腔医院牙体牙髓病科;
【基金】：国家自然科学基金(30770597)~~
【分类号】：R781.1

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