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Digital Imaging Fiber-Optic Trans-Illumination과 LaserFluorescence를 이용한 법f랑질 우식증의 조기 진단에관한 비교 연구

Comparative study on the early detection of enamellesions using difoti and lase fluorescence

김종수|김승오|맹명호
대한소아치과학회 (The Korean Academy Of Pediatric Dentistry)|2006.06|대한소아치과학회지 (Journal of the Korean academy of pediatric dentistry)|제33권 제2호|pp. 207-220

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키워드

dental caries치아우식증early detection조기 진단Digital Imaging Fiber-Optic Trans-Illumination레이저 형광 진단기Digital Image Fiber-optic Trans-illuminationlaser fluorescence
주제분류치의학

초록

새로 개발된 조기 진단 장비들로는 laser fluorescence device(LFD), 초음파 진단 시스템, confocal laser scanning microscopy(CLSM), quantitative light-induced fluorescence(QLF) 시스템 그리고 digital imaging fiber-optic trans-illumination(DIFOTI) 시스템 등이 있다. 본 연구는 임상에서 사용되고 있는 DIFOTI 시스템과 LFD를 이용하여 유치 교환 시기에 있는 환아 21명, 25개의 유치를 대상으로 각 치아당 1～3점을 선정하여 구강내에서 초기 우식법랑질에 대한 DIFOTI 이미지 촬영 결과와 LFD 계측값을 3회 측정하고 그 평균을 대표값으로 한 결과를 CLSM과 비교하여 진단 능력을 평가하였다. 실험실 연구에서는 인공우식 용액을 이용하여 수거된 40개의 유치를 협설면에 2X3㎜ 크기의 창을 형성하고 4, 8, 12, 16일간 탈회시키면서 그 변화를 DIFOTI 시스템과 LFD를 이용하여 측정하고 이를 CLSM과 비교 분석하여 다음과 같은 결론을 얻었다. 1. 구강내에서 촬영된 DIFOTI의 민감도는 88.2%이었고, 특이도는 76.9%이었다. 2. 구강내에서 측정된 LDD의 민감도는 76.5%이었고, 특이도는 69.2%이었다. 3. 실험실 연구에서 유치 법랑질의 탈회 기간에 따른 DIFOTI 광투과율의 회귀 분석한 결과, 탈회 시간에 따라 광투과율은 감소하였다(r = -0.96, p<0.05). 4. 실험실에서 탈회 기간에 따른 LFD의 측정값의 회귀 분석 결과 통계적 유의성을 보이지 않았다(p>0.05). 5. DIFOTI 이미지의 광투과율과 CLMS의 병소 깊이에 대한 상관 계수는 -0.688이었으나(p<0.05), LFD의 측정값은 유의성을 보이지 않았다.

Abstract

The newly developed equipments for the early detection of carious lesion are LFD(laser fluorescence device), Ultrasonic diagnostic system, CLSM(confocal laser scanning microscopy), QLF(quantitative light-induced fluorescence) and DIFOTI(digital imaging fiber-optic trans-illumination) system. In this study, DIFOTI system and LFD were used for the detection of early enamel caries. Twenty five primary teeth extracted from twenty one children at around the dentitional exchanging period were selected as samples. The results obtained from DIFOTI imaging and LFD measurement were compared with those of CLSM and comprehensive evaluations were made for the diagnostic capacity of each device. In vitro test, 40 sample teeth with their buccal & lingual surface formed by a window of 2*3mm in diameter were immersed in artificial demineralizing solution for the period of 4,8,12 and 16 days. The results obtained from the experimental groups (DIFOTI, LFD) were compared to control group (CLSM) and we have reached to the following conclusions. 1. The sensitivity and specificity of DIFOTI system operated in oral environment was 88.2% and 76.9% respectively. 2. The sensitivity and specificity of LFD measured in oral environment was 76.5% and 69.2% respectively. 3. Regression analysis on the light transparent rate of DIFOTI showed its decrease according to the length of primary enamel decalcification performed in vitro (r=-0.96, p<0.05). 4. No statistically significant difference between LFT measurement and the length of in vitro decalcification was found in regression analysis(p>0.05). 5. The correlation coefficient of DIFOTI image transparent rate and the lesion depth of CLMS was -0.6988(p<0.05), whereas no statistically significant difference was found for LFD measurement.

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