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레이저 형광법을 이용한 인접면 우식증 탐지효과

Detection of proximal caries using laser fluorscence

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초록

본 연구는 레이저 형광을 치아의 인접면에 적용하여 임상에서 초기 인접면 우식증의 감별에 레이저의 이용가능성을 평가하는데 그 목적이 있다. 염료와 레이저 형광법의 인접면 우식증 탐지효과를 평가하기 위해 조선대학교 소아치과에 내원한 아동 중 유구치의 탈락이 없으며 인접면의 수복치료를 받지 않은 3-9세 사이의 어린이 30명을 대상으로 하였으며, 시진, 교익 방사선사진, 레이저 형광법, 염료와 레이저 형광법을 이용해 관찰한 결과를 비교하여 다음과 같은 결과를 얻었다. 1. 인접면 우식증의 교익 방사선 사진검사와 시진, 레이저 형광법, 염료와 레이저 형광법 사이에서 모두 높은 상관 관계(r=0.725-0.911)를 보였다(p<0.05). 2. 인접면 우식증의 교익 방사선사진 검사와 각 검사법간의 일치도(kappa치)는 각각 시진이 0.451, 레이저 형광법이 0.683, 염료와 레이저 형광법이 0.772로 가장 일치도가 높았다. 이상의 결과를 종합해 보면 교익 방사선사진 검사법과 염료와 레이저 형광법 검사 수치의 상관관계가 진단학적 일치도가 높아 레이저 형광법이 향후 교익방사선사진 검사법을 대치할 수 있는 인접면 우식증 검사법으로 사료된다.

Abstract

The purpose of this study was to evaluate the diagnostic validity of early proximal caries lesions using laser fluorescence and whether the detection could be enhanced using a fluorescent dye. Direct visual examination and bitewing radiograph were used for comparison. The subjects of this study were 30 children of 3-9 years old. Laser fluorescence and dye-enhanced laser fluorescence(mixed wavelength of 488 and 514 ㎚) were used and viewed through glasses(excluding wavelength < 520 ㎚). For dye-enhanced laser fluorescence a 0.075% sodium fluorescein dye was applied before examination. Proximal caries lesion of each subject was assessed using visual examination, bitewing radiograph, laser fluorescence, and dye-enhanced laser fluorescence. The results in the three detection methods were compared to the assessment of bitewing radiograph. The results from the present study can be summarized as follows: 1. There was highly correlation(r=0.725-0.911) between the bitewing radiograph and all three detection methods(p<0.05) 2. The reproducibility(kappa value) of the visual examination, laser fluorescence and dye-enhanced laser fluorescence comparing with bitewing radiograph of proximal caries was 0.451, 0.683, 0.772, respectively. There was highest correlation between dye-enhanced laser fluorescence and bitewing radiograph for detection of proximal caries. The results from this study indicated that the dye-enhanced laser fluorescence considered to be accurate and reliable method in detecting proximal caries.

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