Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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Diagnosis of Early Dental Caries with Dye-Enhancing Quantitative Light-Induced Fluorescence (QLF)

정량 광유도 형광법(QLF)과 광활성제를 이용한 초기 치아우식증의 진단

  • Kim, Mihee (Department of Pediatric Dentistry, College of Dentistry, Chosun University) ;
  • Lee, Sangho (Department of Pediatric Dentistry, College of Dentistry, Chosun University) ;
  • Lee, Nanyoung (Department of Pediatric Dentistry, College of Dentistry, Chosun University)
  • 김미희 (조선대학교 치의학전문대학원 소아치과학교실) ;
  • 이상호 (조선대학교 치의학전문대학원 소아치과학교실) ;
  • 이난영 (조선대학교 치의학전문대학원 소아치과학교실)
  • Received : 2015.02.03
  • Accepted : 2015.03.31
  • Published : 2015.08.31
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Abstract

This study used sodium fluorescein to improve imaging diagnostic ability by increasing the fluorescence difference between sound enamel and caries lesions. It also made it easier to discriminate between stain and caries lesions using quantitative light-induced fluorescence (QLF). Half of the specimen surface was covered with nail varnish as a control. Specimens were divided randomly in six decalcification groups and decalcified for different lengths of time. Then, ${\Delta}F$ was measured using QLF-D. After applying 0.075% sodium fluorescein, we measured ${\Delta}F$ again and compared it with the initial value. After cutting the central portion of the specimen, we measured the lesion depth using scanning electron microscopy. The lesion surfaces observed with QLF were darker than normal enamel, whereas they were lighter than normal enamel after applying fluorescein. Longer decalcification time was associated with greater fluorescent dye penetration. The ${\Delta}F$ measured after applying fluorescein was higher than the initial value (p < 0.05). Due to QLF measurement using fluorescein being more sensitive for diagnosing early decalcification, this approach will enable early diagnosis of dental caries before the cavity formation stage, allowing the treatment of early caries lesions. With QLF and sodium fluorescein, we can easily discriminate between stain and caries lesions.

본 연구의 목적은 건전 법랑질과 우식 병소의 형광 차이를 증진시켜 QLF의 영상학적인 진단강도를 높이고, QLF로 촬영한 이미지 상에서 착색과 우식병소를 감별하기 위해 형광 염색제인 플루오레세인나트륨을 접목하여 사람 치아의 법랑질 표면에 유발된 초기 우식병소를 평가하는데 있다. 치아우식증이나 균열이 없는 최근 발거된 소구치 및 제3대구치를 대상으로 하여 치아의 평활면을 $6mm{\times}3mm{\times}3mm$ 크기로 절단한 후 아크릴 주형에 매몰하였고, 시편 표면적의 1/2에 nail varnish를 도포하여 대조군으로 설정하였다. 시편은 무작위로 15개씩 총 6개 탈회그룹(6, 12, 24, 48, 72, 96시간)으로 나누었다. 시편을 각 시간에 맞게 탈회시키고 생리 식염수로 세척한 후 QLF-D를 이용하여 탈회 정도(${\Delta}F$)를 측정하고 0.075% 플루오레세인나트륨을 적용한 후 세척하고 ${\Delta}F$ 값을 측정하여 그 값을 비교하였다. 시편의 중앙 부위를 삭제하고 연마하여 주사전자현미경 상으로 영상을 저장한 후 병소 깊이를 측정하였다. QLF를 이용하여 관찰한 우식병소는 건전 법랑질보다 어둡게, 플루오레세인나트륨을 도포한 후 QLF로 관찰한 우식병소는 건전 법랑질보다 밝게 관찰되었으며 탈회시간이 증가함에 따라 형광염료는 더 많이 침투하였다. 플루오레세인나트륨을 적용한 후 측정한 ${\Delta}F$ 값은 염색 전과 비교하여 모두 증가하였다(p < 0.05). QLF 수치와 병소 깊이는 높은 상관관계를 보였고 회귀분석을 통해 선형 방정식을 추출하였다. 따라서 플루오레세인나트륨을 접목시킨 QLF 측정은 임상적으로 초기우식을 감지하고 분류하는데 기여할 수 있을 것이며, QLF로 촬영한 이미지에서 우식병소와 착색을 감별하는데 도움을 줄 것이다.

Keywords

References

  1. Lee SH : Present situation and prospect of pediatric dentistry in Korea - Focused on management of dental caries -. J Korean Acad Pediatr Dent, 39:206-225, 2012. https://doi.org/10.5933/JKAPD.2012.39.2.206
  2. Wefel JS, Harless JD : Comparison of artificial white spots by microradiography and polarized light microscopy. J Dent Res, 63:1271-1275, 1984. https://doi.org/10.1177/00220345840630110301
  3. Ekstrand K, Qvist V, Thylstrup A : Light microscope study of the effect of probing in occlusal surfaces. Caries Res, 21:368-374, 1987. https://doi.org/10.1159/000261041
  4. van Dorp CS, Exterkate RA, ten Cate JM : The effect of dental probing on subsequent enamel demineralization. ASDC J Dent Child, 55:343-347, 1988.
  5. Lussi A : Validity of diagnostic and treatment decisions of fissure caries. Caries Res, 25:296-303, 1991. https://doi.org/10.1159/000261380
  6. Penning C, van Amerongen JP, Seef RE, ten Cate JM : Validity of probing for fissure caries diagnosis. Caries Res, 26:445-449, 1992. https://doi.org/10.1159/000261485
  7. Warren JJ, Levy SM, Wefel JS : Explorer probing of root caries lesions: an in vitro study. Spec Care Dentist, 23:18-21, 2003. https://doi.org/10.1111/j.1754-4505.2003.tb00284.x
  8. Akarsu S, Koprulu H : In vitro comparison of the efficacy of DIAGNOdent by visual inspection and radiographic diagnostic techniques in the diagnosis of occlusal caries. J Clin Dent, 17:53-58, 2006.
  9. Costa AM, Bezzerra AC, Fuks AB : Assessment of the accuracy of visual examination, bite-wing radiographs and DIAGNOdent on the diagnosis of occlusl acries. Eur Arch Paediatr Dent, 8:118-122, 2007. https://doi.org/10.1007/BF03262580
  10. Sridhar N, Tandon S, Rao N : A comparative evaluation of DIAGNOdent with visual and radiography for detection of occlusal caries: an in vitro study. Indian J Dent Res, 20:326-331, 2009. https://doi.org/10.4103/0970-9290.57376
  11. Stookey GK : Quantitative light fluorescence: a technology for early monitorig of the caries process. Dent Clin North Am, 49:753-770, 2005. https://doi.org/10.1016/j.cden.2005.05.009
  12. Hwang KS, Kim JS, Yoo SH : Comparative study on the efficacy of Digital Imaging Fiber-Optic Trans-Illumination and Laser Fluorescence in monitoring the remineralization process of incipient smooth surface enamel lesions. J Korean Acad Pediatr Dent, 34:183-191, 2007.
  13. Yanikoglu F, Ozturk F, Stookey GK, et al. : Detection of natural white spot caries lesions by an ultrasonic system. Caries Res, 34:225-232, 2000. https://doi.org/10.1159/000016595
  14. Kim HS, Kim WK, Lee CS, Lee SH : Optical sensitivity of laser fluorescence for incipient caries detection. J Korean Acad Pediatr Dent, 26:109-118, 1999.
  15. Maeng MH, Kim JS, Kim SO : Comparative study on the early detection of enamel lesions using DIFOTI and laser fluorescence. J Korean Acad Pediatr Dent, 33:207-220, 2006.
  16. Adeyemi AA, Jarad FD, Pender N, Higham SM : Comparison of quantitative light-induced fluorescence (QLF) and digital imaging applied for the detection and quantification of staining and stain removal on teeth. J Dent, 34:460-466, 2006 https://doi.org/10.1016/j.jdent.2005.10.006
  17. al-Sehaibany F, White G, Rainey JT : The use of caries detector dye in diagnosis of occlusal caries lesions. J Clin Pediatr Dent, 20:293-298, 1996.
  18. Van de Rijke JW, Ten Bosch JJ : Optical quantification of caries-like lesion in vitro by use of a fluorescent dye. J Dent Res, 69:1184-1187, 1990. https://doi.org/10.1177/00220345900690051201
  19. Van de Rijke JW : Use of dyes in cariology. Int Dent J, 41:111-116, 1991.
  20. Eggertsson H, Analoui M, Stookey G, et al. : Detection of early proximal caries in vitro using laser fluorescence, dye-enhanced laser fluorescence and direct visual examination. Caries Res, 33:227-233, 1999. https://doi.org/10.1159/000016521
  21. Vaarkamp J, ten Bosch J, Verdonschot EH, Huysmans MC : Wavelength-dependent fiber-optic transillumination of small approximal caries lesions: The use of a dye, and a comparison to bitewing radiography. Caries Res, 31:232-237, 1997. https://doi.org/10.1159/000262405
  22. Arends J, ten Bosch JJ : Demineralization and remineralization evaluation techniques. J Dent Res, 71 Spec No:924-928, 1992.
  23. Reynolds EC : Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res, 76:1587-1595, 1997. https://doi.org/10.1177/00220345970760091101
  24. Benson PE, Pender N, Higham SM : An in situ caries model to study demineralization during fixed orthodontics. Clin Orthod Res, 2:143-153, 1999. https://doi.org/10.1111/ocr.1999.2.3.143
  25. Ogaard B, Rola G : The in vivo orthodontic banding model for vital teeth and the in situ orthodontic banding model for hard-tissue slabs. J Dent Res, 71 Spec No:832-835, 1992.
  26. Fontana M, Li Y, Stookey GK, et al. : Measurement of enamel demineralization using microradiography and confocal microscopy. A correlation study. Caries Res, 30:317-325, 1996. https://doi.org/10.1159/000262337
  27. Aljehani A, Tranaeus S, Shi XQ, et al. : In vitro quantification of white spot enamel lesions adjacent to fixed orthodontic appliances using quantitative light-induced fluorescence and DIAGONOdent. Acta Odontol Scand, 62:313-318, 2004. https://doi.org/10.1080/00016350410001793
  28. Kühnisch J, Ifland S, Heinrich-Weltzien R : In vivo detection of non-cavitated caries lesions on occlusal surfaces by visual inspection and quantitative lightinduced flurescence. Acta Odontol Scand, 65:183-188, 2007. https://doi.org/10.1080/00016350701291685
  29. Alammari MR, Smith PW, de Josselin de Jong E, Higham SM : Quantitative light-induced fluorescence:a tool for early occlusal dental caries detection and supporting decision making in vivo. J Dent, 41:127-132, 2013. https://doi.org/10.1016/j.jdent.2012.08.013
  30. Kim HE, Kwon HK, Kim BI : Recovery percentage of remineralization according to severity of early caries. Am J Dent, 26:132-136, 2013.
  31. Sagel PA, Lapujade PG, Miller JM, Sunberg RJ : Objective quantification of plaque using digital image analysis. Monogr Oral Sci, 17:130-143, 2000. https://doi.org/10.1159/000061638
  32. Lund F, Jogestrand T, Kolegard R : Computerized analysis of video fluorescein imaging of the skin. Clin Physiol, 20:374-379, 2000. https://doi.org/10.1046/j.1365-2281.2000.00274.x
  33. Rosen B : Fluorescein angiography in laser treatment of diabetic macular edema. Ophthalmology, 108:237-239, 2001.
  34. Mormann W, Regolati B, Lutz F, Saxer UP : The gingivitis fluorescein test in recruits. Helv Odontol Acta, 19:27-30, 1975.
  35. Van der Veen MH, Tsuda H, Arends J, ten Bosch JJ : Evaluation of sodium fluorescein for quantitative diagnosis of root caries. J Dent Res, 75:588-593, 1996. https://doi.org/10.1177/00220345960750011201
  36. Van der Veen MH, ten Bosch JJ : An in vitro evaluation of fluorescein penetration into natural root surface carious lesions. Caries Res, 27:258-261, 1993. https://doi.org/10.1159/000261546
  37. Lee SH, Han KJ, Lee CS : Diagnosis of early caries with dye-enhanced laser fluorescence. J Korean Acad Pediatr Dent, 30;1-9, 2003.
  38. Pretty IA, Ingram GS, Higram SM, et al. : The use of fluorescein-enhanced quantitative light-induced fluorescence to monitor de- and re- mineralization of in vitro root caries. J Oral Rehabil, 30:1151-1156, 2003. https://doi.org/10.1111/j.1365-2842.2003.01188.x

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