Microcomputed Tomography Mineral Density Profile as Reference Standard for Early Carious Lesion Activity Assessment.

Autor: Hoxie AM; Division of Diagnostic Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Division of Craniofacial and Surical Care, Department of Orthodontics, UNC Adams School of Dentistry, Chapel Hill, North Carolina, USA., Neves AA; Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., Moss K; Statistics, Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., de Vasconcellos AB; Division of Comprehensive Oral Health, Operative Dentistry, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Zandona AF; Department of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA., Ribeiro AA; Division of Diagnostic Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Jazyk: angličtina
Zdroj: Caries research [Caries Res] 2023; Vol. 57 (3), pp. 220-230. Date of Electronic Publication: 2023 Aug 16.
DOI: 10.1159/000533563
Abstrakt: Early caries diagnosis is crucial to treatment decisions in dentistry and requires identification of lesion activity: whether a carious lesion is active (progressively demineralizing) or arrested (progressively remineralizing). This study aimed to identify microtomographic (micro-CT) differences between active and arrested smooth surface enamel lesions, to quantify those micro-CT differences by creating thresholds for ex vivo caries activity assessment to serve as a future reference standard, and to validate those thresholds against the remaining sample. Extracted human permanent teeth (n = 59) were selected for sound surfaces and non-cavitated smooth surface carious lesions. Each surface was then examined for caries activity by calibrated individuals via visual-tactile examination using the International Caries Classification and Management System (ICCMS) activity criteria. Each tooth was scanned via micro-CT and the mineral density was plotted against lesion depth. The area under the curve (AUC) was calculated and represented the loss of density for the outermost 96 μm of enamel. AUC thresholds obtained from micro-CT were established to classify sound, remineralized, and demineralized surfaces against the gold standard examiner's lesion assessment of sound, inactive, and active lesions, respectively. The established AUC thresholds demonstrated moderate agreement with the assessment in identifying demineralized lesions (k = 0.45), with high sensitivity (0.73) and specificity (0.77). This study demonstrated quantifiable differences among demineralized lesions, remineralized lesions, and sound surfaces, which contributes to the establishment of micro-CT as a reference standard for caries activity that may be used to improve clinical and laboratorial dental caries evaluations.
(© 2023 S. Karger AG, Basel.)
Databáze: MEDLINE
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