CLINICAL DENTAL CARIES: EARLY DETECTION AND INTERVENTION

临床龋齿：早期发现和干预

• 批准号: 6287832
• 负责人: George K Stookey
• 金额: $ 10.84万
• 依托单位: INDIANA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-03-01 至 2005-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6287832
• 关键词: bioimaging /biomedical imaging; clinical trials; dental caries; dental disorder diagnosis; dental visualization; dentistry; early diagnosis; human subject; human therapy evaluation; patient oriented research; preventive dentistry

During the past 40 years has been a remarkable decline in the prevalence of dental caries in children and adults due to the widespread use of fluoride in public health programs, such as communal water fluoridation, dental practice and in oral hygiene products. In spite of this dramatic improvement, dental caries continues to be the most prevalent dental disease. It is known that the traditional visual-tactile clinical caries examination procedure cannot detect the lesions until they are well advanced and involve 300-500 microns of enamel. Further, such lesions are difficult to reverse with fluorides and other measures often resulting in the need for restorative treatment. It is reasonable to assume that lesions detected at a much earlier stage of development might be more readily reversed and numerous recent reports support the use of new imaging technologies for t he detection of dental cries much earlier than is possible with current clinical methods. These technologies include quantitative laser fluorescence (QLF), electroconductivity (EC), infra-red fluorescence (IR), direct digital radiography (DDR) and digital imaging fiber-optic transillumination (DIFOTI). These technologies have the potential to offer higher specificity and sensitivity with respect to caries detection and quantification. However, little clinical data are available to validate the use of any of these methodologies to detect early dental caries. In addition, the availability of early caries detection technologies will permit the investigation of novel caries interventions which may further reduce the prevalence of dental caries. The fundamental hypotheses to be tested in this investigation are: (1) Developing technologies such as quantitative light or laser fluorescence will permit the accurate detection of dental cries much earlier than is possible with the conventional visual-tactile method; and, (2) Innovative interventions can be identified that will effectively reverse and control early carious lesions. This project will involve two clinical studies: a validation study and an intervention study. The validation study (years 1-3) will validate the use of QLF, IR, EC, DDR, and DIFOTI for the detection of early primary dental caries on occlusal, buccal-lingual and interproximal surfaces as compared to polarized light microscopy (PLM), an accepted "gold standard", on subsequently exfoliated deciduous teeth. The intervention study will utilize the validated method(s) in a clinical trial to determine the efficacy of the most effective interventions determined from Project 1 for the treatment of early primary dental caries. The specific aims of the proposed studies are to: 1, conduct a clinical trial to validate QLF, IR, EC, DDR and/or DIFOTI as a means to detect early caries and, 2) conduct a clinical trial using the validated early detection method(s) with the most effective interventions identified in Project 1 to determine their efficacy in preventing or reversing early primary caries.

在过去的40年中，由于在公共卫生计划中广泛使用氟化物，例如公共水氟化，牙科实践和口腔卫生产品，儿童和成人龋齿的流行率显着下降。尽管有了这种巨大的改善，但龋齿仍然是最普遍的牙齿疾病。众所周知，传统的视觉症状龋齿检查程序直到病变良好并涉及300-500微米的搪瓷后才能检测到病变。此外，这种病变很难用氟化物和其他措施逆转，通常导致需要恢复性治疗。可以合理地假设在开发的早期阶段发现的病变可能会更容易逆转，并且最近的许多报告支持使用新成像技术来检测牙齿哭泣的时间比目前的临床方法要早得多。这些技术包括定量激光荧光（QLF），电导率（EC），红外荧光（IR），直接数字X线摄影（DDR）和数字成像光纤透射量（DIFOTI）。这些技术有可能在龋齿检测和定量方面具有更高的特异性和敏感性。但是，很少有临床数据可验证使用这些方法中的任何一种来检测早期牙齿龋齿。此外，早期龋齿检测技术的可用性将允许研究新颖的龋齿干预措施，这可能进一步降低龋齿的患病率。在这项研究中要检验的基本假设是：（1）开发诸如定量光或激光荧光之类的技术将允许对牙齿哭声的准确检测要比传统的视觉效果方法提前得多； （2）可以确定将有效逆转和控制早期症状病变的创新干预措施。该项目将涉及两项临床研究：一项验证研究和一项干预研究。验证研究（1 - 3年）将验证QLF，IR，EC，DDR和DIFOTI的使用，以检测早期的原发性龋齿在咬合，颊 - 语言和二异位表面上与偏光光显微镜（PLM）相比，这是一种接受的“金标准”，这是一种接受的“黄金标准”。干预研究将在临床试验中利用经过验证的方法来确定项目1中最有效的干预措施的疗效，以治疗早期原发性龋齿。拟议研究的具体目的是：1，进行临床试验，以验证QLF，IR，EC，DDR和/或DIFOTI作为检测早期龋齿的一种手段，以及2）使用经过验证的早期检测方法（S）进行临床试验，并在项目1中确定其在预防或取得早期主要汽车方面确定其效率。