Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Rezidüel Çürük Tespitinde Lazer Floresans Cihazının Performansının in vivo Olarak Değerlendirilmesi
in vivo Evaluation of Clinical Performance of a Laser Fluorescence Device for Detection of Residual Caries
Burcu GÖZETİCİ ÇİLa
aİstanbul Medipol Üniversitesi Diş Hekimliği Fakültesi, Restoratif Diş Tedavisi AD, İstanbul, Türkiye
Turkiye Klinikleri J Dental Sci. 2024;30(3):506-13
doi: 10.5336/dentalsci.2024-102879
Article Language: TR
Full Text
ÖZET
 Amaç: Primer derin çürüklü dişlerde çürüğün uzaklaştırılmasının ardından, lazer floresans (LF) yönteminin kalan sağlam etkilenmiş dentin dokusunu ayırt edebilme performansının araştırılmasıydı. Gereç ve Yöntemler: Dentin dokusunun en az yarısını kapsayan çürüklere sahip 42 gönüllü çalışmaya dâhil edildi. Çürüğün tungsten karbid frezler yardımıyla temizlenmesinden önce ve çürük sert dentine kadar temizlendikten sonra DIAGNOdent Pen ile ölçülen LF değerleri kaydedildi. Çürüklü dokudan alınan LF değerleri ile çürük temizlendikten sonra kalan sağlam dokudan alınan LF değerleri arasındaki ilişkinin incelenmesinde Spearman sıralama korelasyonu kullanıldı. Radyografik derinlik ve çürük karakterine göre kategorize edilen LF ölçümlerinin karşılaştırılmasında Mann-Whitney U Kruskal-Wallis ve ''post hoc'' Dunn testleri kullanıldı. Cut-off değeri ROC analizi ile hesaplandı. Bulgular: Çürüklü ve çürüksüz dokudan ölçülen LF değerleri arasında pozitif korelasyon olduğu görüldü. Cut-off değeri 26,5 olarak hesaplandı. Bu cut-off değerine göre DIAGNOdent Pen cihazının kalan sağlam dokuyu ayırt edebilme spesifitesi %85,7 olarak hesaplandı. Çürük karakterinin LF ölçümlerini etkilemediği ancak, radyografik derinliğinin LF değerlerine etkisinin olduğu bulundu. Sonuç: DIAGNOdent Pen cihazının radyografik derinliği 1/2 olan çürükler temizlendikten sonra klinik olarak sağlam dokunun doğru şekilde ayırt edilmesinde kullanılabileceği sonucuna varıldı. Radyografik derinliği 3/4 olan çürüklerde ise yanlış tespit olasılığının arttığı görüldü. Bu nedenle, DIAGNOdent Pen cihazının, bu derinlikteki çürüklerde dikkatli şekilde kullanılması tavsiye edilebilir.

Anahtar Kelimeler: Çürük bulucu; diş çürükleri; konservatif tedavi
ABSTRACT
 Objective: Investigation of the clinical performance of an laser fluorescence (LF) device to discriminate the remaining affected dentin after removal of primary deep caries. Material and Methods: A total of 42 participants with deep caries lesions involving at least half of dentin were included in the study. LF values measured by DIAGNOdent Pen were recorded, prior to caries removal with tungsten carbide burs and after removal of caries to firm dentin. Spearman rank correlation was used to evaluate the relationship between LF values obtained from carious tissue and intact dentin. Mann-Whitney U, KruskalWallis and post-hoc Dunn tests were used for comparison of LF measurements categorized according to radiographic depth and carious tissue characteristics. Cut-off values were calculated using ROC analysis. Results: A positive correlation was found between LF values obtained from carious and non-carious dentin tissue. According to 26.5. cut-off value, the specifity of DIAGNOdent Pen to discriminate hard dentin was found to be 85.7%. No significant effect of characteristics of carious tissue on LF measurements was observed, whereas radiographic depth had an effect on LF values. Conclusion: DIAGNOdent Pen could be used for detection of remaining sound tissue of caries lesions radiographically involving 1/2 of the dentin. False positive readings were common among lesions with 3/4 radiographic depth. Therefore, use of DIAGNOdent Pen device cautiously for these carious lesions might be recommended.

Keywords: Caries detector; dental caries; conservative treatment
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