特征谱诊断龋病的新方法

Li Liu, Jing Tang, Song-zhan Li
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引用次数: 1

摘要

通过研究激光与牙组织的相互作用机制以及激光与牙组织光学特性的关系,提出了一种适合于早期龋病光学诊断的无创新方法。该方法不带滤光片,与诊断®和PNC方法的不同之处在于其记录荧光光谱的能力。牙组织特征谱包含了龋的组成、结构、空间构象等丰富的信息。在体外进行了研究,分析了特征光谱的三个组成部分:后向散射、反射和自荧光。它不仅可以通过分析自身荧光光谱的特征频率来评估牙齿的化学变化,还可以利用抗斯托克斯荧光光谱来估计组织的结构和形态变化。初步结果表明,该方法在定量诊断龋病的各个阶段具有潜在的应用价值,对早期龋病和健康牙釉质表面损伤的检测具有较高的灵敏度。龋齿是由细菌感染引起的高发口腔疾病,严重危害人类健康。传统的检测龋齿的方法是无法检测到病变的,直到它们进展得很好,并且涉及到大约三分之一的牙釉质厚度。早期龋齿形成和发展的问题仍然存在科学争论。龋齿脱矿的第一个迹象与牙釉质微孔的增加有关。此外,众所周知,龋齿的过程是周期性的,并且随着酸的渗透增加。通过控制口腔环境因素,可以消除牙釉质晶体结构的微损伤。只有在非常早期的阶段才能完全重建牙齿组织。提出了一种基于后向散射、后向反射和自荧光的荧光光谱检测龋病的方法,该方法对早期龋病、健康牙釉质表面损伤的检测更为敏感。2龋齿过程一般认为,龋齿过程是由于口腔平衡在较长一段时间内偏向脱矿而非再矿化。因此,身体的自然防御机制根本无法以与脱矿继续发生相同的速度修复损伤。最终,一个“初期”的龋齿病变被检测为所谓的“白斑”。对这一阶段病变的检查显示,一层薄的部分去物化的牙釉质覆盖了一大片去矿化的区域。蛀牙的发生与牙齿表面的类型、主人的年龄或牙齿是乳牙还是恒牙无关。我们也知道,在这个阶段,这些病变的再矿化只能发生在病变上的薄层牙釉质保持完整的情况下;如果表层被破坏,病变可能会停止,但不会发生完全的再矿化,恢复牙齿原有的结构(1)。酸化过程可以用化学式表示:
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A New Method for Caries Diagnosis by Characteristic Spectrum
A new and non-invasive method adapted for optical diagnosis of early caries is proposed by researching on the interaction mechanism of laser with dental tissue and relations of remitted light with optical properties of the tissue. This method without light filter, differed from the DIAGNodent ® and PNC method in its ability for registering fluorescence spectrum. The characteristic spectrum of dental tissue contains rich information about caries components, structure, spatial conformation, and so on. The research was conducted in vitro, and three components of characteristic spectrum are analyzed: backscattering, reflection and auto-fluorescence. It enables not only to evaluate chemical changes in tooth by analyzing characteristic frequencies of auto-fluorescence spectrum, but also to estimate structure and morphological changes in tissue by means of anti-stokes fluorescence spectrum. Preliminary results show that this method has a potential application in the quantitive diagnosis of various stages of dental caries and high sensitivity for detecting early caries and the surface damage of health enamel. Dental caries is oral disease with high incidence caused by bacterial infection, which seriously endangers human health. Conventional procedures for caries detection are unable to detect the lesions until they are well advanced and involve about one-third of the thickness of enamel. The problem of early caries lesions formation and development is still present for scientific debates. The first sign of the caries demineralization is concerned with the increase of microporosity of enamel. Additionally it is known that caries process is periodic and with the increased penetration of acids. It is possible to eliminate micro-lesions of crystalline structure of enamel by controlling environmental factors of oral cavity. Total reconstruction of tooth tissue is possible only in very early stage. A caries diagnosis method by detecting fluorescence spectrum including backscattering, back-reflected and auto- fluorescence is proposed, which is more sensitive to detect early caries, surface damage of health enamel. II. CARIES PROCESS It is generally recognized that that the caries process results from a shift in the oral equilibrium favoring demineralization over re-mineralization for a prolonged period of time. Thus, the body's natural defense mechanisms are simply unable to repair the damage at the same rate that demineralization continues to occur. Eventually, an "incipient" caries lesion is detected as a so-called "white spot". An examination of this stage of the lesion reveals a thin layer of partially-dematerialized enamel covering a large de-mineralized area. Caries occurs regardless of the type of tooth surface, the age of the host or whether the tooth is deciduous or permanent. It is also known that re- mineralization of these lesions at this stage can only occur as long as the thin layer of enamel remains intact over the lesion; if the surface layer is broken, the lesion may become arrested but total re-mineralization to restore the original tooth structure will not occur (1). Acidification process can be expressed by chemical formula:
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