摘要
目的：评估诊断激光荧光（DIAGNOdent）、定量光诱导荧光（QLF）、扫描电镜结合能谱分析（SEM-EDS）及比色法在白斑病变（WSL）评估中的阶段特异性方法间相关性，并比较用于解释QLF衍生病变体积（ΔQ）的替代模型结构。
方法：本二次体外匹配块分析纳入20颗牛切牙，分割为四个牙面（共80个表面）。每颗牙齿的表面被分配至四组之一。分别在基线（T0）、脱矿后（T1）、治疗后第7天（T2）和第30天（T3）获取测量值。记录DIAGNOdent、QLF指标（ΔF、病变面积[LA]和ΔQ）、比色法和SEM-EDS数值。统计分析包括Spearman相关分析和混合效应模型。
结果：在T1时，方法间相关性有限，QLF、SEM-EDS和DIAGNOdent之间关联较弱。在T3时观察到更强的相关性，特别是基于强度的QLF指标与矿物相关参数之间。Ca/P与ΔF和ΔQ呈正相关，而LA与Ca/P呈负相关。DIAGNOdent评分与Ca/P和ΔF呈负相关，与LA呈正相关。混合效应分析确定了ΔQ的少量显著预测因子，联合模型在T1和T3时的样本内拟合度均优于临床模型和成分模型。
结论：WSL评估方法提供的是互补而非可互换的信息。病变诱导后跨方法相关性有限，而治疗后观察到更强的相关性，特别是基于强度的QLF参数与矿物相关测量值之间。没有任何单一指标能完全表征WSL的变化，且联合模型显示出适度的解释性能。
临床意义：没有单一的椅旁测量方法足以涵盖WSL评估的所有方面。在本体外研究的限制范围内，基于强度的QLF测量值在治疗后与矿物相关变化更为一致，而LA和基于颜色的指数提供了关于病变范围和可见外观的互补信息。
原文摘要
AIMS: To evaluate stage-specific intermethod association among DIAGNOdent, quantitative light-induced fluorescence (QLF), scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDS), and colourimetry in white spot lesion (WSL) assessment, and to compare alternative explanatory model structures for QLF-derived lesion volume (ΔQ).
METHODS: This secondary in vitro matched-block analysis included 20 bovine incisors sectioned into four enamel surfaces (80 surfaces). Within each tooth, surfaces were allocated to one of four groups. Measurements were obtained at baseline (T0), postdemineralization (T1), day 7 (T2), and day 30 post-treatment (T3). DIAGNOdent, QLF metrics (ΔF, lesion area [LA], and ΔQ), colourimetry, and SEM-EDS values were recorded. Statistical analyses included Spearman correlation and mixed-effects models.
RESULTS: At T1, intermethod association was limited, with weak associations among QLF, SEM-EDS, and DIAGNOdent. At T3, stronger associations were observed, particularly between intensity-based QLF metrics and mineral-related parameters. Ca/P showed positive associations with ΔF and ΔQ, while LA was inversely associated with Ca/P. DIAGNOdent scores were inversely associated with Ca/P and ΔF and positively associated with LA. Mixed-effects analyses identified a limited number of significant predictors of ΔQ, and the combined model demonstrated better relative in-sample fit than the clinical and compositional models at both T1 and T3.
CONCLUSIONS: WSL assessment methods provided complementary rather than interchangeable information. Cross-method associations were limited after lesion induction, whereas stronger associations were observed after treatment, particularly between intensity-based QLF parameters and mineral-related measures. No single metric fully characterized WSL change, and the combined model showed modest explanatory performance.
CLINICAL RELEVANCE: No single chairside measure appears sufficient for all aspects of WSL assessment. Within the limits of this in vitro study, intensity-based QLF measures were more closely aligned with mineral-related changes after treatment, whereas LA and colour-based indices provided complementary information on lesion extent and visible appearance.
出处
International dental journal 2026;76(5):109740. DOI: 10.1016/j.identj.2026.109740.
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