中国实用口腔科杂志

中国实用口腔科杂志 ›› 2026, Vol. 19 ›› Issue (1): 49-53.DOI: 10.19538/j.kq.2026.01.007

• 论著 • 上一篇    下一篇

定量光激发荧光技术辅助口腔龋病的检测与评估效果研究

徐昕恺1，2，王红艳1，2，孙玉春1，2，陈    虎1，胡世鹏1，李天祥1，邓    锐1，吴劼珉3，屠津梁3，田素坤1   

  1. 1. 北京大学口腔医学院·口腔医院口腔医学数字化研究中心，口腔修复教研室，国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，国家卫生健康委口腔数字医学重点实验室，口腔数字医学北京市重点实验室，中国医学科学院口腔数字医学重点实验室，北京 100081；2. 北京大学医学部医学技术研究院，北京 100191；3. 三炫谱贸易（上海）有限公司，上海 200333
  • 出版日期:2026-01-30 发布日期:2026-01-30
  • 通讯作者: 田素坤
  • 基金资助:
    国家重点研发计划项目（2023YFB4605400）；国家自然科学基金（52105265）；北京市自然科学基金（L232145）；三炫谱贸易（上海）有限公司委托横向课题（PKUSSIIT2024031）

  • Online:2026-01-30 Published:2026-01-30

摘要： 目的    研究定量光激发荧光技术在辅助口腔龋病检测与评估中的作用效果。方法    选取2024年7月至2025年3月于北京大学口腔医院口腔颌面外科因治疗拔除的恒磨牙及前磨牙120颗（共140个窝沟龋病灶）。使用TRIOS 5对所有离体牙进行扫描；经搭载定量光激发荧光的口内扫描同时获得基础型牙色纹理三维模型和荧光增强型三维模型（含牙色-荧光双模态纹理），对离体牙实体样本、基础型牙色纹理三维模型及荧光增强型三维模型中的窝沟龋病灶进行分级。以国际龋病检测与评估系统（International Caries Detection and Assessment System，ICDAS）分级为诊断参考标准，利用灵敏度及特异度表示不同龋损深度（ICDAS 0 ~ 6级）的检测效能；通过加权Kappa系数（Weighted Kappa）评估基础型牙色纹理三维模型和荧光增强型三维模型与ICDAS结果的有序分类一致性，Kappa值> 0.8为诊断一致性达阈值，并比较2种三维模型的Kappa值差异。结果    荧光增强型三维模型和基础型牙色纹理三维模型的Kappa值分别为0.811（95%CI：0.738 ~ 0.886）和0.525（95%CI：0.431 ~ 0.619），差异有统计学意义（Z = 4.686，P < 0.001）。荧光增强型三维模型检测各级龋病的灵敏度和特异度分别为：0级灵敏度0.846、特异度0.969，1级灵敏度0.762、特异度0.958，2级灵敏度0.909、特异度0.975，3级灵敏度0.744、特异度0.970，4级灵敏度0.846、特异度0.945，5级灵敏度1.000、特异度1.000，6级灵敏度0.926、特异度0.983。结论    定量光激发荧光技术可辅助口腔龋病的检测与评估，其结果与ICDAS的一致性较高，且较常规口内扫描具有显著优势。

关键词: 龋病, 定量光激发荧光, 口内扫描仪, 疾病检测

Abstract: Objective    To investigate the role of quantitative light-induced fluorescence（QLF）technology in assisting the detection and assessment of dental caries. Methods    From July 2024 to March 2025，a total of 120 extracted permanent molars and premolars（140 pit and fissure carious lesions）from the Department of Oral and Maxillofacial Surgery，Peking University School and Hospital of Stomatology，were included. All samples were scanned using the TRIOS 5 intraoral scanner. Conventional color-textured 3D models and fluorescence-enhanced 3D models with dual-modality textures（color and fluorescence）were obtained through QLF-assisted intraoral scanning. The carious lesions on the physical specimens，conventional color-textured models，and fluorescence-enhanced models were graded according to the International Caries Detection and Assessment System（ICDAS），which was used as the diagnostic reference standard. Sensitivity and specificity were calculated for each ICDAS level（0 - 6）to evaluate detection performance. Weighted Kappa coefficients were used to assess ordinal consistency between each 3D model and ICDAS grading，with Kappa  >  0.8 indicating diagnostic consistency，and Kappa differences were compared between the two 3D models. Results    The Kappa values of fluorescence-enhanced and conventional color-textured 3D models were 0.811（95%CI：0.738 - 0.886）and 0.525（95%CI：0.431 - 0.619），respectively，showing a statistically significant difference（Z  =  4.686，P  <  0.001）. For fluorescence-enhanced models，the sensitivity and specificity for detecting caries of different ICDAS grades were as follows：0.846 and 0.969 for grade 0，0.762 and 0.958 for grade 1，0.909 and 0.975 for grade 2，0.744 and 0.970 for grade 3，0.846 and 0.945 for grade 4，1.000 and 1.000 for grade 5，and 0.926 and 0.983 for grade 6. Conclusion    Quantitative light-induced fluorescence technology can assist in the detection and assessment of dental caries，whose results show high consistency with ICDAS grading and demonstrate significant advantages over conventional intraoral scanning.

Key words: dental caries, quantitative light-induced fluorescence, intraoral scanner, disease detection

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