KR101675429B1 - Method for evaluating objective endodontic infection - Google Patents

Abstract

The present invention relates to a method of evaluating objective endodontic infection using quantitative light-induced fluorescence-digital (QLF-D). According to the present invention, the method of evaluating objective endodontic infection is able to be used instead of a conventional method of evaluating endodontic infection; improves accuracy and sensitivity as a contamination level is objectively evaluated; and is usefully used for a reliable clinical evaluation method as anyone is able to check the degree of endodontic infection. The method of evaluating objective endodontic infection comprises: a step of photographing an endodontic exudation of a patient using QLF-D; and a step of calculating an RF score by multiplying together an intensity and area of the photographed image.

Description

A method for evaluating objective endodontic infection

The present invention relates to an objective root canal infection evaluation method using QLF-D.

The root canal refers to the minute space surrounding the soft tissue that is rich in nerve and blood vessels inside the tooth. Endodontic treatment, also called nerve therapy, is performed when the inside of the root canal is infected or inflamed . In general, endodontic treatment is primarily to clean the inside of the root canal after removing the infected tissue, and to fill the empty space with medicines and to proceed with the treatment. In this case, the cause of contamination inside the root canal, Endodontic treatment can be successfully terminated (domestic application 10-2007-7001615). However, when the causative bacteria are not removed completely, the reinsertion occurs after the treatment is completed. In addition, since the nerve that senses the sensation is removed after the root canal treatment, the pain is not felt at the reinfection and the discovery is delayed, so that the appropriate treatment time may be missed. Therefore, for successful endodontic treatment, it is very important to evaluate the degree of contamination of the root canal during root canal treatment.

However, the method of confirming the result of endodontic treatment which has been used in the clinic is a method of confirming the filling state on the radiograph after the completion of the canal filling, and the failure of the root canal treatment can be confirmed only after the symptoms of reinfection appear later. Therefore, at present, generally, during the root canal treatment, the exudate inside the root canal is taken using the paper point, and the sensory evaluation method is used in which the degree of the root canal infection is judged subjective by using the presence of the exudate and the odor. However, since this sensory evaluation method is influenced by the subjective judgment of the physician, the degree of contamination can not be objectively evaluated, and the accuracy is low. In addition, it is difficult to determine the degree of contamination in the case of a physician who has not enough clinical experience, and it is difficult to determine whether or not the current root canal state is suitable for root canal filling.

Therefore, if a method to quantitatively and objectively evaluate the degree of infection of the root canal is developed, it can be used as a reliable method for clinical evaluation because it can increase the accuracy and sensitivity of the root canal infection evaluation. It is expected that it will be easy to understand. However, there is no research on this.

SUMMARY OF THE INVENTION It is an object of the present invention to provide an objective root canal infection evaluation method capable of quantitatively and objectively evaluating the degree of infection of root canals using QLF-D.

However, the technical problem to be solved by the present invention is not limited to the above-mentioned problems, and other matters not mentioned can be clearly understood by those skilled in the art from the following description.

Hereinafter, various embodiments described herein will be described with reference to the drawings. In the following description, for purposes of complete understanding of the present invention, various specific details are set forth, such as specific forms, compositions, and processes, and the like. However, certain embodiments may be practiced without one or more of these specific details, or with other known methods and forms. In other instances, well-known processes and techniques of manufacture are not described in any detail, in order not to unnecessarily obscure the present invention. Reference throughout this specification to "one embodiment" or "embodiment" means that a particular feature, form, composition, or characteristic described in connection with the embodiment is included in at least one embodiment of the invention. Accordingly, the appearances of the phrase " in one embodiment "or" an embodiment "in various places throughout this specification are not necessarily indicative of the same embodiment of the present invention. In addition, a particular feature, form, composition, or characteristic may be combined in any suitable manner in one or more embodiments.

As used herein, the term "root canal infection" refers to a state in which a micro-organism infects the tissue of the inside of a root canal, which is a fine space surrounding a soft tissue-like dimension rich in nerves and blood vessels inside the tooth, Including, but not limited to, pathogens that may be infected, or microorganisms that may infect the tissue.

As used herein, "evaluation" refers to identifying the presence or characteristic of a pathological condition, and includes determining the susceptibility of an object to a particular disease or disorder, determining whether an object currently has a particular disease or disorder And determining the prognosis of an object that has suffered from a specific disease or disorder, and preferably means confirming the degree of infection of the endocervical internal tissues.

As used herein, the term "exudation " is intended to encompass all of the substances exuding into the root canal, and is preferably an exudate that exudes into the tissue or body cavity from the vein, May include cellular components and liquid components, and more preferably, substances that are secreted by microorganisms infected by root canals. However, it is not limited to any substance that can be produced in the root canal due to root canal infection.

The present invention provides a method of imaging a patient, comprising: a) imaging a patient's root canal exudate using quantitative light-induced fluorescence-digital (QLF-D); And b) calculating an integrated fluorescence score (RF score) with a fluorescence intensity and a fluorescence area value of the photographed image.

In one embodiment of the present invention, the integrated fluorescence score is a method of quantitatively indicating the degree of red fluorescence by using a fluorescence intensity value and a fluorescence area value, and is preferably obtained by multiplying the fluorescence intensity value and the fluorescence area value, But the present invention is not limited thereto as long as the method can show the degree of fluorescence.

In another embodiment of the present invention, the objective root canal infection evaluation method may preferably determine that the root canal is not infected when the integrated fluorescence score is zero, and may determine that the root canal is infected when the integrated fluorescence score is zero or more. The degree of infection may be determined by the integrated fluorescence score. For example, in the case of more than 0 to 30, it may be judged that the root canal is weakly infected, but it is not limited to this because the measurer can arbitrarily designate it.

In another embodiment of the present invention, the fluorescence intensity value is preferably calculated as the average / green ratio (R / G value) of each pixel within the total area, but the fluorescence intensity value The method is not limited thereto.

In another embodiment of the present invention, the fluorescence area value may calculate the number of red fluorescent pixels for all pixels within a whole area as a percentage, but is not limited thereto, as long as the method can calculate fluorescence area (area).

In another embodiment of the present invention, the fluorescence is preferably not metal-free porphyrin fluorescence, but is not limited thereto as long as it can observe the dental infectious bacteria.

In another embodiment of the present invention, the root canal exudate can be obtained by inserting a paper point into the root canal, but is not limited thereto, as long as it can acquire exudate inside the root canal.

The present invention also relates to a method of detecting a cancellous exudate of a patient using a quantitative light-induced fluorescence-digital (QLF-D) b) an arithmetic unit for measuring and multiplying the fluorescence intensity and the fluorescence area value of the image to calculate an integrated fluorescence score (RF score); And c) an output section for indicating whether or not the root canal is examined by the integrated fluorescence score.

The objective evaluation method of endodontic infection according to the present invention is a method of quantitatively and objectively evaluating the degree of contamination by quantifying the degree of root canal infection using QLF-D. It is possible to replace the existing subjective endodontic evaluation method, Because it can be evaluated objectively, it can increase the accuracy and sensitivity, and anyone can easily confirm the degree of root canal infection, so it is expected to be useful as a reliable evaluation method in clinical practice.

FIG. 1 is a schematic diagram showing the process of the present invention.
FIG. 2 is a view showing a QLF-D image and a fluorescence evaluation result and a sensory evaluation result according to an embodiment of the present invention.

Hereinafter, the present invention will be described in more detail with reference to Examples. It will be apparent to those skilled in the art that these embodiments are only for describing the present invention in more detail and that the scope of the present invention is not limited by these embodiments in accordance with the gist of the present invention .

Example

Example  1: Pollution measurement

1.1. Target and target tooth selection

For the measurement of pollution degree, 28 adults aged 20 to 65 years (mean age 38.9 years, standard deviation 13.5) undergoing endodontic treatment were subjected to the following tests and examined at the Yonsei University Dental Hospital The procedure followed by the Commission (2-2012-0007) and the STROBE guide were followed. Patients who received antibiotics or antibiotics or systemic disease three months before the experiment, and those who underwent endodontic treatment were excluded from the teeth.

1.2. Measurement of pollution degree through sensory evaluation

First, the degree of contamination of the root canals of the study subjects was measured through the sensory evaluation generally performed in the past. For the sensory evaluation, a paper point was inserted into the root canal of the subject to check whether or not there was exudate and foul odor, and the confirmed result was scored based on the following criteria and recorded.

0 point: no contamination, no exudate when paper point is inserted in root canal.

1 point: Excessive contamination, exudate within 1/3 of root canal, no odor.

2 points: In the state of moderate contamination, exudate is present in more than 1/3 of root canal and there is no odor.

3 points: In a state of severe pollution, exudes come out with odor.

1.3. QLF Measurement of contamination using -D

QLF-D (quantitative light-induced fluorescence-digital) in order to measure a pollution level of the root canal, Example 1.2 A paper point the QLF-D system (QLF-D Biluminator ™ Complete the sensory test was collected from the use of the 2 ^+, Inspektor Research systems BV, The Netherlands) and software (C2 v1.0.0.7, Inspektor Research Systems BV, The Netherlands). In order to maximize the state of the QLF-D image at the time of shooting, the sensitivity of the camera light was maximized in the same place so as not to affect the image quality under the selected shooting conditions, The ring was mounted on a light tube of the QLF-D camera so that the distance between the illumination and the paper point was kept constant throughout the entire surface of the paper point. Using the full-frame sensor digital SLR camera (Model 550D, Canon, Japan) capable of "Live View", the white light image and continuous fluorescent image of the paper point are set at shutter speed 1/45, aperture value 3.2, ISO speed 1600 Respectively.

The images were analyzed using Image Pro Plus 6.0 (Media Cybernetics, USA). Since the total area of the paper points after the exudates may be different, the total area (AOI) to be analyzed at each sample paper point was set in consideration of this. The red fluorescence intensity and fluorescence emission area expressed in the corresponding AOI were measured. The measured red fluorescence intensity values were calculated as the average green ratio (R / G value) of each pixel within the total area (AOI) of each image, and the fluorescence area value was calculated as the total area (AOI) (%) Of the number of red fluorescent pixels for all the pixels in the sample. In order to quantify the degree of contamination of individual's canals, an integrated fluorescence score (RF score = Intensity x area), which reflects the area and intensity simultaneously by multiplying the two areas by the fluorescence area and the fluorescence intensity And the degree of root canal infection was scored. The results of the QLF-D image and fluorescence evaluation and the sensory evaluation thereof are shown in Fig.

1.4. Evaluation of the integrated fluorescence score

Statistical analysis was performed to evaluate the feasibility of using integrated fluorescence scoring (RF score) to measure contamination of root canal infection. All variables were assessed using the Kolmogorov-Smirnov test. The difference in QLF-D fluorescence between groups according to sensory evaluation was assessed using the Mann-Whitney test and the Bonferroni correction ) And post - analysis (multiple test). The correlations between the degree of pollution of the subjects according to the sensory evaluation and the fluorescence parameters of each paper point and the integrated fluorescence score (RF score) were analyzed using Spearman correlation analysis and the correlation levels were compared. The receiver operating characteristic (ROC) graph was generated and analyzed to see if the calculated integrated fluorescence score (RF score) could be used to measure the contamination level of root canal infection. All the obtained results were analyzed using PASW Statistics 18.0 (SPSS, IBM, USA) and Medcalc (Medcalc Software, Belgium) statistical software. Table 1 shows the distribution of fluorescence between groups according to the sensory evaluation, and the correlation between the fluorescence parameter and the pollution degree by the conventional sensory evaluation is shown in Table 2.

[Table 1]

Values are the mean (SD).

Kruskal-wallis test α = 0.05.

As shown in Table 1, it was confirmed that fluorescence intensity and fluorescence area measured by QLF-D were significantly increased as the degree of contamination increased as a result of sensory evaluation. In addition, it was confirmed that the integrated fluorescence score (RF score) calculated by combining these values was increased to be the same as the degree of contamination according to the sensory evaluation result, and the results were confirmed to be statistically significant.

[Table 2]

Spearman correlation analysis, P <0.05 ^* , P <0.01 ^**

As shown in Table 2, it was confirmed that the degree of contamination according to the sensory evaluation result and the integrated fluorescence score (RF score) calculated using QLF-D showed a high correlation.

Based on the above results, the evaluation method of root canal infection using QLF-D is not only replaceable with the existing root canal infection evaluation method, but also can easily confirm the degree of root canal infection because of the numerical result value. In addition, although the conventional method has subjectively measured the degree of contamination depending on the visual and olfactory sense, the endodontic infection evaluation method of the present invention uses an image to visualize the degree of infection and objectively measures the numerical value, so that objective and quantitative root canal infection The accuracy of the evaluation can be increased by reducing the error value in the evaluation.

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the same is by way of illustration and example only and is not to be construed as limiting the scope of the present invention. It is therefore intended that the scope of the invention be defined by the claims appended hereto and their equivalents.

Claims (8)

a) imaging the patient's root canal exudate using quantitative light-induced fluorescence-digital (QLF-D); And
b) calculating an integrated fluorescence score (RF score) by multiplying the fluorescence intensity and the fluorescence area value of the photographed image,
Wherein the integrated fluorescence score is increased in proportion to the degree of contamination of the root canal infection, and when the integrated fluorescence score is 0, it is determined that the root canal is not infected.
delete delete The method according to claim 1,
Wherein the fluorescence intensity value is calculated as an average green ratio (R / G value) of each pixel within the entire area.
The method according to claim 1,
Wherein the fluorescence area value is calculated as a percentage of red fluorescence pixels for all pixels within the total area.
The method according to claim 1,
Wherein the fluorescence is metal-free porphyrin fluorescence, which is a metabolic product of pathogenic bacteria in the oral cavity.
The method according to claim 1,
Wherein the root canal exudate is obtained by inserting a paper point into a root canal.
a) an input part for receiving an image of a patient taken from a root canal exudate using quantitative light-induced fluorescence-digital (QLF-D);
b) an arithmetic unit for measuring and multiplying the fluorescence intensity and the fluorescence area value of the image to calculate an integrated fluorescence score (RF score); And
c) an output section for indicating whether or not the root canal is inspected by the integrated fluorescence score,
Wherein the integrated fluorescence score is increased in proportion to the contamination degree of the root canal infection, and when the integrated fluorescence score is 0, it is determined that the root canal is not infected.

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