早期龋管理研究进展OA

Early caries confined to the enamel layer represent a critical window for achieving noninvasive interven-tion in caries management.Caries management has shifted from the traditional"drill-and-fill"model toward a modern paradigm centered on caries risk and lesion management.Based on contemporary concepts,this review systematically summarizes recent advances in early caries management,including caries risk assessment,early diagnosis,treatment strategy selection,and follow-up monitoring,while highlighting the major challenges currently being faced,and further reviewing and discussing the application of artificial intelligence(AI)in early caries management.In terms of risk man-agement,conventional systems including the American Dental Association,Caries Management by Risk Assessment,Cariogram,and the Caries-Risk Assessment Tool remain mainstays in clinical practice.However,AI offers predictive capability through higher-dimensional data processing and the integration of numerous influencing factors,with the po-tential to improve the accuracy of risk stratification.For diagnosis,visual inspection,tactile examination,and bitewing radiography remain fundamental methods,yet their sensitivity for early caries—particularly proximal lesions—is lim-ited.The application of optical technologies,including quantitative light-induced fluorescence,optical coherence tomog-raphy,near-infrared light transillumination,fiber-optic transillumination,and laser-induced fluorescence,enables digi-tal characterization of caries lesions,providing a data foundation for demineralization assessment,lesion activity evalua-tion,and AI model development.The management of early caries primarily relies on noninvasive and minimally inva-sive approaches.Remineralization therapy is suitable for superficial lesions,resin infiltration offers the dual advantages of inhibiting lesion progression and improving aesthetics,and microabrasion and bleaching may serve as adjunctive aes-thetic treatments.Emerging modalities such as laser,ozone,and photodynamic therapy have also demonstrated poten-tial.Treatment decision-making should comprehensively consider lesion activity,patient caries risk status,demineraliza-tion depth,patient compliance,and treatment preferences.However,precise quantification of demineralization depth re-mains challenging,and standardized decision-making criteria are still lacking.Follow-up management should be indi-vidualized based on risk stratification,with attention to lesion changes,patient compliance,and the risk of recurrence.In summary,intelligent and precision-based approaches are expected to define the future of early caries management,and the application of AI in risk prediction,image analysis,and clinical decision support is anticipated to further en-hance the efficiency and effectiveness of early caries diagnosis and treatment.