Fluorescence-based methods for detecting caries lesions: systematic review, metaanalysis and sources of heterogeneity

• Grant number: 13/07407-9
• Support Opportunities: Regular Research Grants - Publications - Scientific article
• Start date: June 01, 2013
• End date: November 30, 2013
• Field of knowledge: Health Sciences - Dentistry - Pediatric Dentistry
• Principal Investigator: Fausto Medeiros Mendes
• Grantee: Fausto Medeiros Mendes
• Host Institution: Faculdade de Odontologia (FO). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Background: Fluorescence-based methods have been proposed to aid caries lesiondetection. Summarizing and analysing findings of studies about fluorescence-basedmethods could clarify if their real benefits.Objective: We aimed to perform a comprehensive systematic review and meta-analysisto evaluate the accuracy of fluorescence-based methods in detecting caries lesions.Data source: Two independent reviewers searched PubMed, Embase and Scopusthrough June 2012 to identify papers/articles published. Other sources were checkedto identify non-published literature.Study eligibility criteria, participants and diagnostic methods: The eligibility criteria werestudies that: (1) have assessed the accuracy of fluorescence-based methods ofdetecting caries lesions on occlusal, approximal or smooth surfaces, in both primary orpermanent human teeth, in the laboratory or clinical setting; (2) have used a referencestandard; and (3) have reported sufficient data relating to the sample size and theaccuracy of methods.Study appraisal and synthesis methods: A diagnostic 2X2 table was extracted fromincluded studies to calculate the pooled sensitivity, specificity and overall accuracyparameters (Diagnostic Odds Ratio and Summary Receiver-Operating curve). Theanalyses were performed separately for each method and different characteristics ofthe studies. The quality of the studies and heterogeneity were also evaluated.Results: Seventy five studies met the inclusion criteria from the 434 articles initiallyidentified. The search of the grey or non-published literature did not identify any furtherstudies. In general, the analysis demonstrated that the fluorescence-based methodtend to have similar accuracy for all types of teeth, dental surfaces or settings. Therewas a trend of better performance of fluorescence methods in detecting moreadvanced caries lesions. We also observed moderate to high heterogeneity andevidenced publication bias.Conclusions: Fluorescence-based devices have similar overall performance; however,better accuracy in detecting more advanced caries lesions has been observed. (AU)