The performance of conventional and fluorescence-based methods for occlusal caries detection An in vivo study with histologic validation

Author(s)

Diniz, Michele B. ^{[1, 2]} ; Boldieri, Thalita ^[1] ; Rodrigues, Jonas A. ^[3] ; Santos-Pinto, Lourdes ^[1] ; Lussi, Adrian ^[4] ; Cordeiro, Rita C. L. ^[1]

Affiliation

^[1] UNESP Univ Estadual Paulista, Sch Dent Araraquara, Dept Pediat Dent, Sao Paulo - Brazil

^[2] Cruzeiro Sul Univ UNICSUL, Sch Dent, Dept Pediat Dent, BR-04110060 Sao Paulo - Brazil

^[3] Univ Fed Rio Grande do Sul, Sch Dent, Dept Pediat Dent, Porto Alegre, RS - Brazil

^[4] Univ Bern, Sch Dent Med, Dept Prevent Restorat & Pediat Dent, CH-3012 Bern - Switzerland

• Document type: Journal article
• Source: JOURNAL OF THE AMERICAN DENTAL ASSOCIATION; v. 143, n. 4, p. 339-350, APR 2012.
• Web of Science Citations: 38

Abstract

Background. The authors conducted an in vivo study to determine clinical cutoffs for a laser fluorescence (LF) device, an LF pen and a fluorescence camera (FC), as well as to evaluate the clinical performance of these methods and conventional methods in detecting occlusal caries in permanent teeth by using the histologic gold standard for total validation of the sample. Methods. One trained examiner assessed 105 occlusal surfaces by using the LF device, LF pen, FC, International Caries Detection and Assessment System (ICDAS) criteria and bitewing (BW) radiographic methods. After tooth extraction, the authors assessed the teeth histologically. They determined the optimal clinical cutoffs by means of receiver operating characteristic curve analysis. Results. The specificities and sensitivities for enamel and dentin caries detection versus only dentin caries detection thresholds were 0.60 and 0.93 and 0.77 and 0.52 (ICDAS), 1.00 and 0.29 and 0.97 and 0.44 (BW radiography), 1.00 and 0.85 and 0.77 and 0.81 (LF device), 0.80 and 0.89 and 0.71 and 0.85 (LF pen) and 0.80 and 0.74 and 0.49 and 0.85 (FC), respectively. The accuracy values were higher for ICDAS, the LF device and the LF pen than they were for BW radiography and the FC. Conclusions. The clinical cutoffs for sound teeth, enamel carious lesions and dentin carious lesions were, respectively, 0 through 4, 5 through 27 and 28 through 99 (LF device); 0 through 4, 5 through 32 and 33 through 99 (LF pen); and 0 through 1.2, 1.3 and 1.4 through 5.0 (FC). The ICDAS, the LF device and the LF pen demonstrated good performance in helping detect occlusal caries in vivo. The ICDAS did not seem to perform as well at the D, threshold (histologic scores 3 and 4) as at the D-3 threshold (histologic scores 1-4). BW radiography and the FC had the lowest performances in helping detect lesions at the D-1 and Da thresholds, respectively. Clinical Implications. Occlusal caries detection should be based primarily on visual inspection. Fluorescence-based methods may be used to provide a second opinion in clinical practice. (AU)

• FAPESP's process: 09/00218-0 - Performance evaluation of the fluorescence devices to detect caries lesion: in vivo and in vitro study
• Grantee: Rita de Cássia Loiola Cordeiro
• Support Opportunities: Regular Research Grants