Accuracy of the fluorescence-aided identification technique (FIT) for detecting tooth-colored restorations utilizing different fluorescence-inducing devices: an ex vivo comparative study

Abstract

Objectives The aim of the present study was to compare the accuracy of the conventional illumination method (CONV) and the fluorescence-aided identification technique (FIT) for distinguishing between composite restorations and intact teeth using different fluorescence-inducing devices commonly used for FIT. Materials and methods Six groups of six dentists equipped with one of six different FIT systems each independently attempted to identify composite restorations and intact teeth on a full-mouth model with 22 composite restorations using CONV and, 1 h later, FIT. The entire procedure was repeated 1 week later. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, including 95% confidence intervals (CI), were calculated for CONV and FIT overall and for each device. The influence of examiner age, method, and device on each parameter was assessed by multivariate analysis of variance. Results The sensitivity (84%, CI 81–86%), specificity (94%, CI 93–96%), PPV (92%, CI 90–94%), and NPV (90%, CI 88–91%) of FIT was significantly higher than that of CONV (47%, CI 44–50%; 82%, CI 79–84%; 66%, CI 62–69%, and 69%, CI 68–71%, respectively; p<0.001). The differences between CONV and FIT were significant for all parameters and FIT systems except VistaCam, which achieved no significant difference in specificity. Examiners younger than 40 years attained significantly higher sensitivity and negative predictive values than older examiners. Conclusions FIT is more reliable for detecting composite restorations than the conventional illumination method. Clinical relevance FIT can be considered an additional or alternative tool for improving the detection of composite restorations.

Evaluation of five methods to identify composite restorations in human teeth on a forensic purpose—an ex vivo comparative study

“…Differences between the actual study and Meller et al [15] and Leontiev et al [24] may be explained with the aging of the composite resin material, which can lower the fluorescence property of the restoration [30,31]. But even if the composite resin material does not significantly differ in its fluorescence property, it should still be possible to detect foreign material [12].…”

“…A significant improvement was shown for the PPV, indicating that the use of a direct light source enhances the probability of an identified restorations to actually be restored from 48 up to 62%. This method is comparable to the conventional illumination method in the study of Leontiev et al [24] and Meller et al [15], who used the same tooth models. Their conventional illumination method contained the use of a dental unit lamp (27′000 Lux).…”

“…The tooth models used were the same as described in previous studies of Meller et al [15] and Leontiev et al [24]. Thirty-two extracted teeth were mounted on a mandibular and maxillary arch in their anatomical position.…”

“…Using blue-violet light-induced fluorescence during composite removal can prevent overpreparation, contribute to less invasive treatment, and be useful removing composite-bonded orthodontic appliances or trauma splints [19,22,23]. Although it is still unusual to use fluorescence-inducing devices for diagnostic purposes, previous studies showed a significant higher detection rate of composite restorations with a fluorescence-aided identification technique (FIT) then with a conventional illumination method [15,24].…”

Enhanced Clinical Decision-Making and Delivery of Minimally Invasive Care Using the ICCMS4D Integrated with Hands-Free Fluorescence-Based Loupes and a Chemomechanical Caries Removal Agent

“…The use of fluorescence identification of restorative materials is well documented in splint removal, orthodontic brackets debonding, and dental forensics. 24 The use of a clean, instantaneous, hands-free adjunct may be a welcoming addition for clinical armamentarium. From potential aid in lesion discovery, to caries tissue removal, to monitoring in the restorative phase.…”