Performance of laser fluorescence devices, visual and radiographic examination for the detection of occlusal caries in primary molars

Abstract

The aim of this in vitro study was to compare the performance of two laser fluorescence devices (LF, LFpen), conventional visual criteria (VE), ICDAS and radiographic examination on occlusal surfaces of primary teeth. Thirty-seven primary human molars were selected from a pool of extracted teeth, which were stored frozen at -20 °C until use. Teeth were assessed twice by two experienced examiners using laser fluorescence devices (LF and LFpen), conventional visual criteria, ICDAS and bitewing radiographs, with a 2-week interval between measurements. After measurement, the teeth were histologically prepared and assessed for caries extension. The highest sensitivity was observed for ICDAS at D(1) and D(3) thresholds, with no statistically significant difference when compared to the LF devices, except at the D(3) threshold. Bitewing radiographs presented the lowest values of sensitivity. Specificity at D(1) was higher for LFpen (0.90) and for VE at D(3) (0.94). When VE was combined with LFpen the post-test probabilities were the highest (94.0% and 89.2% at D(1) and D(3) thresholds, respectively). High values were observed for the combination of ICDAS and LFpen (92.0% and 80.0%, respectively). LF and LFpen showed the highest values of ICC for interexaminer reproducibility. However, regarding ICDAS, BW and VE, intraexaminer reproducibility was not the same for the two examiners. After primary visual inspection using ICDAS or not, the use of LFpen may aid in the detection of occlusal caries in primary teeth. Bitewing radiographs may be indicated only for approximal caries detection.

Light-emitting diode and laser fluorescence–based devices in detecting occlusal caries

“…[9][10][11] Besides, some studies have also shown a better performance of these devices than the radiographic examination, suggesting that they could be indicated as auxiliary methods for caries detection. 6,12,13 More recently, other fluorescence-based devices were introduced in the market and few data have been published concerning their performance. These devices are comprised of a light emitting diode (LED) and have been developed also aiming at caries detection.…”

Lesiones cariosas reversibles e irreversibles en escolares mexicanos de 11 y 12 años de edad: un análisis de regresión binomial negativa

“…Aunque se ha observado una disminución en la prevalencia e incidencia de caries dental en la mayoría de los países industrializados, en los menos desarrollados todavía se observan importantes contrastes entre países y aún dentro de un mismo país (15). La presencia de caries dental depende de una serie de variables relacionadas con el huésped, el agente y el medio ambiente como en otras partes del mundo, donde se han asociado diversas variables con la caries dental.…”

Evaluation of Diagnostic Tests Using Information Theory for Multi-Class Diagnostic Problems and its Application for the Detection of Occlusal Caries Lesions

“…According to some of the results, the radiographic method was found to have worse performance than the visual examination and LF device methods when compared using sensitivity, specificity, accuracy, and AUC values (20)(21)(22)(23). This could be due to the depth of the caries lesion on the radiograph, difficulty in noticing hidden caries because of the fissure system and not removing all of the colorization on the occlusal region (21,24,25). Therefore, new methods are being researched for early caries lesions.…”

“…The LF device had provided results than the radiographic method according to the assessment of sensitivity, specificity, accuracy, AUC, and likelihood ratio values. (12,21,22,27 or various other reasons. The radiographic method and the LF device supplied more diagnostic information than the visual method.…”