Performance of methods of occlusal caries detection in permanent teeth under clinical and laboratory conditions (original) (raw)
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European journal of oral sciences, 2016
The aim of this in vivo study was to validate the DIAGNOdent laser fluorescence method and the International Caries Detection and Assessment System (ICDAS) for caries classification against the gold standard, histological examination, for detecting occlusal caries on permanent molars; the thresholds used were the outer enamel (D1), the inner enamel and outer third of the dentine (D2), and the inner two-thirds of the dentine (D3). Patients with non-impacted third molars (n = 43) were recruited from a university clinic. A trained examiner performed the examinations. After the teeth were extracted, the histological criterion was used to determine the severity of the lesions. Intra-examiner agreement (weighted kappa) for ICDAS was 0.60 and reliability (intraclass correlation coefficient) for DIAGNOdent was 0.968. The correlations with the histological reference were weak for DIAGNOdent (rs = 0.369) and moderate for ICDAS (rs = 0.515). The areas under the receiver-operating characteristi...
Journal of Biomedical Optics, 2012
The aim of this study was to evaluate the diagnostic capabilities of a laser fluorescence tool DIAGNOdent (KaVo, Biberach, Germany) and two light-emitting diode fluorescence tools-Spectra Caries Detection Aid (AIR TECHNIQUES, Melville, NY), and SOPROLIFE light-induced fluorescence evaluator in daylight and blue florescence mode (SOPRO, ACTEON Group, La Ciotat, France)-in comparison to the caries detection and assessment system (ICDAS-II) in detection of caries lesions. In 100 subjects (age 23.4 AE 10.6 years), 433 posterior permanent unrestored teeth were examined. On the occlusal surfaces, up to 1066 data points for each assessment method were available for statistical evaluation, including 1034 ICDAS scores (intra-examiner kappa ¼ 0.884). For the SOPROLIFE tool, a new caries-scoring system was developed. Per assessment tool each average score for one given ICDAS code was significantly different from the one for another ICDAS code. Normalized data linear regression revealed that both SOPROLIFE assessment tools allowed for best caries score discrimination followed by DIAGNOdent and Spectra Caries Detection Aid. The area under the receiver operating characteristics curve calculations showed the same grading sequence when cutoff point ICDAS codes 0-1-2 were grouped together. Sensitivity and specificity values at the same cutoff were calculated (DIAGNOdent 87/66, Spectra Caries Detection Aid 93/37, SOPROLIFE 93/63, SOPROLIFE blue fluorescence 95/55.)
Clinical Oral Investigations
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 D1 and D3 thresholds, with no statistically significant difference when compared to the LF devices, except at the D3 threshold. Bitewing radiographs presented the lowest values of sensitivity. Specificity at D1 was higher for LFpen (0.90) and for VE at D3 (0.94). When VE was combined with LFpen the post-test probabilities were the highest (94.0% and 89.2% at D1 and D3 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.
Performance of a laser fluorescence device in detecting oclussal caries in vitro
oral health and dental management, 2008
The aim of this study was to compare the validity of the measurements of the laser fluorescence device, KaVo DIAGNOdent, with the result of polarized light microscopy in the detection of occlusal fissure caries in extracted third molars and premolars. Fourty-three extracted third molars and premolars which had macroscopically intact occlusal surface were selected. The DIAGNOdent measurements of the occlusal test site were recorded by two observers at intervals of 2 days. The teeth were then sectioned at the specified test sites for histological examinations. Prepared specimens were evaluated under the polarized light microscopy and all images were scored with the caries classification of D1 (sound and fissure lesion in the half of the outer enamel), D2 (enamel decay) and D3 (dentin decay) level (gold standard). Value of specificity for the detection of enamel caries at D1 level was 0,72 and sensitivity values at D2 and D3 levels were 0,66 and 1, respectively. The present study indic...
Clinical performance of a laser fluorescence device for detection of occlusal caries lesions
European Journal of Oral Sciences, 2001
Children and adolescents must be examined often for occlusal caries. Diagnosis of ®ssure caries is dif®cult especially when the tooth surface appears seemingly intact. It has been shown that using traditional clinical methods, as little as 20% of teeth with ®ssure caries under intact surfaces were correctly recognised as such. Therefore, new methods for increasing the accuracy of diagnosis have been sought for years. Recently, a new device, based on¯uorescence measurements, was introduced. The purpose of this study was to test the device under in vivo conditions in order to provide recommendations for its use in the dental of®ce. Seven general dental practitioners examined a total of 332 occlusal surfaces in 240 patients. Caries extent was determined for each site after operative intervention (=`gold standard'). Clinical inspection and analysis of bitewing radiographs exhibited statistically signi®cant lower sensitivities (31±63%) than did the DIAGNOdent device (sensitivity §92%). It is recommended that the laser device is used in the decision-making process in relation to the diagnosis of occlusal caries as a second opinion in cases of doubt after visual inspection.
Lasers in Medical Science, 2011
The aim of this study was to compare the in situ and in vitro performances of a laser fluorescence (LF) device (DIAGNOdent 2095) with visual inspection for the detection of occlusal caries in permanent teeth. Sixty-four sites were selected, and visual inspection and LF assessments were carried out, in vitro, three times by two independent examiners, with a 1-week interval between evaluations. Afterwards, the occlusal surfaces were mounted on the palatal portion of removable acrylic orthodontic appliances and placed in six volunteers. Assessments were repeated and validated by histological analysis of the tooth sections under a stereomicroscope. For both examiners, the highest intra-examiner values were observed for the visual inspection when in vitro and in situ evaluations were compared. The inter-examiner reproducibility varied from 0.61 to 0.64, except for the in vitro assessment using LF, which presented a lower value (0.43). The methods showed high specificity at the D1 threshold (considering enamel and dentin caries as disease). In vitro evaluations showed the highest values of sensitivity for both methods when compared to the in situ evaluations at D1 and D2 (considering only dentinal caries as the disease) thresholds. For both methods, the results of sensitivity (at D1 and D2) and accuracy (at D1) showed significant differences between in vitro and in situ conditions. However, the sensitivity (at D1 and D2), specificity and accuracy (both at D1) of the methods were not significantly different when the same condition was considered. It can be concluded that visual inspection and LF showed better performance in vitro than in situ.
Occlusal caries diagnosis in permanent teeth: an in vitro study
Brazilian Oral Research, 2005
The reduction in caries prevalence has not occurred uniformly for all dental surfaces. As the occlusal surfaces are still the most likely sites for the development of lesions, new methods of diagnosis are still being evaluated. This study compared a laser fluorescence (LF) system (DIAGNOdent) with the Ekstrand’s visual system for in vitro detection of occlusal caries. A total of 57 extracted molars with macroscopically intact occlusal surfaces were selected. Two-examiners assessed 110 sites by visual inspection (VI) and LF. After ten days from the first measurement, all teeth were re-evaluated through the same methods by each examiner. Caries extension was histologically assessed (X 40). The methods were compared by means of sensitivity, specificity, intra- and inter-examiner reproducibility and area under the ROC curve. The kappa’s test showed good intra- and inter-examiner reproducibility for both methods. VI and LF showed similar sensitivities for both examiners, however, VI show...
A Clinical Study of Caries Diagnosis With a Laser Fluorescence System
The Journal of the American Dental Association, 2008
Background. The authors conducted an in vivo study to compare a laser fluorescence system with a visual system for occlusal caries diagnosis in children's primary and permanent molars. Methods. The authors selected for evaluation 320 untreated, cavityfree primary and permanent molars in healthy children aged 6 through 14 years. Two of the authors conducted the laser fluorescence evaluation. Another of the authors completed the clinical evaluation. The κ value was 0.68. The authors compared sensitivity, specificity, predictive values, odds ratio and receiver operating characteristic (ROC) curves for the laser fluorescence system. Results. For the whole sample, the sensitivity and specificity of the laser fluorescence system were 0.79 and 0.87, respectively. The positive and negative odds ratios for the whole sample were 6.33 and 0.23. The positive and negative predictive values for the whole sample were 33.9 percent and 98.1 percent. The value of the area beneath the ROC curve (AUC) was 0.92 for the whole sample. Conclusions. The laser fluorescence system was more precise than visual evaluation in identifying lesions without cavities and healthy surfaces in primary and permanent molars. Clinical Implications. In daily practice, dentists can consider the laser fluorescence system a complementary tool in the visual exploration of occlusal surfaces of primary molars and permanent first molars.
Effect of Cut-Off Points on Performance of Laser Fluorescence for Detecting Occlusal Caries
Journal of Clinical Pediatric Dentistry, 2007
This in vitro study aimed to evaluate the influence of cut-off points on the performance of laser fluorescence(LF) in detecting occlusal caries in permanent and primary teeth. The use of different cut-off points influenced the performance of LF device in detection of occlusal caries in both kind of teeth, but the performance in permanent teeth suffered more influence from variation of cut-off points scales than in primary group.