Validity of caries detection on occlusal surfaces and treatment decisions based on results from multiple caries-detection methods (original) (raw)
Related papers
Effect of dental material fluorescence on DIAGNOdent readings
Acta Odontologica Scandinavica, 2008
Objective. Diagnosis of secondary caries with the DIAGNOdent device has been found to be comparable to visual and radiographic diagnostic methods, but the fluorescence of restorative materials might affect DIAGNOdent values and result in false-positive diagnosis. The aims of this study were: (1) to measure baseline fluorescence of restorative materials and fluorescence changes induced by aging, bleaching, staining, and polishing; (2) to assess intra-examiner reproducibility of these measurements; and (3) to compare the values obtained with the DIAGNOdent against the threshold values for enamel and dentinal caries. Material and Methods. 270 disk-shaped specimens fabricated from 15 different restorative materials were divided into 3 groups, which were aged in water, bleached with 10% carbamide peroxide, and stained with red wine. Specimen fluorescence was measured with the DIAGNOdent before and after these treatments. The red-wine-stained specimens were also polished and measured again. Results. Intra-examiner reproducibility of the measurements was excellent. For all materials, baseline DIAGNOdent values, as well as the values of aged and bleached samples, were considerably lower than the dentinal caries threshold. The values of one stained filled resin fissure sealant, one stained resin composite, and one stained resin-modified glass ionomer exceeded the dentinal caries threshold. Polishing reduced these DIAGNOdent values to below the dentinal caries threshold, except for the filled resin fissure sealant specimen. Conclusions. Stained dental materials might affect DIAGNOdent readings and consequently result in false-positive diagnoses of secondary caries. Dental fillings should be polished prior to DIAGNOdent measurement.
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.
An In Vitro Comparison of Different Diagnostic Methods in Detection of Residual Dentinal Caries
International Journal of Dentistry, 2010
The aim of this study was to investigate the efficiency of different diagnostic methods in detection of residual dentinal caries in excavated cavities. Fifty extracted molar with deep dentinal carious lesions were excavated using a slow-speed handpiece. All cavities were assessed by laser fluorescence(LF) device, electronic caries monitor(ECM), and caries detector dye(CDD) by three independent observers blindly. The measurements were repeated after two weeks. Specimens containing dentin slices 150 µm in thickness were prepared for histological analyses. The existence and absence of carious dentin was determined using a lightmicroscope. The average intraobserver accuracy was 1.00 (perfect agreement) for CDD, 0.86 (excellent agreement) for ECM, and 0.50 (good agreement) for LF. The average interobserver accuracy values were 0.92 (excellent agreement), (0.36 marginal agreement) and 0.48 (good agreement), for CDD, ECM, and LF, respectively. The average specificity was 0.60 for CDD, 73% for ECM, and 0.50 for LF. The average sensitivity was 0.55 for CDD, 0.85 for LF, and 0.47 for ECM. The average accuracy values were 0.53, 0.51, and 0.81 for CDD, ECM, and LF, respectively. LF had the greatest sensitivity and accuracy values of any of the methods tested. As a conclusion, LF device is appeared to most reliable method in detection of remain caries in cavity. However, because of its technical sensitivity it may susceptible to variations in measurements. To pay attention to the rule of usage and repeated measurements can minimize such variations in clinical practice. It was concluded that LF is an improvement on the currently available aids for residual caries detection.
Traditional and novel methods for occlusal caries detection: performance on primary teeth
Lasers in Medical Science, 2012
This study aimed to assess the performance of International Caries Detection and Assessment System (ICDAS), radiographic examination, and fluorescencebased methods for detecting occlusal caries in primary teeth. One occlusal site on each of 79 primary molars was assessed twice by two examiners using ICDAS, bitewing radiography (BW), DIAGNOdent 2095 (LF), DIAGNOdent 2190 (LFpen), and VistaProof fluorescence camera (FC). The teeth were histologically prepared and assessed for caries extent. Optimal cutoff limits were calculated for LF, LFpen, and FC. At the D 1 threshold (enamel and dentin lesions), ICDAS and FC presented higher sensitivity values (0.75 and 0.73, respectively), while BW showed higher specificity (1.00). At the D 2 threshold (inner enamel and dentin lesions), ICDAS presented higher sensitivity (0.83) and statistically significantly lower specificity (0.70). At the D 3 threshold (dentin lesions), LFpen and FC showed higher sensitivity (1.00 and 0.91, respectively), while higher specificity was presented by FC (0.95), ICDAS (0.94), BW (0.94), and LF (0.92). The area under the receiver operating characteristic (ROC) curve (Az) varied from 0.780 (BW) to 0.941 (LF). Spearman correlation coefficients with histology were 0.72 (ICDAS), 0.64 (BW), 0.71 (LF), 0.65 (LFpen), and 0.74 (FC). Inter-and intraexaminer intraclass correlation values varied from 0.772 to 0.963 and unweighted kappa values ranged from 0.462 to 0.750. In conclusion, ICDAS and FC exhibited better accuracy in detecting enamel and dentin caries lesions, whereas ICDAS, LF, LFpen, and FC were more appropriate for detecting dentin lesions on occlusal surfaces in primary teeth, with no statistically significant difference among them. All methods presented good to excellent reproducibility.
Pediatric Dental Journal, 2012
Fluorescence-based devices are adjunct tools for caries detection. Both DIAGNOdent 2095 (LF) and DIAGNOdent 2190 (LF pen) were developed for this application. The purpose of this in vivo study was to compare the relationship between the measurements obtained using the LF and LF pen devices in primary and permanent teeth. The same sample of occlusal and smooth surfaces caries were evaluated by one examiner using both LF and LF pen devices in children. For occlusal caries, measurements were made at 51 sites in primary teeth, and at 83 sites in permanent teeth. For smooth surface caries, measurements were made at 63 sites in primary teeth, and 163 sites in permanent teeth. The values obtained with the LF pen for occlusal caries in primary and permanent teeth (17.6±2.14, 20.6±1.40, respectively) were significantly higher than those obtained with the LF (9.7±1.24, 11.3±0.78). For caries on smooth surfaces, the values obtained with the LF pen for primary and permanent teeth (8.2±1.22, 7.2±0.45) were higher than those obtained with the LF (4.5±0.57, 3.3±0.23). For both occlusal and smooth surface caries, the values were significantly different between the two devices (P<0.01). The Spearman's correlation coefficients comparing the LF and LF pen values for primary and permanent teeth were Rs=0.87 and 0.86 for occlusal caries and 0.80 and 0.74 for smooth surface caries, respectively. Values from both devices showed high correlation coefficients, indicating similar principle of function. However, the actual values were significantly different, which indicated that the values obtained with the two devices did not agree. The LF pen should be used with caution in patients for whom the LF is already being used to manage caries. a laser fluorescence device (LF, DIAGNOdent 2095, KaVo, Biberach, Germany; Fig. 1A) with a pulsed near-infrared diode laser (wavelength 655 nm) was developed for the diagnosis of dental caries. With this device, pulsed laser irradiation of a carious lesion causes the emission of reflected fluorescent light at 700-800 nm 2). The reliability of the device was reported to be similar to that of conventional diagnostic methods used to detect caries in permanent 3-6) and primary teeth 7-11). The apparatus uses two types of tip, type A reveals caries in fissure and type B detects caries on smooth surfaces (Fig. 1B,
Journal of lasers in medical sciences, 2013
Today the prevalence of teeth decays has considerably decreased. Related organizations and institutions mention several reasons for it such as improvement of decay diagnostic equipment and tools which are even capable of detecting caries in their initial stages. This resulted in reduction of costs for patients and remarkable increase in teeth life span. There are many methods for decay diagnostic, like: visual and radiographic methods, devices with fluorescence such as Quantitative light-induced fluorescence (QLF), Vista proof, Laser fluorescence (LF or DIAGNOdent), Fluorescence Camera (FC) and Digital radiography. Although DIAGNOdent is considered a valuable device for decay diagnostic ,there are concerns regarding its efficacy and accuracy. Considering the sensitivity of decaydiagnosis and the exorbitant annual expenses supported by government and people for caries treatment, finding the best method for early caries detection is of the most importance. Numerous studies were perfor...
Lasers in Medical Science, 2020
The aim of this study was to compare the clinical performance of clinical-visual examination using the International Caries Detection and Assessment System (ICDAS) II, digital bitewing radiography, near-infrared light transillumination (NIR-LT), and laser fluorescence (LF) for the detection of non-cavitated proximal enamel and dentin caries. The study included 335 patients, aged 12-18 years, with no cavities in the posterior teeth. Clinical-visual inspections of 335 non-cavitated proximal caries were performed by two examiners. For enamel caries, clinical validation included a combination of clinical-visual and digital bitewing radiography assessments. For dentin caries, the clinical validation was opening the cavity. The accuracy rate, sensitivity, specificity, predictive values, and areas under receiver operating characteristic curves were determined. The agreement between the examiners' measurements was calculated using the kappa coefficient. The sensitivity, specificity, and accuracy of the methods were compared using the McNemar test. The significance level was set at p < 0.05. Digital bitewing radiography had the highest sensitivity (0.96) and accuracy (0.96), and LF had the lowest sensitivity (0.38) and accuracy (0.39). After separation of the lesions into enamel and dentin caries, clinical-visual examination had the highest sensitivity (0.98) and accuracy (0.98) for enamel caries, while digital bitewing radiography had the highest sensitivity (0.97) and accuracy (0.97) for dentin caries. The NIR-LT method had a higher sensitivity for enamel caries (0.86). Each method also differed significantly from the others (p < 0.001). Digital bitewing radiography gave the best prediction of proximal enamel and dentin caries. NIR-LT showed good potential for detection of proximal caries.
2013
Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The aim of this study was to investigate the efficiency of different diagnostic methods in detection of residual dentinal caries in excavated cavities. Fifty extracted molar with deep dentinal carious lesions were excavated using a slow-speed handpiece. All cavities were assessed by laser fluorescence(LF) device, electronic caries monitor(ECM), and caries detector dye(CDD) by three independent observers blindly. The measurements were repeated after two weeks. Specimens containing dentin slices 150 µm in thickness were prepared for histological analyses. The existence and absence of carious dentin was determined using a lightmicroscope. The average intraobserver accuracy was 1.00 (perfect agreement) for CDD, 0.86 (excellent agreement) for ECM, and 0.50 (good agreement) for LF. The average interobserver accuracy values were 0...