Abstract
ObjectivesThe 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 methodsSix 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.ResultsThe 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.ConclusionsFIT is more reliable for detecting composite restorations than the conventional illumination method.Clinical relevanceFIT can be considered an additional or alternative tool for improving the detection of composite restorations.
Highlights
High-quality restorative resin composite materials, able to satisfy the high esthetic demands of contemporary patients, have been available for some time [1]
The accuracy of identifying a composite restoration was significantly higher with fluorescence-aided identification technique (FIT) (84%; confidence intervals (CI) 81– 86%) compared to conventional illumination method (CONV) (47%; CI 44–50%); p
The accuracy of identifying sound tooth-structure as “non-restored” was significantly higher with FIT (94%; CI 93–96%) than with CONV (82%; CI 79–84%); p
Summary
High-quality restorative resin composite materials, able to satisfy the high esthetic demands of contemporary patients, have been available for some time [1]. Modern concepts for applying multiple layers of tooth-colored materials so as to match the natural tooth shade and translucency can mimic. Misdiagnosis of a restoration may result in various drawbacks. A failure to detect a filling may lead to unidentified excess material or undetected new pathological findings beyond the margins [4]. Healthy tooth structure may be mistakenly removed or, composite remnants may be left behind during preparation as a result of difficulty distinguishing between tooth structure and composite [3]. Composite remnants diminish the quality of later adhesive restorations [3]. Overlooked fillings lead to dental charting errors, which may result in false caries risk
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