Clinical effectiveness of fluorescence, digital images and ICDAS for detecting occlusal caries

Cristina Dupim Presoto,Osmir Batista De Oliveira-Junior,Juliana Alvares Duarte Bonini Campos,Andrea Abi-Rached Dantas,Tamara Carolina Trevisan,Maria Costa De Andrade

doi:10.1590/1807-2577.12416

Abstract

Abstract Introduction The detection of small caries lesions is still a challenge for dental professionals who in their clinical practice have a wide variety of methods to detect caries on occlusal surfaces. Objective To clinically assess the effectiveness of the Vista Proof fluorescence camera, the Vista Cam digital intraoral micro camera and the International Caries Detection and Assessment System (ICDAS) visual criterion for detecting caries lesions on occlusal surfaces of permanent teeth. Material and method One hundred and seven posterior teeth from adult patients were examined visually and by means of digital radiographs by an examiner who rated them according to the presence or absence of occlusal caries. The teeth were then assessed by the other examiner using ICDAS, fluorescence and magnified digital images. The effectiveness of the methods was measured based on sensitivity, specificity, positive and negative likelihood ratio. For each method, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC curve (AUROC) were estimated. Result There was exceptional discrimination capacity for the intraoral images (AUROC=.93) and the ICDAS (AUROC=.91), with no significant statistical difference between them (z=.35, p=.73). The fluorescence exhibited an acceptable discrimination capacity (AUROC=0.78), although it was lower than the others. The positive likelihood ratio for the fluorescence was only 2.32, compared to 20.58 for the intraoral image and 58.11 for the ICDAS. Conclusion Both methods and the ICDAS exhibited an adequate clinical performance, although the ICDAS and intraoral image were more effective than the fluorescence.

Highlights

The detection of small caries lesions is still a challenge for dental professionals who in their clinical practice have a wide variety of methods to detect caries on occlusal surfaces
The detection of small lesions, especially on occlusal surfaces, is still a challenge for dental professionals[2,3,4,5], mainly due to the complex anatomy of dental grooves and fissures[6,7,8], overlapping structures during radiography and the increased number of hidden caries lesions caused by the continuous use of fluorides[9,10]
Dentists use a wide variety of methods to detect caries on occlusal surfaces[11,12]

Summary

Introduction

The detection of small caries lesions is still a challenge for dental professionals who in their clinical practice have a wide variety of methods to detect caries on occlusal surfaces. Dentists use a wide variety of methods to detect caries on occlusal surfaces[11,12] These methods include visual inspection, visual-tactile inspection, radiographs, digital radiographs, laser or light fluorescence based-methods, electrical impedance measurements[12], intraoral images[13], dyes and fiber-optic transillumination[11]. An ideal method to detect caries lesions should be fast and easy to use, with high sensitivity and specificity[14,15], as well as reliability and an accessible cost This will enable the documentation and detection of caries at an early stage, without causing discomfort for the patient, as well as the possibility of differentiating reversible and irreversible damage, with similar effectiveness when applied to all dental surfaces[16]. Satisfying all of these requirements is not an easy task

Objectives

Methods

Conclusion