Clinical performance of fluorescence-based methods for detection of occlusal caries lesions in primary teeth.

Laura Regina Antunes Pontes,Bruna Lorena Pereira Moro,Mariana Minatel Braga,Tatiane Fernandes Novaes,Fausto Medeiros Mendes

doi:10.1590/1807-3107bor-2017.vol31.0091

Laura Regina Antunes Pontes, Bruna Lorena Pereira Moro + Show 3 more

Open Access

https://doi.org/10.1590/1807-3107bor-2017.vol31.0091

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Abstract

We aimed to investigate the performance of fluorescence-based methods (FBMs), compared to visual inspection after histological validation, in detecting and assessing the activity status of occlusal carious lesions in primary teeth. One examiner evaluated 50 primary molars close to exfoliation in 24 children. Teeth were assessed using quantitative light-induced fluorescence (QLF) and pen-type laser fluorescence (LFpen). After exfoliation, histological validation was performed. Teeth were cut and sections were evaluated for lesion depth and activity status (after utilization of a pH indicator) under a stereomicroscope. Parameters related to the performance of the methods in detecting caries lesions at two thresholds (initial and dentin lesions) were calculated. Regarding the activity status, lesions were classified into sound+inactive or active, and the area under the ROC curve and the diagnostic odds ratio values of the methods were calculated and compared. Evaluation of red fluorescence using QLF presented higher sensitivity but lower specificity than visual inspection in detecting dentin caries lesions. However, QLF considering different parameters and LFpen had similar performance to that obtained with visual inspection. Regarding activity assessment, all FBMs and visual inspection also presented similar performance. In conclusion, FBMs did not prove advantageous for the detection and activity assessment of occlusal caries lesions in primary molars when compared to visual inspection.

Highlights

Visual inspection is the most widely used method for the detection and activity assessment of caries lesions,[1,2] it is subjective[3] and it could be influenced by the examiners’ experience.[4]
An attempt to overcome these limitations is the creation of detailed visual indices, such as the International Caries Detection and Assessment System (ICDAS).[5]
This study evaluated different fluorescencebased methods (FBMs) for detecting and assessing the activity status of carious lesions in primary molars

Summary

Introduction

Visual inspection is the most widely used method for the detection and activity assessment of caries lesions,[1,2] it is subjective[3] and it could be influenced by the examiners’ experience.[4] An attempt to overcome these limitations is the creation of detailed visual indices, such as the International Caries Detection and Assessment System (ICDAS).[5] the use of detailed and validated indices improves the performance of visual inspection for the detection of carious lesions.[2] Another advantage of visual inspection is that it permits the evaluation of activity status of carious lesions through validated additional criteria.[6] even when well-described criteria are used, the method is examiner-dependent

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Conclusion