Abstract
The purpose of the present cross-sectional clinical study was to check the ability of plaque detection and quantification by QLF-D against conventional digital photographs of disclosed plaque in multibracket appliance (MB) patients. 20 patients were included according to the following criteria: (1) upper and lower jaw treated by MB appliance, (2) patients being 16 years of age or older, (3) all central and lateral incisors as well as canines in situ, (4) absence of developmental defects, carious lesions, surface fillings, prosthetic restorations or recessions greater than 1/3 of root length in central/lateral incisors and canines as well as (5) declaration of consent. QLF-D and conventional photographs were analyzed planimetrically regarding plaque coverage on buccal and oral surfaces of central/lateral incisors and canines. The conventional photographs of stained plaque served as gold standard. On average, in QLF-D pictures 20.7% ± 17.4 of the tooth surfaces were covered with plaque, while the conventional photographs of disclosed plaque presented a mean plaque-covered area of 36.2% ± 23.5. The Bland-Altman plot for both imaging modalities showed a very large inconsistent scattering with both negative and positive deviations. The method discrepancy increased with increasing plaque coverage, thus indicating a systematic method error. On average, the deviation of the methods from the optimal line of accordance was −15.5%. In patients wearing MB appliances, there was no clinical significant agreement regarding the plaque-covered tooth surface depicted by QLF-D respectively conventional images of disclosed plaque. Due to the large method discrepancy, QLF-D is currently not reliable for precise plaque quantification in MB patients.
Highlights
Plaque control during multibracket appliance (MB) treatment is a special challenge because a MB inevitably increases the number of retentive niches for plaque accumulation
Photographs of the tooth surfaces are taken and the amount of plaque is calculated as a percentage of tooth surface coverage[6,7,8,9]
Quantitative light-induced fluorescence (QLF) has been previously established for caries detection, caries monitoring and effects of oral hygiene and remineralization approaches[10,11,12,13], but could be useful for plaque quantification[3,14] and has already shown its capacity and validity compared to oral hygiene indices[15,16,17]
Summary
Plaque control during multibracket appliance (MB) treatment is a special challenge because a MB inevitably increases the number of retentive niches for plaque accumulation. Detection and quantification of dental plaque plays an important role in everyday practice, both for patients’ education and motivation Plaque indices allow for a fast assessment of the amount and localization of plaque, they have their disadvantages especially for research purposes, as due to their subjective nature time- and cost-intensive examiner training for calibration and reliability is required. QLF has been previously established for caries detection, caries monitoring and effects of oral hygiene and remineralization approaches[10,11,12,13], but could be useful for plaque quantification[3,14] and has already shown its capacity and validity compared to oral hygiene indices[15,16,17]. Using either the blue or the white LEDs, the camera system is able to produce QLF-D images as well as conventional digital photographs
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