Abstract
The aim of this study was to present an optimal diagnostic protocol by comparing and analyzing a conventional examination and the quantitative light-induced fluorescence (QLF) technique. Selected were 297 teeth of 153 patients to take QLF images and bitewing radiographs. Occlusal dental caries, proximal dental caries and cracks were evaluated and scored using QLF, X-ray and/or visual criteria. The sensitivity, specificity, and area under the curve (AUC) of a receiver operating characteristic analysis were calculated. Two fluorescence parameters (|ΔFmax| and ΔRmax) were utilized to evaluate the fluorescence pattern according to the severity of lesions based on QLF or X-ray criteria. QLF showed higher scores for detecting occlusal dental caries and cracks than the conventional method. ΔRmax increased more clearly than ΔFmax did with occlusal dental caries. The |ΔFmax| values of occlusal dental caries, proximal dental caries and cracks showed good AUC levels (0.84, 0.81 and 0.83, respectively). The ΔRmax of occlusal dental caries showed the highest AUC (0.91) and the ΔRmax of proximal dental caries showed a fail level (0.59) compared to bitewing radiographs. The QLF image could visualize and estimate the degree of occlusal dental caries or cracks. Consequently, the QLF technique may be an adjunct tool to conventional methods for the detection of occlusal caries and peripheral cracks.
Highlights
The prevalence of dental caries is on the decline worldwide due to the use of fluoride and increasing awareness of oral health
The prevalence of occlusal dental caries missed on visual examination has been a clinical issue for several decades
Classifying occlusal dental caries according to the quantitative light-induced fluorescence (QLF) criteria and the X-ray criteria, most of the X-ray criteria results showed a value of 0, the correlation analysis between the two criteria was meaningless
Summary
The prevalence of dental caries is on the decline worldwide due to the use of fluoride and increasing awareness of oral health. To treat the initial stage of caries requires early detection, the evaluation of lesions, and non-operative preventive treatments, where accurate diagnosis is essential. The prevalence of occlusal dental caries missed on visual examination has been a clinical issue for several decades. The detection and diagnosis of proximal caries is difficult because of limited visual access [4]. Detecting tooth cracks using conventional visual examination methods is diagnostically challenging [7]. Clinicians seek better methods for the detection and accurate diagnosis of carious lesions and dental cracks that are difficult to find in clinical examinations. Radiographic examination is a useful method to confirm a clinical suspicion of dental caries. Demineralized tissue is observed radiographically as the attenuation of X-rays is less than that in the normal tissue
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