Abstract
The aim of this study was to assess the possibility of digital image analysis of pit-and-fissure discoloration in order to diagnose caries. Digital images showing pit-and-fissure discoloration in 100 teeth of 19 patients were analyzed to obtain the fractal dimension (FD) and the proportion of the area of pit-and-fissure discoloration to the area of occlusal surface (PA). DIAGNOdent values were measured (DD), and dentists' diagnoses were also obtained. The sensitivity and specificity of FD, PA, DD, and the combination of FD and PA compared to the dentists' diagnoses were calculated. The sensitivities of FD, PA, DD, and the combination of FD and PA were 0.89, 0.47, 0.69, and 0.86, respectively, and the specificities were 0.84, 0.95, 0.91, and 0.86, respectively. Although further research is needed for the practical use, it is possible to use the analysis of digital images of pit-and-fissure molar discoloration as a diagnostic tool.
Highlights
In recent years, the concept of minimal intervention (MI) has prevailed in dentistry
The two-way ANOVA revealed that the fractal dimension (FD), PA, and DIAGNOdent values were measured (DD) were different among the clinical diagnosis (P < .01)
It was reported that the fractal dimension and the proportion of the area of pit-and-fissure discoloration to the area of occlusal surface were significantly correlated with the depth of the caries and the DIAGNOdent values in extracted teeth [9]
Summary
The concept of minimal intervention (MI) has prevailed in dentistry. The importance of diagnosing caries at an early stage has increased. The diagnosis of caries has mainly consisted of visual inspection and tactile assessment with probing. Lussi [2] reported that the sensitivity of detecting caries was 0.62 by visual inspection and 0.82 by probing. The pressure of probing can damage the demineralized fissure and increase the risk that caries progress [3, 4]. To promote MI, diagnosis without a probe has been recommended [3]. The laser fluorescence-based caries detection device DIAGNOdent (Kavo, Germany) has been introduced as an alternative. No single detection method for caries is sufficient; the combination of some detection methods has been recommended [5,6,7]
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