Laser fluorescence device does not perform well in detection of early caries lesions in primary teeth: an in vitro study.
ABSTRACT To evaluate if using the laser fluorescence (LF) device improves the detection of early or more advanced occlusal caries lesions in primary teeth.
A total of 181 occlusal sites in primary teeth were assessed by one examiner using DIAGNOdent. The same examiner and a second examiner evaluated 72 of the sites again to assess intra- and inter-examiner reproducibility. After histological validation, lesions were divided at three thresholds according to the lesion depth: outer half of the enamel (D1), inner half of the enamel (D2) and dentine (D3). The sensitivity, specificity, accuracy and area under ROC curve were calculated for cut-off points for the sample considering the aforementioned thresholds. The parameters were compared using chi-square test and by comparison between unpaired ROC curves.
The overall LF performance was better at dentine threshold than at enamel threshold. The higher specificity was found at D3 and D2, and higher accuracy at D3 (P < 0.001). The intra- and inter-examiner agreements were classified as good or excellent for all thresholds.
The LF device performs better at the dentine threshold than at the enamel threshold. This method does not perform well in detecting initial enamel caries lesions.
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ABSTRACT: The aim was to compare the performance of different methods in detecting approximal caries lesions primary molars ex vivo. One hundred thirty-one approximal surfaces were examined by 2 observers with visual inspection (VI) using the International Caries Detection and Assessment System, radiographic interpretation, and clinically using the Diagnodent pen (LFpen). To achieve a reference standard, surfaces were directly examined for the presence of white spots or cavitations, and lesion depth was determined after sectioning. The area under the receiver operating characteristic curve (A(z)), sensitivity, specificity, and accuracy were calculated, as well as the interexaminer reproducibility. Using the cavitation threshold, all methods presented similar sensitivities. Higher A(z) values were achieved with VI at white spot threshold, and VI and LFpen had higher A(z) values at cavitation threshold. VI presented higher accuracy and A(z) than radiographic and LFpen at both enamel and dentin depth thresholds. Higher reliability values were achieved with VI. VI performs better, but both radiographic and LFpen methods also show good performance in detecting more advanced approximal caries lesions.Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 10/2009; 108(4):e35-41. · 1.50 Impact Factor
Article: Performance of laser fluorescence devices, visual and radiographic examination for the detection of occlusal caries in primary molars.[show abstract] [hide abstract]
ABSTRACT: The aim of this in vitro study was to compare the performance of two laser fluorescence devices (LF, LFpen), conventional visual criteria (VE), ICDAS and radiographic examination on occlusal surfaces of primary teeth. Thirty-seven primary human molars were selected from a pool of extracted teeth, which were stored frozen at -20 °C until use. Teeth were assessed twice by two experienced examiners using laser fluorescence devices (LF and LFpen), conventional visual criteria, ICDAS and bitewing radiographs, with a 2-week interval between measurements. After measurement, the teeth were histologically prepared and assessed for caries extension. The highest sensitivity was observed for ICDAS at D(1) and D(3) thresholds, with no statistically significant difference when compared to the LF devices, except at the D(3) threshold. Bitewing radiographs presented the lowest values of sensitivity. Specificity at D(1) was higher for LFpen (0.90) and for VE at D(3) (0.94). When VE was combined with LFpen the post-test probabilities were the highest (94.0% and 89.2% at D(1) and D(3) thresholds, respectively). High values were observed for the combination of ICDAS and LFpen (92.0% and 80.0%, respectively). LF and LFpen showed the highest values of ICC for interexaminer reproducibility. However, regarding ICDAS, BW and VE, intraexaminer reproducibility was not the same for the two examiners. After primary visual inspection using ICDAS or not, the use of LFpen may aid in the detection of occlusal caries in primary teeth. Bitewing radiographs may be indicated only for approximal caries detection.Clinical Oral Investigations 05/2010; 15(5):635-41. · 2.36 Impact Factor
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ABSTRACT: The aim of this study was to assess the performance of two light-emitting diode (LED)- and two laser fluorescence-based devices in detecting occlusal caries in vitro. Ninety-seven permanent molars were assessed twice by two examiners using two LED- (Midwest Caries - MID and VistaProof - VP) and two laser fluorescence-based (DIAGNOdent 2095 - LF and DIAGNOdent pen 2190 - LFpen) devices. After measuring, the teeth were histologically prepared and classified according to lesion extension. At D1 the specificities were 0.76 (LF and LFpen), 0.94 (MID), and 0.70 (VP); the sensitivities were 0.70 (LF), 0.62 (LFpen), 0.31 (MID), and 0.75 (VP). At D(3) threshold the specificities were 0.88 (LF), 0.87 (LFpen), 0.90 (MID), and 0.70 (VP); the sensitivities were 0.63 (LF and LFpen), 0.70 (MID), and 0.96 (VP). Spearman's rank correlations with histology were 0.56 (LF), 0.51 (LFpen), 0.55 (MID), and 0.58 (VP). Inter- and intraexaminer ICC values were high and varied from 0.83 to 0.90. Both LF devices seemed to be useful auxiliary tools to the conventional methods, presenting good reproducibility and better accuracy at D(3) threshold. MID was not able to differentiate sound surfaces from enamel caries and VP still needs improvement on the cut-off limits for its use.Journal of Biomedical Optics 10/2011; 16(10):107003. · 3.16 Impact Factor