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

Abstract

We aimed to investigate the performance of fluorescencebased 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.

Presenting patients with information on their oral health risk: the PREFER three-arm RCT and ethnography

“…Studies put QLF sensitivity as ranging between 0.62 and 0.74 and specificity as ranging from 0.86 to 1.0. [206][207][208] Thus, QLF has a higher specificity than sensitivity (i.e. it is better able to identify teeth without carious disease).…”

Laser fluorescence as an alternative for digital radiography in detecting caries lesions

“…8, 18,19,22,25,26,[36][37][38][39] However, weak specif icit y and sensitiv it y results led other authors to not indicate its use without BW or CT, invalidating the aim of the studies about these appliances. 18,22,[27][28][29][40][41][42][43][44] A study by Subka et al 44 Kühnisch et al 45 and Ozkan et al 46…”

Caracterização de lesões de mancha branca naturais

“…Neste interim, o DIAGNOdent surgiu como uma ferramenta que complementava o diagnóstico visual e radiográfico de lesões, por meio da emissão de uma fluorescência do tecido dental (Shi et al, 2000a;Shi et al, 2000b;Nicolau, 2004;Pretty, 2006;Braga et al, 2010;Pontes et al, 2017). Este aparelho utiliza um laser de diodo com comprimento de onda de 655 nm, que quando em contato com a superfície do dente, irá emitir uma luz vermelha.…”

“…Proporção conteúdo inorgânico e orgânico (960cm -1 /1450cm Nesse estudo, o aparelho DIAGNOdent (Kavo, Biberach, Alemanha) foi utilizado como avaliação inicial das amostras. A luz laser (655nm) foi absorvida por metabólitos, como as porfirinas bacterianas presentes no substrato, e ocorreu a emissão e a captação da fluorescência vermelha pelo aparelho (Shi et al, 2000;Nicolau, 2004;Pretty, 2006;Braga et al, 2010;Pontes et al, 2017;Luczaj-Cepowicz et al, 2019). Os resultados obtidos por esta metodologia apontaram que 75% das superfícies analisadas eram hígidas, 10% eram lesões que acometiam até junção esmalte-dentina, 7% eram cárie em esmalte e outros 7% eram cárie em primeiro terço de dentina.…”