Clinical performance of a diode laser fluorescence device for the detection of occlusal caries in primary teeth

Kavvadia, Katerina; Lagouvardos, Panagiotis

doi:10.1111/j.1365-263x.2007.00913.x

Cited by 27 publications

(36 citation statements)

References 21 publications

(64 reference statements)

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“…The high accuracy of indirect visual examination found in this study was also found previously for primary teeth, 28 and this may have clinical implications. Visual diagnostic methods, such as the use of high-resolution intraoral cameras, might be promising for caries diagnosis in the future, especially with the use of a dedicated image analysis software.…”

supporting

confidence: 71%

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Comparative In Vitro Validation of VistaProof and DIAGNOdent Pen for Occlusal Caries Detection in Permanent Teeth

Seremidi¹,

Lagouvardos²,

Kavvadia³

2012

Operative Dentistry

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Laser/light fluorescence devices were highly reliable for occlusal caries diagnosis in permanent teeth but not superior in accuracy to visual methods. SUMMARYPurpose: Current caries diagnostic tools are neither very accurate nor very reliable for the detection of carious lesions of different depths. Thus, the development of new devices and techniques is needed. The aim of this in vitro study was to validate a newer fluorescence device, VistaProof (VP), and compare it with DIAGNOdent Pen (DP), direct visual (DV) and indirect visual methods (IDV), with respect to accuracy and reliability for the detection of occlusal caries in permanent teeth.Methods and Materials: One hundred seven sites on 41 occlusal surfaces of recently extracted premolars were selected and classified into lesion categories according to Ekstrand's clinical criteria, by direct and indirect visual examination. The fluorescence of the sites was also measured by the two devices, and the teeth were ground through the sites for histological evaluation of their lesion depth. One calibrated examiner of high reliability (intraclass correlation coefficient [ICC].0.85) made all of the evaluations. Sensitivity, specificity, and accuracy of each detection method were estimated based on histological examination as the reference method, estimated using cutoff limits calculated on the basis of best agreement between the devices' values and histological examination. McNemar tests and receiver operating characteristic (ROC) curve , 2012, 37-3, 234-245 analyses were used to compare the validity measures of all detection methods at a=0.05, while the ICC was used to test the reproducibility of the methods based on a second measurement one week after the first.Results: There was no statistically significant difference (p.0.05) between the accuracy of DP and VPs for both enamel and dentin lesions. The areas under the ROC curves (AUC) for the two devices were also found not to be different (p.0.05). The reliability of DP was statistically significantly better than VP (p,0.05).Conclusion: The validity of both fluorescence devices were not found to be significantly different and not better than visual methods for the detection of noncavitated carious lesions.

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supporting

confidence: 71%

“…27,28 Visual inspection aided by magnification has been shown to increase the in vitro sensitivity for caries, 29 while indirect visual examination through photographs 30 or digital images 28,31 seemed to have greater potential for the detection of caries.…”

Section: Introductionmentioning

confidence: 99%

Comparative In Vitro Validation of VistaProof and DIAGNOdent Pen for Occlusal Caries Detection in Permanent Teeth

Seremidi¹,

Lagouvardos²,

Kavvadia³

2012

Operative Dentistry

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“…Clinical studies performed with the first version of the LF method (DIAGNOdent), however, have shown similar performance in both primary [Rocha et al, 2003;Kavvadia and Lagouvardos, 2008] and permanent teeth [Lussi et al, 2001;Reis et al, 2006;Abalos et al, 2009]. Since it works based on the same principles as the new LFpen device, the performance in primary teeth should also be better than in permanent teeth with the first LF device.…”

Section: Discussionmentioning

confidence: 99%

“…Although several in vivo studies have used checking for the presence of caries lesions after operative intervention as a reference standard [Lussi et al, 2001;Krause et al, 2007;Huth et al, 2008;Kavvadia and Lagouvardos, 2008;Abalos et al, 2009], the method is far from an ideal gold standard. In most studies, operative treatment can only be performed where disease is thought to be present.…”

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confidence: 99%

Clinical Performance of Two Fluorescence-Based Methods in Detecting Occlusal Caries Lesions in Primary Teeth

et al. 2011

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This in vivo study aimed to evaluate the performance of 2 fluorescence-based methods in detecting occlusal caries lesions in primary teeth, compared with the performance of visual inspection and radiographic methods, and to propose a mathematic correction of the diagnostic parameters due to the imperfect reference standard method used in the study. Two examiners assessed the occlusal surfaces of 407 primary teeth (62 children) using visual inspection (ICDAS), radiographic, DIAGNOdent pen (pen type laser fluorescence; LFpen), and fluorescence camera (FC) methods. At the noncavitated threshold (NC) the reference standard method was the results of ICDAS, and at the dentine caries threshold (D3) teeth diagnosed with dentine caries by ICDAS or radiographic methods were subjected to operative treatment to confirm the presence of lesion. Reproducibility, sensitivity, specificity, accuracy, and the area under the ROC curve were calculated for the methods at both thresholds. At the NC threshold, LFpen had a slightly better performance compared to the FC and radiographic methods. However, at the D3 threshold, both fluorescence-based methods performed similarly. Visual inspection and radiographic methods presented higher specificities but lower sensitivities than fluorescence methods. After corrections, there was a significant decrease in some parameters. In conclusion, both fluorescence-based methods presented similar performance in detecting occlusal dentine caries lesions in primary teeth, but they usually gave more false-positive results than did the visual and radiographic methods. The correction proposed shows that the performance of the methods can be overestimated, and the correction should be validated and considered in further studies that use an imprecise reference standard method.

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“…Hence, more evidence from clinical studies is needed to guide clinicians on the usefulness of new LF-based detection devices such as DIAGNOdent. For example, DIAGNOdent’s reliability in detecting caries in primary teeth is reportedly high [29, 13], but its clinical performance has not been thoroughly or systematically examined on secondary teeth. The aim of this clinical study was to compare the in vivo validity of visual examination, bitewing radiography, and DIAGNOdent in diagnosing dentinal caries in permanent molars with early signs of fissure caries.…”

Section: Introductionmentioning

confidence: 99%

Clinical diagnosis of fissure caries with conventional and laser-induced fluorescence techniques

Chu

You

2009

Lasers Med Sci

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We studied the in vivo validity of dentinal fissure caries diagnosis by visual examination, bitewing radiography, and use of a laser-induced fluorescence device (DIAGNOdent). A total of 144 and second molars with macroscopically intact occlusal surfaces in 41 Chinese young adults were examined visually, by bitewing radiography, and by DIAGNOdent. Visual examination after pit and fissure opening was used as the reference standard. The sensitivity and specificity of detecting caries that had extended into the dentin were, respectively, 0.89 and 0.44 by visual detection of opacity or discoloration after air drying, 0.13 and 1.00 by bitewing radiography to detect radiolucency extending into the dentin, and 0.70 and 0.84 by DIAGNOdent testing with a cut-off score of 40. Caries detection by a combination of visual examination and DIAGNOdent had a sensitivity of 0.67 and specificity of 0.94. Receiver operating characteristic analysis showed that this combined approach was superior to the other methods.

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Clinical performance of a diode laser fluorescence device for the detection of occlusal caries in primary teeth

Abstract: The LF device presented high reliability in the detection of occlusal caries in primary teeth and its performance was similar to DV and radiographic examinations.

Cited by 27 publications

References 21 publications

Comparative In Vitro Validation of VistaProof and DIAGNOdent Pen for Occlusal Caries Detection in Permanent Teeth

Comparative In Vitro Validation of VistaProof and DIAGNOdent Pen for Occlusal Caries Detection in Permanent Teeth

Clinical Performance of Two Fluorescence-Based Methods in Detecting Occlusal Caries Lesions in Primary Teeth

Clinical diagnosis of fissure caries with conventional and laser-induced fluorescence techniques

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