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

Abstract

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.

Histological Validation of Cone-Beam Computed Tomography Versus Laser Fluorescence and Conventional Diagnostic Methods for Occlusal Caries Detection

“…Seremidi et al 23 reported that LFE showed greater SP and lower SE than VE. In contrast, our results indicated that LFE exhibited lower SP and higher SE than the conventional methods.…”

“…The fluorescence emitted from the tooth is converted into a numerical scale. 22 This quantitative measurement demonstrates validity that does not surpass that of VE for the detection of noncavitated carious lesions, 23 and its ability to discriminate various caries depths was moderate to very good. 24 LFE is suggested as an adjunct tool when conventional diagnostic methods (VE and RE) alone are insufficient.…”

Use of new minimum intervention dentistry technologies in caries management

“…A new version, the VistaCam CL-IX ® with removable head cameras, wireless and a light cure function, has just been launched. 32,33 The camera is placed on the tooth, pictures are recorded with specific software, which then reveals the caries scores. All these devices can be used specifically for diagnostics or treatment, but at this time only Soprolife ® can be used for both.…”

Caries Detection With Laser Fluorescence Devices. Limitations of Their Use

“…16 On the other hand, the visual observation assisted by loops of 1,5X to 4,5X shows increased detection sensitivity. 17 Bitewing radiographs are a useful means of detecting interproximal caries; however, their advantage is quite limited to occlusal carious lesions, due to the overlay phenomenon. 18 Furthermore, 40-60% of the tooth's metal ions have to be lost so as the lesion becomes visible radiographically.…”

“…0.65) was relatively low (16.42). It is worth noting that in the study by Seremidi et al 17 the teeth were stored in tap water for a long time, which is likely to have an impact on the fl uorescence levels of the teeth. The study by Achilleos et al 43 revealed low sensitivity values (0.66-0.75) for DDPen, which may be attributed to the fact that the study was focused on the D1 level, where the performance of this device is reduced compared to the D3 level.…”