Comparison of novel and established caries diagnostic methods: a clinical study on occlusal surfaces

Abstract

Background The purpose of this prospective clinical diagnostic study with validation was to compare the diagnostic accuracy of near-infrared transillumination (NIRT), laser fluorescence measurement (LF), alternating current impedance spectroscopy (ACIS) and their combinations as adjunct methods to visual examination (VE) for occlusal caries detection using a hybrid reference standard. Methods Ninety-six first and second non-cavitated permanent molars from 76 individuals (mean age 24.2) were investigated using (VE) (ICDAS) and bitewing radiography (BWR), as well as NIRT, LF and ACIS. The findings of BWR and NIRT were evaluated by two examiners while the other examinations were conducted by one calibrated dentist. The hybrid reference standard consisted of non-operative validation based on the results of VE and BWR and operative validation. Statistical analysis included cross-tabulations, calculation of sensitivity, specificity and area under the receiver operating characteristic curve at three diagnostic thresholds: caries in general, enamel caries and dentin caries. Results NIRT, LF and ACIS exhibited high sensitivity for caries in general [1.00 (1.00–1.00), 0.77 (0.65–0.88), 0.75 (0.63–0.87)) and for dentin caries (0.97 (0.91–1.03), 0.76 (0.76–0.90), 0.64 (0.47–0.80)]. Sensitivity values for enamel caries were weak (0.21, 0.11, 0.37). Specificity values did not fall below 0.65 (NIRT) for all categories and methods, except for NIRT at the caries detection threshold (0.27). A combination of LF and ACIS with VE improved the diagnostic performance at the overall and the enamel caries threshold. The other methods showed fair to excellent discrimination at the overall caries threshold (NIRT 0.64, LF 0.89 and ACIS 0.86) and acceptable discrimination at the dentin caries threshold (NIRT 0.82, LF 0.81 and ACIS 0.79). AUROC for enamel caries exhibited the weakest discrimination. Accuracy was 65.6% for VE, 69.8% for BWR, 50.0% for NIRT, 53.1% for LF and 74.0% for ACIS. Reliability assessment for BWR and NIRT showed at least substantial agreements for all analyses. Conclusions The methods, NIRT, LF and ACIS, revealed different potential but no impeccable performance for occlusal caries detection. All are suitable instruments to detect hidden carious lesion in dentin. As auxiliaries to VE, LF and ACIS showed an increase in diagnostic performance.

Prevalence of Dental Caries in Patients on Renal Replacement Therapy—A Systematic Review

“…Future studies on dental caries in RRT patients should therefore consider differentiation between different caries stadiums as well as their activity, alongside caries localization, focusing especially on root surfaces. Thereby, additional diagnostic procedures have never been applied to RRT individuals, including, e.g., radiographic diagnostics (bitewing), laser fluorescence or light-induced fluorescence, which have considerable value as diagnostic procedures adjunctive to visual inspection [ 49 , 50 , 51 ]. Due to differences in sensitivity between visual inspection and adjunctive diagnostics [ 52 ], the combination of different diagnostic procedures would be of interest for RRT patients.…”

Emerging Technologies for Dentin Caries Detection—A Systematic Review and Meta-Analysis

“…There were 21 articles that studied more than one caries detection technology. [56,59], and 1 used PTR-LUM technology [78]. There were more data sets from in vitro studies (n = 26) than in vivo studies (n = 9).…”

“…Flow diagram of the study selection process. Ofthe34articlesincluded, 21usedLFtechnology[45-65], 9 used FC technology [45,54,55,58,63,64,66-68], 4 used NIR-LT technology [53,56,61,69], 5 used LED technology [46,53,60,63,70], 4 used OCT technology [71-74], 3 used FOTI technology [71,75,76], 4 used QLF technology [48,71,77,78], 2 used LIF technology [62,71], 2 used ACIS technology[56,59], and 1 used PTR-LUM technology[78]. There were more data sets from in vitro studies (n = 26) than in vivo studies (n = 9).…”

Knowledge, awareness, and practice survey on conventional radiographic methods and processing among dental students

“…Soft and tender tissues allow more radiation to pass through, while the dense bone absorbs more radiation. [ 10 ] The use of conventional radiography is mainly used for fractures, pneumonia, and intestinal obstruction. A three-dimensional object is projected onto a two-dimensional image in conventional radiography.…”