Occlusal Caries Detection and Diagnosis Using Visual ICDAS Criteria, Laser Fluorescence Measurements, and Near-Infrared Light Transillumination Images

Abstract

Objective: Current diagnostic tools for non-cavitated occlusal caries are not very reliable. For this reason, newer systems need to be developed. The aim of this study was to compare the performance of visual inspection (ICDAS-II), laser fluorescence (DIAGNOdent pen), and the near-infrared transillumination technique (DIAGNOcam) in the detection of non-cavitated occlusal caries lesions under clinical and laboratory conditions in 90 third molar teeth planned for extraction. Materials and Methods:Ninety third molar teeth were firstly examined in clinical conditions, scored according to ICDAS-II criteria, and examined with DIAGNOdent pen and DIAGNOcam devices. After finishing the clinical examination, the teeth were re-evaluated shortly after the extractions with the same methods. Then, the teeth were sectioned for histological validation according to Downer’s criteria. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic (ROC) curves were calculated based on the histological results. Results: For the D0–D1–4 threshold, the area under the ROC curve values ranged between 0.754 and 0.881 for all systems. Sensitivity values ranged between 80.5 and 96.1%, and specificity values ranged between 61.5 and 84.6% for the three caries detection methods. DIAGNOcam had the best correlation value (0.616) according to histological observations and demonstrated a sensitivity rate of 96.1%, a specificity rate of 61.5%, and an accuracy rate of 91.1%. Conclusions: DIAGNOcam was found to be the most effective method for the diagnosis of occlusal caries without cavitation in permanent molar teeth.

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

“…It must be considered that a visual assessment performed with unaided eyes would probably have resulted in lower values of SE and SP for VE [ 50 ]. This study additionally provides new diagnostic findings on NIRT and ACIS, which have not previously been reported in the literature [ 14 , 15 , 18 – 21 ].…”

“…Near-infrared light transillumination (NIRT) and alternating current impedance measurement (ACIS) have been recently introduced into dental practice [ 11 – 13 ], and only a few diagnostic studies have analysed their diagnostic performance for occlusal caries detection thus far [ 14 – 20 ]. A few clinical studies directly compared the diagnostic performances of these adjunct methods, highlighting their individual potential for occlusal caries detection at the enamel and dentin threshold [ 15 , 21 , 22 ].…”

Recent Advances and the Potential for Clinical Use of Autofluorescence Detection of Extra-Ophthalmic Tissues

“…Another novel imaging configuration called near-infrared light transillumination (NILT) provides excitation light at 780 nm and may be more suitable for proximal early caries lesions [89]. Using the NILT properties with the DIAGNOcam™ device (KaVo Dental GmbH) was indeed superior compared to the DIAGNOdent™ device (excitation at 655 nm) in detecting occlusal caries [90].…”

Métodos de detecção e diagnóstico de cárie: uma revisão narrativa

“…A câmera DIAGNOcam usa luz infravermelha próxima (Near-Infrared -NIR) para detectar cáries. Este sistema é baseado em transluminação Research, Society and Development, v. 9, n. 10, e36291110019, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i10.10019 digital de fibra óptica (Digital Imaging Fiber-Optic Transillumination Machine -DIFOTI) (Tassoker, Ozcan & Karabekiroglu, 2020).…”