Reliability of Quantitative Laser Fluorescence Analysis of Smooth Surface Lesions Adjacent to the Gingival Tissues

Abstract

The aim of this study was to determine the impact of analysis patch border inclusion or exclusion on the reliability of quantitative laser fluorescence (QLF) analyses of lesions close to the gingival margin. Ninety-three lesions on the maxillary anterior teeth were imaged using a fluorescent capturing system. All the lesions were located on the gingival third of the teeth. One examiner undertook two analyses of the images 1 week apart and another examiner undertook a single analysis. Analyses were undertaken using QLF 2.00 g with four patch borders. Each border was assessed as active or inactive. QLF metrics ΔF, ΔQ and area were exported. Kappa statistics were used to measure the agreement of border inclusion between all three analyses, and intra-class correlation coefficients (ICCs) were used to determine the intra- and inter-examiner reliability of the QLF metrics. Agreement on border exclusion was poor; with intra-examiner kappa of 0.48 and inter-examiner at 0.20. However, despite the inconsistencies in border exclusions the ICCs for each QLF metric were high; intra-examiner ΔQ 0.91, ΔF 0.80 and area 0.92; inter-examiner ΔQ 0.86, ΔF 0.68, area 0.88. Lesions adjacent to the gingival margin will often require a patch analysis border to be excluded in order to ensure a satisfactory reconstruction and thus accurate analysis. The decision to include or exclude a border and, if excluded, which border to select appears to be highly variable between examiners. Nevertheless, the QLF metrics appear to be robust as demonstrated by the high ICCs noted in this study.

In vitro Detection of Occlusal Caries on Permanent Teeth by a Visual, Light-Induced Fluorescence and Photothermal Radiometry and Modulated Luminescence Methods

“…For ICDAS, similar agreement was reported using ICC by Diniz et al [2011]. For Inspektor TM Pro, this study reported findings lower than those reported by Yin et al [2007]. However, repeatability variation among examiners may have been affected by the fact that each examiner analyzed their own set of different images, adding a layer of variation.…”

“…However, repeatability variation among examiners may have been affected by the fact that each examiner analyzed their own set of different images, adding a layer of variation. If the analyses of the Inspektor TM Pro images had been made by a single trained analyst, the variation could have potentially been smaller [Yin et al, 2007]. Nevertheless, more studies are needed to assess the reliability of QLF-D Biluminator TM 2 and The Canary System ® .…”

“…QLF Inspektor TM Pro has been reported to have a strong correlation with histological validation [Shi et al, 2001;Gomez et al, 2013]. It has been correlated with treatment decisions of clinicians for operative intervention [Alammari et al, 2013] and was found reproducible among examiners [Tranaeus et al, 2002;Yin et al, 2007]. However, developmental defects, fluorosis, hypocalcification, and stain may resemble the appearance of caries lesions on fluorescence images [Alammari et al, 2013].…”

Methods Used by Dental Practice-based Research Network (DPBRN) Dentists to Diagnose Dental Caries

“…Various levels of sensitivity have been reported for DIAGNOdent34, 45-50 and FOTI44, 51-53 for the diagnosis of occlusal and proximal dental caries. The strength of the evidence however, is low as the available literature is insufficient to support generalizable estimates of the sensitivity and specificity studies of these diagnostic methods.…”

Reliability and validity of FluoreCam for white‐spot lesion detection: An in vitro study

“…The optical changes are directly related with the mineral content of the enamel. The QLF system provides three measures: demineralized surface area in mm 2 , ΔF (% fluorescence intensity loss), and ΔQ (the impact, which is the product of ΔF and area) . Pictorially, the system depicts demineralized areas as being darker than the surrounding healthy enamel during the very early stages .…”