The intra- and inter-examiner reliability of quantitative light-induced fluorescence (QLF) analyses

Pretty, I. A.; Hall, A.F.; Smith, Patrick W.; Edgar, W.M.; Higham, Susan

doi:10.1038/sj.bdj.4801496a

Cited by 14 publications

(22 citation statements)

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“…The metric output of the proprietary QLF software is highly robust, following both intra-and inter-examiner reliability testing [Angmar-Mänsson and ten Bosch, 2001;Pretty et al, 2002;Tranaeus et al, 2002]. However, the decision to exclude a border is highly subjective and is based on an examiner's assessment of where the borders of the lesion can be seen, the best placement of the analysis patch and the subsequent reconstruction.…”

Section: Discussionmentioning

confidence: 99%

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

Yin

Feng

et al. 2007

Caries Res

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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.

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Section: Discussionmentioning

confidence: 99%

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

Yin

Feng

et al. 2007

Caries Res

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“…A study performed looking at the reliability and effect of subjectivity on QLF analyses found that both intra-and inter-examiner reproducibility was high when assessing in vitro caries lesions. 18 The assessment of stain reduction is simpler, and it is reasonable to extrapolate these results to the reliability of stain assessment. Reliability can also be increased by using multiple examiners or repeated measures by the same examiner.…”

Section: Researchmentioning

confidence: 99%

“…Reliability can also be increased by using multiple examiners or repeated measures by the same examiner. 18 QLF presents an expeditious, user-friendly, economical and resilient method of assessing stain reduction. The data produced can be archived and the ability to blind examiners and conduct repeated analysis of the images strengthens studies employing QLF.…”

Section: Researchmentioning

confidence: 99%

The use of QLF to quantify in vitro whitening in a product testing model

2001

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RESEARCHaesthetic dentistry to practitioners, many do not offer such procedures. Patients must therefore use 'at-home' products to achieve tooth colour change, typically through the removal of extrinsic stain. The majority of these products are marketed as tooth-whitening dentifrices.The causes of extrinsic tooth staining are complex and have been covered in the literature recently. 4 The method of action of these pastes is believed to be a combination of mechanical and chemical effects. 5 Research has assessed both of these modalities, with the current study concentrating on the chemical properties. 6 In order to properly assess these toothpastes a number of studies have been performed. One of the most comprehensive was by Sharif et al. 5 The techniques used in Sharif's paper were developed by Addy and involve the use of stained Perspex with spectrophotometer analysis. 7 The strengths of such a technique include the ability to control the application of the stain, the exposure of the test product to the specimen and also to longitudinally monitor any reduction in stain.However, it would be ideal to retain these experimental strengths while using a more authentic stained substrate, human enamel. Using a new technology for the detection of early carious lesions, the current study describes such a technique. Quantitative light-induced fluorescence (QLF)The detection of very early (and hence reversible) carious lesions by optical methods has been a major research focus of cariologists. 8 One of the most promising devices is the QLF (Inspektor Research Systems BV, NL). 9,10 The underlying principle of the QLF technique is that teeth will auto-fluorescence under certain light conditions, and that demineralised enamel will fluoresce less than sound enamel. When examined under the QLF, demineralised lesions appear as dark areas. With analytical software, the loss of fluorescence characteristic of demineralised areas can be compared with the unaffected fluorescence of the sound enamel and a quantifiable value, ∆Q, reported. Developed from early experimentation with lasers, the QLF device has been the subject of numerous validation articles. 11,12 The QLF handpiece is shown in Figure 1. QLF and staining Amaechi has described the potential for QLF to quantify stain removal. 13 The stain produced on the teeth appears on the QLF image in a similar manner to demineralised lesions. The analytical software is able to compare the stained enamel to adjacent unstained enamel in the same way as demineralised and sound enamel is compared. This study furthers the initial work by incorporating it into a product-testing model. By employing this mechanism a longitudinal and quantifiable analysis of stain reduction on human enamel specimens is possible. Materials and methodsA total of 11 previously extracted human mandibular third molars were selected. Buccal surfaces were devoid of intrinsic stain, enamel cracks or fractures, caries or other enamel defects. The teeth were gently pumiced and their buccal surfaces gently abraded with wet...

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“…A ocorrência de cáries resulta em aumento da quantidade de água na estrutura, e também no aumento do coeficiente de espalhamento da luz na região da lesão em relação ao tecido sadio (PRETTY et al, 2002). O coeficiente de espalhamento aumentado causa a diminuição da fluorescência predominantemente devido ao bloqueio da fluorescência originária da dentina e da junção amelo-dentinária (DE JOSSELIN DE JONG et al, 1995;TRANAEUS et al, 2002).…”

Section: Quantificação Da Fluorescência Induzida Por Luz (Qlf)unclassified

“…Além disso, as imagens e as mensurações de todos os grupos foram realizadas por um único operador cego quanto aos grupos em estudo e treinado para a realização das avaliações segundo os padrões sugeridos por Pretty e colaboradores (PRETTY et al, 2002). Essas medidas foram tomadas para se reduzir a probabilidade de viés (bias) do operador durante as avaliações e também garantir que as decisões subjetivas implícitas ao método fossem baseadas em padrões e regras objetivos (SPITZER;TEN BOSCH, 1977; TEN BOSCH; VAN DER MEI;BORSBOOM, 1984).…”

Section: Influência Da Duração De Pulso -Análises De Pl E Mevunclassified

Avaliação de diferentes parâmetros para irradiação do esmalte dental com o laser de CO2 visando a redução da desmineralização

Oliveira¹

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The intra- and inter-examiner reliability of quantitative light-induced fluorescence (QLF) analyses

Abstract: This study has demonstrated that the analysis stage of QLF is reliable between examiners and within multiple attempts by the same examiner, when analysing in vitro lesions. Novices at the technique should be trained before analysing experimental data.

Cited by 14 publications

References 1 publication

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

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

The use of QLF to quantify in vitro whitening in a product testing model

Avaliação de diferentes parâmetros para irradiação do esmalte dental com o laser de CO2 visando a redução da desmineralização

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