Advertisement

Clinical Oral Investigations

, Volume 15, Issue 5, pp 635–641 | Cite as

Performance of laser fluorescence devices, visual and radiographic examination for the detection of occlusal caries in primary molars

  • Klaus W. Neuhaus
  • Jonas Almeida Rodrigues
  • Isabel Hug
  • Herman Stich
  • Adrian Lussi
Original Article

Abstract

The aim of this in vitro study was to compare the performance of two laser fluorescence devices (LF, LFpen), conventional visual criteria (VE), ICDAS and radiographic examination on occlusal surfaces of primary teeth. Thirty-seven primary human molars were selected from a pool of extracted teeth, which were stored frozen at −20°C until use. Teeth were assessed twice by two experienced examiners using laser fluorescence devices (LF and LFpen), conventional visual criteria, ICDAS and bitewing radiographs, with a 2-week interval between measurements. After measurement, the teeth were histologically prepared and assessed for caries extension. The highest sensitivity was observed for ICDAS at D1 and D3 thresholds, with no statistically significant difference when compared to the LF devices, except at the D3 threshold. Bitewing radiographs presented the lowest values of sensitivity. Specificity at D1 was higher for LFpen (0.90) and for VE at D3 (0.94). When VE was combined with LFpen the post-test probabilities were the highest (94.0% and 89.2% at D1 and D3 thresholds, respectively). High values were observed for the combination of ICDAS and LFpen (92.0% and 80.0%, respectively). LF and LFpen showed the highest values of ICC for interexaminer reproducibility. However, regarding ICDAS, BW and VE, intraexaminer reproducibility was not the same for the two examiners. After primary visual inspection using ICDAS or not, the use of LFpen may aid in the detection of occlusal caries in primary teeth. Bitewing radiographs may be indicated only for approximal caries detection.

Keywords

Enamel caries Dentin caries Caries assessment Occlusal caries detection Deciduous molars 

Notes

Declaration of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Marthaler TM (2004) Changes in dental caries 1953–2003. Caries Res 38:173–181PubMedCrossRefGoogle Scholar
  2. 2.
    Pendlebury ME, Horner K, Eaton KA (eds) (2004) Selection criteria for dental radiography. Faculty of General Dental Practice (UK), LondonGoogle Scholar
  3. 3.
    Jablonski-Momeni A, Stachniss V, Ricketts DN, Heinzel-Gutenbrunner M, Pieper K (2008) Reproducibility and accuracy of the ICDAS-II for detection of occlusal caries in vitro. Caries Res 42:79–87PubMedCrossRefGoogle Scholar
  4. 4.
    Ricketts DN, Ekstrand KR, Kidd EA, Larsen T (2002) Relating visual and radiographic ranked scoring systems for occlusal caries detection to histological and microbiological evidence. Oper Dent 27:231–237PubMedGoogle Scholar
  5. 5.
    Ismail AI (2004) Visual and visuo-tactile detection of dental caries. J Dent Res 83 Spec No C:C56-66Google Scholar
  6. 6.
    Rocha RO, Ardenghi TM, Oliveira LB, Rodrigues CR, Ciamponi AL (2003) In vivo effectiveness of laser fluorescence compared to visual inspection and radiography for the detection of occlusal caries in primary teeth. Caries Res 37:437–441PubMedCrossRefGoogle Scholar
  7. 7.
    Nyvad B, Machiulskiene V, Baelum V (1999) Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions. Caries Res 33:252–260PubMedCrossRefGoogle Scholar
  8. 8.
    Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB (2007) The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 35:170–178PubMedCrossRefGoogle Scholar
  9. 9.
    Kühnisch J, Goddon I, Berger S, Senkel H, Bücher K, Oehme T, Hickel R, Heinrich-Weltzien R (2009) Development, methodology and potential of the new Universal Visual Scoring System (UniViSS) for caries detection and diagnosis. Int J Environ Res Public Health 6:2500–2509PubMedCrossRefGoogle Scholar
  10. 10.
    Ismail AI, Sohn W, Lim S, Willem JM (2008) Progression of early carious lesions in children aged 5 years or less. Caries Res 42:226Google Scholar
  11. 11.
    Rodrigues JA, Hug I, Diniz MB, Lussi A (2008) Performance of fluorescence methods, radiographic examination and ICDAS II on occlusal surfaces in vitro. Caries Res 42:297–304PubMedCrossRefGoogle Scholar
  12. 12.
    Diniz MB, Rodrigues JA, Hug I, Cordeiro Rde C, Lussi A (2009) Reproducibility and accuracy of the ICDAS-II for occlusal caries detection. Community Dent Oral Epidemiol 37:399–404PubMedCrossRefGoogle Scholar
  13. 13.
    Lussi A, Imwinkelried S, Pitts N, Longbottom C, Reich E (1999) Performance and reproducibility of a laser fluorescence system for detection of occlusal caries in vitro. Caries Res 33:261–266PubMedCrossRefGoogle Scholar
  14. 14.
    König K, Flemming G, Hibst R (1998) Laser-induced autofluorescence spectroscopy of dental caries. Cell Mol Biol (Noisy-le-grand) 44:1293–1300Google Scholar
  15. 15.
    Kavvadia K, Lagouvardos P (2008) Clinical performance of a diode laser fluorescence device for the detection of occlusal caries in primary teeth. Int J Paediatr Dent 18:197–204PubMedCrossRefGoogle Scholar
  16. 16.
    Rodrigues JA, Diniz MB, Josgrilberg EB, Cordeiro RC (2009) In vitro comparison of laser fluorescence performance with visual examination for detection of occlusal caries in permanent and primary molars. Lasers Med Sci 24:501–506PubMedCrossRefGoogle Scholar
  17. 17.
    Braga M, Nicolau J, Rodrigues CR, Imparato JC, Mendes FM (2008) Laser fluorescence device does not perform well in detection of early caries lesions in primary teeth: an in vitro study. Oral Health Prev Dent 6:165–169PubMedGoogle Scholar
  18. 18.
    Barberia E, Maroto M, Arenas M, Silva CC (2008) A clinical study of caries diagnosis with a laser fluorescence system. J Am Dent Assoc 139:572–579PubMedGoogle Scholar
  19. 19.
    Francescut P, Zimmerli B, Lussi A (2006) Influence of different storage methods on laser fluorescence values: a two-year study. Caries Res 40:181–185PubMedCrossRefGoogle Scholar
  20. 20.
    Lussi A, Reich E (2005) The influence of toothpastes and prophylaxis pastes on fluorescence measurements for caries detection in vitro. Eur J Oral Sci 113:141–144PubMedCrossRefGoogle Scholar
  21. 21.
    Ekstrand KR, Martignon S, Ricketts DJ, Qvist V (2007) Detection and activity assessment of primary coronal caries lesions: a methodologic study. Oper Dent 32:225–235PubMedCrossRefGoogle Scholar
  22. 22.
    Lussi A, Firestone A, Schoenberg V, Hotz P, Stich H (1995) In vivo diagnosis of fissure caries using a new electrical resistance monitor. Caries Res 29:81–87PubMedCrossRefGoogle Scholar
  23. 23.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310PubMedCrossRefGoogle Scholar
  24. 24.
    Alberg AJ, Park JW, Hager BW, Brock MV, Diener-West M (2004) The use of "overall accuracy" to evaluate the validity of screening or diagnostic tests. J Gen Intern Med 19:460–465PubMedCrossRefGoogle Scholar
  25. 25.
    Schulze RK, Nackat D, D'Hoedt B (2004) In vitro carious lesion detection on D-, E-, and F-speed radiographic films. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 97:529–534PubMedCrossRefGoogle Scholar
  26. 26.
    Schulte AG, Wittchen A, Stachniss V, Jacquet W, Bottenberg P (2008) Approximal caries diagnosis after data import from different digital radiography systems: interobserver agreement and comparison to histological hard-tissue sections. Caries Res 42:57–61PubMedCrossRefGoogle Scholar
  27. 27.
    Nair MK, Nair UP (2001) An in-vitro evaluation of Kodak Insight and Ektaspeed Plus film with a CMOS detector for natural proximal caries: ROC analysis. Caries Res 35:354–359PubMedCrossRefGoogle Scholar
  28. 28.
    Kühnisch J, Berger S, Goddon I, Senkel H, Pitts N, Heinrich-Weltzien R (2008) Occlusal caries detection in permanent molars according to WHO basic methods, ICDAS II and laser fluorescence measurements. Community Dent Oral Epidemiol 36:475–484PubMedCrossRefGoogle Scholar
  29. 29.
    Lussi A, Francescut P (2003) Performance of conventional and new methods for the detection of occlusal caries in deciduous teeth. Caries Res 37:2–7PubMedCrossRefGoogle Scholar
  30. 30.
    Attrill DC, Ashley PF (2001) Occlusal caries detection in primary teeth: a comparison of DIAGNOdent with conventional methods. Br Dent J 190:440–443PubMedGoogle Scholar
  31. 31.
    Ketley CE, Holt RD (1993) Visual and radiographic diagnosis of occlusal caries in first permanent molars and in second primary molars. Br Dent J 174:364–370PubMedCrossRefGoogle Scholar
  32. 32.
    Machiulskiene V, Nyvad B, Baelum V (1999) A comparison of clinical and radiographic caries diagnoses in posterior teeth of 12-year-old Lithuanian children. Caries Res 33:340–348PubMedCrossRefGoogle Scholar
  33. 33.
    Ekstrand KR, Ricketts DN, Kidd EA (1997) Reproducibility and accuracy of three methods for assessment of demineralization depth of the occlusal surface: an in vitro examination. Caries Res 31:224–231PubMedCrossRefGoogle Scholar
  34. 34.
    Burin C, Burin C, Loguercio AD, Grande RH, Reis A (2005) Occlusal caries detection: a comparison of a laser fluorescence system and conventional methods. Pediatr Dent 27:307–312PubMedGoogle Scholar
  35. 35.
    European Commission (2004) Radiation protection. European guidelines on radiation protection in dental radiology. Office for Official Publications of the European Communities, LuxembourgGoogle Scholar
  36. 36.
    Lussi A, Hellwig E (2006) Performance of a new laser fluorescence device for the detection of occlusal caries in vitro. J Dent 34:467–471PubMedCrossRefGoogle Scholar
  37. 37.
    Kühnisch J, Bücher K, Henschel V, Hickel R (2007) Reproducibility of DIAGNOdent 2095 and DIAGNOdent Pen measurements: results from an in vitro study on occlusal sites. Eur J Oral Sci 115:206–211PubMedCrossRefGoogle Scholar
  38. 38.
    Huth KC, Neuhaus KW, Gygax M, Bücher K, Crispin A, Paschos E, R. H, Lussi A (2008) Clinical performance of a new laser fluorescence device for detection of occlusal caries lesions at permanent molars. J Dent 35:1033–1040CrossRefGoogle Scholar
  39. 39.
    Fung L, Smales R, Ngo H, Moun G (2004) Diagnostic comparison of three groups of examiners using visual and laser fluorescence methods to detect occlusal caries in vitro. Aust Dent J 49:67–71, quiz 101PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Klaus W. Neuhaus
    • 1
  • Jonas Almeida Rodrigues
    • 1
  • Isabel Hug
    • 1
  • Herman Stich
    • 1
  • Adrian Lussi
    • 1
  1. 1.Department of Preventive, Restorative and Pediatric Dentistry, School of Dental MedicineUniversity of BernBernSwitzerland

Personalised recommendations