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What diagnostic strategy performs better for caries lesion detection on proximal surfaces of adolescents?

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Abstract

Objective

To evaluate the performance of visual inspection alone and associated to radiographic and laser fluorescence (LF) methods in detecting non-evident caries lesions at adolescents’ proximal surfaces.

Materials and methods

Adolescents (12 to 17 years old) were assessed for the presence of caries lesions through visual inspection, radiographic examination, and LF method (DIAGNOdent pen), at non-cavitated (NC) and cavitated lesion (CAV) thresholds. Temporary separation with orthodontic rubbers followed by direct visual inspection was the reference standard method. Two examiners conducted the examinations, and the first examiner reassessed around 20% of the sample, to evaluate inter- and intra-examiner reproducibility, respectively. Sensitivity, specificity, accuracy, and utility values were calculated for the methods alone and combined with visual inspection using two different strategies: simultaneous and sequential combination.

Results

A total of 834 proximal surfaces (51 adolescents) were included. Visual inspection presented higher reproducibility values (higher than 0.98). Moreover, visual inspection presented higher sensitivity (around 0.51) than those obtained with other diagnostic strategies (varying from 0.09 to 0.20) at the NC threshold. For CAV, visual inspection presented higher specificity (0.996) than the sequential association with adjunct methods (around 0.97), but with lower sensitivity. Accuracy and utility values for combined strategies were similar or lower than those achieved with the visual inspection performed alone.

Conclusion

Visual inspection alone performs better for detecting caries lesions in premolars and molars of adolescents than other diagnostic strategies.

Clinical relevance

The best diagnostic strategy for caries detection of proximal caries lesions in adolescents is the visual inspection alone.

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Acknowledgments

The authors would like to thank all persons from the Clinics for adolescents of the School of Dentistry, University of São Paulo.

Funding

The study was partially supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). FMM and MMB also receive scholarships as awards for Research Productivity in Brazil from the CNPq.

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Authors and Affiliations

  1. Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil

    Caroline M. Moriyama, Fernanda R. Ferreira, Bruna Lorena P. Moro, José Carlos P. Imparato, Mariana M. Braga & Fausto M. Mendes

  2. School of Dentistry, Metropolitan University of Santos, Av Conselheiro Nebias, 536, Santos, 11045-003, Brazil

    Caroline M. Moriyama

  3. School of Dentistry, Cruzeiro do Sul University, R. Galvao Bueno, 868, São Paulo, 01506-000, Brazil

    Tatiane F. Novaes & Michele B. Diniz

  4. Faculdade de Odontologia da Universidade de São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil

    Fausto M. Mendes

Authors
  1. Caroline M. Moriyama
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  2. Tatiane F. Novaes
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  3. Fernanda R. Ferreira
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  4. Bruna Lorena P. Moro
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  5. José Carlos P. Imparato
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  6. Michele B. Diniz
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  7. Mariana M. Braga
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  8. Fausto M. Mendes
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Corresponding author

Correspondence to Fausto M. Mendes.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The research protocol was submitted and approved by the Research Ethics Committee from the School of Dentistry, University of São Paulo (CAAE # 22114814.3.0000.0075). Moreover, the research was conducted in accordance with the international Helsinki Declaration.

Informed consent

The legal guardians of the study participants signed an inform consent, and the adolescents signed an assent form prior to their inclusion.

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The institutions that supported the study had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Moriyama, C.M., Novaes, T.F., Ferreira, F.R. et al. What diagnostic strategy performs better for caries lesion detection on proximal surfaces of adolescents?. Clin Oral Invest 25, 3977–3986 (2021). https://doi.org/10.1007/s00784-020-03728-0

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  • DOI: https://doi.org/10.1007/s00784-020-03728-0

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