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Clinical performance of clinical-visual examination, digital bitewing radiography, laser fluorescence, and near-infrared light transillumination for detection of non-cavitated proximal enamel and dentin caries

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Abstract

The aim of this study was to compare the clinical performance of clinical-visual examination using the International Caries Detection and Assessment System (ICDAS) II, digital bitewing radiography, near-infrared light transillumination (NIR-LT), and laser fluorescence (LF) for the detection of non-cavitated proximal enamel and dentin caries. The study included 335 patients, aged 12–18 years, with no cavities in the posterior teeth. Clinical-visual inspections of 335 non-cavitated proximal caries were performed by two examiners. For enamel caries, clinical validation included a combination of clinical-visual and digital bitewing radiography assessments. For dentin caries, the clinical validation was opening the cavity. The accuracy rate, sensitivity, specificity, predictive values, and areas under receiver operating characteristic curves were determined. The agreement between the examiners’ measurements was calculated using the kappa coefficient. The sensitivity, specificity, and accuracy of the methods were compared using the McNemar test. The significance level was set at p < 0.05. Digital bitewing radiography had the highest sensitivity (0.96) and accuracy (0.96), and LF had the lowest sensitivity (0.38) and accuracy (0.39). After separation of the lesions into enamel and dentin caries, clinical-visual examination had the highest sensitivity (0.98) and accuracy (0.98) for enamel caries, while digital bitewing radiography had the highest sensitivity (0.97) and accuracy (0.97) for dentin caries. The NIR-LT method had a higher sensitivity for enamel caries (0.86). Each method also differed significantly from the others (p < 0.001). Digital bitewing radiography gave the best prediction of proximal enamel and dentin caries. NIR-LT showed good potential for detection of proximal caries.

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References

  1. Takahashi N, Nyvad B (2011) The role of bacteria in the caries process: ecological perspectives. J Dent Res 90(3):294–303

    Article  CAS  Google Scholar 

  2. Baelum V (2010) What is an appropriate caries diagnosis? Acta Odontol Scand 68(2):65–79

    Article  Google Scholar 

  3. Pretty IA, Maupomé G (2004) A closer look at diagnosis in clinical dental practice: part 5. Emerging technologies for caries detection and diagnosis. J Can Dent Assoc 70(8):540 540a-540i

    PubMed  Google Scholar 

  4. Gimenez T, Piovesan C, Braga MM, Raggio DP, Deery C, Ricketts DN et al (2015) Visual inspection for caries detection: a systematic review and meta-analysis. J Dent Res 94(7):895–904

    Article  CAS  Google Scholar 

  5. Machiulskiene V, Nyvad B, Baelum V (2004) Comparison of diagnostic yields of clinical and radiographic caries examinations in children of different age. Eur J Paediatr Dent 5(3):157–162

    PubMed  CAS  Google Scholar 

  6. (2006) The use of dental radiographs: Update and recommendations. J Am Dent Assoc 137(9):1304–1312

  7. LussiA HA, Hug I, Heckenberger H, Megert B, Stich H (2006) Detection of approximal caries with a new laser fluorescence device. Caries Res 40(2):97–103

    Article  Google Scholar 

  8. Moriyama CM, Rodrigues JA, Lussi A, Diniz MB (2014) Effectiveness of fluorescence-based methods to detect in situ demineralization and remineralization on smooth surfaces. Caries Res 48(6):507–514

    Article  CAS  Google Scholar 

  9. 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(4):297–304

    Article  CAS  Google Scholar 

  10. Aljehani A, Yang L, Shi X-Q (2007) In vitro quantification of smooth surface caries with DIAGNOdent and the DIAGNOdent pen. Acta Odontol Scand 65(1):60–63

    Article  Google Scholar 

  11. Mendes FM, Siqueira WL, Mazzitelli JF, Pinheiro SL, Bengtson AL (2005) Performance of DIAGNOdent for detection and quantification of smooth-surface caries in primary teeth. J Dent 33(1):79–84

    Article  Google Scholar 

  12. Söchtig F, Hickel R, Kühnisch J (2014) Caries detection and diagnostics with near-infrared light transillumination: clinical experiences. Quintessence Int 45(6):531–538

    PubMed  Google Scholar 

  13. Abdelaziz M, Krejci I (2015) DIAGNOcam—a near infrared digital imaging transillumination (NIDIT) technology. Int J Esthet Dent 10(1):158–165

    PubMed  Google Scholar 

  14. Kühnisch J, Söchtig F, Pitchika V (2016) In vivo validation of near-infrared light transillumination for interproximal dentin caries detection. Clin Oral Investig 20(4):821–829

    Article  Google Scholar 

  15. Schwendicke F, Splieth C, Breschi L, Banerjee A, Fontana M, Paris S et al (2019) When to intervene in the caries process? An expert Delphi consensus statement. Clin Oral Investig 23(10):3691–3703

    Article  Google Scholar 

  16. Kühnisch J, Ekstrand KR, Pretty I, Twetman S, van Loveren C, Gizani S et al (2016) Best clinical practice guidance for management of early caries lesions in children and young adults: an EAPD policy document. Eur Arch Paediatr Dent 17(1):3–12

    Article  Google Scholar 

  17. Mortensen D, Hessing-Olsen I, Ekstrand KR, Twetman S (2018) In-vivo performance of impedance spectroscopy, laser fluorescence, and bitewing radiographs for occlusal caries detection. Quintessence Int 49(4):293–299

    PubMed  Google Scholar 

  18. World Health Organization (1997) Oral health survey basic methods, 4th edn. WHO, Geneva

    Google Scholar 

  19. 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(3):224–231

    Article  CAS  Google Scholar 

  20. Manji F, Fejerskov O, Baelum V (1989) Pattern of dental caries in an adult rural population. Caries Res 23(1):55–62

    Article  CAS  Google Scholar 

  21. Ozkan G, Guzel KGU (2017) Clinical evaluation of near-infrared light transillumination in approximal dentin caries detection. Lasers Med Sci 32(6):1417–1422

    Article  Google Scholar 

  22. Baltacioglu IH, Orhan K (2017) Comparison of diagnostic methods for early interproximal caries detection with near-infrared light transillumination: an in vivo study. BMC Oral Health 17(1):130

    Article  Google Scholar 

  23. Ekstrand K, Zero DT, Martignon S, Pitts NB (2009) Lesion activity assessment. Monogr Oral Sci 21:63–90

    Article  CAS  Google Scholar 

  24. Zhu W, Zeng N, Wang N (2010) Sensitivity, specificity, accuracy, associated confidence interval and ROC analysis with practical SAS implementations. NESUG Proceedings: Health Care and Life Sciences, Baltimore, Maryland

  25. Florkowski CM (2008) Sensitivity, specificity, receiver-operating characteristic (ROC) curves and likelihood ratios: communicating the performance of diagnostic tests. Clin Biochem Rev 29(Suppl 1):S83–S87

    PubMed  PubMed Central  Google Scholar 

  26. Manton D (2013) Diagnosis of the early carious lesion. Aust Dent J 58(Suppl 1):35–39

    Article  Google Scholar 

  27. Maia A, Karlsson L, Margulis W, Gomes A (2014) Evaluation of two imaging techniques: near-infrared transillumination and dental radiographs for the detection of early approximal enamel caries. Dentomaxillofac Radiol 40(7):429–433

    Article  Google Scholar 

  28. Schwendicke F, Tzschoppe M, Paris S (2015) Radiographic caries detection: a systematic review and meta-analysis. J Dent 43(8):924–933

    Article  Google Scholar 

  29. Diniz MB, Boldieri T, Rodrigues JA, Santos-Pinto L, Lussi A, Cordeiro RC (2012) The performance of conventional and fluorescence-based methods for occlusal caries detection: an in vivo study with histologic validation. J Am Dent Assoc 143(4):339–350

    Article  Google Scholar 

  30. Lussi A, Megert B, Longbottom C, Reich E, Francescut P (2001) Clinical performance of a laser fluorescence device for detection of occlusal caries lesions. Eur J Oral Sci 109(1):14–19

    Article  CAS  Google Scholar 

  31. Casalegno F, Newton T, Daher R, Abdelaziz M, Lodi-Rizzini A, Schürmann F et al (2019) Caries detection with near-infrared transillumination using deep learning. J Dent Res 98(11):1227–1233

    Article  CAS  Google Scholar 

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Acknowledgments

Asst. Prof. Dr. İzgen (Hacıoğulları) KARAKAYA from the Near East University Faculty of Dentistry, Department of Restorative Dentistry is acknowledged for the statistical analyses. Sahin Oter is acknowledged for the technical assistance.

Funding

This prospective clinical study was funded by the Mersin University Unit of Scientific Research Projects (Project number: 2017-1-AP1-2000).

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mersin University, Ciftlikkoy Campus, Yenisehir, 33150, Mersin, Turkey

    Nazan Kocak

  2. Department of Restorative Dentistry, Faculty of Dentistry, Mersin University, Mersin, Turkey

    Esra Cengiz-Yanardag

Authors
  1. Nazan Kocak
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  2. Esra Cengiz-Yanardag
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Contributions

NK contributed in the design of the study, completed the legal allowance procedures, assisted in the clinical setup and execution of the procedures, collected the data, and assisted in the preparation and submission of the article. ECY designed the study, collected the data, analyzed the results with the statistician, and wrote and revised the final manuscript.

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Correspondence to Nazan Kocak.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethical Review Board at the Mersin University (Approval No. 2016/322).

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Informed consent was obtained from all individual participants included in the study.

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Kocak, N., Cengiz-Yanardag, E. Clinical performance of clinical-visual examination, digital bitewing radiography, laser fluorescence, and near-infrared light transillumination for detection of non-cavitated proximal enamel and dentin caries. Lasers Med Sci 35, 1621–1628 (2020). https://doi.org/10.1007/s10103-020-03021-2

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  • DOI: https://doi.org/10.1007/s10103-020-03021-2

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