European Archives of Paediatric Dentistry

, Volume 19, Issue 2, pp 83–89 | Cite as

Validation of fluorescence devices for evaluation of white spot lesions in orthodontic patients

  • K. Kavvadia
  • K. Seremidi
  • C. Reppa
  • M. Makou
  • P. Lagouvardos
Original Scientific Article
  • 39 Downloads

Abstract

Aim

To clinically validate the fluorescence devices, DIAGNOdent Pen™ and Vista Proof™ for the evaluation of non-cavitated white spot lesions (WSL) in orthodontic patients and using direct visual examination after the brackets removal, as the gold standard.

Methods

The sample consisted of 31 patients, 13–28 years old, under fixed appliance orthodontic treatment. Teeth (N = 619) were evaluated with the brackets on, after cleaning and air drying, by direct, indirect visual examination and using the DIAGNOdent Pen™ device. After debonding with direct visual examination and the Vista Proof™ device. WSL were scored with the Gorelick Index for visual examination. The fluorescence devices were validated by calculating sensitivity, specificity and accuracy while ROC curves and area under the curve were used for comparison among the examination methods.

Results

Among the different diagnostic methods, visual examination recorded the highest degree of accuracy. The performance of the fluorescence devices was poor compared with that of the visual methods for mild WSL, while for more extended lesions no difference was found. A comparison between the validity of the two devices’ showed no statistically significant difference.

Conclusions

The validity of DIAGNOdent Pen™ and Vista Proof™ for the chairside diagnosis and quantification of non-cavitated WSL in orthodontic patients was moderate, and no better as compared to the visual diagnostic methods. The fluorescence devices performed similarly to the visual examination for more extended WSL and poorer for milder ones. Validity between the two devices did not differ.

Keywords

White spot lesions Fluorescence devices Orthodontic patients Caries diagnosis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Approval was obtained from the ethics committee of the Dental School of the University of Athens (no. 111, 22/01/2009).

Informed consent

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

References

  1. Al Khateeb S, Forsberg CM, de Josselin de Jong E, Angmar-Mansson B. A longitudinal laser fluorescence study of WSL in orthodontic patients. Am J Orthod Dentofac Orthop. 1998;113:595–602.CrossRefGoogle Scholar
  2. Alencar CJ, Braga MM, de Oliveira E, Nicolau J, Mendes FM. Dye-enhanced laser fluorescence detection of caries lesions around brackets. Lasers Med Sci. 2009;24:865–70.CrossRefPubMedGoogle Scholar
  3. Alexander SA. The effect of fixed orthodontic and functional appliances on enamel decalcifications in early class II treatment. Am J Orthod Dentofac Orthop. 1993;103:45–7.CrossRefGoogle Scholar
  4. Aljehani A, Tranaeus S, Forsberg CM, Angmar-Mansson B, Shi XQ. In vitro quantification of white spot enamel lesions adjacent to fixed orthodontic appliances using quantitative light-induced fluorescence and DIAGNOdent. Acta Odontol Scand. 2004;62:313–8.CrossRefPubMedGoogle Scholar
  5. Aljehani A, Yousif MA, Angmar-Mansson B, Shi XQ. Longitudinal quantification of incipient carious lesions in postorthodontic patients using a fluorescence method. Eur J Oral Sci. 2006a;114:430–4.CrossRefPubMedGoogle Scholar
  6. Aljehani A, Bamzahim M, Yousif MA, Shi XQ. In vivo reliability of an infrared fluorescence method for quantification of carious lesions in orthodontic patients. Oral Health Prev Dent. 2006b;4:145–50.PubMedGoogle Scholar
  7. Almosa NA, Lundgren T, Aldrees AM, Birkhed D, Kjellberg H. Diagnosing the severity of buccal caries lesions in governmental and private orthodontic patients at debonding, using the ICDAS-II and the DIAGNOdent Pen. Angle Orthod. 2014;84:430–6.CrossRefPubMedGoogle Scholar
  8. Artun J, Thylstrup A. Clinical and scanning electron microscopic study of surface changes of incipient caries lesions after debonding. Scand J Dent Res. 1986;94:193–201.PubMedGoogle Scholar
  9. Benson PE, Pender N, Higham SM. Quantifying enamel demineralization from teeth with orthodontic brackets—a comparison of two methods. Eur J Orthod. 2003;25:149–58.CrossRefPubMedGoogle Scholar
  10. Benson PE, Shah AA, Willmot DR. Measurement of white lesions surrounding orthodontic brackets: captured slides vs digital camera images. Angle Orthod. 2005;75:226–30.PubMedGoogle Scholar
  11. Boersma JG, van der Veen MH, Lagerweij MD, Bokhout B, Prahl-Andersen B. Caries prevalence measured with QLF after treatment with fixed orthodontic appliances: influencing factors. Caries Res. 2005;39:41–7.CrossRefPubMedGoogle Scholar
  12. Boyle U, Walsh T, Pretty IA, Tickle M. Comparison of photographic and visual assessment of occlusal caries with histology as the reference standard. BMC Oral Health. 2012;12:10.CrossRefGoogle Scholar
  13. De Benedetto MS, Morais CC, Novaes TF, et al. Comparing the reliability of a new fluorescence camera with conventional laser fluorescence devices in detecting caries lesions in occlusal and smooth surfaces of primary teeth. Lasers Med Sci. 2011;26:157–62.CrossRefPubMedGoogle Scholar
  14. Diniz MB, Campos PH, Sanabe ME, et al. Effectiveness of fluorescence-based methods in monitoring progression of noncavitated caries-like lesions on smooth surfaces. Oper Dent. 2015;40:230–41.CrossRefGoogle Scholar
  15. Geiger AM, Gorelick L, Gwinnett AJ, Griswold PG. The effect of a fluoride program on white spot formation during orthodontic treatment. Am J Orthod Dentofac Orthop. 1988;93:29–37.CrossRefGoogle Scholar
  16. Gomez J, Tellez M, Pretty IA, Ellwood RP, Ismail AI. Non-cavitated carious lesions detection methods: a systematic review. Community Dent Oral Epidemiol. 2013;41:54–66.CrossRefPubMedGoogle Scholar
  17. Gorelick L, Geiger AM, Gwinnett AJ. Incidence of white spot formation after bonding and banding. Am J Orthod. 1982;81:93–8.CrossRefPubMedGoogle Scholar
  18. Livas C, Kuijpers-Jagtman AM, Bronkhorst E, Derks A, Katsaros C. Quantification of WSL around orthodontic brackets with image analysis. Angle Orthod. 2007;78:585–90.CrossRefGoogle Scholar
  19. Lopatiene K, Borisovaite M, Lapenaite E. Prevention and treatment of white spot lesions during and after treatment with fixed orthodontic appliances: a systematic literature review. J Oral Maxillofac Res. 2016;7(2):e1.PubMedPubMedCentralGoogle Scholar
  20. Lovrov S, Hertrich K, Hirschfelder U. Enamel demineralization during fixed orthodontic treatment—incidence and correlation to various oral-hygiene parameters. J Orofac Orthop. 2007;68:353–63.CrossRefPubMedGoogle Scholar
  21. Mitchell L. Decalcification during orthodontic treatment with fixed appliances—an overview. Br J Orthod. 1992;19:199–205.CrossRefPubMedGoogle Scholar
  22. Mizrahi E. Surface distribution of enamel opacities following orthodontic treatment. Am J Orthod. 1982;82:62–7.CrossRefPubMedGoogle Scholar
  23. Moriyama CM, Rodrigues JA, Lussi A, Diniz MB. Effectiveness of fluorescence-based methods to detect in situ demineralization and remineralization on smooth surfaces. Caries Res. 2014;48:507–14.CrossRefPubMedGoogle Scholar
  24. Novaes TF, Moriyama CM, De Benedetto MS, et al. Performance of fluorescence-based methods for detecting and quantifying smooth-surface caries lesions in primary teeth: an in vitro study. Int J Paediatr Dent. 2016;26:13–9.CrossRefPubMedGoogle Scholar
  25. Øgaard B, Rǿlla G, Arends J. Orthodontic appliances and enamel demineralization. Part 1: lesion development. Am J Orthod Dentofac Orthop. 1989;94:68–73.CrossRefGoogle Scholar
  26. Rodrigues JA, Hug I, Diniz MB, Lussi A. Performance of fluorescence methods, radiographic examination and ICDAS II on occlusal surfaces in vitro. Caries Res. 2008;42:297–304.CrossRefPubMedGoogle Scholar
  27. Seremidi K, Lagouvardos P, Kavvadia K. Comparative in vitro validation of VistaProof and DIAGNOdent pen for occlusal caries detection in permanent teeth. Oper Dent. 2012;37:234–45.CrossRefPubMedGoogle Scholar
  28. Staudt CB, Lussi A, Jacquet J, Kiliaridis S. WSL around brackets: in vitro detection by laser fluorescene. Eur J Oral Sci. 2004;112:237–43.CrossRefPubMedGoogle Scholar
  29. Twetman S, Axelsson S, Dahlen G, et al. Adjunct methods for caries detection: a systematic review of literature. Acta Odontol Scand. 2013;71:388–97.CrossRefPubMedGoogle Scholar
  30. Van der Veen MH, Mattousch T, Boersma JG. Longitudinal development of caries lesions after orthodontic treatment evaluated by quantitative light-induced fluorescence. Am J Orthod Dentofac Orthop. 2007;131:223–8.CrossRefGoogle Scholar
  31. Willmot DR, Benson PE, Pender N, Brook AH. Reproducibility of quantitative measurement of white enamel demineralisation by image analysis. Caries Res. 2000;34:175–81.CrossRefPubMedGoogle Scholar
  32. Zachrisson BU. Direct bonding in orthodontics. Am J Orthod. 1977;71:173–89.CrossRefPubMedGoogle Scholar
  33. Zachrisson BU, Zachrisson S. Caries incidence and orthodontic treatment with fixed appliances. Scand J Dent Res. 1971;79:183–92.PubMedGoogle Scholar
  34. Zhou XH, Obuchowski NA, McClish DK. Statistical methods in diagnostic medicine. 2nd ed. New York: Wiley; 2011.CrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2018

Authors and Affiliations

  • K. Kavvadia
    • 1
  • K. Seremidi
    • 1
  • C. Reppa
    • 1
  • M. Makou
    • 2
  • P. Lagouvardos
    • 3
  1. 1.Department of Paediatric Dentistry, School of DentistryNational and Kapodistrian University of AthensGoudiGreece
  2. 2.Department of Orthodontics, School of DentistryNational and Kapodistrian University of AthensGoudiGreece
  3. 3.Department of Operative Dentistry, School of DentistryNational and Kapodistrian University of AthensGoudiGreece

Personalised recommendations