title: Performance of laser fluorescence devices, visual and radiographic examination for the detection of occlusal caries in primary molars.
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 D(1) and D(3) thresholds, with no statistically significant difference when compared to the LF devices, except at the D(3) threshold. Bitewing radiographs presented the lowest values of sensitivity. Specificity at D(1) was higher for LFpen (0.90) and for VE at D(3) (0.94). When VE was combined with LFpen the post-test probabilities were the highest (94.0% and 89.2% at D(1) and D(3) 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.
authors.affiliation: Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland. klaus.neuhaus@zmk.unibe.ch
authors.forename: Klaus W
authors.initials: KW
authors.lastname: Neuhaus
authors.forename: Jonas Almeida
authors.initials: JA
authors.lastname: Rodrigues
authors.forename: Isabel
authors.initials: I
authors.lastname: Hug
authors.forename: Herman
authors.initials: H
authors.lastname: Stich
authors.forename: Adrian
authors.initials: A
authors.lastname: Lussi
mesh_terms: D019540:Area Under Curve; D003731:Dental Caries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000473:pathology; D003804:Dentin / Q000000981:diagnostic imaging / Q000473:pathology; D005453:Fluorescence; D006801:Humans; D007834:Lasers; D008963:Molar / Q000000981:diagnostic imaging / Q000473:pathology*; D015588:Observer Variation; D010808:Physical Examination / Q000592:standards; D011237:Predictive Value of Tests; D012372:ROC Curve; D016300:Radiography, Bitewing / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014094:Tooth, Deciduous / Q000000981:diagnostic imaging / Q000473:pathology*