In vivo performance of a laser fluorescence device for the approximal detection of caries in permanent molars.
OBJECTIVE
The aim of this randomised clinical trial was to investigate if a laser fluorescence device is able to discriminate between sound and carious approximal sites and between enamel and dentinal lesions, as well as to find appropriate cut-off values.


METHODS
One hundred and seventeen sound or uncavitated carious sites in permanent molars were visually and radiographically examined, then either opened or not, after which their laser fluorescence was measured. Forty-three lesions were opened, the caries removed and the clinically identified caries depths were registered in addition to the radiographical scoring. Seventy-four sites were radiographically deemed sound or had enamel caries and were not opened. Here, the radiographical scorings were registered.


RESULTS
Taking the radiographic scoring as gold standard for all investigated approximal sites, sound sites (D(0), n=40) showed significantly lower laser fluorescence measurements than carious sites (D(1-4), n=77) (Mann-Whitney test, P<0.025) suggesting a cut-off at 7 (sensitivity=0.68, specificity=0.7). Comparing measurements of D(0-2) (n=74) and D(3,4) (n=43), the results were also different by a statistically significant amount (P<0.025) and the cut-off calculated to be 16 (sensitivity=0.6, specificity=0.84). A fair positive correlation between laser fluorescence values and radiographical scoring was found (rho=+0.47, P<0.01). Analysing the 43 opened lesions with their clinically found lesion depths as gold standard, there was a fair positive correlation to the laser fluorescence values (rho=+0.34, P=0.03) and a moderately strong correlation to the radiographic scoring (rho=+0.67, P<0.01).


CONCLUSIONS
The device may be an adjunct tool in the approximal detection of caries along with established procedures.
Huth
K C
KC
Department of Restorative Dentistry, Periodontology and Paediatric Dentistry, Dental School, Ludwig-Maximilians-University, Goethestr. 70, 80336 Munich, Germany. khuth@dent.med.uni-muenchen.de
Lussi
A
A
Gygax
M
M
Thum
M
M
Crispin
A
A
Paschos
E
E
Hickel
R
R
Neuhaus
K W
KW
D000293:Adolescent; D000328:Adult; D002648:Child; D003731:Dental Caries / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D005453:Fluorescence; D006801:Humans; D007834:Lasers; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000473:pathology; D015588:Observer Variation; D011862:Radiography, Panoramic; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D055815:Young Adult