title: Performance of fluorescence-based and conventional methods of occlusal caries detection in primary molars - an in vitro study.
abstract: OBJECTIVE
  This in vitro study aimed to test the performance of fluorescence-based methods in detecting occlusal caries lesions in primary molars compared to conventional methods.
  
  
  METHODS
  Two examiners assessed 113 sites on 77 occlusal surfaces of primary molars using three fluorescence devices: DIAGNOdent (LF), DIAGNOdent pen (LFpen), and fluorescence camera (VistaProof-FC). Visual inspection (ICDAS) and radiographic methods were also evaluated. One examiner repeated the evaluations after one month. As reference standard method, the lesion depth was determined after sectioning and evaluation in stereomicroscope. The area under the ROC curve (Az), sensitivity, specificity, and accuracy of the methods were calculated at enamel (D1) and dentine caries (D3) lesions thresholds. The intra and interexaminer reproducibility were calculated using the intraclass correlation coefficient (ICC) and kappa statistics.
  
  
  RESULTS
  At D1, visual inspection presented higher sensitivities (0.97-0.99) but lower specificities (0.18-0.25). At D3, all the methods demonstrated similar performance (Az values around 0.90). Visual and radiographic methods showed a slightly higher specificity (values higher than 0.96) than the fluorescence based ones (values around 0.88). In general, all methods presented high reproducibility (ICC higher than 0.79).
  
  
  CONCLUSIONS
  Although fluorescence-based and conventional methods present similar performance in detecting occlusal caries lesions in primary teeth, visual inspection alone seems to be sufficient to be used in clinical practice.
authors.affiliation: School of Dentistry, Universidade de São Paulo, São Paulo, Brazil. tatifn@usp.br
authors.forename: Tatiane F
authors.initials: TF
authors.lastname: Novaes
authors.forename: Ronilza
authors.initials: R
authors.lastname: Matos
authors.forename: Thais
authors.initials: T
authors.lastname: Gimenez
authors.forename: Mariana M
authors.initials: MM
authors.lastname: Braga
authors.forename: Monique S
authors.initials: MS
authors.lastname: DE Benedetto
authors.forename: Fausto M
authors.initials: FM
authors.lastname: Mendes
mesh_terms: D003731:Dental Caries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003732:Dental Caries Activity Tests / Q000295:instrumentation* / Q000379:methods; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000473:pathology*; D005453:Fluorescence; D006801:Humans; D008963:Molar / Q000000981:diagnostic imaging; D011861:Radiography, Dental; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014094:Tooth, Deciduous