In vitro performance of different methods in detecting occlusal caries lesions
Available online 9 November 2012
Abstract
Early
caries detection is essential for the implementation of preventive,
therapeutic and intervention strategies within general dental practice.
Objective: The aim of this study was to compare the in vitro performance
of the International Caries Detection and Assessment System (ICDAS),
Digital Photographs scored with ICDAS (ICDAS photographs), Fibre-Optic
Trans-Ilumination (FOTI), Optical Coherence Tomography (OCT), SoproLife®
camera and two implementations of Quantitative Light-Induced
Fluorescence a commercial (QLF-Inspektor Research systems) and a custom
(QLF-Custom) system, to detect early and intermediate occlusal lesions.
Methods: One hundred and twelve permanent extracted teeth were selected
and assessed with each detection method. Histological validation was
used as a gold standard. The detection methods were compared by means of
sensitivity, specificity, Areas Under Receiver Operating Characteristic
(AUROC) curves for enamel and dentine levels and with the Spearman's
rank correlation coefficient against histology. Results: For any enamel
or dentine caries detection, the AUROC curves ranged from 0.86 (OCT) to
0.98 (ICDAS and ICDAS photographs, SoproLife® camera) and at
the dentine level from 0.83 (OCT) to 0.96 for FOTI. The correlations
with histology ranged between 0.65 (OCT) and 0.88 (ICDAS and FOTI).
Under in vitro conditions, the assessed detection methods showed
excellent intra-examiner reproducibility. All the methods were strongly
correlated with histology (p < 0.01) except OCT which showed a
moderate correlation (0.65). Conclusion: Even though all methods present
similar performance in detecting occlusal caries lesions, visual
inspection seems to be sufficient to be used in clinical practice for
detection and assessment of lesion depth. Other methods may be useful in
monitoring caries lesion behaviour.
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