scholarly journals Occlusal Caries Detection and Diagnosis Using Visual ICDAS Criteria, Laser Fluorescence Measurements, and Near-Infrared Light Transillumination Images

2019 ◽  
Vol 29 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Melek Tassoker ◽  
Sevgi Ozcan ◽  
Said Karabekiroglu

Objective: Current diagnostic tools for non-cavitated occlusal caries are not very reliable. For this reason, newer systems need to be developed. The aim of this study was to compare the performance of visual inspection (ICDAS-II), laser fluorescence (DIAGNOdent pen), and the near-infrared transillumination technique (DIAGNOcam) in the detection of non-cavitated occlusal caries lesions under clinical and laboratory conditions in 90 third molar teeth planned for extraction. Materials and Methods:Ninety third molar teeth were firstly examined in clinical conditions, scored according to ICDAS-II criteria, and examined with DIAGNOdent pen and DIAGNOcam devices. After finishing the clinical examination, the teeth were re-evaluated shortly after the extractions with the same methods. Then, the teeth were sectioned for histological validation according to Downer’s criteria. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic (ROC) curves were calculated based on the histological results. Results: For the D0–D1–4 threshold, the area under the ROC curve values ranged between 0.754 and 0.881 for all systems. Sensitivity values ranged between 80.5 and 96.1%, and specificity values ranged between 61.5 and 84.6% for the three caries detection methods. DIAGNOcam had the best correlation value (0.616) according to histological observations and demonstrated a sensitivity rate of 96.1%, a specificity rate of 61.5%, and an accuracy rate of 91.1%. Conclusions: DIAGNOcam was found to be the most effective method for the diagnosis of occlusal caries without cavitation in permanent molar teeth.

Author(s):  
Lucila Massu Yoshizaki Akinaga Moreira ◽  
Bruna Cordeiro Amarante ◽  
Bruno Munhoz Marotta ◽  
Christyan Hiroshi Iida ◽  
Danielle Ayumi Nishimura ◽  
...  

Diagnosis of caries lesions consists of visual/tactile methods following the International Caries Detection and Assessment System (ICDAS) and radiographic methods (BW), however these methods have limitations for detecting caries at different depths and locations and is usually influenced by the examiner’s experience. New technologies have emerged to improve caries diagnosis methods, among these are methods that use optical principles to quantify differences between healthy and demineralized tissues, for example: quantitative light- -induced fluorescence (QLF), the “DIAGNOdent” caries detection pen, and VistaProof (fluorescence camera). This literature review aims to provide up-to-date information on the applicability of fluorescence-based methods in the diagnosis of caries. The results show that DIAGNOdent pen was the most effective method for diagnosing caries, wherein some authors indicate that it can be used as the only diagnostic method, but most recommend using it as a complementary method to ICDAS and BW. LFpen must be used in association with ICDAS and 2 articles indicate near-infrared light transillumination (NILT) as a substitute for BW, however there is still a need for further studies to reach a concrete decision. In conclusion, digital methods for the diagnosis of caries are efficient, but they do not replace visual/tactile methods and bitewing radiographs. Therefore, they should be used as a complementary diagnostic method to those already known and widely used and studied.


2021 ◽  
Vol 16 (2) ◽  
pp. 113-126
Author(s):  
Ilham Wan Mokhtar ◽  
Annapurny Venkiteswaran ◽  
Mohd Yusmiaidil Putera Mohd Yusof

Dental caries is a commonly progressive disease that proceeds through various degrees of severity that a dentist can detect. The aims of the in vivo study were to assess the accuracy of the individual model (near-infrared light transillumination [NILT] device, visual and radiographic examinations) in detecting occlusal caries, and to evaluate the performance of visual and NILT device combination for occlusal caries detection in deciding the treatment options. Fifty-two non-cavitated occlusal surfaces from 16 patients were assessed with three different diagnostic devices in random order. Identified lesions were prepared and validated. Logistic regression analysis was performed for each method. The sensitivity and specificity values for each method and the combined models were statistically measured using RStudio version 0.97.551. At the enamel level, visual detection was the most sensitive method (0.88), while NILT was the most specific (0.93). NILT scored the highest for sensitivity (0.93) at the dentine level and visual detection scored the highest for specificity (0.88). Visual detection + NILT model was significantly better (p = 0.04) compared to visual detection or NILT alone (df = 1). The visual-NILT combination is a superior model in detecting occlusal caries on permanent teeth. The model provided surplus value in caries detection hence improving the treatment decision-making in occlusal surfaces.


2019 ◽  
Vol 43 (3) ◽  
pp. 173-179
Author(s):  
Murat Ünal ◽  
Arzu Koçkanat ◽  
Seniha Güler ◽  
Esra Gültürk

Aim: This in vitro study was aimed to investigate the performance of the new caries detection tools on the incipient occlusal caries. Study design: In our study, 100 permanent molar teeth, which were considered to have incipient, enamel caries (D1 and D2 threshold values) according to ICDAS II score. After the visual examination, caries measurements have been applied to all teeth by using DIAGNOdent pen (DP), CarieScan PRO (CP) and SoproLife camera (SC). In addition, in vitro examinations were repeated 2 weeks later. After sectioning and evaluation in stereomicroscope, the lesion depth was determined with histological criteria that are accepted for the gold standard for this research. Sensitivity, specificity, accuracy and area under the ROC curve were calculated at D1 and D2 thresholds. The intra-examiners' reproducibility were analysed using Cohen's kappa statistics and intraclass correlation coefficient (ICC). Results: Intra-examiner repeatability values varied from 0.94 to 0.99 and kappa values ranged from 0.90 to 0.99. While the highest sensitivity and specificity value showed for SC at D1 and D2 thresholds, CP presented the lowest values. The area under ROC curves (Az) varied from 0.70 to 0.99. ICDAS II showed the highest area under ROC curves (Az). Conclusions: ICDAS II, visual diagnostic method by itself is considered to sufficient in order to diagnose incipient occlusal caries. SC may be used as an alternative method for the ICDAS II, since its advantages by displaying caries lesion on the computer monitor, follow-up and motivation of the patients provided.


2007 ◽  
Vol 23 (3) ◽  
pp. 307-312 ◽  
Author(s):  
Meryem Toraman Alkurt ◽  
Ilkay Peker ◽  
Hacer Deniz Arisu ◽  
Oya Bala ◽  
Bülent Altunkaynak

2021 ◽  
Vol 17 (14) ◽  
Author(s):  
Rana Kassab ◽  
Nayer Abo Elsaad ◽  
Shiern Badr

Background: There has been an increased incidence of dental caries in children due to recent changes in lifestyle. More sensitive and reproducible diagnostic tools for precise caries detection in children are needed because of the complex occlusal anatomy. Aim: To compare the clinical performance and accuracy of international caries detection and assessment system-II (ICDAS II) versus DIAGNOdent pen and digital bitewing radiograph in the detection of occlusal caries in the primary teeth. Materials and Methods: Fifty children aged 6-11 years were assessed of both gender (29 girls and 21 boys) and 377 occlusal surface of primary teeth were examined by visual ICDAS II, DIAGNOdent pen and digital bitewing radiographic examination at D0 (non caries lesions), D1 (lesions limited to enamel) and D2 (lesions limited to dentin) thresholds. Results: Sensitivity at D0 for ICADS II was 14.23% and 95.95% for DIAGNOdent pen and 87.85% for digital bitewing, radiographs while specificity for both ICADS II and bitewing radiographs were 99.23% but 73.85% for DIAGNOdent pen. At D1, threshold sensitivity of ICADS II and digital bitewing radiographs were higher than DIAGNOdent pen but specificity for bitewing radiographs and DIAGNOdent pen 90.69% - 87.99%. were highly significant than ICADS II At D2, threshold specificity for all diagnostic methods was almost similar with better sensitivity for ICADS II and digital bitewing radiographs. Conclusion: This study showed that ICDAS II, Diagnodent pen, and bitewing radiography are effective for the detection of occlusal caries for primary molars. Digital bitewing radiography correlated stronger with ICDASII than Diagnodent pen and proved to be the best method to detect occlusal lesions within the dentin in primary molars while Diagnodent pen and bitewing radiography are better for detecting enamel caries lesion. In addition, the clinical performance of three diagnostic methods was insufficient to detect occlusal caries lesions separately. Consequently, it is advisable to use a combination of diagnostic methods, especially in unclear cases, as well as in cases of initial lesions and their monitoring.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Timucin Ari ◽  
Nilgun Ari

Early detection of occlusal caries in children is challenging for the dentists, because of the morphology of pit and fissures. The aim of this study was to compare in vitro the diagnostic performance of low-powered magnification with light-emitting diode headlight (LPMLED) using ICDAS-II criteria and AC Impedance Spectroscopy (ACIS) device, on occlusal surfaces of primary molars. The occlusal surfaces of 18 extracted primary molars were examined blindly by two examiners. The teeth were sectioned and examined under light microscopy using Downer’s histological criteria as gold standard. Good to excellent inter- and intraexaminer reproducibility, higher sensitivity, specificity, and AUC values were achieved by LPMLED at D1 threshold. Also the relationship between histology and LPMLED was statistically significant. In conclusion visual aids have the potential to improve the performance of early caries detection and clinical diagnostics in children. Despite its potential, ACIS device should be considered as an adjunct method in detecting caries on primary teeth.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Maria Melo ◽  
Agustin Pascual ◽  
Isabel Camps ◽  
Fadi Ata-Ali ◽  
Javier Ata-Ali

Abstract The objective of this study was to evaluate the clinical ability of Near-Infrared Light-Transillumination (NILT) for approximal dentinal caries detection and to compare with direct digital-radiography (DDR), as well as to determine whether the combination of both techniques improves the diagnostic capacity of the lesions. From 88 patients (over 18 years), 138 posterior teeth (76 molars and 62 premolars), that had approximal caries reached into dentine determined by DDR, were included. Lesion extension and DDR images were scored as follows: D0 = sound surface, D1/D2 = caries restricted to the outer/inner-half of the enamel, and D3/4 = caries restricted to the outer/inner-half of the dentin. Opening of the approximal surface using 0.5 mm-in-diameter diamond-bar was used as gold-standard. The lesion extension was then determined by the following criteria: no dentinal caries (D0/1/2) or dentinal caries (D3/4). Seventy-one lesions were D3 and 67 lesions were D4. Sensitivities of overall/D3/D4 were 98.0/95.7/100.0 (NILT) and 100/100/100 (DDR), respectively. Correlations with gold-standard were 0.92 (NILT) and 0.42 (DDR), respectively. The correlation increased to 0.97 (p = 0.045) on combining NILT and DDR. There was no difference in sensitivity between the methods (p > 0.05); but was differences in the correlation (p < 0.01). It can be concluded that NILT showed sensitivity similar to that of DDR and higher correlation than DDR for approximal dentinal caries detection. Accordingly, it may be used to monitor the progression of caries without exposing the patient to ionizing radiation, this being of particular interest in growing patients and in pregnant women. In this respect, NILT can be an effective diagnostic tool adjunctive to bitewing radiographs in detecting approximal dentinal caries. The combination of NILT and DDR represents an increase in the diagnosis of approximal lesions The proposed diagnostic protocol comprises visual examination, followed by NILT and DDR only if the former technique detects approximal caries.


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