scholarly journals Detection Methods for Early Caries Diagnosis: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-13
Author(s):  
Petros Foros ◽  
Elissaios Oikonomou ◽  
Despina Koletsi ◽  
Christos Rahiotis

The aim was to appraise the evidence on the performance of various means for the detection of incipient caries in vivo. Five databases of published and unpublished research were searched for studies from January 2000 to October 2019. Search terms included “early caries” and “caries detection.” Inclusion criteria involved diagnostic test accuracy studies for early caries detection in permanent and primary teeth. A risk-of-bias assessment was performed using the QUADAS-2 tool. We performed the study selection, data extraction, and risk-of-bias assessment in duplicate. The review protocol was a priori registered in the Open Science Framework. Of the initially 22,964 search results, 51 articles were included. For permanent teeth, when histologic examination was considered as the reference for occlusal surfaces, the sensitivity (Se) range appeared high for the DIAGNOdent Pen (DD Pen) at 0.81–0.89, followed by ICDAS-II at 0.62–1, DIAGNOdent (DD) at 0.48–1, and bitewing radiography (BW) at 0–0.29. The corresponding specificity (Sp) range was: DD Pen 0.71–0.8, ICDAS-II 0.5–0.84, DD 0.54–1, and BW 0.96–1. When operative intervention served as the reference for occlusal surfaces, again, the DD means valued the most promising results on Se: DD 0.7–0.96 and DD Pen 0.55–0.90, followed by ICDAS-II 0.25–0.93, and BW 0–0.83. The Sp range was: DD 0.54–1, DD Pen 0.71–1, ICDAS-II 0.44–1, and BW 0.6–1. For approximal surfaces, the Se was: BW 0.75–0.83, DD Pen 0.6, and ICDAS-II 0.54; the Sp was: BW 0.6–0.9, DD Pen 0.2, and ICDAS-II 1. For primary teeth, under the reference of histologic assessment, the Se range for occlusal surfaces was: DD 0.55–1, DD Pen 0.63–1, ICDAS-II 0.42–1, and BW 0.31–0.96; the respective Sp was: DD 0.5–1, DD Pen 0.44–1, ICDAS-II 0.61–1, and BW 0.79–0.98. For approximal surfaces, the Se range was: DD Pen 0.58–0.63, ICDAS-II 0.42–0.55, and BW 0.14–0.71. The corresponding Sp range was: DD Pen 0.85–0.87, ICDAS-II 0.73–0.93, and BW 0.79–0.98. Se and Sp values varied, due to the heterogeneity regarding the setting of individual studies. Evidently, robust conclusions cannot be drawn, and different diagnostic means should be used as adjuncts to clinical examination. In permanent teeth, visual examination may be enhanced by DD on occlusal surfaces and BW on approximal surfaces. In primary teeth, DD Pen may serve as a supplementary tool across all surfaces.

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.


2016 ◽  
Vol 17 (9) ◽  
pp. 774-779 ◽  
Author(s):  
Sophie Doméjean ◽  
Julie Rongier ◽  
Michèle Muller-Bolla

ABSTRACT Aim The aim of this systematic review was to assess the in vivo scientific evidence regarding the ability of a recently developed light fluorescence device, SoproLife® (Sopro-Acteon group, La Ciotat, France) in detecting occlusal carious lesions. The PubMed database was searched for in vivo trials that evaluated the validity of the SoproLife® camera for the detection of occlusal carious lesions. Among the 11 articles originally identified with the keyword “Soprolife,” only three articles were included. The three included surveys used the International Caries Detection and Assessment System (ICDAS)-II criteria as gold standard for the assessment of SoproLife® compared or not to other detection devices (DIAGNOdent® and Spectra Caries Detection Aid®). Two of the included studies reported only on permanent teeth or both primary and permanent teeth. The SoproLife® validity values varied markedly among studies with a sensitivity ranging between 0.43 and 0.95 and a specificity between 0.55 and 1. Interobserver reproducibility with the SoproLife® was reported in two of the three studies (0.98 and 0.72) and none of the studies reported about intraobserver reproducibility. No clear-cut conclusion can be made based on the three included clinical studies; further in vivo investigations are needed to confirm the validity of the SoproLife® camera in terms of detection of occlusal carious lesions. How to cite this article Doméjean S, Rongier J, Muller-Bolla M. Detection of Occlusal Carious Lesion using the SoproLife® Camera: A Systematic Review. J Contemp Dent Pract 2016;17(9):774-779.


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.


2021 ◽  
Vol 27 (2) ◽  
pp. 146045822110075
Author(s):  
Duc Long Duong ◽  
Malitha Humayun Kabir ◽  
Rong Fu Kuo

Untreated caries is significant problem that affected billion people over the world. Therefore, the appropriate method and accuracy of caries detection in clinical decision-making in dental practices as well as in oral epidemiology or caries research, are required urgently. The aim of this study was to introduce a computational algorithm that can automate recognize carious lesions on tooth occlusal surfaces in smartphone images according to International Caries Detection and Assessment System (ICDAS). From a group of extracted teeth, 620 unrestored molars/premolars were photographed using smartphone. The obtained images were evaluated for caries diagnosis with the ICDAS II codes, and were labeled into three classes: “No Surface Change” ( NSC); “Visually Non-Cavitated” ( VNC); “Cavitated” ( C). Then, a two steps detection scheme using Support Vector Machine (SVM) has been proposed: “ C versus (VNC  +  NSC)” classification, and “ VNC versus NSC” classification. The accuracy, sensitivity, and specificity of best model were 92.37%, 88.1%, and 96.6% for “ C versus (VNC  +  NSC),” whereas they were 83.33%, 82.2%, and 66.7% for “ VNC versus NSC.” Although the proposed SVM system required further improvement and verification, with the data only imaged from the smartphone, it performed an auspicious potential for clinical diagnostics with reasonable accuracy and minimal cost.


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.


2019 ◽  
Vol 8 (6) ◽  
Author(s):  
Ana Luzia Araújo Batista ◽  
Thamyres Maria Silva Simões ◽  
Maria das Graças Barbosa da Silva ◽  
Maria Helena Chaves de Vasconcelos Catão

Nas últimas décadas, um dos grandes avanços na Área da Saúde foi o desenvolvimento dos aparelhos de Laser, que possibilitou uma nova abordagem nos procedimentos odontológicos. A Laserterapia tem diversas aplicabilidades na Cariologia, seja como método de diagnóstico, como auxiliar nas medidas preventivas ou como tratamento da cárie dentária. Portanto, o objetivo desta revisão é proporcionar uma leitura atualizada da aplicabilidade da Laserterapia na Cariologia e, para tanto, foi realizada uma revisão literária sistematizada, na base de dados MEDLINE – Pubmed, abrangendo os últimos anos. Mediante esse estudo literário e considerando a evolução dos estudos científicos, ainda existem controvérsias a respeito da eficácia clínica do Laser na Cariologia.Descritores: Lasers; Cárie Dentária; Flúor.ReferênciasSichani AV, Javadinejad S, Ghafari R. Diagnostic value of DIAGNOdent in detecting caries under composite restorations of primary molars. Dent Res J. 2016;13(4):327-32.Montedori A, Abraha I, Orso M, D'errico PG, Pagano S, Lombardo G. Lasers for caries removal in deciduous and permanent teeth. Cochrane Database Syst Rev. 2016;26(9):CD010229.Nagata JY, Hioka N, Kimura E, Batistela VR, Terada RS, Graciano AX et al. Antibacterial photodynamic therapy for dental caries: evaluation of the photosensitizers used and light source properties. Photodiagnosis Photodyn Ther. 2012;9(2):122-31.Bahrololoomi Z, Fotuhi  Ardakani F, Sorouri M. In vitro comparison of the effects of diode laser and co2 laser on topical fluoride uptake in primary teeth. J Dent (Tehran). 2015;12(8):585-91.Nokhbatolfoghahaie H, Alikhasi M, Chiniforush N, Khoei F, Safavi N, Yaghoub Zadeh B. Evaluation of Accuracy of DIAGNOdent in Diagnosis of Primary and Secondary Caries in Comparison to Conventional Methods. J Lasers Med Sci. 2013; 4(4):159-67.Melo M, Pascual A, Camps I, Del Campo Á, Ata-Ali J. Caries diagnosis using light fluorescence devices in comparison with traditional visual and tactile evaluation: a prospective study in 152 patients. Odontology. 2017;105(3):283-90.Gimenez T, Braga MM, Raggio DP, Deery C, Ricketts DN, Mendes FM. Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of heterogeneity. PLoS One. 2013;8(4):e60421.Kositbowornchai S, Sukanya C, Tidarat T, Chanoggarn T. Caries detection under composite restorations by laser fluorescence and digital radiography. Clin Oral Investig. 2013; 17(9):2079-84.Rosa MI, Schambeck VS, Dondossola ER, Alexandre MC, Tuon L, Grande AJ, Hugo F. Laser fluorescence of caries detection in permanent teeth in vitro: a systematic review and meta-analysis. J Evid Based Med. 2016;  9(4):213-24.Heravi F, Ahrari F, Mahdavi M, Basafa S. Comparative evaluation of the effect of Er:YAG laser and low level laser irradiation combined with CPP-ACPF cream on treatment of enamel caries. J Clin Exp Dent. 2014;6(2):e121-26.Mang TS, Tayal DP, Baier R. Photodynamic therapy as an alternative treatment for disinfection of bacteria in oral biofilms. Lasers Surg Med. 2012;44(7):588-96.Fornaini C, Brulat N, Milia G, Rockl A, Rocca JP. The use of sub-ablative Er:YAG laser irradiation in  prevention of dental caries during orthodontic treatment. Laser Ther. 2014;23(3):173-81.Karandish M. The efficiency of laser application on the enamel surface: a systematic review. J Lasers Med Sci. 2014;5(3):108-14.Twetman S, Axelsson S, Dahlén G, Espelid I, Mejàre I, Norlund A et al. Adjunct methods for caries detection: a systematic review of literature. Acta Odontol Scand. 2013;71(3-4):388-97.Bahrololoomi Z, Lotfian M. Effect of diode laser irradiation combined with topical fluoride on enamel microhardness of primary teeth. J Dent (Tehran). 2015;12(2):85-9.Ramos-Oliveira TM, Ramos TM, Esteves-Oliveira M, Apel C, Fischer H, Eduardo CP et al. Potential of CO2 lasers (10.6 µm) associated with fluorides in inhibiting human enamel erosion. Braz Oral Res. 2014;28(1):1-6.Souza-Gabriel AE, Turssi CP, Colucci V, Tenuta LM, Serra MC, Corona SA. In situ study of the anticariogenic potential of fluoride varnish combined with CO2 laser on enamel. Arch Oral Biol. 2015;60(6):804-10.


2020 ◽  
Vol 10 (1) ◽  
pp. 5 ◽  
Author(s):  
Ariana M. Kelly ◽  
Anna Kallistova ◽  
Erika C. Küchler ◽  
Helena F. Romanos ◽  
Andrea Lips ◽  
...  

Objectives: The hierarchical structure of enamel gives insight on the properties of enamel and can influence its strength and ultimately caries experience. Currently, past caries experience is quantified using the decayed, missing, filled teeth/decayed, missing, filled surface (DMFT/DMFS for permanent teeth; dmft/dmfs for primary teeth), or international caries detection and assessment system (ICDAS) scores. By analyzing the structure of enamel, a new measurement can be utilized clinically to predict susceptibility to future caries experience based on a patient’s individual’s biomarkers. The purpose of this study was to test the hypothesis that number of prisms by square millimeter in enamel and average gap distance between prisms and interprismatic areas, influence caries experience through genetic variation of the genes involved in enamel formation. Materials and Methods: Scanning electron microscopy (SEM) images of enamel from primary teeth were used to measure (i) number of prisms by square millimeter and interprismatic spaces, (ii) prism density, and (iii) gap distances between prisms in the enamel samples. The measurements were tested to explore a genetic association with variants of selected genes and correlations with caries experience based on the individual’s DMFT+ dmft score and enamel microhardness at baseline, after an artificial lesion was created and after the artificial lesion was treated with fluoride. Results: Associations were found between variants of genes including ameloblastin, amelogenin, enamelin, tuftelin, tuftelin interactive protein 11, beta defensin 1, matrix metallopeptidase 20 and enamel structure variables measured (number of prisms by square millimeter in enamel and average gap distance between prisms and interprismatic areas). Significant correlations were found between caries experience and microhardness and enamel structure. Negative correlations were found between number of prisms by square millimeter and high caries experience (r value= −0.71), gap distance between prisms and the enamel microhardness after an artificial lesion was created (r value= −0.70), and gap distance between prisms and the enamel microhardness after an artificial lesion was created and then treated with fluoride (r value= −0.81). There was a positive correlation between number of prisms by square millimeter and prism density of the enamel (r value = 0.82). Conclusions: Our data support that genetic variation may impact enamel formation, and therefore influence susceptibility to dental caries and future caries experience. Clinical Relevance: The evaluation of enamel structure that may impact caries experience allows for hypothesizing that the identification of individuals at higher risk for dental caries and implementation of personalized preventative treatments may one day become a reality.


2009 ◽  
Vol 2009 ◽  
pp. 1-7 ◽  
Author(s):  
Anahita Jablonski-Momeni ◽  
David N. J. Ricketts ◽  
Monika Heinzel-Gutenbrunner ◽  
Richard Stoll ◽  
Vitus Stachniss ◽  
...  

Carious lesions can occur at different sites on the occlusal surfaces of teeth and may differ in appearance and severity. This study aimed to evaluate how estimates of reproducibility and accuracy of ICDAS-II were affected when all lesions on occlusal surfaces, or only a representative lesion, were scored. 100 permanent teeth with 1–4 investigation sites on the occlusal surface were examined visually by four examiners. Serial sections of the teeth were assessed for lesion depth. Intra- and interexaminer reproducibility (weighted kappa values), sensitivity, and specificity were calculated for all investigation sites and for a randomly selected site per tooth. Comparing the kappa values for the whole sample and the independent sites, no effect or only a small effect was found. Comparing the areas under the ROC-curves no effect could be shown. Examining multiple sites on teeth leads to results comparable to when a single independent site is chosen per tooth.


Author(s):  
Marta Mazur ◽  
Maciej Jedliński ◽  
Artnora Ndokaj ◽  
Denise Corridore ◽  
Antonello Maruotti ◽  
...  

Background: Early diagnosis of occlusal caries is of paramount importance for a minimally invasive approach in dentistry. The aim of the present in vivo clinical prospective study was to compare the diagnostic outcomes of visual subjective evaluation between the International Caries Detection and Assessment System (ICDAS-II) and an intraoral fluorescence-based camera (VistaCam iX Proof, Dürr Dental, Bietigheim-Bissingen, Germany) for the detection of pits and fissures in early caries lesions of posterior teeth. Methods: The study included 1011 posterior teeth in 255 patients aged 13–20 years (mean age 16 ± 2.2 years). Two blinded operators evaluated all the occlusal surfaces and the first assigned an ICDAS-II code, while the second assessed the VistaCam score: sound enamel (score 0–1.2); initial enamel decay (score 1.2–1.5); dentine caries (score 1.5–3). Results: Some 283 (28%) of the assessed teeth were ICDAS-II code 0; 334 (33%) code 1; 189 (18.7%) code 2; 176 (17.4%) code 3; and 29 (2.9%) code 4. The level of agreement between the two procedures was expressed by using Cohen’s and Fleiss’ kappa statistics and performing McNemar’s test. VistaCam assessed in 513 (50.7%) sound enamel; in 292 (28.9%) initial enamel decay; and in 206 (20.4%) dentine caries. Conclusions: This comparative study showed a poor agreement between the two diagnostic methods, especially between ICDAS-II 0, 1 and 2 codes and fluorescence assessments.


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