scholarly journals Comparison of novel and established caries diagnostic methods: a clinical study on occlusal surfaces

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Friederike Litzenburger ◽  
Gerrit Schäfer ◽  
Reinhard Hickel ◽  
Jan Kühnisch ◽  
Katrin Heck

Abstract Background The purpose of this prospective clinical diagnostic study with validation was to compare the diagnostic accuracy of near-infrared transillumination (NIRT), laser fluorescence measurement (LF), alternating current impedance spectroscopy (ACIS) and their combinations as adjunct methods to visual examination (VE) for occlusal caries detection using a hybrid reference standard. Methods Ninety-six first and second non-cavitated permanent molars from 76 individuals (mean age 24.2) were investigated using (VE) (ICDAS) and bitewing radiography (BWR), as well as NIRT, LF and ACIS. The findings of BWR and NIRT were evaluated by two examiners while the other examinations were conducted by one calibrated dentist. The hybrid reference standard consisted of non-operative validation based on the results of VE and BWR and operative validation. Statistical analysis included cross-tabulations, calculation of sensitivity, specificity and area under the receiver operating characteristic curve at three diagnostic thresholds: caries in general, enamel caries and dentin caries. Results NIRT, LF and ACIS exhibited high sensitivity for caries in general [1.00 (1.00–1.00), 0.77 (0.65–0.88), 0.75 (0.63–0.87)) and for dentin caries (0.97 (0.91–1.03), 0.76 (0.76–0.90), 0.64 (0.47–0.80)]. Sensitivity values for enamel caries were weak (0.21, 0.11, 0.37). Specificity values did not fall below 0.65 (NIRT) for all categories and methods, except for NIRT at the caries detection threshold (0.27). A combination of LF and ACIS with VE improved the diagnostic performance at the overall and the enamel caries threshold. The other methods showed fair to excellent discrimination at the overall caries threshold (NIRT 0.64, LF 0.89 and ACIS 0.86) and acceptable discrimination at the dentin caries threshold (NIRT 0.82, LF 0.81 and ACIS 0.79). AUROC for enamel caries exhibited the weakest discrimination. Accuracy was 65.6% for VE, 69.8% for BWR, 50.0% for NIRT, 53.1% for LF and 74.0% for ACIS. Reliability assessment for BWR and NIRT showed at least substantial agreements for all analyses. Conclusions The methods, NIRT, LF and ACIS, revealed different potential but no impeccable performance for occlusal caries detection. All are suitable instruments to detect hidden carious lesion in dentin. As auxiliaries to VE, LF and ACIS showed an increase in diagnostic performance.

Author(s):  
Svetlana Kapor ◽  
Mila Janjic Rankovic ◽  
Yegane Khazaei ◽  
Alexander Crispin ◽  
Ina Schüler ◽  
...  

Abstract Aim This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. Materials and methods A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. Results SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. Conclusion The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds. Clinical relevance VE, BW and LF provide acceptable measures for their diagnostic performance on occlusal surfaces, but the results should be interpreted with caution due to the limited data in many categories.


2008 ◽  
Vol 24 (3) ◽  
pp. 295-300 ◽  
Author(s):  
Michele Baffi Diniz ◽  
Jonas de Almeida Rodrigues ◽  
Andréia Bolzan de Paula ◽  
Rita de Cássia Loiola Cordeiro

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 ◽  
Author(s):  
Stavroula Michou ◽  
Mathias S. Lambach ◽  
Panagiotis Ntovas ◽  
Ana R. Benetti ◽  
Azam Bakhshandeh ◽  
...  

Abstract The use of 3D intraoral scanners (IOS) and software that can support automated detection and objective monitoring of oral diseases such as caries, tooth wear or periodontal diseases is increasingly receiving attention from researchers and industry. This study clinically validates an automated caries scoring system for occlusal caries detection and classification, previously developed for an IOS system featuring fluorescence (TRIOS 4, 3Shape TRIOS A/S, Denmark). Four algorithms (ALG1, ALG2, ALG3, ALG4) are assessed for the IOS; the first three are based only on fluorescence information, while ALG4 also takes into account the tooth color information. The diagnostic performance of these automated algorithms is compared with the diagnostic performance of the clinical visual examination, while histological assessment is used as reference. Additionally, possible differences between in vitro and in vivo diagnostic performance of the IOS system are investigated. The algorithms show comparable in vivo diagnostic performance to the visual examination. Only minor differences between their in vitro and in vivo diagnostic performance are noted. This novel IOS system exhibits encouraging performance for clinical application on occlusal caries detection and classification. Different approaches can be investigated for possible optimization of the system.


2008 ◽  
Vol 24 (3) ◽  
pp. 461-461
Author(s):  
Michele Baffi Diniz ◽  
Jonas de Almeida Rodrigues ◽  
Andréia Bolzan de Paula ◽  
Rita de Cássia Loiola Cordeiro

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

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stavroula Michou ◽  
Mathias S. Lambach ◽  
Panagiotis Ntovas ◽  
Ana R. Benetti ◽  
Azam Bakhshandeh ◽  
...  

AbstractThe use of 3D intraoral scanners (IOS) and software that can support automated detection and objective monitoring of oral diseases such as caries, tooth wear or periodontal diseases, is increasingly receiving attention from researchers and industry. This study clinically validates an automated caries scoring system for occlusal caries detection and classification, previously defined for an IOS system featuring fluorescence (TRIOS 4, 3Shape TRIOS A/S, Denmark). Four algorithms (ALG1, ALG2, ALG3, ALG4) are assessed for the IOS; the first three are based only on fluorescence information, while ALG4 also takes into account the tooth color information. The diagnostic performance of these automated algorithms is compared with the diagnostic performance of the clinical visual examination, while histological assessment is used as reference. Additionally, possible differences between in vitro and in vivo diagnostic performance of the IOS system are investigated. The algorithms show comparable in vivo diagnostic performance to the visual examination with no significant difference in the area under the ROC curves ($$p>0.05$$ p > 0.05 ). Only minor differences between their in vitro and in vivo diagnostic performance are noted but no significant differences in the area under the ROC curves, ($$p>0.05$$ p > 0.05 ). This novel IOS system exhibits encouraging performance for clinical application on occlusal caries detection and classification. Different approaches can be investigated for possible optimization of the system.


Sign in / Sign up

Export Citation Format

Share Document