Clinical performance of a new laser fluorescence device for detection of occlusal caries lesions in permanent molars

Huth, K.C.; Neuhaus, K.W.; Gygax, M.; Bücher, K.; Crispin, A.; Paschos, E.; Hickel, R.; Lussi, A.

doi:10.1016/j.jdent.2008.08.013

« Previous Next »Journal of Dentistry
Volume 36, Issue 12 , Pages 1033-1040, December 2008

Clinical performance of a new laser fluorescence device for detection of occlusal caries lesions in permanent molars

K.C. Huth
- Department of Restorative Dentistry, Periodontology and Paediatric Dentistry, Ludwig-Maximilians-University, Munich, Germany
- Corresponding author at: Department of Restorative Dentistry, Periodontology and Pedodontics, Dental School, Ludwig-Maximilians-University, Goethestr. 70, 80336 Munich, Germany. Tel.: +49 89 5160 9411; fax: +49 89 5160 9302.
K.W. Neuhaus
- Department of Preventive, Restorative and Paediatric Dentistry, University of Bern, Switzerland
M. Gygax
- Department of Preventive, Restorative and Paediatric Dentistry, University of Bern, Switzerland
K. Bücher
- Department of Restorative Dentistry, Periodontology and Paediatric Dentistry, Ludwig-Maximilians-University, Munich, Germany
A. Crispin
- Department of Medical Informatics, Biometry & Epidemiology, Ludwig-Maximilians-University, Munich, Germany
E. Paschos
- Department of Orthodontics, Ludwig-Maximilians-University, Munich, Germany
R. Hickel
- Department of Restorative Dentistry, Periodontology and Paediatric Dentistry, Ludwig-Maximilians-University, Munich, Germany
A. Lussi
- Department of Preventive, Restorative and Paediatric Dentistry, University of Bern, Switzerland

Received 21 May 2008; received in revised form 20 August 2008; accepted 26 August 2008.

Abstract

Objectives

To determine the clinical performance of a laser fluorescence device (DIAGNOdent pen, KaVo) to discriminate between different occlusal caries depths (D₀–D_1–4; D_0–2–D_3,4) in permanent molars.

Methods

In this prospective, randomized two-centre-study 120 sound/uncavitated carious sites in 120 patients were measured after visual and radiographic caries assessment. In cases of operative intervention (n=86), the lesion depths after caries removal were recorded (reference). In cases of preventive intervention (n=34), the sites were reassessed visually/radiographically after 12 months to verify the status assessed before (reference). The discrimination performance was determined statistically (Mann–Whitney test, Spearman’s rho coefficient, and areas under the receiver operating characteristic curves (AUCs)). Sensitivities (SE) and specificities (SP) were plotted as a function of the measured values and cut-off values for the mentioned thresholds suggested.

Results

Sound sites (n=13) had significantly minor fluorescence values than carious sites (n=107) (P<0.0001) as had sites with no/enamel caries (n=63) compared to dentinal caries (n=57). The AUCs for the same discriminations were 0.92 and 0.78 (P<0.001). For the D₀–D_1–4 threshold, a cut-off at a value of 12 (SE: 0.88, SP: 0.85) and for the D_0–2–D_3,4 threshold at 25 (SE: 0.67, SP: 0.79) can be suggested. A moderate positive correlation between the measurements and the caries depths was calculated (rho=+0.57, P=0.01).

Conclusion

Within this study, the device’s discrimination performance for different caries depths was moderate to very good and it may be recommended as adjunct tool in the diagnosis of occlusal caries.

Keywords: Occlusal caries, Caries detection, Laser fluorescence, DIAGNOdent pen, Randomized clinical trial, Permanent molars