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

Content Provider	Springer Nature : BioMed Central
Author	Litzenburger, Friederike Schäfer, Gerrit Hickel, Reinhard Kühnisch, Jan Heck, Katrin
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.
Related Links	https://bmcoralhealth.biomedcentral.com/counter/pdf/10.1186/s12903-021-01465-8.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14726831
DOI	10.1186/s12903-021-01465-8
Journal	BMC Oral Health
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2021-03-05
Access Restriction	Open
Subject Keyword	Dentistry Oral and Maxillofacial Surgery Dental caries Occlusal caries Occlusal caries detection Diagnostic imaging Near‐infrared transillumination Bitewing radiography Laser‐fluorescence Alternating current impedance spectroscopy Sensitivity Specificity
Content Type	Text
Resource Type	Article
Subject	Dentistry
Journal Impact Factor	2.6/2023
5-Year Journal Impact Factor	3.2/2023

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