Effectiveness of Different Caries Diagnosis Methods in Cleft Lip/Palate Children

Objectives: To compare the operating microscope and optical fluorescence device as diagnosis methods of caries lesions in cleft and lip palate patients through ICDAS-II system.
Methods: 332 labial, palatal, mesial and distal surfaces of the teeth closest to the cleft area of 6-12 year-old children (mean of 10 years and 8 months-old) at mixed dentition, with complete unilateral cleft lip and palate (right or left), complete bilateral cleft lip and palate, unilateral cleft lip and alveolus (right or left) and bilateral cleft lip and alveolus were assessed. The teeth closest to the cleft area were observed according to the following diagnosis methods: visual-tactile examination (Method 1), visual-tactile examination with the aid of an operating microscope (Method 2), visual examination with the aid of fluorescence device (Method 3). Prior to the assessments, dental surfaces were cleaned by dental floss and dental prophylaxis with pumice and tergentol with the aid of a rubber cup and a WHO dental probe. Then, under light and after 5-second air-drying, the surfaces were evaluated by Methods 1, 2, 3. In all assessments, ICDAS-II scores were used by two examiners previously calibrated and trained (k > 0.85). The diagnosis methods and percentage of each ICDAS-II score were respectively compared among groups by Friedman and Chi-square tests with level of significance of 5%.
Results: No statistically significances were detected among the types (P=0.214) and efficacy (P=0.725) of the different diagnosis methods for the different ICDAS-II scores.
Conclusions: The effectiveness of operating microscope and optical fluorescence examinations were similar to that of unaided visual-tactile clinical examination on teeth closest to cleft area. Further studies comprising greater prevalence of caries lesions are necessary to verify the effectiveness of these new technologies.