Validity of Soprolife® Camera in Carious Lesion Activity Assessment

Objectives: It is now commonly accepted that caries diagnostic at the lesion level encompasses, beside the detection (presence/absence) and the severity assessment (depth and cavitation), the activity assessment (active/inactive). Several concepts/tools have been described in the literature and/or by manufacturers for the lesion activity assessment (LAA): systems based on visual and tactile criteria, devices based on pH assessment or on optics/light such as the Soprolife® camera.
This present study aims to investigate, ex-vivo, the validity of the Soprolife® camera (sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and positive log-likelihood (PLL)) for LAA in reference to Nyvad criteria as Gold Standard.
Methods:
A total of 121 permanent molars was included. Within the 48 hours after extraction: 1) two trained senor investigators allocated a Nyvad score to each of the 121 occlusal surfaces (consensus was reached in case of disagreement); 2) pictures of the 121 occlusal surfaces were captured using the Soprolife® camera (detection mode). The pictures were shown to 3 examiners who are graduated dentists and who were previously shown the Soprolife® manufacturer recommendations for LAA (active/inactive according to the fluorescence). The 3 examiners were asked to record independently the activity status of each of the 121 occlusal surfaces. Calculations were done using Stata®.
Results: Se was 60.9% [95% CI: 53.7 to 67.9%]; Sp was 73.1% [95% CI: 65.8 to 79.6%]; PPV was 71.8% [95% CI: 64.2 to 78.5%]; NPV was 62.5% [95 % CI: 55.4 to 69.2%] and PLL was 2.3 [95% CI: 1.7 to 3.0].
Conclusions: The present survey, the first of its kind, showed that Soprolife® camera is a promising tool in term of LAA in clinical practice. Nevertheless, further investigations are needed to validate its use.