Clinical Validation of Caries Detection Methodologies: Preliminary Results

Objective: The objective of this longitudinal two-year clinical validation study is to determine the ability of different technologies to detect primary caries. Methods: The study was initiated with 119 children 8-12 years of age.The deciduous 1st and 2nd molars were examined for caries by several methods: visual examination (VE), quantitative light fluorescence (QLF), infrared laser fluorescence (IR), fiber optic transillumination (FOTI), and digital imaging fiber optic transillumniation (DIFOTI). These examinations were repeated at 6-month intervals. Each method was performed by the same examiner at each examination. Exfoliated teeth were collected from the children, examined again using QLF, sectioned through predetermined sites selected during the visual examination, examined for the presence of caries using polarized light microscopy (PLM), and all data subjected to statistical analysis. The PLM analyses also categorized observed lesions with regard to depth (E1,E2,D1,D2) and extent. Results: The results observed on the first 88 exfoliated teeth indicate that the sensitivity and specificity of the instrumental methods are affected by depth of the lesion determined by PLM. In addition, the sensitivity and specificity of QLF is significantly altered by changes in the threshold selected. When all PLM-detected lesions, regardless of depth or extent, were used the ranking of the detection methods in terms of decreasing sensitivity was: QLF, VE, FOTI, DIFOTI, IR. Conclusion: The ability of different methods for caries detection to accurately identify carious lesions varies significantly and is influenced by the depth and extent of the lesion. Supported by NIH/NIDCR #P01 DE013540