Validation of Diagnostic Techniques for the Detection of Early Caries

METHODS: 100 children, 6 to 9 years of age, who were in need of Class I or Class II restorations on primary molars received restorations accordingly. Baseline, 6 months, 12 months, 18 months and 24 months clinical diagnostic data was obtained when evaluating for recurrent caries using DIAGNOdent Laser Fluorescence and Quantitative Light Fluorescence (QLF). At this time, 40 teeth from this study have been collected upon natural exfoliation, sectioned and evaluated for caries using polarized light microscopy.

RESULTS: The 40 exfoliated teeth produced 232 sections to be evaluated by polarized light microscopy. From this evaluation 15 teeth with recurrent caries sites were identified and then compared with the clinical diagnostic data. Thirteen (86.7%) recurrent caries lesions were recorded with intra-oral QLF examination but only 8 (53.3%) were detected with the DIAGNOdent examination. All lesions extending to dentin were diagnosed with both DIAGNOdent and QLF, however, in terms of enamel lesions only 30% were detected using the DIAGNOdent diagnostic technique, while 80% of these lesions were diangosed with the QLF diagnostic system. The smaller the lesion depth, the less likely was the DIAGNOdent examination to be an effective diagnostic technique for recurrent caries.

CONCLUSION: QLF examination was the most effective recurrent caries diagnostic technique evaluated, particularly for minimal enamel lesion depths.

This research was supported by NIH/NIDCR Grant #P01 DE13540-05