Performance of a fluorescence device against conventional caries diagnostic methods

Objective: Early caries detection is essential in treatment planning and crucial in discrimination between preventive, therapeutic and intervention decisions in general dental practice. The purpose of the study is to evaluate the efficacy of a laser fluorescence device for caries diagnosis (SOPROLIFE, Sopro - Acteon Group) in caries detection. Thus, ICDAS II scores, digital radiography and SOPROLIFE fluorescence mode (SFM) were compared in detection of occlusal lesions. Tissue examination of sectioned teeth was used as a gold standard for caries detection.

Method: Ninety-six pit or fissure areas were randomly selected on thirty posterior teeth. Specimens were evaluated with a) ICDAS II scores, b) radiographic examination, c) SFM d) tissue examination after sectioning in microtome and were classified in scale 0-4. Score 0 was regarded as healthy for all examination methods. The detection methods were compared by means of sensitivity, specificity, and were correlated against tissue examination.

Result: Intra-rater and inter-rater reliability for radiographic evaluation and SFM evaluation were excellent (p<0.001). Stronger positive correlation was exhibited between ICDAS II scores and SFM (rho=0.688, p<0.001) or between SFM and tissue examination (rho=0.556, p<0.001) than when radiographic evaluation was correlated with the same (rho=0.372, rho=0.395 respectively, p<0.001). Sensitivity and specificity values are as follows:

 

Treatment	Index	Value
ICDAS II	sensitivity	0.91
	specificity	0.57
Radiographic Evaluation	sensitivity	0.54
	specificity	0.24
SOPROLIFE fluorescence mode	sensitivity	0.92
	specificity	0.47

Conclusion: Occlusal imaging with SFM allows for better caries lesion discrimination than radiographic examination, however the camera identifies more precicely a decayed tooth as decayed. Presenting sensitivity and specificity values similar to clinical examination, it cannot replace clinical examination, but it can be regarded as a usefull technological aid in caries diagnosis also helping in monitoring caries lesion behaviour.