Methods: Patients undergoing fixed appliance therapy were invited to participate in the study. Arch wires were removed and ultra-sonic scaling was carried out. A soft bristle tooth brush was given to the patients to remove soft debris. Then an oral examination was carried out using ICDAS II, followed by a separate operator (blinded) who carried out FluoreCam™ readings. Caries detection was only carried out for the buccal aspect that had bonded brackets. For ICDAS, the regions surrounding the brackets were scored together and the other regions were scored separately. The worst score from each of these were recorded as the final score for the tooth.
Results:
Thirty-five participants were enrolled for the study (10 males,25 females) of which 32 had stainless steel brackets, one with a ceramic bracket and two with self-ligating bracket. The FluoreCam™ was able to detect 76 lesions. ICDAS II detected 216 lesions around the brackets and 75 lesions from surfaces beyond the brackets.
Analysis between ICDAS score 2 and dichotomous outcome for FluoreCam™; the sensitivity obtained was 0.91 (0.89-0.92), specificity was 0.63 (0.51-0.73), positive predictive value (PPV) of 0.96 (0.94-0.97), and negative predictive value (NPV) of 0.49(0.40-0.57). For the analysis between ICDAS score 1 and the dichotomous outcome for FluoreCam™; the sensitivity obtained was 0.97 (0.95 – 0.98), the specificity was 0.27 (0.24-0.29), PPV was 0.67 (0.65-0.68) and NPV of 0.84 (0.74-0.91).
Conclusions: The ability to detect caries was more different when the ICDAS scores were divided at 1 when compared to 2. This may reflect the ability of FluoreCam™ and ICDAS to agree better, when the lesions are more obvious.