Laser fluorescence detection of occlusal caries

This study compared six diagnostic methods with a histologic standard, including diode laser fluorescence, caries detection dye, and an operating microscope.

Diagnosis groups included: visual only (VO); visual and bitewing radiograph (VX); visual, bitewing radiograph and explorer (VXE); Global Protege operating microscope at x10 (S); caries detection dye (CDD); diode laser fluorescence (DLF). Three examiners individually evaluated five independent sites on 29 extracted human molars using the above methods. Teeth were sectioned and evaluated histologically. Response Operating Characteristic (ROC) analysis was used to descriptively and inferentially assess the relationship between occlusal caries and the six diagnostic methods.

In this in vitro study, the resulting AUCs (areas under the ROC curve) showed that the DLF method appeared to be superior, when compared to traditional methods (VO, VX, VXE) and caries detection dye. While caries detection with DLF ranked higher than use of an operating scope, they were not statistically different although the difference tended toward significance (P = 0.0511). Furthermore, the AUC for CDD would be ranked lower in accuracy than the other diagnostic methods tested and could result in over treatment of sound teeth. DLF use offers improved detection of suspected hidden caries that have not become radiographically evident.