Histological validation of a laser fluorescence device for occlusal caries detection in primary molars

This was to validate in vitro a laser fluorescence device, DIAGNOdent 2095 - DD, on the detection of occlusal caries in primary molars using the histological examination as the gold standard and to compare the laser fluorescence findings to the results of the conventionally used diagnostic methods.

111 occlusal pits in 24 extracted primary molars were examined for caries by one trained operator (Intra-examiner Reliability K>0.83), using direct visual (DV), indirect visual (IDV), radiographic (XR) and fluorescence (DD) examinations and then the extent of caries was determined histologically. Sensitivity, specificity, accuracy and the area under the ROC curve - AUC were calculated for all methods, using the histological evaluation as the gold standard.

Differences between examination methods were estimated by pair-wise comparison of their respective AUC.

DD's sensitivity for enamel and for dentine lesions respectively was 0.90 and 0.36, its specificity 0.36 and 0.91 and its accuracy 0.61 and 0.65. The DD device exhibited better sensitivity than specificity for enamel lesions and better specificity than sensitivity for lesions into dentine. The DD device was found to have the highest sensitivity for lesions into enamel, specificity and accuracy and as well as the largest AUC compared with all other methods. For lesions into dentine however, according to AUC values the DD was not statistically significant different from the other methods.

Compared with the other methods, the DD had the highest validity for enamel caries while its validity for caries into dentine was not statistical different from the other methods.