Light-emitting diode and laser fluorescence-based devices in detecting occlusal caries

Area of Science:

• Dental diagnostics
• Caries detection technology
• In vitro studies

Background:

• Accurate detection of occlusal caries is crucial for timely intervention.
• Conventional methods have limitations in early caries detection.
• Novel diagnostic devices, including LED and laser fluorescence, are being developed.

Purpose of the Study:

• To compare the diagnostic performance of two LED devices (Midwest Caries - MID, VistaProof - VP) and two laser fluorescence (LF) devices (DIAGNOdent 2095, DIAGNOdent pen 2190) for detecting occlusal caries in vitro.
• To evaluate the accuracy, specificity, and sensitivity of these devices against histological findings.
• To assess inter- and intra-examiner reliability.

Main Methods:

• Ninety-seven permanent molars were examined twice by two examiners.
• Devices used: two LED (MID, VP) and two LF (LF, LFpen).
• Teeth were histologically prepared and classified for lesion depth (D1 and D3 thresholds).
• Statistical analysis included Spearman's rank correlation and ICC for reliability.

Main Results:

• At the D3 threshold, LF devices showed specificities of 0.88 (LF) and 0.87 (LFpen), and sensitivities of 0.63 for both.
• The MID device demonstrated high specificity (0.94 at D1, 0.90 at D3) but lower sensitivity (0.31 at D1, 0.70 at D3).
• The VP device showed higher sensitivity (0.75 at D1, 0.96 at D3) but lower specificity (0.70 at both thresholds).
• Spearman correlations ranged from 0.51 to 0.58, indicating moderate agreement with histology.
• Inter- and intra-examiner reliability (ICC) was high (0.83-0.90).

Conclusions:

• Laser fluorescence devices are valuable auxiliary tools for caries detection, offering good reproducibility and improved accuracy at the D3 threshold.
• The MID device was insufficient for differentiating sound surfaces from early enamel caries.
• The VP device requires refinement of its cut-off limits for optimal clinical application.