Non-cavitated carious lesions detection methods: a systematic review.

Area of Science:

• Dental diagnostics
• Caries detection technology
• Evidence-based dentistry

Background:

• Accurate detection of non-cavitated carious lesions (NCCLs) is crucial for timely intervention.
• Existing diagnostic methods for NCCLs vary in performance and reliability.
• A critical appraisal of current detection techniques is needed to guide clinical practice.

Purpose of the Study:

• To critically appraise the performance of various detection methods for non-cavitated carious lesions (NCCLs).
• To compare the sensitivity, specificity, and reliability of different diagnostic tools.
• To identify promising methods for early caries detection.

Main Methods:

• Systematic literature search of Medline, Cochrane Collaboration, Scielo, and EMBASE.
• Inclusion of 42 studies describing 85 clinical assessments, evaluating Visual (V), Caries Lesion Activity Assessment (CLAA), Laser Fluorescence (LF), Radiographic (R), Fibre-optic Transillumination (FOTI), Electrical Conductance (EC), and Quantitative Light-induced Fluorescence (QLF) methods.
• Histological assessment or clinical/visual validation used as gold standard; sensitivity, specificity, and reliability reported.

Main Results:

• Overall quality of evidence for NCCL detection methods was rated 'poor', except for EC ('fair').
• Sensitivity (SE) and Specificity (SP) values showed wide variations across methods.
• EC (SE: 0.61–0.92, SP: 0.73–1.0) and QLF (SE: 0.82, SP: 0.92) demonstrated promising results for early lesion detection.

Conclusions:

• Significant variability and inconsistency exist in the definition of disease and analytical methods for NCCL detection.
• Electrical Conductance (EC) and Quantitative Light-induced Fluorescence (QLF) are promising for detecting early non-cavitated carious lesions.
• Despite limitations, visual methods remain the standard for clinical assessment in dental practice due to cost and practicality.