Comparison Between Detection of Orthodontic-Related Carious Lesions With Fluorescence or Visual Method: A Systematic...

Area of Science:

• Dental diagnostics
• Cariology
• Orthodontics

Background:

• Carious lesions are a common complication during fixed orthodontic treatment.
• Early detection of demineralization is crucial for effective management.
• Visual clinical examination (VCE) has limitations in detecting early-stage lesions.

Purpose of the Study:

• To compare the efficacy of digital fluorescent methods (DFMs) with VCE for detecting carious lesions in patients with orthodontic appliances.
• To evaluate the diagnostic performance of DFMs in identifying non-cavitated carious lesions.

Main Methods:

• A systematic literature search was conducted across five databases and grey literature up to January 2023.
• Included studies compared at least one DFM with VCE in patients treated with fixed orthodontic appliances.
• Risk of bias and certainty of evidence were assessed using QUADAS-2 and GRADE approaches.

Main Results:

• Five cross-sectional studies were synthesized, evaluating 137 to 1653 teeth.
• DFMs provided quantitative data on lesion severity (e.g., fluorescence loss), unlike qualitative VCE.
• The quantitative light-induced fluorescence (QLF) method showed an average fluorescence loss of 12.6% in visually detected lesions.
• Correlation between DIAGNODent and VCE scores ranged from 0.40 to 0.71.
• Studies exhibited a risk of bias with very low certainty of evidence.

Conclusions:

• DFMs demonstrated a similar detection pattern to VCE but identified a greater number of non-cavitated carious lesions.
• DFMs offer advantages such as objective diagnosis and pedagogical value through measurable data display.
• Despite being more time-consuming and costly, DFMs are encouraged for early caries detection in orthodontic patients, with potential cost reduction through technological advancements.