Graduate Program in Dentistry, Cruzeiro do Sul University, Rua Galvão Bueno, 868, Liberdade, São Paulo, SP 01506-000, Brazil.
Department of Operative Dentistry and Periodontology, Center of Dental Medicine, University of Freiburg, Hugstetter Strasse 55, Freiburg DE-79106, Germany.
Photodiagnosis Photodyn Ther. 2023 Dec;44:103744. doi: 10.1016/j.pdpdt.2023.103744. Epub 2023 Aug 9.
This study compared the performance of near-infrared light transillumination (NILT; DIAGNOcam [DC]) in detecting occlusal caries lesions in deciduous molars with the performance of the International Caries Detection and Assessment System (ICDAS), digital radiographic method (RX) and laser fluorescence (DIAGNOdent pen [LFpen]).
Fifty-seven extracted deciduous molars with no frank cavitation caries lesions were selected. One site per tooth was evaluated twice each by two examiners using all methods. Then, a histological examination was performed using a stereomicroscope. The performance of the methods was assessed with respect to two thresholds: D (all visible caries lesions affecting enamel) and D (caries lesions extended into dentin).
A weighted kappa and intraclass correlation coefficients were calculated for intra- and inter-observer reproducibilities, varying from 0.31 (RX) to 0.89 (LFpen). The intra-observer reproducibility at D and D thresholds varied from 0.51 (ICDAS) to 0.85 (DC) and from 0.30 (ICDAS) to 1.00 (RX), respectively. The inter-observer reproducibility varied from 0.28 (RX) to 0.47 (DC) and from 0.22 (LFpen) to 0.75 (DC), respectively. At the D threshold, higher sensitivity and accuracy were found for LFpen (0.76/0.71) and ICDAS (0.65/0.66); and higher specificities were found for RX (0.94), DC (0.79), and ICDAS (0.71). At the D threshold, all methods exhibited lower sensitivities (0.13-0.35) and higher specificity, accuracy, and area under the ROC curve values (0.70-1.00). All methods showed a correlation with histological results, especially for ICDAS and DC.
NILT technology (DC) and LFpen exhibited similar performance for the detection of occlusal caries lesions in deciduous molars when compared with ICDAS criteria.
本研究比较了近红外光透射(NILT;DIAGNOcam [DC])检测乳牙咬合面龋损的性能与国际龋病检测与评估系统(ICDAS)、数字射线照相法(RX)和激光荧光(DIAGNOdent pen [LFpen])的性能。
选择 57 颗无明显空洞龋损的离体乳牙,每颗牙的一个部位由两名检查者使用所有方法各检查两次。然后,使用立体显微镜进行组织学检查。使用两种阈值(D,所有可见的龋损累及釉质;D,龋损延伸至牙本质)评估方法的性能。
计算了观察者内和观察者间重复性的加权 Kappa 和组内相关系数,范围为 0.31(RX)至 0.89(LFpen)。D 和 D 阈值下的观察者内重复性分别为 0.51(ICDAS)至 0.85(DC)和 0.30(ICDAS)至 1.00(RX)。观察者间重复性分别为 0.28(RX)至 0.47(DC)和 0.22(LFpen)至 0.75(DC)。在 D 阈值下,LFpen(0.76/0.71)和 ICDAS(0.65/0.66)的敏感性和准确性较高;RX(0.94)、DC(0.79)和 ICDAS(0.71)的特异性较高。在 D 阈值下,所有方法的敏感性(0.13-0.35)较低,特异性、准确性和 ROC 曲线下面积值(0.70-1.00)较高。所有方法均与组织学结果相关,尤其是 ICDAS 和 DC。
与 ICDAS 标准相比,NILT 技术(DC)和 LFpen 对乳牙咬合面龋损的检测具有相似的性能。