Ku Jason Chi-Kit, Lam Walter Yu-Hang, Li Kar Yan, Hsung Richard Tai-Chiu, Chu Chun-Hung, Yu Ollie Yiru
Faculty of Dentistry, The University of Hong Kong, Hong Kong, S.A.R., PR China.
Department of Computer Science, Hong Kong Chu Hai College, Hong Kong, S.A.R., PR China.
J Dent. 2025 Feb;153:105541. doi: 10.1016/j.jdent.2024.105541. Epub 2024 Dec 22.
To evaluate and compare the accuracy of detection methods for the diagnosis of secondary caries around direct restorations in posterior teeth.
Accuracy parameters including sensitivity, specificity, diagnostic odds ratio (DOR), area under curve (AUC), and partial AUC (pAUC) are generated from studies assessing the accuracy of detection methods for secondary caries.
Publications from PubMed, Web of Science, Scopus, Medline, EMBASE and Cochrane Library databases.
STUDY SELECTION/RESULTS: This review included 25 studies evaluating visual examination (V(laboratory); n = 9 & V(clinical); n = 2), tactile examination (T; n = 3), intra-oral radiography (IR; n = 14), cone-beam computed tomography (CBCT; n = 4), quantitative light-induced fluorescence (QLF; n = 4), laser fluorescence (LF; n = 8) and digital imaging fiber-optic transillumination (DIFOTI; n = 1). The pooled sensitivity [95 % Confidence Interval, CI] and specificity [95 % CI] of detection methods for secondary caries were 0.60[0.45-0.73] and 0.67[0.53-0.78] for V(laboratory); 0.82[0.23-0.99] and 0.77[0.15-0.98] for V(clinical); 0.31[0.25-0.39] and 0.95[0.78-0.99] for T; 0.59[0.52-0.66] and 0.82[0.75-0.88] for IR; 0.61[0.48-0.73] and 0.82[0.64-0.92] for CBCT; 0.71[0.64-0.78] and 0.51[0.40-0.62] for QLF; 0.57[0.43-0.71] and 0.81[0.76-0.85] for LF; and 0.63[0.47-0.76] and 0.95[0.90-0.98] for DIFOTI. DOR values [95 % CI] of the secondary caries detection methods were V(laboratory)-2.88[2.18-3.80]; V(clinical)-16.66[3.84-72.28]; T-6.36[1.12-36.28]; IR-6.55[3.44-12.46]; CBCT-6.18[1.42-26.91]; QLF-2.25[1.39-3.63]; LF-4.86[2.40-9.82]; and DIFOTI-30.00[11.94-75.36], respectively. Respective AUC (pAUC) were V-0.645(0.535); T-0.379(0.315); IR-0.767(0.693); CBCT-0.887(0.820); QLF-0.581(0.633) and LF-0.828(0.590). AUC values were not available for DIFOTI and V(clinical).
Among the seven types of detection method for secondary caries diagnosis, none of the detection methods demonstrate satisfactory accuracy in detecting secondary caries around direct restorations in posterior teeth.
This systematic review provides insights for the clinician and researcher in selecting the clinical detection method for secondary caries diagnosis and facilitates clinical decision making.
评估并比较后牙直接修复体周围继发龋诊断检测方法的准确性。
通过评估继发龋检测方法准确性的研究得出准确性参数，包括灵敏度、特异度、诊断比值比（DOR）、曲线下面积（AUC）和部分曲线下面积（pAUC）。
来自PubMed、科学网、Scopus、Medline、EMBASE和Cochrane图书馆数据库的出版物。
研究选择/结果：本综述纳入了25项评估视觉检查（实验室视觉检查；n = 9，临床视觉检查；n = 2）、触觉检查（T；n = 3）、口内放射摄影（IR；n = 14）、锥形束计算机断层扫描（CBCT；n = 4）、定量光诱导荧光（QLF；n = 4）、激光荧光（LF；n = 8）和数字成像光纤透照（DIFOTI；n = 1）的研究。继发龋检测方法的合并灵敏度[95%置信区间，CI]和特异度[95%CI]分别为：实验室视觉检查为0.60[0.45 - 0.73]和0.67[0.53 - 0.78]；临床视觉检查为0.82[0.23 - 0.99]和0.77[0.15 - 0.98]；触觉检查为0.31[0.25 - 0.39]和0.95[0.78 - 0.99]；口内放射摄影为0.59[0.52 - 0.66]和0.82[0.75 - 0.88]；锥形束计算机断层扫描为0.61[0.48 - 0.73]和0.82[0.64 - 0.92]；定量光诱导荧光为0.71[0.64 - 0.78]和0.51[0.40 - 0.62]；激光荧光为0.57[0.43 - 0.71]和0.81[0.76 - 0.85]；数字成像光纤透照为0.63[0.47 - 0.76]和0.95[0.90 - 0.98]。继发龋检测方法的DOR值[95%CI]分别为：实验室视觉检查 - 2.88[2.18 - 3.80]；临床视觉检查 - 16.66[3.84 - 72.28]；触觉检查 - 6.36[1.12 - 36.28]；口内放射摄影 - 6.55[3.44 - 12.46]；锥形束计算机断层扫描 - 6.18[1.42 - 26.91]；定量光诱导荧光 - 2.25[1.39 - 3.63]；激光荧光 - 4.86[2.40 - 9.82]；数字成像光纤透照 - 30.00[
