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Al Saffan AD. Current Approaches to Diagnosis of Early Proximal Carious Lesion: A Literature Review. Cureus 2023; 15:e43489. [PMID: 37719595 PMCID: PMC10499541 DOI: 10.7759/cureus.43489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Integrating technological tools with clinical visual examination for caries detection and diagnosis can improve preventative measures in dentistry, resulting in decreased treatment expenses and reduced time and costs associated with testing potential anticaries agents. This article provides an overview of the conventional and new emerging modern technologies that can assist dental professionals in the early detection and diagnosis of dental caries. These technologies aid in assessing the progression of carious lesions and monitoring them quantitatively or qualitatively over time. Traditional techniques (visual, tactile, and radiographic) have limitations in diagnosing early proximal caries accurately. Novel methods like fluorescence and transillumination, as well as advanced tools like OCT (optical coherence tomography), laser fluorescence, and QLF (quantitative light-induced fluorescence), are effective for early caries detection. Optical methods like fluorescence and transillumination are particularly successful in identifying initial caries stages. Moreover, this review highlights the clinical relevance of these methods and discusses potential future technologies like terahertz imaging and artificial intelligence (AI)-based approaches.
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Affiliation(s)
- Abdulrahman D Al Saffan
- Preventive Dentistry Department, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, SAU
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Janjic Rankovic M, Kapor S, Khazaei Y, Crispin A, Schüler I, Krause F, Ekstrand K, Michou S, Eggmann F, Lussi A, Huysmans MC, Neuhaus K, Kühnisch J. Systematic review and meta-analysis of diagnostic studies of proximal surface caries. Clin Oral Investig 2021; 25:6069-6079. [PMID: 34480645 PMCID: PMC8531083 DOI: 10.1007/s00784-021-04113-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 07/29/2021] [Indexed: 12/26/2022]
Abstract
AIM This systematic review and meta-analysis aimed to assess the diagnostic accuracy and reliability of commonly used caries detection methods for proximal caries diagnostics. Visual examination (VE), bitewing radiography (BWR), laser fluorescence (LF), and fibre-optic transillumination (FOTI) were considered in detail. MATERIAL AND METHODS PRISMA guidelines for the reporting of systematic reviews and meta-analyses were applied. The mnemonic PIRDS (problem, index test, reference test, diagnostic and study type) concept was used to guide the literature search. Next, studies that met the inclusion criteria were stepwise selected and evaluated for their quality with a risk of bias (RoB) assessment tool. Studies with low/moderate bias and sufficient reporting were considered for meta-analysis. The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR), and area under the ROC curve (AUC) were calculated. RESULTS From 129 studies meeting the selection criteria, 31 in vitro studies and five clinical studies were finally included in the meta-analysis. The AUC values for in vitro VE amounted to 0.84 (caries detection) and 0.85 (dentin caries detection). BWR ranged in vitro from 0.55 to 0.82 (caries detection) and 0.81-0.92 (dentin caries detection). LF showed higher AUC values for overall caries detection (0.91) and dentin caries detection (0.83) than did other methods. Clinical data are limited. CONCLUSION The number of diagnostic studies with low/moderate RoB was found to be low and indicates a need for high-quality, well-designed caries diagnostic studies. CLINICAL RELEVANCE BWR and LF showed good diagnostic performance on proximal surfaces. However, because of the low number of includable clinical studies, these data should be interpreted with caution.
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Affiliation(s)
- Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Svetlana Kapor
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Yegane Khazaei
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Alexander Crispin
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Ina Schüler
- Department of Orthodontics, Section of Preventive and Paediatric Dentistry, University Hospital, Jena, Germany
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Aachen, Germany
| | - Kim Ekstrand
- Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - Stavroula Michou
- Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - Florin Eggmann
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Klaus Neuhaus
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital - Bern University Hospital, Bern, Switzerland
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.
- Poliklinik für Zahnerhaltung und Parodontologie, Klinikum der Universität München, LMU München, Goethestraße 70, 80336, Munich, Germany.
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Wang F, Su C, Yang C, von den Hoff JW, Bian Z, Meng L. Validity of near-infrared light transillumination for the assessment of proximal caries in permanent teeth. Aust Dent J 2021; 67:46-54. [PMID: 34689336 DOI: 10.1111/adj.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/06/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to evaluate the performance of DIAGNOcam (DC) in diagnosing proximal caries and to compare its effectiveness with the International Caries Detection and Assessment System (ICDAS) and bitewing radiography (BWR). METHODS 118 premolars extracted for orthodontic reasons were included and examined using three detection methods and validated by histological sections as the gold standard. The sensitivity, specificity and areas under the ROC curve (Az value) at the outer half enamel (D1), inner half enamel (D2) and dentine (D3) thresholds were compared between different methods. RESULTS At all categories, the specificity of DC was almost as high as ICDAS and BWR. DC showed a significantly higher sensitivity (0.68) than both visual (0.33) and radiographic examination (0.47) at the D1 threshold. DC presented the highest Az value (area under the ROC curve) at the D1 and D2 threshold (0.81, 0.86), while BWR showed the greatest Az values at D3 (0.94). Furthermore, DC had the highest association strength with the gold standard (Spearman's ρ = 0.80). CONCLUSIONS It can be concluded that DC could detect proximal caries effectively and showed comparable or even better performance than ICDAS and BWR.
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Affiliation(s)
- F Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine of Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - C Su
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine of Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - C Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine of Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - J W von den Hoff
- Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Z Bian
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine of Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - L Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine of Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
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da Silva EJ, de Miranda EM, Mota CCBDO, Das A, Gomes ASL. Photoacoustic imaging of occlusal incipient caries in the visible and near-infrared range. Imaging Sci Dent 2021; 51:107-115. [PMID: 34235056 PMCID: PMC8219446 DOI: 10.5624/isd.20200259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/27/2020] [Accepted: 12/08/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to demonstrate the presence of dental caries through a photoacoustic imaging system with visible and near-infrared wavelengths, highlighting the differences between the 2 spectral regions. The depth at which carious tissue could be detected was also verified. Materials and Methods Fifteen permanent molars were selected and classified as being sound or having incipient or advanced caries by visual inspection, radiography, and optical coherence tomography analysis prior to photoacoustic scanning. A photoacoustic imaging system operating with a nanosecond pulsed laser as the light excitation source at either 532 nm or 1064 nm and an acoustic transducer at 5 MHz was developed, characterized, and used. En-face and lateral (depth) photoacoustic signals were detected. Results The results confirmed the potential of the photoacoustic method to detect caries. At both wavelengths, photoacoustic imaging effectively detected incipient and advanced caries. The reconstructed photoacoustic images confirmed that a higher intensity of the photoacoustic signal could be observed in regions with lesions, while sound surfaces showed much less photoacoustic signal. Photoacoustic signals at depths up to 4 mm at both 532 nm and 1064 nm were measured. Conclusion The results presented here are promising and corroborate that photoacoustic imaging can be applied as a diagnostic tool in caries research. New studies should focus on developing a clinical model of photoacoustic imaging applications in dentistry, including soft tissues. The use of inexpensive light-emitting diodes together with a miniaturized detector will make photoacoustic imaging systems more flexible, user-friendly, and technologically viable.
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Affiliation(s)
| | | | | | - Avishek Das
- Department of Physics, Universidade Federal de Pernambuco, Recife, Brazil
| | - Anderson Stevens Leônidas Gomes
- Graduate Program in Dentistry, Universidade Federal de Pernambuco, Recife, Brazil.,Department of Physics, Universidade Federal de Pernambuco, Recife, Brazil
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Cameron A, Webster J, Walker TWM, Colbert SD. Patients' perception of using a smartphone light source in the clinical environment. Br Dent J 2020; 228:849-852. [PMID: 32541746 DOI: 10.1038/s41415-020-1635-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction A satisfactory light source is of paramount importance during an oral head and neck examination. It has become common practice for the light source on a smartphone to be used during inpatient intra-oral examination. We determined if patients identified the use of a smartphone as a light source, during head and neck examinations, as unprofessional.Methods and materials A clinical photograph illustrating professional errors was presented to patients as a pilot survey (n = 10); a smartphone camera flash being used as a light source was featured. Patients were then asked which aspects they considered unprofessional. Following staff training and improvements to the survey wording, the same photo was presented to patients (n = 150) as the main study.Results Of the patients surveyed, 97% considered the use of a smartphone in the staged clinical photograph as unprofessional. They also noted: a clinician sitting on the bed (88%), clinicians not wearing gloves (81%), lack of privacy/curtain not drawn (62%), long hair not tied back (50%), a clinician's name badge not visible (23%), clinician bare below the elbows (15%) and clinician not wearing a tie (12%).Conclusions This is the first piece of research into the use of a smartphone light source within clinical examination. The use of a smart phone light source during clinical examination was the most reported 'error' and was recognised more than a clinician not wearing gloves. Eighty-five percent of patients considered the use of a smartphone light source unprofessional. Authors, therefore, do not advocate the use of a smartphone light source in the clinical care of patients.
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Affiliation(s)
- Alice Cameron
- Specialty Doctor in OMFS, Department of Oral and Maxillofacial Surgery, Royal United Hospital, Combe Park Road, Bath, BA1 3NG, UK.
| | - James Webster
- Dental Core Trainee 2 in OMFS, Department of Oral and Maxillofacial Surgery, Royal United Hospital, Combe Park Road, Bath, BA1 3NG, UK
| | - Tom W M Walker
- Specialist Registrar in OMFS, Department of Oral and Maxillofacial Surgery, Bristol Children's Hospital, Dental Hospital & Royal Infirmary, University Hospital Bristol NHS Foundation Trust, Lower Maudlin Street, Bristol, BS2 8HW, UK
| | - Serryth D Colbert
- Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Royal United Hospital, Combe Park Road, Bath, BA1 3NG, UK
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Marmaneu-Menero A, Iranzo-Cortés JE, Almerich-Torres T, Ortolá-Síscar JC, Montiel-Company JM, Almerich-Silla JM. Diagnostic Validity of Digital Imaging Fiber-Optic Transillumination (DIFOTI) and Near-Infrared Light Transillumination (NILT) for Caries in Dentine. J Clin Med 2020; 9:jcm9020420. [PMID: 32033068 PMCID: PMC7073697 DOI: 10.3390/jcm9020420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 01/07/2023] Open
Abstract
The objective of the study is to analyse the available evidence for the validity of the transillumination method in the diagnosis of interproximal caries. Bibliographic searches were carried out in three data bases (PubMed, Embase, Scopus) with the key words “Transillumination AND caries”. A total of 11 studies were selected for the qualitative analysis and meta-analysis. In the qualitative analysis, both in vivo and in vitro studies were included. The gold standards were tomography, digital radiography, and clinical visual diagnosis. The meta-analysis determined the sensitivity, specificity, and area below the ROC curve relative to the transillumination method in the diagnosis of caries in dentine. Meta-analysis results obtained for transillumination gave a sensitivity value of 0.69 (confidence interval: 0.54–0.81), a specificity value of 0.89 (confidence interval: 0.61–0.98), while giving an AUC value of 0.79 (confidence interval: 0.67–0.87). Transillumination is a method offering moderate validity in the diagnosis of carious lesions in dentine, there is no strong evidence that may enable us to affirm that transillumination may fully substitute X-rays in the complementary diagnosis of carious lesions
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