1
|
Macey R, Walsh T, Riley P, Glenny AM, Worthington HV, Fee PA, Clarkson JE, Ricketts D. Fluorescence devices for the detection of dental caries. Cochrane Database Syst Rev 2020; 12:CD013811. [PMID: 33319353 PMCID: PMC8677328 DOI: 10.1002/14651858.cd013811] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Caries is one of the most prevalent and preventable conditions worldwide. If identified early enough then non-invasive techniques can be applied, and therefore this review focusses on early caries involving the enamel surface of the tooth. The cornerstone of caries detection is a visual and tactile dental examination, however alternative methods of detection are available, and these include fluorescence-based devices. There are three categories of fluorescence-based device each primarily defined by the different wavelengths they exploit; we have labelled these groups as red, blue, and green fluorescence. These devices could support the visual examination for the detection and diagnosis of caries at an early stage of decay. OBJECTIVES Our primary objectives were to estimate the diagnostic test accuracy of fluorescence-based devices for the detection and diagnosis of enamel caries in children or adults. We planned to investigate the following potential sources of heterogeneity: tooth surface (occlusal, proximal, smooth surface or adjacent to a restoration); single point measurement devices versus imaging or surface assessment devices; and the prevalence of more severe disease in each study sample, at the level of caries into dentine. SEARCH METHODS Cochrane Oral Health's Information Specialist undertook a search of the following databases: MEDLINE Ovid (1946 to 30 May 2019); Embase Ovid (1980 to 30 May 2019); US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov, to 30 May 2019); and the World Health Organization International Clinical Trials Registry Platform (to 30 May 2019). We studied reference lists as well as published systematic review articles. SELECTION CRITERIA We included diagnostic accuracy study designs that compared a fluorescence-based device with a reference standard. This included prospective studies that evaluated the diagnostic accuracy of single index tests and studies that directly compared two or more index tests. Studies that explicitly recruited participants with caries into dentine or frank cavitation were excluded. DATA COLLECTION AND ANALYSIS Two review authors extracted data independently using a piloted study data extraction form based on the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Sensitivity and specificity with 95% confidence intervals (CIs) were reported for each study. This information has been displayed as coupled forest plots and summary receiver operating characteristic (SROC) plots, displaying the sensitivity-specificity points for each study. We estimated diagnostic accuracy using hierarchical summary receiver operating characteristic (HSROC) methods. We reported sensitivities at fixed values of specificity (median 0.78, upper quartile 0.90). MAIN RESULTS We included a total of 133 studies, 55 did not report data in the 2 x 2 format and could not be included in the meta-analysis. 79 studies which provided 114 datasets and evaluated 21,283 tooth surfaces were included in the meta-analysis. There was a high risk of bias for the participant selection domain. The index test, reference standard, and flow and timing domains all showed a high proportion of studies to be at low risk of bias. Concerns regarding the applicability of the evidence were high or unclear for all domains, the highest proportion being seen in participant selection. Selective participant recruitment, poorly defined diagnostic thresholds, and in vitro studies being non-generalisable to the clinical scenario of a routine dental examination were the main reasons for these findings. The dominance of in vitro studies also means that the information on how the results of these devices are used to support diagnosis, as opposed to pure detection, was extremely limited. There was substantial variability in the results which could not be explained by the different devices or dentition or other sources of heterogeneity that we investigated. The diagnostic odds ratio (DOR) was 14.12 (95% CI 11.17 to 17.84). The estimated sensitivity, at a fixed median specificity of 0.78, was 0.70 (95% CI 0.64 to 0.75). In a hypothetical cohort of 1000 tooth sites or surfaces, with a prevalence of enamel caries of 57%, obtained from the included studies, the estimated sensitivity of 0.70 and specificity of 0.78 would result in 171 missed tooth sites or surfaces with enamel caries (false negatives) and 95 incorrectly classed as having early caries (false positives). We used meta-regression to compare the accuracy of the different devices for red fluorescence (84 datasets, 14,514 tooth sites), blue fluorescence (21 datasets, 3429 tooth sites), and green fluorescence (9 datasets, 3340 tooth sites) devices. Initially, we allowed threshold, shape, and accuracy to vary according to device type by including covariates in the model. Allowing consistency of shape, removal of the covariates for accuracy had only a negligible effect (Chi2 = 3.91, degrees of freedom (df) = 2, P = 0.14). Despite the relatively large volume of evidence we rated the certainty of the evidence as low, downgraded two levels in total, for risk of bias due to limitations in the design and conduct of the included studies, indirectness arising from the high number of in vitro studies, and inconsistency due to the substantial variability of results. AUTHORS' CONCLUSIONS There is considerable variation in the performance of these fluorescence-based devices that could not be explained by the different wavelengths of the devices assessed, participant, or study characteristics. Blue and green fluorescence-based devices appeared to outperform red fluorescence-based devices but this difference was not supported by the results of a formal statistical comparison. The evidence base was considerable, but we were only able to include 79 studies out of 133 in the meta-analysis as estimates of sensitivity or specificity values or both could not be extracted or derived. In terms of applicability, any future studies should be carried out in a clinical setting, where difficulties of caries assessment within the oral cavity include plaque, staining, and restorations. Other considerations include the potential of fluorescence devices to be used in combination with other technologies and comparative diagnostic accuracy studies.
Collapse
Affiliation(s)
- Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Patrick A Fee
- Dundee Dental School, University of Dundee, Dundee, UK
| | - Janet E Clarkson
- Division of Oral Health Sciences, Dundee Dental School, University of Dundee, Dundee, UK
| | | |
Collapse
|
2
|
Akgul S, Bala O, Yikilgan İ. Performance of Different Methods for Detection of Incipient Occlusal Caries Lesions: An In Vitro Study. Photomed Laser Surg 2017; 36:191-197. [PMID: 29261013 DOI: 10.1089/pho.2017.4353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this in vitro study was to evaluate the diagnostic performance of visual inspection (VI), laser fluorescence (LF pen), fluorescence camera (FC), and alternating current impedance spectroscopy technique (ACIST) for detection of incipient occlusal caries lesions. Histology was used as the gold standard to determine the interexaminer reliability of the methods, among three examiners with different levels of experiences (Examiner 1: 5 years; examiner 2: 10 years; and examiner 3: 25 years). MATERIALS AND METHODS One hundred two molar teeth were selected. The occlusal surfaces of teeth were evaluated with VI, LF pen, FC, and ACIST devices independently by three examiners. Diagnostic performances of methods were evaluated with binormal receiver-operating characteristics analysis. Interexaminer agreement of detection methods was assessed using Cohen's kappa coefficient values (p < 0.001). RESULTS Incipient enamel lesions were determined more successfully with VI by all examiners. All detection methods were presented with statistically acceptable interexaminer agreement (p < 0.001). For D2 and D3 thresholds, FC for examiner 1, VI for examiner 2, and both VI and FC for examiner 3 demonstrated statistically high sensitivity and specificity (p < 0.05). CONCLUSIONS It can be concluded that diagnostic performance of the methods was insufficient for detecting incipient occlusal caries lesions by itself. Performance can be improved by using them with VI as a traditional caries detection method.
Collapse
Affiliation(s)
- Sinem Akgul
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University , Ankara, Turkey
| | - Oya Bala
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University , Ankara, Turkey
| | - İhsan Yikilgan
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University , Ankara, Turkey
| |
Collapse
|
3
|
Berdouses ED, Koutsouri GD, Tripoliti EE, Matsopoulos GK, Oulis CJ, Fotiadis DI. A computer-aided automated methodology for the detection and classification of occlusal caries from photographic color images. Comput Biol Med 2015; 62:119-35. [PMID: 25932969 DOI: 10.1016/j.compbiomed.2015.04.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/20/2015] [Accepted: 04/12/2015] [Indexed: 12/01/2022]
Abstract
The aim of this work is to present a computer-aided automated methodology for the assessment of carious lesions, according to the International Caries Detection and Assessment System (ICDAS II), which are located on the occlusal surfaces of posterior permanent teeth from photographic color tooth images. The proposed methodology consists of two stages: (a) the detection of regions of interest and (b) the classification of the detected regions according to ICDAS ΙΙ. In the first stage, pre-processing, segmentation and post-processing mechanisms were employed. For each pixel of the detected regions, a 15×15 neighborhood is used and a set of intensity-based and texture-based features were extracted. A correlation based technique was applied to select a subset of 36 features which were given as input into the classification stage, where five classifiers (J48, Random Tree, Random Forests, Support Vector Machines and Naïve Bayes) were compared to conclude to the best one, in our case, to Random Forests. The methodology was evaluated on a set of 103 digital color images where 425 regions of interest from occlusal surfaces of extracted permanent teeth were manually segmented and classified, based on visual assessments by two experts. The methodology correctly detected 337 out of 340 regions in the detection stage with accuracy of detection 80%. For the classification stage an overall accuracy 83% is achieved. The proposed methodology provides an objective and fully automated caries diagnostic system for occlusal carious lesions with similar or better performance of a trained dentist taking into consideration the available medical knowledge.
Collapse
Affiliation(s)
- Elias D Berdouses
- Department of Paediatric Dentistry, Dental School, National and Kapodistrian University of Athens, GR 11527, Athens, Greece.
| | - Georgia D Koutsouri
- Department of Electrical and Computer Engineering, National Technical University of Athens, GR 15780, Athens, Greece.
| | - Evanthia E Tripoliti
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110, Ioannina, Greece.
| | - George K Matsopoulos
- Department of Electrical and Computer Engineering, National Technical University of Athens, GR 15780, Athens, Greece.
| | - Constantine J Oulis
- Department of Paediatric Dentistry, Dental School, National and Kapodistrian University of Athens, GR 11527, Athens, Greece.
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110, Ioannina, Greece.
| |
Collapse
|
4
|
Betrisey E, Rizcalla N, Krejci I, Ardu S. Caries diagnosis using light fluorescence devices: VistaProof and DIAGNOdent. Odontology 2013; 102:330-5. [PMID: 23467922 DOI: 10.1007/s10266-013-0105-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 01/07/2013] [Indexed: 11/30/2022]
Abstract
The modern concept of minimally invasive dentistry encompasses early detection of incipient carious lesions and their treatment. Due to the low sensitivity of visual inspection and radiography in the detection of occlusal hidden carious lesions under a macroscopically sound surface, several devices have been developed to increase detection accuracy. DIAGNOdent is one of the tools used for that purpose and VistaProof is a new device recently introduced into the market. They both use light fluorescence to detect incipient carious lesions. DIAGNOdent is based on the fact that carious lesions show higher level of fluorescence than sound tissues when excited by light at specific wavelength. Vistaproof is based on the same principle, but it uses a different wavelength of excitation than DIAGNOdent and a video camera for the detection of fluorescence. The aim of this article was to compare these two devices and present their clinical use.
Collapse
Affiliation(s)
- E Betrisey
- Division of Cardiology and Endodontology, University of Geneva, Rue Barthélemy-Menn 19, 1205, Geneva, Switzerland,
| | | | | | | |
Collapse
|
5
|
Guerrieri A, Gaucher C, Bonte E, Lasfargues JJ. Minimal intervention dentistry: part 4. Detection and diagnosis of initial caries lesions. Br Dent J 2012; 213:551-7. [DOI: 10.1038/sj.bdj.2012.1087] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2012] [Indexed: 11/09/2022]
|
6
|
Influence of moisture and plaque on the performance of a laser fluorescence device in detecting caries lesions in primary teeth. Lasers Med Sci 2011; 27:1169-74. [DOI: 10.1007/s10103-011-1025-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 10/25/2011] [Indexed: 10/15/2022]
|
7
|
Jablonski-Momeni A, Schipper HM, Rosen SM, Heinzel-Gutenbrunner M, Roggendorf MJ, Stoll R, Stachniss V, Pieper K. Performance of a fluorescence camera for detection of occlusal caries in vitro. Odontology 2011; 99:55-61. [PMID: 21271327 DOI: 10.1007/s10266-010-0139-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 05/19/2010] [Indexed: 10/18/2022]
|
8
|
Braga MM, Mendes FM, Ekstrand KR. Detection activity assessment and diagnosis of dental caries lesions. Dent Clin North Am 2010; 54:479-93. [PMID: 20630191 DOI: 10.1016/j.cden.2010.03.006] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article reviews the current methods for detection and assessment of caries lesions focusing on applicability for daily clinical practice. The end point is to arrive at a diagnosis for each caries lesion. Visual inspection aided by a ball-ended probe is essential for caries lesions assessment and the method must be used for all patients. Use of indices, for example, the International Caries Detection and Assessment System (ICDAS), can improve the performance of this method. Using visual inspection, the clinician must decide about the presence, severity and activity of lesions. After this process, additional methods could aid the dentist in reaching a more appropriate treatment decision in some cases. The ICDAS, including the activity assessment system or the Nyvad system, seems to be the best option to reach final diagnoses for managing lesions. The radiographic method is the most recommended additional method available for daily clinical practice.
Collapse
Affiliation(s)
- Mariana M Braga
- Department of Pediatric Dentistry, Faculdade de Odontologia da Universidade de São Paulo, São Paulo, SP 05508-900, Brazil
| | | | | |
Collapse
|
9
|
Astvaldsdóttir A, Tranæus S, Karlsson L, Peter Holbrook W. DIAGNOdent measurements of cultures of selected oral bacteria and demineralized enamel. Acta Odontol Scand 2010; 68:148-53. [PMID: 20100119 DOI: 10.3109/00016350903567176] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Carious tissue fluoresces with a wavelength different from sound tissue when stimulated by light with a wavelength of 655 nm. This difference is thought to have a bacterial origin rather than indicating demineralization. This study aimed to measure fluorescence emitted by normal cultivable caries-associated bacterial flora and typical porphyrin-producing bacteria with DIAGNOdent, and to verify earlier findings that demineralization of the dental hard tissue does not affect DIAGNOdent readings. MATERIAL AND METHODS Bacterial samples were collected from five occlusal caries lesions in three subjects. From these, mixed anaerobic flora, Lactobacilli and mutans Streptococci were cultured in up to three different kinds of culture medium. Colonies of Lactobacilli and mutans Streptococci were also measured after transferring them to glass slides. Laboratory teaching strains of Prevotella spp., Porphyromonas gingivalis and Actinomyces odontolyticus were cultured anaerobically and fluorescence measured directly after an appropriate incubation period. Sound enamel surfaces of 15 extracted premolars were demineralized and changes in fluorescence measured. RESULTS DIAGNOdent readings > 20 were only obtained from young colonies of Prevotella and from colonies of mutans Streptococci cultured on mitis-salivarius-bacitracin agar. Higher measurements were obtained as the bacterial colonies aged. Lower measurements were obtained after transferring colonies to glass slides. Demineralization of enamel did not affect the DIAGNOdent measurements. CONCLUSIONS The change in fluorescence measured with DIAGNOdent has a bacterial origin rather than occurring as a result of demineralization. The measurements are presumably dependent on bacterial metabolites rather than bacteria themselves, and probably record synergistic effects during the carious process rather than the quantity or species of bacteria involved.
Collapse
Affiliation(s)
- Alfheiður Astvaldsdóttir
- Department of Cariology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
| | | | | | | |
Collapse
|
10
|
Comparing the reliability of a new fluorescence camera with conventional laser fluorescence devices in detecting caries lesions in occlusal and smooth surfaces of primary teeth. Lasers Med Sci 2010; 26:157-62. [PMID: 20157753 DOI: 10.1007/s10103-010-0757-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Accepted: 01/15/2010] [Indexed: 10/19/2022]
|
11
|
Kühnisch J, Berger S, Goddon I, Senkel H, Pitts N, Heinrich-Weltzien R. Occlusal caries detection in permanent molars according to WHO basic methods, ICDAS II and laser fluorescence measurements. Community Dent Oral Epidemiol 2008; 36:475-84. [DOI: 10.1111/j.1600-0528.2008.00436.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
12
|
Krause F, Jepsen S, Braun A. Comparison of two laser fluorescence devices for the detection of occlusal caries in vivo. Eur J Oral Sci 2007; 115:252-6. [PMID: 17697163 DOI: 10.1111/j.1600-0722.2007.00456.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Laser fluorescence measurements have been shown to be well suited for caries diagnosis. The aim of this study was to compare two laser fluorescence devices and to correlate the respective values with the visual and radiographic assessment and with the extent of the carious lesion. Ninety-four clinically non-cavitated occlusal carious lesions in the premolars and molars of 82 patients were examined. Laser fluorescence values on the surface were measured with a conventional laser fluorescence system and a novel laser fluorescence pen device. When operative intervention at a site was indicated, the extent of caries was determined after its removal. Readings obtained with both systems were significantly different with an interdevice factor of 0.64. Sensitivity and specificity for operative care were 92.6% and 53.7%, respectively, for the conventional, and 88.9% and 53.7%, respectively, for the pen device. For both devices, a correlation between laser fluorescence values and the visual and radiographic assessment and with the extent of the lesion was shown. The study indicates that the novel laser fluorescence device seems to be suitable for occlusal caries diagnosis. However, proposed guidelines for the clinical use of laser fluorescence readings of the conventional device cannot be transferred to the novel pen system.
Collapse
Affiliation(s)
- Felix Krause
- Department of Operative and Preventive Dentistry, University of Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany.
| | | | | |
Collapse
|
13
|
Francescut P, Zimmerli B, Lussi A. Influence of Different Storage Methods on Laser Fluorescence Values: A Two-Year Study. Caries Res 2006; 40:181-5. [PMID: 16707864 DOI: 10.1159/000092223] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Accepted: 07/19/2005] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to assess the influence on the infrared laser fluorescence response of some storage methods commonly used in dental research. Forty extracted permanent teeth, selected from a pool of frozen teeth, were divided into four groups of 10. Three groups were stored at 4 degrees C in 1% chloramine, 10% formalin or 0.02% thymol solution. The fourth group was stored at -20 degrees C (no storage solution added). Fluorescence measurements were performed at 14, 77, 113, 168, 232, 486 and 737 days. After 2 years, significant decreases in fluorescence (p<0.01) for the samples in formalin (-60%), chloramine (-72%) and thymol (-54%) were observed. The frozen teeth showed a slight but non-significant increase in fluorescence of 5% (p>0.01). Storing solutions have a significant influence on the fluorescence yield. Samples used for in vitro purposes stored frozen do not significantly change their fluorescence response. Thus, cut-off values obtained under the latter conditions could be extrapolated to the in vivo situation.
Collapse
Affiliation(s)
- P Francescut
- Department of Operative, Paediatric and Preventive Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | | | | |
Collapse
|
14
|
Mendes FM, de Oliveira E, de Faria DLA, Nicolau J. Ability of laser fluorescence device associated with fluorescent dyes in detecting and quantifying early smooth surface caries lesions. JOURNAL OF BIOMEDICAL OPTICS 2006; 11:024007. [PMID: 16674197 DOI: 10.1117/1.2191046] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
A laser fluorescence (LF) device is a portable tool, but it does not measure minor mineral changes. Our in vitro study aim is to propose the association of an LF with two fluorescent dyes and to evaluate the performance in detecting and quantifying early demineralization. Artificial caries lesions are created in 40 primary canine teeth using a demineralizing solution (pH=4.8) for 12, 24, 48, and 96 h. LF measurements are performed with DIAGNOdent after demineralization in these samples and in 20 sound primary teeth. Measurements with LF with 0.2-mM tetrakis(N-methylpyridyl)porphyrin (LF TMPyP) and with 4-mM protoporphyrin IX (LF PPIX) are made. The amount of calcium loss is determined by atomic emission spectrometry. A correlation between LF and LF with dyes and mineral loss and receiver operating characteristics analysis are performed, as well as comparisons of sensitivity, specificity, and accuracy values. Significant correlation is obtained with LF TMPyP and mineral loss of lesions demineralized for 24, 48, and 96 h. Better performance is achieved with LF TMPyP for all parameters than with LF alone. LF PPIX does not present good results. In conclusion, LF TMPyP provides good performance in detecting and quantifying very early enamel caries lesions.
Collapse
Affiliation(s)
- Fausto Medeiros Mendes
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Odontopediatria, Av. Lineu Prestes, 2227 CEP 05508-900, São Paulo, SP, Brazil.
| | | | | | | |
Collapse
|