A clinical study of caries diagnosis with a laser fluorescence system.

ABSTRACT

BACKGROUND: The authors conducted an in vivo study to compare a laser fluorescence system with a visual system for occlusal caries diagnosis in children's primary and permanent molars. METHODS: The authors selected for evaluation 320 untreated, cavity-free primary and permanent molars in healthy children aged 6 through 14 years. Two of the authors conducted the laser fluorescence evaluation. Another of the authors completed the clinical evaluation. The kappa value was 0.68. The authors compared sensitivity, specificity, predictive values, odds ratio and receiver operating characteristic (ROC) curves for the laser fluorescence system. RESULTS: For the whole sample, the sensitivity and specificity of the laser fluorescence system were 0.79 and 0.87, respectively. The positive and negative odds ratios for the whole sample were 6.33 and 0.23. The positive and negative predictive values for the whole sample were 33.9 percent and 98.1 percent. The value of the area beneath the ROC curve (AUC) was 0.92 for the whole sample. CONCLUSIONS: The laser fluorescence system was more precise than visual evaluation in identifying lesions without cavities and healthy surfaces in primary and permanent molars. CLINICAL IMPLICATIONS In daily practice, dentists can consider the laser fluorescence system a complementary tool in the visual exploration of occlusal surfaces of primary molars and permanent first molars.