Clinical validity of fluorescence-based devices versus visual-tactile method in detection of secondary caries around resin composite restorations: diagnostic accuracy study.

IF 2.5 Q2 DENTISTRY, ORAL SURGERY & MEDICINE BDJ Open Pub Date : 2025-01-06 DOI:10.1038/s41405-024-00284-7

Aya Mohamed Adly, Shereen Hafez Ibrahim, Amira Farid El-Zoghbi

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Abstract

Objectives: To assess the validity of light-induced and laser-induced fluorescence devices compared to the visual-tactile method for detecting secondary caries around resin composite restorations.

Materials and methods: The study included 20 participants with 30 resin-composite restored teeth. Restorations' margins were examined using three diagnostic methods: the visual-tactile method (FDI criteria), the light-induced fluorescence camera (VistaCam iX), and the laser-induced fluorescence device (DIAGNOdent pen), and the reference was visual inspection after removal of defective restorations. The validity of each method was evaluated. Inter-examiner reliability was calculated using Cohen's kappa statistics. The level of significance was set at P = 0.05.

Results: DIAGNOdent pen showed the highest sensitivity (100%) followed by VistaCam (98.82%) and the visual-tactile method (98.82%) at the enamel threshold. DIAGNOdent pen and VistaCam had lower specificity values than the visual-tactile method (81.69%, 76.06%, and 88.73% respectively). At the dentin threshold, DIAGNOdent pen yielded the highest sensitivity (89.36%), whereas VistaCam had the lowest (8.51%). The sensitivity of the visual-tactile method was low (57.45%) whereas all diagnostic methods had high specificity. There was perfect agreement in inter-examiner reliability for all assessment methods (Kappa 0.858-0.992).

Conclusions: Both fluorescence-based devices and the visual-tactile method are reliable for detecting secondary caries around resin composite restorations. DIAGNOdent pen is accurate in enamel and dentin, while VistaCam and the visual-tactile method can detect secondary caries in enamel only.

Clinical relevance: Fluorescence-based devices could be used as a valuable aid to supplement or as a second opinion after the visual-tactile method.

Trial registration: The study was listed on www.

Clinicaltrials: gov with registration number (NCT04426604) on 11/06/2020.

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荧光装置与视觉触觉法检测树脂复合修复体周围继发性龋的临床有效性：诊断准确性研究。

目的：比较光诱导荧光仪和激光诱导荧光仪检测树脂复合修复体周围继发性龋的有效性。材料与方法：研究对象20名，30颗树脂复合修复牙。采用视觉触觉法（FDI标准）、光诱导荧光相机（visacam iX）和激光诱导荧光仪（DIAGNOdent笔）三种诊断方法检查修复体边缘，参照为缺损修复体去除后的目视检查。对每种方法的有效性进行了评价。使用Cohen's kappa统计量计算被测者间信度。P = 0.05为显著性水平。结果：诊断笔在牙釉质阈值上的灵敏度最高（100%），其次是visacam（98.82%）和视觉触觉法（98.82%）。诊断笔和visacam的特异性值低于视觉触觉法（分别为81.69%、76.06%和88.73%）。在牙本质阈值处，诊断笔的灵敏度最高（89.36%），而visacam的灵敏度最低（8.51%）。视觉触觉法的敏感性较低（57.45%），而所有诊断方法的特异性均较高。各评价方法间信度完全一致（Kappa 0.858 ~ 0.992）。结论：荧光法和视触觉法检测树脂复合修复体周围继发龋均可靠。诊断笔在牙釉质和牙本质上是准确的，而visacam和视觉触觉法只能检测牙釉质上的继发性龋齿。临床意义：基于荧光的设备可作为视觉触觉法之后的辅助辅助或辅助意见。试验注册：该研究已于2020年6月11日在www.Clinicaltrials: gov上注册，注册号为NCT04426604。

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