Clinical evaluation of a laser fluorescence system for the diagnosis of occlusal caries lesions

Abstract

The aim of this study was to evaluate the effectiveness of the laser fluorescence device Diag- nodent for the correct diagnosis of occlusal lesions, validating the results through cavity opening. The sample consisted of 153 per- manent molars with microcavi- ties in school children aged 6 to 8 years, enrolled in public schools in the city of Piracicaba. The exams were carried out in a dental office using artificial light, plane mirror, and an explorer probe was used only when the biofilm needed to be removed. The study validation was performed through the cavity opening with round burs until the carious tissue was completely re- moved. The results showed that the sensitivity values and positive predictive values for Diagnodent were high when the enamel caries validation criterion was used, with the following sensitivity values: 0.99 at cut-point 20 and 0.98 at cut-point 30. The positive predicti- ve values were 0.97 and 1.00, res- pectively, for the two established cut-off thresholds. Concerning the dentin validation, the sensitivity values were 0.84 at cut-point 30 and 0.99 at cut-point 20. The posi- tive predictive values for cut-point 20 and cut-point 30 were 0.80 and 0.89, respectively. Therefore, it may be concluded that the Diagno- dent laser device is highly capable of identifying early alterations in dental enamel; however, it sho- wed a high number of false-posi- tive diagnosis when dentin lesions were used as dentin lesions valida- tion criterion. Key words: methods, preventive dentistry, diagnosis, occlusal ca- ries, laser fluorescence.