Diagnostic efficacy of light-induced fluorescence method and digital fiber-optic transillumination in the assessment of early caries in children

Introduction
New diagnostic devices’ development is very important to detect caries lesions at earliest stage. The main aim of the study was the assessment of new dental caries detection methods: digital fiber-optic trans- illumination (DIFOTI) and quantitative light-induced fluorescence (QLF), in comparison with conventional method: visual and tactile examination. Objectives: Specific aims were the comparison of efficacy of diagnostic devices, including DIAGNOcam (DIFOTI), DIAGNOdent pen, and VistaCam iX (QLF) in early caries detection in children, and the assessment of their sensitivity and specificity.

Material and methods
In total, 61 children, aged 5-18 were examined. Early caries (caries incipiens) on occlusal and approximal surfaces of molar deciduous, and permanent teeth and premolar teeth were diagnosed. Examination scheme included visual and tactile examination according to ICDAS-II (international caries detection and assessment system), and assessment of dental caries with VistaCam iX, DIAGNOdent pen, and DIAGNOcam devices.

Results
227 surfaces were examined, including 129 permanent molars’ surfaces, 50 deciduous molars’ surfaces, and 48 premolars’ surfaces. Therefore in total, 172 occlusal surfaces and 55 approximal surfaces were analyzed. The highest sensitivity was obtained with VistaCam iX – 0.9655, lower DIAGNOcam – 0.8649, and DIAGNOdent pen – 0.6410. The highest specificity was obtained with DIAGNOdent pen – 0.9043, lower VistaCam iX – 0.9028, and DIAGNOcam – 0.8947.

Conclusions
The clinical visual and tactile examination should be the basic diagnostic method, and their results should be confirmed with additional devices, such as VistaCam iX, DIAGNOcam, or DIAGNOdent pen. None of the mentioned modern devices provided total efficacy in early caries detection. VistaCam iX and DIAGNOcam obtained better sensitivity than DIAGNOdent pen; however, all devices achieved high specificity.