In vivo performance of a laser fluorescence device for the approximal detection of caries in permanent molars

Objectives The aim of this randomised clinical trial was to investigate if a laser fluorescence device is able to discriminate between sound and carious approximal sites and between enamel and dentinal lesions as well as to find appropriate cut off values Methods One hundred and seventeen sound or uncavitated carious sites in permanent molars were visually and radiographically examined then either opened or not after which their laser fluorescence was measured Forty three lesions were opened the canes removed and the clinically identified canes depths were registered in addition to the radiographical scoring Seventy four sites were radiographically deemed sound or had enamel canes and were not opened Here the radiographical scorings were registered Results Taking the radiographic scoring as gold standard for all investigated approximal sites, sound sites (D-0 n = 40) showed significantly lower laser fluorescence measurements than carious sites (D1-4, n = 77) (Mann-Whitney test P < 0 025) suggesting a cut off at 7 (sensitivinty = 0 68 specificity = 0 7) Comparing measurements of D0-2 (n = 74) and D-3 (4) (n = 43) the results were also different by a statistically significant amount (P < 0 025) and the cut off calculated to be 16 (sensitivity = 06, specificity = 0 84) A fair positive correlation between laser fluorescence values and radiographical scoring was found (rho = +047 P < 0 01) Analysing the 43 opened lesions with their clinically found lesion depths as gold standard there was a fair positive correlation to the laser fluorescence values (rho = +0 34 P = 0 03) and a moderately strong correlation to the radiographic scoring (rho = +067, P < 0 01) Conclusion The device may be an adjunct tool in the approximal detection of canes along with established procedures (C) 2010 Elsevier Ltd All rights reserved