Journal
CLINICAL ORAL INVESTIGATIONS
Volume 25, Issue 8, Pages 4801-4815Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00784-021-04024-1
Keywords
Occlusal caries; Pit and fissure caries; Caries detection; Caries diagnostics; Visual examination; Bitewing radiography; Laser fluorescence measurements; Fibre-optic transillumination; Systematic review; Meta-analysis; Diagnostic performance; Accuracy; Sensitivity; Specificity
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Funding
- German Research Foundation (Deutsche Forschungsgemeinschaft) [SCHU-3217/1-1]
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This study aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics. Results showed significant differences in specificity (SP) between methods under laboratory conditions, and visual examination (VE) had lower areas under ROC curves (AUCs). Under clinical conditions, VE had higher sensitivity (SE) than specificity (SP).
Aim This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. Materials and methods A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. Results SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. Conclusion The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds.
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