Clinical performance of a new laser fluorescence device for detection of occlusal caries lesions in permanent molars

Objectives: To determine the clinical performance of a laser fluorescence device (DIAGNOdent pen, KaVo) to discriminate between different occlusal caries depths (D-0-D1-4; D0-2-D-3,D-4) in permanent molars. Methods: In this prospective, randomized two-centre-study 120 sound/uncavitated carious sites in 120 patients were measured after visual and radiographic caries assessment. In cases of operative intervention (n = 86), the lesion depths after caries removal were recorded (reference). In cases of preventive intervention (n = 34), the sites were reassessed visually/radiographically after 12 months to verify the status assessed before (reference). The discrimination performance was determined statistically (Mann-Whitney test, Spearman's rho coefficient, and areas under the receiver operating characteristic curves (AUCs)). Sensitivities (SE) and specificities (SP) were plotted as a function of the measured values and cut-off values for the mentioned thresholds suggested. Results: Sound sites (n = 13) had significantly minor fluorescence values than carious sites (n = 107) (P < 0.0001) as had sites with no/enamel caries (n = 63) compared to dentinal caries (n = 57). The AUCs for the same discriminations were 0.92 and 0.78 (P < 0.001). For the D-0-D1-4 threshold, a cut-off at a value of 12 (SE: 0.88, SP: 0.85) and for the D0-2-D-3,D-4 threshold at 25 (SE: 0.67, SP: 0.79) can be suggested. A moderate positive correlation between the measurements and the caries depths was calculated (rho = +0.57, P = 0.01). Conclusion: Within this study, the device's discrimination performance for different caries depths was moderate to very good and it may be recommended as adjunct tool in the diagnosis of occlusal caries. (C) 2008 Elsevier Ltd. All rights reserved.