Validity of micro-CT for in vitro caries detection: a systematic review and meta-analysis

Objective: To investigate the validity of micro-CT for in vitro caries detection in comparison with histology as the reference standard. Methods: A systematic search was conducted in the databases Latin American and Caribbean Health Sciences (LILACS), LIVIVO, PubMed, Scopus and Web of Science from their inception to 16 January 2019. Grey literature was searched on Open Grey, ProQuest Dissertations and Theses Database and Google Scholar. In vitro studies assessing the validity of micro-CT for caries detection were included when compared with histology as the reference standard were included. Two authors independently collected the information and sensitivity, specificity, positive and negative likelihood ratios, as well as diagnostic odds ratios were calculated. The risk of bias of the included studies was assessed using the QUADAS-2 tool. Certainty of evidence was assessed with GRADE. Results: A total of 270 papers were identified, and after a 2-phase selection, 12 studies were included in qualitative and three in quantitative synthesis. For enamel caries diagnostic, sensitivity values ranged from 29.0 to 84.0% indicating high variability while specificity varied from 88.0 to 95.0% indicating good to excellent micro-CT capability do identify the true negative. For dentine caries diagnostic, sensitivity values ranged from 61.0 to 77.0% indicating fairto-good probability of micro-CT to identify the true positives, while specificity varied from 88.0 to 94.0%. The majority of the included studies presented low risk of bias and moderate certainty of evidence. Conclusions: This study demonstrated the validity of micro-CT for in vitro caries detection in comparison with histology.