ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Use Laser Fluorescence Only As An Adjunctive Aid In Diagnosing Noncavitated Carious Lesions
Clinical Question When detecting non-cavitated occlusal caries lesions in adult dentition, does the use of DIAGNOdent compared to visual examination offer a better detection method?
Clinical Bottom Line The DIAGNOdent, due to the sensitivity and specificity of the device, should only be used as an adjunct tool in clinically detecting occlusal caries. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 15551982Bader/2004 Human teeth with and without cariesSystematic Review
Key resultsThe DIAGNOdent appeared to be highly sensitive, but it not very specific leading to false positives, which can be caused by organic matter and retained sealants. The DIAGNOdent is limited in its usefulness in detecting caries.
#2) 18930575Huth/2008120 sound/uncavitated carious sites in 120 patients.Radomized Controlled Study.
Key resultsThe device showed “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.”
Evidence Search "Dental Caries"[Mesh] AND "Fluorescence"[Mesh] ...view in PubMed
Comments on
The Evidence
The systematic review was a comprehensive search with detailed exclusion criteria that searched as far back in the literature that was valid. The reviews looked at 25 studies that were reviewed by 2 reviewers. The included studies were assessed for the quality elements that make for good diagnostic studies. There appears to be no competing interests and the study appears valid. The RCT study treated all groups similar at start and had a 100% completion rate. The study was double blinded and randomized but unsure on if there was any recall bias. All patients were recalled in 12 months, which seems adequate. There appears to be no competing interests and the study appears to be valid.
Applicability These studies are applicable to all patients with sound non-cavitated teeth that present with or without caries. Because of its low specificity, its use may result in over- treatment of incipient lesions due to possibility of false positives.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Restorative Dentistry)
Keywords Dental Caries, Fluorescence
ID# 547
Date of submission: 03/29/2010spacer
E-mail mayen@livemail.uthscsa.edu
Author Steven Mayen
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Kevin M. Gureckis, DMD
Faculty mentor/Co-author e-mail gureckis@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Chelsea Padgett (San Antonio, TX) on 04/23/2012
On April 2012, I conducted a PubMed search on this subject. In this search, I found a more recent publication (PMID 21913840) agreeing with the results presented in this CAT.
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