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ORIGINAL RESEARCH Table of Contents   
Year : 2009  |  Volume : 20  |  Issue : 2  |  Page : 136-140
The relative diagnostic yields of clinical, FOTI and radiographic examinations for the detection of approximal caries in youngsters


Department de Odontologia Social, Faculdade de Odontologia de Piracicaba, Piracicaba Dental School, Unicamp, Brazil

Click here for correspondence address and email

Date of Submission12-Dec-2006
Date of Decision02-Mar-2007
Date of Acceptance25-May-2007
Date of Web Publication23-Jun-2009
 

   Abstract 

Background: The detection of carious lesions in the initial stages of development is very important in order to prevent the occurrence of cavitation.
Aims and Objectives: The aim of the present study was to compare three methods-visual examination, FOTI, and bitewing radiographic examination-for the detection of noncavitated and cavitated approximal carious lesions.
Materials and Methods: Seventy students (mean age 14 years) with low caries prevalence were examined by three examiners. The tooth surfaces judged as having caries by at least one examiner or one diagnostic method were scheduled for tooth separation.
Results: The results showed that the incorporation of FOTI and radiographic examination represented an additional diagnostic yield of 50% and about 110%, respectively, compared to clinical examination alone.
Conclusion: We conclude that FOTI or radiographic examination, or both, used as adjuncts to clinical examination, could improve the detection of noncavitated and cavitated approximal carious lesions. Although FOTI should not replace bitewing radiographic examination, it does seem to have additional value for the detection of carious lesions on approximal surfaces of the posterior teeth in school children with low caries prevalence.

Keywords: Bitewing radiographs, caries detection, fiberoptic transillumination

How to cite this article:
Mialhe FL, Pereira AC, Meneghim Md, Ambrosano GM, Pardi V. The relative diagnostic yields of clinical, FOTI and radiographic examinations for the detection of approximal caries in youngsters. Indian J Dent Res 2009;20:136-40

How to cite this URL:
Mialhe FL, Pereira AC, Meneghim Md, Ambrosano GM, Pardi V. The relative diagnostic yields of clinical, FOTI and radiographic examinations for the detection of approximal caries in youngsters. Indian J Dent Res [serial online] 2009 [cited 2019 Dec 9];20:136-40. Available from: http://www.ijdr.in/text.asp?2009/20/2/136/52881
In view of the decrease in caries activity in many communities and the recent advances in the understanding of the dynamics of the carious process, the management of caries has shifted away from restorative approaches to remineralizing strategies or tissue conservation procedures. [1],[2] Thus, the detection of carious lesions in the early stages is essential if dentists are to provide good dental care for their patients. [2],[3]

The diagnosis of approximal carious lesions has been primarily through visual clinical examination. However, in situations where the teeth are are normally in anatomical contact with others, it is a very difficult task for the dentist to detect caries in posterior teeth by that exam, resulting in a high proportion of false negative decisions. [3],[4],[5]

Conventional bitewing radiography remains the most common diagnostic aid because it has been shown to enhance the detection of approximal lesions. [5],[6],[7] However, there are some problems associated with this technique, for example, if the horizontal angulation is incorrect, overlapping of approximal surfaces will occur on the radiograph. Other problem is the incapacity of method to distinguish noncavitated from cavitated lesions.

Fibre-optic transillumination (FOTI) has been investigated as an alternative method for the detection of approximal carious lesions. [8],[9] In this method, a white light from a cold-light source is passed through a fiber to an intra-oral fiber-optic light probe that is placed on the buccal or lingual side of the tooth and the surfaces are examined through transmitted light, which is viewed from the occlusal surface. A carious lesion has a lowered index of light transmission and so appears as a darkened shadow when transilluminated.[8] FOTI is a simple, noninvasive, and painless procedure that can be used repeatedly with no risk to the patient. In the literature, the validity of diagnoses made with FOTI has usually been assessed by comparison with the radiographic diagnosis of the same surface, although it is well known that radiography itself is not an accurate method. [9],[10],[11],[12] Little information is available about the performance of FOTI in the detection of early approximal carious lesions in vivo using validation methods other than radiographic examinations. [13],[14]

One technique to assist in the diagnosis of approximal caries is teeth separation. It has been stated that this technique provides a unique opportunity for assessing the clinical integrity of approximal surfaces in the in vivo situation; [15],[16],[17] however, the method has been questioned because of its lack of reproducibility, and it has been considered a 'silver standard' validation method. [13] Nevertheless, it seems that the results of examination of teeth after temporary separation are superior to the results of any another method, particularly when the objective is to confirm the presence of cavitation. [13],[14],[15],[16]

Considering that clinical examination usually underestimate the prevalence of approximal caries, it is important for epidemiologists and general dental practitioners know how different methods could be used in an integrated diagnostic system for detection of dental caries. [3] Although there are a great number of studies comparing individual methods for detection of approximal carious lesions, there have been few studies that have investigated, in vivo, the performance of different combinations of caries detection methods. Therefore, the purpose of the present study was to investigate the extra diagnostic yield provided by FOTI and bitewing radiographs in relation to clinical examination for the detection of noncavitated and cavitated approximal carious lesions in a population of schoolchildren with low caries prevalence.


   Materials and Methods Top


The study sample consisted of 70 school children selected randomly (45 females and 25 males) with a mean age of 14 years (range 13-15 years) and with low caries prevalence (DMFT = 1.4).

Before starting the clinical study, three examiners (A, B, and C) standardized the scoring system for approximal caries. Each examiner was responsible for just one diagnostic method to avoid bias in the results of the examinations.

The approximal surfaces between the two premolars, between the second premolars and first molars, and between the first and second molars were examined.

For the visual examination, all children were examined in a dental chair with the aid of a dental lamp, a 3-in-1 syringe, and a mirror. All patients received thorough dental prophylaxis before the examination. A WHO-621 periodontal probe(Trinity, Campo Mourγo, PR, Brazil) was used to examine the surface contour and to remove adherent debris. Surfaces were kept dry with cotton rolls, compressed air, and a suction apparatus. Examiner A performed the visual examination with no input from the other observers and methods. Codes and criteria used were as follows: code 0 = sound, code 1 = noncavitated carious lesion (whitish and discolored enamel lesions), and code 2 = cavitated carious lesions.

Following the visual examination, all posterior surfaces were examined by examiner B, using FOTI (Fiber-LiteÒ PL 800 series (Dolan-Jenner Industries, Lawrence, MA, USA)) and a 0.5-mm-diameter probe. During the FOTI examination, the dental lamp and room lights were turned off and only a wall-mounted, standard X-ray viewing box illuminated the room. The tip of the fiberoptic probe was positioned beneath the contact point of the approximal surfaces to be examined. The surfaces were kept dry as was done during the visual examination. The marginal ridge was viewed from the occlusal surface. The following codes and criteria were used: 0 = no shadow, 1 = shadow restricted to enamel, and 2 = shadow reaching dentine.

Two posterior bitewing radiographs were taken in each side of the mouth of all patients using Kodak Ekta Speed Plus film (Kodak, Rochester, New York, USA) and film holders (Indusbello, Londrina, Paranα, Brazil) . The film was developed in an automatic processor (Gendex GXP, Gendex Corporation, Illinois, USA). Examiner C examined all pictures in a random order on a view box with ×2 magnification. The following codes and criteria were used: Code 0 = sound, code 1 = radiolucency in the outer half of enamel, code 2 = radiolucency in the inner half of enamel, code 3 = radiolucency in the outer one-third of dentine, and code 4 = radiolucency in the inner two-thirds of dentine.

Through the sum of the surfaces considered carious by each one of the three examiners, 199 surfaces of the 1.680 examined in the 70 schoolchildren, were considered as having carious lesions. Only these surfaces were scheduled for tooth separation. Those surfaces that were considered sound by all the methods were not considered for tooth separation.

For teeth separation, an orthodontic rubber ring (G & H Wire Company, Greenwood, IN) was placed with dental floss tied around the contact point of the teeth surfaces in which carious lesions had been detected. The rings were removed 24 h later and the surfaces were cleaned with dental floss and dried before examination. The three examiners jointly examined the surfaces and decided whether caries was or was not present; they used the same criteria as was used during the clinical examination.

About 2 weeks after the study was completed, the clinical, radiographic, and FOTI examinations were repeated in a randomly selected subsample (10%) of children in order to test intra-examiner agreement (Kappa values). [18]

The diagnostic yields of the clinical, radiographic, and FOTI examinations were assessed at two diagnostic levels: noncavitated and cavitated caries lesions.


   Results Top


Kappa values for intra-observer agreement were 0.79 for visual examination, 0.83 for FOTI, and 0.85 for radiographic examination. Fleiss [18] has suggested that Kappa statistics equaling 0.75 or over represents excellent agreement.

By direct visual examination after tooth separation (validation method), it was observed that of all the 199 surfaces initially considered carious by the three diagnostic methods, only 171 was really decayed. Of that, 143 surfaces showed noncavitated caries, and 28 showed cavitated carious lesions.

[Figure 1] shows the number of non-cavitated and cavitated approximal caries lesions detected by clinical, FOTI and radiographic examination found after temporary tooth separation. Of the 171 decayed surfaces, 72 (42.1%) were detected by clinical, 65 (38.0%) by FOTI and 111 (64.9%) by radiographic examination. However, some lesions were detected exclusively by just one or two methods. For example, it was observed that a number of 29, 20 and 63 lesions were detected exclusively by clinical, FOTI and radiographic examinations. Besides, these two last methods found 16 same lesions that were not detected by clinical examination.

Therefore, the additional 36 lesions detected by FOTI or 79 by radiographs, represented a extra diagnostic yield of 50% and 110%, respectively, in relation to clinical examination alone.

Of the 143 noncavitated carious lesions detected by visual inspection after tooth separation, 87 (60.8%) were detected by radiographic examination, 59 (41.3%) were detected by clinical examination, and 46 (32.2%) were detected by FOTI. However, there were lesions that were detected exclusively for just a type of examination method. 57 noncavitated carious lesion were detected exclusively by radiographic examination, 29 exclusively by clinical examination, and 17 exclusively by FOTI. The FOTI examination detected 27 noncavitated lesions that were not detected by clinical examination, which represents an additional diagnostic yield of about 46%. In the same way, radiographic examination detected 67 that were not detected by clinical examination, which represents an additional diagnostic yield of 113.6% [Figure 1] and [Table 1].

With regard to the 28 cavitated carious lesions detected by visual inspection after tooth separation, 24 were detected by radiographic examination, 19 by FOTI, and 13 by clinical examination. With regard to the 28 cavitated carious lesions detected by visual inspection after tooth separation, 24 also were detected by radiographic examination, 19 by FOTI, and 13 by clinical examination. The nine cavitated carious lesions detected exclusively by FOTI that were not found in clinical examination represented an additional diagnostic yield of 69.2% over that examination. On the other hand, the 12 lesions detected by radiographic examination, represented an additional diagnostic yield of 92.3%, compared to clinical examination [Figure 1] and [Table 1].


   Discussion Top


We found that a combination of all three methods could improve the number of carious lesions detected. This is very relevant for general dentists and epidemiologists improve their caries detection processes. [1],[2],[19]

It is important to detect carious lesions in the early stages of development because if the dynamic nature of lesion progression could be arrested by the re-establishment of physiological equilibrium between tooth mineral and the oral environment. [2],[19] Lawrence et al. (1997), [20] in a study done in the state of Rio de Janeiro, Brazil, found that lesion progression from the outer half of enamel into the outer half of the dentin takes approximately 3-4 years (assuming a constant rate over time) in schoolchildren (mean age 14.1 years at baseline) from fluoridated areas who exhibited high caries activity. We believe that the progression rate of caries in our sample of school students will be lower that that seen in other groups with high caries activity in Brazil and, thus, preventive measures can be expected to be more effective in these children. Although clinical examination remains the basic detection system for dental caries, several studies have shown that it is not very accurate in detecting carious lesions in approximal surfaces. [3],[5],[15],[16],[19],[21] Pitts [22] concluded that clinical examinations alone generally detected less than 50% of the 'total' approximal lesions found with clinical plus radiographic examination. The results of the present study are in line with these conclusions.

For the diagnosis of the integrity of approximal surfaces, temporary tooth separation with an elastic separator or some other apparatus seems to be better than other conventional methods. [13],[14],[15] In day-to-day practice, the use of temporary tooth separation is recommended when the diagnosis is uncertain. [15] In the present study, the tooth separation was done for this indication. This experimental methodology has also been used by other authors. [23],[24],[25],[26]

Regarding the detection of noncavitated lesions, clinical examination used alone detected 41.3% and bitewing radiography detected about 61% of the total number of approximal noncavitated lesions that were identified after tooth separation. These findings differ from the results obtained by Machiulkiene et al. [27] who found that 75% of approximal noncavitated lesions were detected by clinical examination alone and 55% by radiographs.

With respect to the detection of cavitated lesions, clinical examination alone detected 46.4% and bitewing radiography detected about 85.5% of the total number of approximal cavitated lesions that were detected after tooth separation. These findings are close to the results obtained by Machiulkiene et al. [27] who reported that 56% of the total number of approximal noncavitated lesions was detected by clinical examination alone and 87% of approximal cavitated lesions was detected by radiographs. However, in that study, the authors did not separate the approximal surfaces to confirm the presence or absence of carious lesions. De Vries et al., [28] in a study on patients under the age of 12 years, concluded that omission of radiographic examination did not result in a substantial loss of information. However, for patients above this age the authors advised the adjunctive use of radiography for diagnosis of caries of approximal surfaces. The results of the present study are in line with the conclusions of these authors.

Of the three methods, FOTI detected the least number of carious lesions as much in enamel as in dentine. These findings are in line with the results obtained by others authors. [13],[14],[21] Despite these findings, FOTI may still have a role, especially in clinicswithout radiographic equipment. Moreover, studies have observed that in general dental practice more approximal lesions were detected when FOTI was incorporated into the standard clinical examination.[29] FOTI has been studied as an alternative to radiographic examination. [10],[11],[12],[13],[14],[15],[19],[21],[30] In the present study, incorporation of FOTI into a traditional examination enabled detection of a greater number of noncavitated and cavitated carious lesions. The data presented in [Figure 1] suggest that in places where bitewing radiography is unavailable for detection of posterior approximal caries, FOTI can increase by up to 50% the detection of lesions that is achieved by clinical examination alone. Unfortunately, the technique is rarely taught in dental schools or used in general practice. [29]

In conclusion, the combined use of clinical plus radiographic or FOTI examinations in this age-group (school students) can improve the diagnosis of noncavitated as cavitated lesions of approximal surfaces in comparison to clinical examinations alone.

 
   References Top

1.Pitts NB. Are we ready to move from operative to non-operative/preventive treatment of dental caries in clinical practice? Caries Res 2004;38:294-304.  Back to cited text no. 1    
2.Fejerskov O. Changing paradigms in concepts on dental caries: Consequences for oral health care. Caries Res 2004;38:182-91.  Back to cited text no. 2    
3.Ismail AI. Clinical diagnosis of precavitated carious lesions. Community Dent Oral Epidemiol 1997;25:13-23.  Back to cited text no. 3    
4.Bader JD, Shugars DA, Bonito AJ. A systematic review of the performance of methods for identifying carious lesions. J Public Heatlh Dent 2002;62:201-13.  Back to cited text no. 4    
5.Pitts NB, Rimmer PA. An in vivo comparison of radiographic and directly assessed clinical caries status of posterior approximal surfaces in primary and permanent teeth. Caries Res 1992;26:146-52.  Back to cited text no. 5    
6.Hopcraft MS, Morgan MV. Comparison of radiographic and clinical diagnosis of approximal and occlusal caries in young adult population. Community Dent Oral Epidemiol 2005;33:212-8.  Back to cited text no. 6    
7.Yang J, Dutra V. Utility of radiology, laser fluorescence and transillumination. Dent Clin N Am 2005;49:739-52.  Back to cited text no. 7    
8.Friedman J, Marcus MI. Transillumination of the oral cavity with use of fiber optics. J Am Dent Assoc 1970;80:801-9.  Back to cited text no. 8    
9.Mitropoulos CM. A comparison of fibre-optic transillumination with bitewing radiographs. Br Dent J 1985;159:21-3..  Back to cited text no. 9    
10.Stephen KW, Russell JI, Creanor SL, Burchell CK. Comparison of fibre optic transillumination with clinical and radiographic caries diagnosis. Community Dent Oral Epidemiol 1987;15:90-4.  Back to cited text no. 10    
11.Sidi AD, Naylor, MN. A comparison of bitewing radiography and interdental transillumination as adjuncts to the clinical identification of approximal caries in posterior teeth. Br Dent J 1988;164:15-8.  Back to cited text no. 11    
12.Verdonschot EH, Bronkhorst EM, Wenzel A. Approximal caries diagnosis using fiber-optic transilumination: A mathematical adjustement to improve validity. Community Dent Oral Epidemiol 1991;19:329-32.  Back to cited text no. 12    
13.Hintze H, Wenzel A, Danielsen B. Reliability of visual examination, fibre-optic transillumination, and bite-wing radiography, and reproducibility of direct visual examination following tooth separation for the identification of cavitated carious lesions in contacting approximal surfaces. Caries Res 1998;32:204-9.  Back to cited text no. 13    
14.Deery C, Care R, Chesters R, Huntington E, Stelmachonoka S, Gudkina Y Prevalence of dental caries in Latvian 11-to15-years old children and the enhanced diagnostic yield of temporary tooth separation, FOTI and electronic caries measurement. Caries Res 2000;34:2-7.  Back to cited text no. 14    
15.Pitts NB, Longbottom C. Temporary tooth separation with special reference to the diagnosis and preventive management of equivocal approximal carious lesions. Quintessence Int 1987;18:563-73.  Back to cited text no. 15    
16.Rimmer PA, Pitts NB. Temporary elective tooth separation as a diagnostic in general dental practice. Br Dent J 1990;169:87-92.  Back to cited text no. 16    
17.Mialhe FL, Pereira AC, Pardi V, de Castro Meneghim M. Comparison of three methods for detection of carious lesions in proximal surfaces versus direct visual examination after tooth separation. J Clin Pediatr Dent 2003;28:59-62.  Back to cited text no. 17    
18.Fleiss JL, Fischman SL, Chilton NW, Park MH. Reliability of discrete measurements in caries trials. Caries Res 1979;13:23-31.  Back to cited text no. 18    
19.Zandona AF, Zero DT. Diagnostic tools for early caries detection. J Am Dent Assoc 2006;137:1675-84.  Back to cited text no. 19    
20.Lawrence HP, Benn DK, Sheiham A. Digital radiographic measurement of approximal caries progression in fluoridated and non-fluoridated areas of Rio de Janeiro, Brazil. Community Dent Oral Epidemiol 1997;25:412-8.  Back to cited text no. 20    
21.Young DA, Featherstone JD. Digital imaging fiber-optic trans-illumination, F-speed radiographic film and depth of approximal lesions. J Am Dent Assoc 2005; 136:1682-7.  Back to cited text no. 21    
22.Pitts NB. Review article. The use of bitewing radiographs in the management of dental caries: Scientific and practical considerations. Dentomaxillofac Radiol 1996;25:5-16.  Back to cited text no. 22    
23.de Araujo, FB, Rosito DB, Toigo E, dos Santos CK. Diagnosis of approximal caries: Radiographic versus clinical examination using tooth separation. Am J Dent 1992;5:245-8.  Back to cited text no. 23    
24.Akpata ES, Farid MR, al-Saif K, Roberts EA. Cavitation at radiolucent areas on proximal surfaces of posterior teeth. Caries Res 1996;30:313-6.  Back to cited text no. 24    
25.Mejàre I, Malmgren B. Clinical and radiographic appearance of proximal carious lesions at the time of operative treatment in young permanent teeth. Scand J Dent Res 1986;94:19-26.  Back to cited text no. 25    
26.Cτrtes DF, Palma RG, Navarro MF. Comparison of five caries diagnostic methods for posterior approximal surfaces. Caries Res 1994;28:192/ORCA Congress -abstract n.40.  Back to cited text no. 26    
27.Machiulskiene V, Nyvad B, Baelum V. A comparison of clinical and radiographic caries diagnoses in posterior teeth of 12-years-old Lithuanina children. Caries Res 1999;33:340-8.  Back to cited text no. 27    
28.de Vries HC, Ruiken HM, Kφnig KG, van 't Hof MA. Radiographic versus clinical diagnosis of approximal carious lesions. Caries Res 1990;24:364-70.  Back to cited text no. 28    
29.Davies GM, Worthington HV, Clarkson JE, Davies RM. The use of fibre-optic transillumination in general dental practice. Br Dent J 2001;3:145-7.  Back to cited text no. 29    
30.Vaarkamp J, ten Bosch JJ, Verdonschot EH, Bronkhoorst EM. The real performance of bitewing radiography and fiber-optic transillumination in approximal caries diagnosis. J Dent Res 2000;79:1747-51.  Back to cited text no. 30    

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Correspondence Address:
Fabio Luiz Mialhe
Department de Odontologia Social, Faculdade de Odontologia de Piracicaba, Piracicaba Dental School, Unicamp
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.52881

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