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Comparative Study
. 2013 Jul;92(7 Suppl):84S-9S.
doi: 10.1177/0022034513490167. Epub 2013 May 20.

Longitudinal analyses of early lesions by fluorescence: an observational study

A Ferreira Zandoná  1 , M Ando, G F Gomez, M Garcia-Corretjer, G J Eckert, E Santiago, B P Katz, D T Zero
Affiliations
Comparative Study

Longitudinal analyses of early lesions by fluorescence: an observational study

A Ferreira Zandoná et al. J Dent Res. 2013 Jul.

Abstract

Previous caries experience correlates to future caries risk; thus, early identification of lesions has importance for risk assessment and management. In this study, we aimed to determine if Quantitative Light-induced Fluorescence (QLF) parameters--area (A [mm(2)]), fluorescence loss (F [%]), and Q [% × mm(2)]--obtained by image analyses can predict lesion progression. We secured consent from 565 children (from 5-13 years old) and their parents/guardians and examined them at baseline and regular intervals over 48 months according to the International Caries Detection Assessment System (ICDAS), yearly radiographs, and QLF. QLF images from surfaces with ICDAS 0/1/2/3/4 at baseline that progressed (N = 2,191) to cavitation (ICDAS 5/6) or fillings and surfaces that did not progress to cavitation/fillings (N = 4,141) were analyzed independently for A, F, and Q. Linear mixed-effects models were used to compare means and slopes (changes over time) between surfaces that progressed and those that did not. QLF A, F, and Q increased at a faster rate for surfaces that progressed than for surfaces that did not progress (p = .0001), regardless of type of surface or baseline ICDAS score. AUC for ICDAS ranged from 0.65 to 0.80, but adding QLF information improved AUC (0.82-0.87, p < .0005). We concluded that faster changes in QLF variables can indicate lesion progression toward cavitation and be more clinically relevant than actual QLF values.

Keywords: dental caries; early diagnosis; fluorescence imaging; prospective study; visual examination.

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Conflict of interest statement

The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Examples of reflectance and fluorescent images of lesions that progressed to cavitation and did not progress to cavitation based on baseline ICDAS scores.
Figure 2.
Figure 2.
Fluorescence loss (∆F) from baseline to last visit before cavitation as determined by ICDAS based on progression status and surface.
Figure 3.
Figure 3.
Regression slopes for QLF ∆F values by ICDAS scores at baseline for lesions that progressed to cavitation and lesions that did not progress to cavitation, based on the number of visits that preceded cavitation.
Figure 4.
Figure 4.
Receiver operating characteristic (ROC) curves to predict progression with and without the inclusion of QLF parameters.
See this image and copyright information in PMC

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