. 2024 Mar 22;28(4):227.

doi: 10.1007/s00784-024-05597-3.

ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I: caries lesion detection and depth assessment

Jan Kühnisch¹, Johan Km Aps², Christian Splieth³, Adrian Lussi^{4

5}, Anahita Jablonski-Momeni⁶, Fausto M Mendes⁷, Gottfried Schmalz^{8

9}, Margherita Fontana¹⁰, Avijit Banerjee¹¹, David Ricketts¹², Falk Schwendicke¹³, Gail Douglas¹⁴, Guglielmo Campus^{5

15}, Monique van der Veen^{16

17}, Niek Opdam¹⁸, Sophie Doméjean^{19

20}, Stefania Martignon²¹, Klaus W Neuhaus^{22

23}, Keith Horner²⁴, Marie-Charlotte Dnjm Huysmans¹⁸

Affiliations

¹ Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany. jan.kuehnisch@med.uni-muenchen.de.
² OpiniDent BV, Kortrijk, Belgium.
³ Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany.
⁴ University Hospital for Conservative Dentistry and Periodontology, Medical University of Innsbruck, Innsbruck, Austria.
⁵ Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
⁶ Department of Orthodontics, Dental School, Philipps-University Marburg, Marburg, Germany.
⁷ Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
⁸ Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany.
⁹ Department of Periodontology, University of Bern, Bern, Switzerland.
¹⁰ Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, USA.
¹¹ Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
¹² Unit of Restorative Dentistry, University of Dundee, Dundee, UK.
¹³ Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany.
¹⁴ Department of Dental Public Health, University of Leeds Dental School, Leeds, UK.
¹⁵ Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy.
¹⁶ Departments of Preventive Dentistry and Paediatric Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands.
¹⁷ Oral Hygiene School, Inholland University of applied sciences, Amsterdam, The Netherlands.
¹⁸ Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
¹⁹ Centre de Recherche en Odontologie Clinique EA 4847, UFR d'Odontologie, Département d'Odontologie Conservatrice, Université Clermont Auvergne, Clermont-Ferrand, France.
²⁰ Service d'Odontologie, CHU Estaing Clermont-Ferrand, Clermont-Ferrand, France.
²¹ UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia.
²² Department of Pediatric Oral Health, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland.
²³ Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
²⁴ Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.

PMID: 38514502
PMCID: PMC10957694
DOI: 10.1007/s00784-024-05597-3

ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I: caries lesion detection and depth assessment

Jan Kühnisch et al. Clin Oral Investig. 2024.

. 2024 Mar 22;28(4):227.

doi: 10.1007/s00784-024-05597-3.

Authors

Affiliations

¹ Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany. jan.kuehnisch@med.uni-muenchen.de.
² OpiniDent BV, Kortrijk, Belgium.
³ Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany.
⁴ University Hospital for Conservative Dentistry and Periodontology, Medical University of Innsbruck, Innsbruck, Austria.
⁵ Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
⁶ Department of Orthodontics, Dental School, Philipps-University Marburg, Marburg, Germany.
⁷ Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
⁸ Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany.
⁹ Department of Periodontology, University of Bern, Bern, Switzerland.
¹⁰ Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, USA.
¹¹ Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
¹² Unit of Restorative Dentistry, University of Dundee, Dundee, UK.
¹³ Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany.
¹⁴ Department of Dental Public Health, University of Leeds Dental School, Leeds, UK.
¹⁵ Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy.
¹⁶ Departments of Preventive Dentistry and Paediatric Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands.
¹⁷ Oral Hygiene School, Inholland University of applied sciences, Amsterdam, The Netherlands.
¹⁸ Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
¹⁹ Centre de Recherche en Odontologie Clinique EA 4847, UFR d'Odontologie, Département d'Odontologie Conservatrice, Université Clermont Auvergne, Clermont-Ferrand, France.
²⁰ Service d'Odontologie, CHU Estaing Clermont-Ferrand, Clermont-Ferrand, France.
²¹ UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia.
²² Department of Pediatric Oral Health, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland.
²³ Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
²⁴ Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.

PMID: 38514502
PMCID: PMC10957694
DOI: 10.1007/s00784-024-05597-3

Abstract

Objectives: The aim of the present consensus paper was to provide recommendations for clinical practice considering the use of visual examination, dental radiography and adjunct methods for primary caries detection.

Materials and methods: The executive councils of the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) nominated ten experts each to join the expert panel. The steering committee formed three work groups that were asked to provide recommendations on (1) caries detection and diagnostic methods, (2) caries activity assessment and (3) forming individualised caries diagnoses. The experts responsible for "caries detection and diagnostic methods" searched and evaluated the relevant literature, drafted this manuscript and made provisional consensus recommendations. These recommendations were discussed and refined during the structured process in the whole work group. Finally, the agreement for each recommendation was determined using an anonymous Delphi survey.

Results: Recommendations (N = 8) were approved and agreed upon by the whole expert panel: visual examination (N = 3), dental radiography (N = 3) and additional diagnostic methods (N = 2). While the quality of evidence was found to be heterogeneous, all recommendations were agreed upon by the expert panel.

Conclusion: Visual examination is recommended as the first-choice method for the detection and assessment of caries lesions on accessible surfaces. Intraoral radiography, preferably bitewing, is recommended as an additional method. Adjunct, non-ionising radiation methods might also be useful in certain clinical situations.

Clinical relevance: The expert panel merged evidence from the scientific literature with practical considerations and provided recommendations for their use in daily dental practice.

Keywords: Adjunct methods; Assessment; Bitewing radiography; Caries detection; Dental radiography; Diagnosis; Laser fluorescence; Visual examination.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1**
Steps in the caries diagnostic process and selection of therapy

**Fig. 2**
Scheme for a structured diagnostic examination

See this image and copyright information in PMC

References

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1. Santamaría RM, Abudrya MH, Gül G, Mourad MS, Gomez GF, Zandona AGF. How to intervene in the Caries process: Dentin Caries in primary teeth. Caries Res. 2020;54:306–323. doi: 10.1159/000508899. - DOI - PubMed

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ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I: caries lesion detection and depth assessment

Affiliations

ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I: caries lesion detection and depth assessment

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical