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The aim of this clinical study was to evaluate the diagnostic outcome of the detection of smooth surface lesions by the quantitative light-induced fluorescence (QLF) method in comparison with visual inspection (VI). Thirty-four 15-year-old adolescents were involved in the study. After professional tooth-cleaning 918 buccal and 917 lingual surfaces of the subjects were examined visually with aid of compressed air and magnifying glass (3.5!). Fluorescence images of the smooth surfaces were captured by a CCD camera after excitation with blue light, and images were stored and analysed with Inspektor QLF 2.00 programs. QLF images were analysed blind by two examiners; presence or absence of a lesion was not marked on the fluorescence images. Average fluorescence loss (¢F), lesion area (A) and ¢Q (¢FW A) were determined. Surfaces scored as sound, filled or with frank lesions by both methods were excluded. 17.8% of the buccal/ lingual initial enamel lesions (n = 489) were detected by VI, 53.8% by VI/QLF and 28.4% by QLF, respectively. Although histological validation is not possible in vivo, there was a significant difference (Mann-Whitney U-test) in A, ¢F and ¢Q between smooth surface lesions recorded by both VI/QLF, and QLF only. QLF was able to detect smaller enamel lesions with smaller fluorescence loss than lesions recorded by VI/QLF together. Lesion detection by QLF was limited in cases of partially erupted and plaque covered surfaces, and in patients with poor oral hygiene associated with reduced surface size caused by gingivitis. Small focal depth on lingual surfaces was a limiting factor. It was concluded that QLF is a sensitive method for quantification of visually undetected incipient caries lesions; however interfering factors may obscure lesion detection. |