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Various clinical criteria are used to assess the severity and treatment need of root caries lesions. However, estimation of the lesions' penetration depth into the root is difficult, especially if the surface is still intact. The purpose of the study was to investigate the validity and reproducibility of laser fluorescence and electrical resistance readings on root caries lesions. One hundred and three freshly extracted human teeth exhibiting varying degrees of natural root caries were Root surface caries is a common problem for some populations, particularly the elderly. Conventional diagnostic techniques detect root caries when it is relatively advanced and a significant amount of tissue has been lost. In a previous study we determined the ability of visual examination (VE), quantitative light-induced fluorescence (QLF), electrical conductance measurement (ECM) and DIAGNOdent (DD) to detect early root surface caries on extracted teeth. However, several potential problems were encountered carrying out the study. The purpose of this study was to repeat the previous study correcting the problems. One hundred extracted human teeth with root surfaces presenting different clinical conditions - stains, calculus, sound without stain or calculus, early demineralization, early cavitation and combinations of them - were examined. Examinations on 25% of the specimens were repeated. After the examinations, the teeth were analyzed by confocal microscopy. Repeatability within examiner was very strong. Agreement among examiners was very good generally and excellent for DD. Based on the area under the ROC curves, the methods have similar diagnostic capabilities (QLF: 0.78, VE: 0.79, ECM: 0.76, DD: 0.82). In terms of accuracy there were no differences (0.73-0.80). ECM had a higher specificity than QLF and DD, but one similar to VE. DD showed higher sensitivity. In conclusion, the four techniques were equally accurate in detecting small carious lesions on root surfaces of extracted teeth, showing good repeatability and agreement among examiners. However, there were differences among some of the methods in terms of sensitivity and specificity. Supported by NIDCR. |