The diagnostic efficacy of quantitative light-induced fluorescence in detection of dental caries of primary teeth

Objectives: To evaluate a quantitative light-induced fluorescence (QLF) caries detection method using a portable device under clinical conditions and present a QLF scoring index (QS-index) for primary teeth. Methods: A total of 878 tooth surfaces (proximal and occlusal) of 44 children were studied. After visual inspection and radiographic examination, images of dental caries captured with the QLF device were classified according to caries progression stages and analyzed with a specialized software. Cut-off values, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were calculated for the QLF parameters: fluorescence loss (Delta F) and bacterial activity (Delta R). The reliability of logistic regression model to combine Delta F and Delta R was evaluated by the AUROC. Results: QLF parameters showed a good sensitivity (0.72-0.91), specificity (0.74-0.96), and AUROC (0.861-0.940). The AUROC of logistic regression model (0.90-0.957) was higher than Delta F or Delta R average alone in all types of carious lesions. Every level of the QS-index was properly defined to represent the progression of dental caries with corresponding statistical significance. Conclusions: The reliability of QLF for dental caries detection in primary teeth was similar to or slightly higher than that of the traditional diagnostic methods of visual inspection or radiographic examination in clinical conditions. Clinical significance: The results of QLF were reliable in detecting all types of dental caries in primary teeth. The QLF method can provide visual images as well as quantitatively analyze the carious lesion.