Agreement Between the Spectra Light Fluorescence System and Bitewing Radiographs for Detecting Approximal Caries

Abstract

Background: In order to provide dental treatment for a carious lesion, the dentist must be able to assess accurately the presence and severity of the lesion, along with the degree of cavitation on the surface of each tooth. The use of traditional methods combined with more sensitive methods may assist clinicians in early caries detection and implementing non-invasive treatments. The diagnostic capacity of the Spectra Light Fluorescence System (SLFS) has been studied, and the results showed that the sensitivity and the specificity are acceptable for the detection of occlusal caries. However, no study has evaluated the diagnostic capacity of the SLFS in detecting cavitated and non-cavitated approximal caries lesions in primary and permanent molars. Moreover, no study has determined the distribution of dental caries on posterior primary and permanent teeth based on bitewing radiographs (BWR). Purpose: The aims of this study are: (1) to determine the agreement between SLFS and BWR for detecting approximal caries in primary molars and permanent first molars, (2) to determine the prevalence and distribution of approximal caries in primary molars and permanent first molars based on BWR, and (3) to compare the prevalence of approximal caries in primary molars and permanent first molars using the SLFS and BWR. Methods: This retrospective cross-sectional study is based on secondary data collected from a study performed in 2017 on the sensitivity and specificity of three methods used in the detection of occlusal caries. The secondary data includes the occlusal and approximal caries detection of 859 primary first and second molars and 632 permanent first molars of 160 children, 7-12 years old from an elementary public school in Lima, Peru. Occlusal and approximal caries in all teeth were detected using SLFS and BWR. To accomplish the aims of this study, only images of the mesial and distal occlusal zones captured with the SLFS and the mesial and distal approximal surfaces on BWR were included in the analysis. Descriptive and inferential data analysis were performed using SAS 9.4 software. Results: The weighted Kappa coefficients of the agreement between SLFS and BWR showed very low to fair agreement between the two systems in the detection of the approximal caries in primary molars and permanent first molars. The mesial surface of primary maxillary second molars showed the highest prevalence of total dental caries. The prevalence of caries was in general higher using SLFS for the detection of the mesial and distal caries (total caries, caries in enamel, caries in dentin) in permanent first molars and in the detection of distal caries (total caries, caries in enamel) in primary molars. The mesial caries (total caries, caries in enamel, caries in dentin) and the distal dentin caries prevalence of the primary molars was higher using BWR. Conclusions: There is a very low to fair agreement between SLFS and BWR in the detection of the approximal caries in primary molars and permanent first molars. The overall prevalence of caries was very high for primary first and second molars, and low for permanent first molars. In addition, caries prevalence varied among the mesial and distal zones/surfaces of first primary molars, second primary molars, and permanent first molars using SLFS and BWR.