Reproducibility of a New Fluorescence-Based Method for the Detection of Occlusal Caries Lesions in Vitro

Background: The variation in the reproducibility of methods for detecting caries lesions may impact on the clinical management of dental caries disease. The aim of the study was to evaluate in vitro the intra- and inter-examiner reproducibility of a new fluorescence-based adjunct method (Cam X Spectra Caries Detection Aid, USA) and compare it to the ICDAS (International Caries Detection and Assessment System) visual criteria in the detection of occlusal caries lesions in permanent teeth.

Methods: The sample consisted of 100 extracted permanent posterior teeth and a healthy or carious lesion occlusal site was selected per tooth. Two trained examiners (A and B) independently assessed the teeth twice, with a one-week interval, using the Cam X Spectra, which provides numerical values between 0 to 5 (composed of 4 violet LEDs that differentiate fluorescence between the healthy and carious tissue) and the ICDAS visual criteria. To evaluate intra- and inter-examiner reproducibility, weighted Kappa Coefficient (ICDAS) and Intraclass Correlation Coefficient (Cam X Spectra) were calculated.

Results: For intra-examiner reproducibility for ICDAS and Cam X Spectra, the values were 0.71 and 0.67 (examiner A) and 0.72 and 0.87 (examiner B), respectively. For inter-examiner reproducibility, the values were 0.65 (ICDAS) and 0.73 (Cam X Spectra).

Conclusions: It could be concluded that intra- and inter-examiner reproducibility values were moderate to good for both Cam X Spectra and ICDAS visual criteria in the detection of occlusal caries lesions in permanent teeth in vitro.