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Oral Health & Preventive Dentistry



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Oral Health Prev Dent 14 (2016), No. 6     12. Dec. 2016
Oral Health Prev Dent 14 (2016), No. 6  (12.12.2016)

Page 555-561, doi:10.3290/j.ohpd.a37140, PubMed:27957565

Effectiveness of DIAGNOdent in Detecting Root Caries Without Dental Scaling Among Community-dwelling Elderly
Zhang, Wen / McGrath, Colman / Lo, Edward C.M.
Purpose: The purpose of this clinical research was to analyze the effectiveness of DIAGNOdent in detecting root caries without dental scaling.
Materials and Methods: The status of 750 exposed, unfilled root surfaces was assessed by visual-tactile examination and DIAGNOdent before and after root scaling. The sensitivity and specificity of different cut-off DIAGNOdent values in diagnosing root caries with reference to visual-tactile criteria were evaluated on those root surfaces without visible plaque/calculus. The DIAGNOdent values from sound and carious root surfaces were compared using the nonparametric Mann-Whitney U-test. The level of statistical significance was set at 0.05.
Results: On root surfaces without plaque/calculus, significantly different (p < 0.05) DIAGNOdent readings were obtained from sound root surfaces (12.2 ± 11.1), active carious root surfaces (37.6 ± 31.7) and inactive carious root surfaces (20.9 ± 10.5) before scaling. On root surfaces with visible plaque, DIAGNOdent readings obtained from active carious root surfaces (29.6 ± 20.8) and inactive carious root surfaces (27.0 ± 7.2) were not statistically significantly different (p > 0.05). Furthermore, on root surfaces with visible calculus, all DIAGNOdent readings obtained from sound root surfaces were > 50, which might be misinterpreted as carious. After scaling, the DIAGNOdent readings obtained from sound root surfaces (8.1 ± 11.3), active carious root surfaces (37.9 ± 31.9) and inactive carious root surfaces (24.9 ± 11.5) presented significant differences (p < 0.05). A cut-off value between 10 and 15 yielded the highest combined sensitivity and specificity in detecting root caries on root surfaces without visible plaque/calculus before scaling, but the combined sensitivity and specificity are both around 70%.
Conclusion: These findings suggest that on exposed, unfilled root surfaces without visible plaque/calculus, DIAGNOdent can be used as an adjunct to the visual-tactile criteria in detecting root-surface status without pre-treatment by dental scaling.

Keywords: caries detection, dental scaling, DIAGNOdent, laser fluorescence, root caries