TY - JOUR

T1 - Systematic review and meta-analysis of diagnostic methods for occlusal surface caries

AU - Kapor, Svetlana

AU - Rankovic, Mila Janjic

AU - Khazaei, Yegane

AU - Crispin, Alexander

AU - Schüler, Ina

AU - Krause, Felix

AU - Lussi, Adrian

AU - Neuhaus, Klaus

AU - Eggmann, Florin

AU - Michou, Stavroula

AU - Ekstrand, Kim

AU - Huysmans, Marie-Charlotte

AU - Kühnisch, Jan

N1 - Funding Information: Open Access funding enabled and organized by Projekt DEAL. This project was funded by a grant for creating a scientific network obtained from the German Research Foundation (Deutsche Forschungsgemeinschaft, SCHU-3217/1–1). Publisher Copyright: © 2021, The Author(s).

PY - 2021

Y1 - 2021

N2 - Aim: This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. Materials and methods: A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. Results: SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. Conclusion: The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds. Clinical relevance: VE, BW and LF provide acceptable measures for their diagnostic performance on occlusal surfaces, but the results should be interpreted with caution due to the limited data in many categories.

AB - Aim: This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. Materials and methods: A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. Results: SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. Conclusion: The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds. Clinical relevance: VE, BW and LF provide acceptable measures for their diagnostic performance on occlusal surfaces, but the results should be interpreted with caution due to the limited data in many categories.

KW - Accuracy

KW - Bitewing radiography

KW - Caries detection

KW - Caries diagnostics

KW - Diagnostic performance

KW - Fibre-optic transillumination

KW - Laser fluorescence measurements

KW - Meta-analysis

KW - Occlusal caries

KW - Pit and fissure caries

KW - Sensitivity

KW - Specificity

KW - Systematic review

KW - Visual examination

U2 - 10.1007/s00784-021-04024-1

DO - 10.1007/s00784-021-04024-1

M3 - Review

C2 - 34128130

AN - SCOPUS:85107893109

VL - 25

SP - 4801

EP - 4815

JO - Clinical Oral Investigations

JF - Clinical Oral Investigations

SN - 1432-6981

IS - 8

ER -