TY - JOUR

T1 - What is the most accurate method for detecting caries lesions? A systematic review

AU - Gimenez, Thais

AU - Tedesco, Tamara K.

AU - Janoian, Fernando

AU - Braga, Mariana Minatel

AU - Raggio, Daniela Prócida

AU - Deery, Christopher

AU - Ricketts, David N. J.

AU - Ekstrand, Kim Rud

AU - Mendes, Fausto M.

PY - 2021

Y1 - 2021

N2 - Objective: To perform a systematic review and meta-analysis of the performance of different methods for detecting carious lesions in permanent and primary teeth, considering all types of tooth surface. Methods: Two reviewers searched PubMed, Embase, Scopus and other sources up to November 2020 to identify published and nonpublished studies in English. We focused on three caries detection methods: visual inspection (VI), radiographic (RX) and fluorescence-based (LF). We included studies investigating at least one of these methods which (a) assessed the accuracy of the method in detecting caries lesions; (b) considered occlusal, proximal or free smooth surfaces in primary or permanent teeth; (c) used a reference standard other than one of the three methods; and (d) reported data on sample size and accuracy. Multilevel analyses, meta-regressions and comparisons of bivariate summary receiver operating characteristics curves were undertaken. Results: Two hundred and forty manuscripts from 14 129 articles initially identified met the inclusion criteria. VI was better than RX on occlusal surfaces at all caries lesion thresholds and proximal surfaces of permanent teeth only at all lesion thresholds in laboratory setting. LF was slightly better than VI for advanced lesions on occlusal surfaces of permanent teeth in the clinical setting and for all lesions on proximal surfaces of permanent teeth in the laboratory setting. Still, LF was worse than VI for advanced occlusal lesions in permanent teeth in the laboratory setting. Although LF showed slightly better performance than VI with advanced lesions, the latter had significantly higher specificity than other methods in all settings. Conclusion: Visual caries detection alone is adequate for most patients in daily clinical practice regardless of tooth type or surface.

AB - Objective: To perform a systematic review and meta-analysis of the performance of different methods for detecting carious lesions in permanent and primary teeth, considering all types of tooth surface. Methods: Two reviewers searched PubMed, Embase, Scopus and other sources up to November 2020 to identify published and nonpublished studies in English. We focused on three caries detection methods: visual inspection (VI), radiographic (RX) and fluorescence-based (LF). We included studies investigating at least one of these methods which (a) assessed the accuracy of the method in detecting caries lesions; (b) considered occlusal, proximal or free smooth surfaces in primary or permanent teeth; (c) used a reference standard other than one of the three methods; and (d) reported data on sample size and accuracy. Multilevel analyses, meta-regressions and comparisons of bivariate summary receiver operating characteristics curves were undertaken. Results: Two hundred and forty manuscripts from 14 129 articles initially identified met the inclusion criteria. VI was better than RX on occlusal surfaces at all caries lesion thresholds and proximal surfaces of permanent teeth only at all lesion thresholds in laboratory setting. LF was slightly better than VI for advanced lesions on occlusal surfaces of permanent teeth in the clinical setting and for all lesions on proximal surfaces of permanent teeth in the laboratory setting. Still, LF was worse than VI for advanced occlusal lesions in permanent teeth in the laboratory setting. Although LF showed slightly better performance than VI with advanced lesions, the latter had significantly higher specificity than other methods in all settings. Conclusion: Visual caries detection alone is adequate for most patients in daily clinical practice regardless of tooth type or surface.

KW - dental caries

KW - diagnostic techniques and procedures

KW - performance

KW - systematic reviews as topic

U2 - 10.1111/cdoe.12641

DO - 10.1111/cdoe.12641

M3 - Review

C2 - 33847007

AN - SCOPUS:85104239293

VL - 49

SP - 216

EP - 224

JO - Community Dentistry and Oral Epidemiology

JF - Community Dentistry and Oral Epidemiology

SN - 0301-5661

IS - 3

ER -