A systematic review of the performance of a laser fluorescence device for detecting caries
A systematic review of the performance of a laser fluorescence device for detecting caries
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DOI：
10.14219/jada.archive.2004.0051
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发表时间：
2004-10-01
影响因子：
3.9
通讯作者：
Shugars, DA
中科院分区：
文献类型：
--
作者：
Bader, JD;Shugars, DA
背景诊断，或DD（KaVo美国，苏黎世湖，伊利诺伊州），一种使用激光荧光检测龋齿的装置在过去的三年中越来越流行。虽然它的诊断性能的几个评价已经出现在文献中，报告的性能的范围是广泛的。作者对文献进行了系统综述，以评估DD的诊断性能。在检索到的115篇文章中，根据组织学验证标准和结果（以敏感性和特异性值表示），有25篇研究被纳入综述。对于牙本质龋齿的检测，灵敏度值范围很广（0.19至1.0），尽管大多数往往很高。特异性值显示出相似的模式，范围为0.52 - 1.0。与视觉评估方法相比，DD表现出几乎总是较高的灵敏度值和几乎总是较低的特异性值。证据主体的特点主要是体外研究，因此推广到临床环境是不确定的。由于龋齿阈值变化很大，在整个研究中，综合估计的性能是不可能的。结论和临床意义。DD显然比传统的诊断方法更敏感;然而，与视觉方法相比，假阳性诊断的可能性增加，限制了其作为主要诊断工具的有用性。
Background. The DIAGNOdent, or DD (KaVo America, Lake Zurich, Ill.), a device for detecting caries using laser fluorescence, has been growing in popularity during the past thee years. Although several evaluations of its diagnostic performance have appeared in the literature, the range of reported performance is extensive.Types of Studies Reviewed. The authors conducted a systematic review of the literature to assess the diagnostic performance of the DD. Of 115 articles identified in the search, 25 studies were included in the review according to criteria requiring histologic validation and outcomes expressed as sensitivity and specificity values.Results. For detection of dentinal caries, sensitivity values ranged widely (0.19 to 1.0), although most tended to be high. Specificity values exhibited a similar pattern, ranging from 0.52 to 1.0. In comparison with visual assessment methods, the DD exhibited a sensitivity value that was almost always higher and a specificity value that was almost always lower. The body of evidence is characterized largely by in vitro studies, so that generalization to the clinical setting is uncertain. Because caries thresholds varied substantially across the studies, synthesized estimates of performance were not possible.Conclusions and Clinical Implications. The DD clearly is more sensitive than traditional diagnostic methods; however, the increased likelihood of false-positive diagnoses compared with that with visual methods limits its usefulness as a principal diagnostic tool.