Evaluation of the Clinical Performance of a New Light-induced Fluorescent Device in Detecting Occlusal Caries: A Cross-sectional Study

Aim: This cross-sectional study aimed to investigate the clinical performance of a light fluorescence-based intraoral camera in detecting the pigmented occlusal pits and fissures using the International Caries Detection and Assessment System (ICDAS), as well as compare between individual caries risk assessment (CRA) and the ICDAS codes.Materials and methods: A light fluorescence-based intraoral camera (Soprolife®, Acteon, La Clotat, France) was used to investigate n = 92 pigmented occlusal pits and fissures.The criteria for inclusion in the study were the occlusal surfaces of the posterior teeth.Visual ICDAS examination was performed before the fluorescence camera investigation.Every patient included in the study was subjected to the CRA assessment, and the pits and fissures investigated were assigned to either the high caries risk (HCR) group or the low caries risk (LCR) group, according to the CAMBRA criteria.Visual images of the occlusal pits and fissures were recorded for every fluorescence camera investigation and codified depending on whether it gave a red signal, dark red signal, or green signal with red shadow as either an active or inactive carious lesion.A relationship was established between light fluorescence-based intraoral camera signal, as ICDAS code 3 or ICDAS code 4, for both HCR group and LCR group patients.Results: Investigations were conducted for n = 92 occlusal pits and fissures.After the ICDAS examination, they were assigned code 1 to code 4.After ICDAS examination, light fluorescence-based intraoral camera investigation was conducted, and n = 71 (77.1%) showed red signal (active carious lesion) and n = 21 (22.8%)showed dark red signal (inactive carious lesion).The HCR patients were n = 67 (72.8%), and the LCR patients were n = 25 (27.1%).Most of the occlusal pits and fissures included in the HCR group were ICDAS code 3 and showed an active carious lesion (red signal) in situ.There was no statistical correlation between the CRA and the presence of either red or dark/red signal.There was a statistically significant correlation between the presence of a red signal (active carious lesion) and visible cavitation (p < 0.05).There was a statistically significant correlation between dark/red signal (inactive carious lesion) and the absence of visible cavitation (p < 0.05). Conclusion and clinical relevance:The conclusion of this study, within its limitations, was that the light fluorescence-based camera may be beneficial to the clinician in diagnosing early carious lesions in deep pigmented pits and fissures.A combination of occlusal visual inspection with ICDAS and the light fluorescence-based intraoral camera can help improve the detection of early and active occlusal carious lesions.Individual caries risk according to CAMBRA criteria, with a specific focus on HCR patients, was not statistically related to the red signal of light fluorescence-based intraoral camera but was an important factor to consider in the treatment of assessed early occlusal carious lesions with a mini-invasive dentistry approach (MID).