Comparison of Laser Fluorescence Devices’ Diagnostic Validity in Occlusal Caries of Primary Teeth

Objective: To compare the diagnostic validity of laser fluorescence devices in occlusal caries of primary teeth.Methods: 48 examination sites were classified into five groups according to the ICDAS-II criteria and measurements were taken using diagnostic devices according to each manufacturerʼs instructions.All examination sites were analyzed using Micro-CT and classified into three groups based on caries depth (no radiographic transparency, radiographic transparency limited to enamel, radiographic transparency extending to dentin).ROC curve analysis was performed to calculate sensitivity and specificity and to determine the optimal cut-off value for caries progression.Results: All laser fluorescence devices showed an increasing trend in measurement values as the ICDAS-II code increased.DIAGNOdent showed significant differences between Code 1 and Code 2, and between Code 2 and Code 3. DIAGNOdent pen showed significant differences between all groups except between Code 0 and Code 1. SmarTooth showed significant differences between Code 1 and Code 3, and between Code 3 and Code 4 and above.Conclusion: ROC curve analysis results indicated that for enamel caries diagnosis, the accuracy was highest with DIAGNOdent, followed by SmarTooth, and then DIAGNOdent pen.For dentin caries diagnosis, the accuracy was highest with SmarTooth, followed by DIAGNOdent pen, and then DIAGNOdent.However, all three devices demonstrated high accuracy in diagnosing occlusal caries in primary teeth.The cut-off values for primary teeth differed from the manufacturerʼs instructions based on permanent teeth.It is believed that using appropriate cut-off values could make these devices a supplementary method for caries diagnosis.