Non-Cochrane · DTA · PM23593215
Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of heterogeneity.
Gimenez Thais, Braga Mariana Minatel, Raggio Daniela Procida, et al. · PloS one · 2013 · PubMed · doi:10.1371/journal.pone.0060421
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
62
current version
GRADE rated
0
No studies
0
Included studies
75
linked below
No studies 0 · 0%Ungraded 62 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Human permanent or primary teeth; occlusal, approximal or smooth surfaces; laboratory (in vitro) or clinical (in vivo) setting; detection of caries lesions | 75 included studies (publication years 1999-2012); majority permanent teeth, occlusal surfaces, laboratory setting, histological reference standard |
| Intervention | Fluorescence-based caries-detection methods: laser fluorescence (LF; DIAGNOdent), pen-type laser fluorescence (LFpen; DIAGNOdent pen), fluorescence camera (FC; VistaProof), quantitative light-induced fluorescence (QLF) | LF most studied, followed by LFpen; FC fewer studies; QLF only 3 studies (no meta-analysis) |
| Comparison | Reference/gold standard (histological examination, operative intervention, or other/visual examination) | Histological (majority), operative intervention, and other reference standards |
| Outcomes | Diagnostic accuracy: sensitivity, specificity, diagnostic odds ratio (DOR), positive/negative likelihood ratios (PLR/NLR), summary ROC (AUC); heterogeneity (I2); publication bias; meta-regression sources of heterogeneity | Similar overall accuracy across methods, teeth, surfaces and settings; better accuracy (higher DOR) at more advanced threshold; specificity generally higher than sensitivity (except occlusal permanent at advanced threshold); heterogeneity moderate to high (I2 0-93%); publication bias evident on several funnel plots; sensitivity analysis (leave-one-out) showed no significant change |
| Study designs | Diagnostic accuracy studies, in vitro and in vivo; no restriction on study design | Vast majority laboratory (in vitro); some clinical (in vivo) |
| Timing | Two lesion-severity thresholds: initial caries lesions and more advanced (dentine/cavitated) lesions | Both thresholds analyzed; trend to better performance (higher DOR) at the more advanced threshold |
Search date: 19 June 2012. Databases: MEDLINE (PubMed), Embase, Scopus; grey/unpublished literature via OpenSIGLE and Annals of the ORCA Congress (last 10 years); reference lists of included articles
Questions and results
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination)
Population: Permanent teeth, occlusal surfaces, with suspected caries lesions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) More advanced (dentine/cavitated) caries lesions threshold Laser fluorescence on occlusal surfaces of permanent teeth (more advanced-lesion threshold): pooled DOR higher for LF (and FC) than for LFpen; heterogeneity I2=77%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 6 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 6); pooled DOR higher for LF (and FC) than for LFpen. Heterogeneity I2=77%. Numeric pooled values not available in the… | NR | Ungraded |
Relative DOR by reference standard (LF, initial, occlusal permanent) Initial caries lesions threshold · Other reference standard vs histological (reference) LF performed significantly better with other reference standards than with histological validation at the initial threshold (RDOR 4.13, 1.24 to 13.76). Source: Table 2 · same question in other reviews | RDOR 4.13 [1.24, 13.76] | NR | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · LF, occlusal, permanent teeth Population: Permanent teeth with occlusal surfaces Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=77%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Specificity 0.779 [0.765, 0.794] | 37 studies | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · LF, occlusal, permanent teeth Population: Permanent teeth with occlusal surfaces Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=77%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Sensitivity 0.809 [0.791, 0.827] | 37 studies | Ungraded |
Relative DOR by reference standard (LF, advanced, occlusal permanent) More advanced (dentine/cavitated) caries lesions threshold · Other reference standard vs histological (reference) No significant difference vs histological for LF at the advanced threshold (RDOR 0.62, 0.15 to 2.46). Source: Table 3 · same question in other reviews | RDOR 0.62 [0.15, 2.46] | NR | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) Initial caries lesions threshold Laser fluorescence on occlusal surfaces of permanent teeth (initial-lesion threshold): accuracy (sensitivity, specificity, DOR, PLR, NLR, sROC AUC) similar among LF, LFpen and FC; heterogeneity I2=65%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 6 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 6); accuracy (sensitivity, specificity, DOR, PLR, NLR, sROC AUC) similar among LF, LFpen and FC. Heterogeneity I2=65%.… | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LF, occlusal, permanent teeth Population: Permanent teeth with occlusal surfaces Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=65%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Specificity 0.712 [0.690, 0.734] | 27 studies | Ungraded |
Relative DOR by reference standard (LF, advanced, occlusal permanent) More advanced (dentine/cavitated) caries lesions threshold · Operative intervention vs histological (reference) LF performed significantly better with operative-intervention reference standard than with histological at the advanced threshold (RDOR 3.01, 1.26 to 7.20). Source: Table 3 · same question in other reviews | RDOR 3.01 [1.26, 7.20] | NR | Ungraded |
Relative DOR by reference standard (LF, initial, occlusal permanent) Initial caries lesions threshold · Operative intervention vs histological (reference) No significant difference vs histological reference standard for LF at the initial threshold (RDOR 0.91, 0.37 to 2.22). Source: Table 2 · same question in other reviews | RDOR 0.91 [0.37, 2.22] | NR | Ungraded |
Relative DOR by setting (LF, advanced, occlusal permanent) More advanced (dentine/cavitated) caries lesions threshold · Laboratory vs clinical (reference) For LF on occlusal permanent teeth (advanced threshold), laboratory studies had significantly lower diagnostic accuracy than clinical studies (RDOR 0.28, 0.12 to 0.66). Source: Table 1 · same question in other reviews | RDOR 0.28 [0.12, 0.66] | NR | Ungraded |
Relative DOR by setting (LF, advanced, occlusal permanent) More advanced (dentine/cavitated) caries lesions threshold · Laboratory using frozen teeth vs clinical (reference) No significant difference between laboratory-frozen and clinical LF studies (RDOR 0.45, 0.12 to 1.67). Source: Table 1 · same question in other reviews | RDOR 0.45 [0.12, 1.67] | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LF, occlusal, permanent teeth Population: Permanent teeth with occlusal surfaces Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=65%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Sensitivity 0.779 [0.763, 0.794] | 27 studies | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard
Population: Permanent teeth with occlusal surfaces
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
More advanced caries lesion detection More advanced caries lesion threshold · LFpen, occlusal, permanent teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=73%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Specificity 0.718 [0.683, 0.751] | 10 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) More advanced (dentine/cavitated) caries lesions threshold Population: Permanent teeth, occlusal surfaces, with suspected caries lesions Pen-type laser fluorescence on occlusal surfaces of permanent teeth (more advanced-lesion threshold): pooled DOR for LFpen lower than for LF and FC; heterogeneity I2=73%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 6 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 6); pooled DOR for LFpen lower than for LF and FC. Heterogeneity I2=73%. Numeric pooled values not available in the… | NR | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · LFpen, occlusal, permanent teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=73%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Sensitivity 0.724 [0.672, 0.772] | 10 studies | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LFpen, occlusal, permanent teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=54%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Specificity 0.818 [0.751, 0.873] | 9 studies | Ungraded |
Relative DOR by reference standard (LFpen, initial, occlusal permanent) Initial caries lesions threshold · Other reference standard vs histological (reference) Population: Permanent teeth, occlusal surfaces, with suspected caries lesions No significant reference-standard difference for LFpen at the initial threshold (RDOR 4.41, 0.19 to 103.92). Source: Table 2 · same question in other reviews | RDOR 4.41 [0.19, 103.92] | NR | Ungraded |
Relative DOR by setting (LFpen, advanced, occlusal permanent) More advanced (dentine/cavitated) caries lesions threshold · Laboratory using frozen teeth vs clinical (reference) Population: Permanent teeth, occlusal surfaces, with suspected caries lesions No significant setting difference for LFpen (RDOR 1.27, 0.18 to 8.79). Source: Table 1 · same question in other reviews | RDOR 1.27 [0.18, 8.79] | NR | Ungraded |
Relative DOR by setting (LFpen, advanced, occlusal permanent) More advanced (dentine/cavitated) caries lesions threshold · Laboratory vs clinical (reference) Population: Permanent teeth, occlusal surfaces, with suspected caries lesions No significant setting difference for LFpen (RDOR 0.35, 0.04 to 2.99). Source: Table 1 · same question in other reviews | RDOR 0.35 [0.04, 2.99] | NR | Ungraded |
Relative DOR by reference standard (LFpen, advanced, occlusal permanent) More advanced (dentine/cavitated) caries lesions threshold · Operative intervention vs histological (reference) Population: Permanent teeth, occlusal surfaces, with suspected caries lesions No significant reference-standard difference for LFpen at the advanced threshold (RDOR 0.96, 0.12 to 7.77). Source: Table 3 · same question in other reviews | RDOR 0.96 [0.12, 7.77] | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LFpen, occlusal, permanent teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=54%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Sensitivity 0.749 [0.715, 0.781] | 9 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) Initial caries lesions threshold Population: Permanent teeth, occlusal surfaces, with suspected caries lesions Pen-type laser fluorescence on occlusal surfaces of permanent teeth (initial-lesion threshold): accuracy similar among LF, LFpen and FC; heterogeneity I2=54%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 6 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 6); accuracy similar among LF, LFpen and FC. Heterogeneity I2=54%. Numeric pooled values not available in the provided… | NR | Ungraded |
Fluorescence camera (FC; VistaProof) vs Reference standard (histological examination, operative intervention, or other/visual examination)
Population: Permanent teeth, occlusal surfaces, with suspected caries lesions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relative DOR by setting (FC, advanced, occlusal permanent) More advanced (dentine/cavitated) caries lesions threshold · Laboratory using frozen teeth vs clinical (reference) No significant setting difference for FC (RDOR 2.96, 0.36 to 24.45). Source: Table 1 · same question in other reviews | RDOR 2.96 [0.36, 24.45] | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · FC, occlusal, permanent teeth Population: Permanent teeth with occlusal surfaces Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=0%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Sensitivity 0.708 [0.669, 0.745] | 8 studies | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · FC, occlusal, permanent teeth Population: Permanent teeth with occlusal surfaces Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=17%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Specificity 0.669 [0.627, 0.708] | 8 studies | Ungraded |
Relative DOR by setting (FC, advanced, occlusal permanent) More advanced (dentine/cavitated) caries lesions threshold · Laboratory vs clinical (reference) No significant setting difference for FC (RDOR 3.83, 0.53 to 27.73). Source: Table 1 · same question in other reviews | RDOR 3.83 [0.53, 27.73] | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · FC, occlusal, permanent teeth Population: Permanent teeth with occlusal surfaces Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=0%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Specificity 0.821 [0.739, 0.885] | 8 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) Initial caries lesions threshold Fluorescence camera on occlusal surfaces of permanent teeth (initial-lesion threshold): accuracy similar among the three methods (very low inconsistency); heterogeneity I2=0%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 6 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 6); accuracy similar among the three methods (very low inconsistency). Heterogeneity I2=0%. Numeric pooled values not… | NR | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) More advanced (dentine/cavitated) caries lesions threshold Fluorescence camera on occlusal surfaces of permanent teeth (more advanced-lesion threshold): pooled DOR for FC among the higher values, exceeding LFpen; heterogeneity I2=17%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 6 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 6); pooled DOR for FC among the higher values, exceeding LFpen. Heterogeneity I2=17%. Numeric pooled values not… | NR | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · FC, occlusal, permanent teeth Population: Permanent teeth with occlusal surfaces Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=17%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 6 · same question in other reviews | Sensitivity 0.876 [0.826, 0.916] | 8 studies | Ungraded |
Laser fluorescence (LF) vs Reference standard
Population: Primary teeth with occlusal surfaces
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
More advanced caries lesion detection More advanced caries lesion threshold · LF, occlusal, primary teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=23%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Sensitivity 0.672 [0.616, 0.725] | 13 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) More advanced (dentine/cavitated) caries lesions threshold Population: Primary teeth, occlusal surfaces, with suspected caries lesions Laser fluorescence on occlusal surfaces of primary teeth (more advanced-lesion threshold): pooled DOR lowest for LF among the three methods; heterogeneity I2=23%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 7 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 7); pooled DOR lowest for LF among the three methods. Heterogeneity I2=23%. Numeric pooled values not available in the… | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LF, occlusal, primary teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=75%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Specificity 0.838 [0.810, 0.864] | 14 studies | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LF, occlusal, primary teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=75%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Sensitivity 0.622 [0.592, 0.651] | 14 studies | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · LF, occlusal, primary teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=23%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Specificity 0.816 [0.793, 0.837] | 13 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) Initial caries lesions threshold Population: Primary teeth, occlusal surfaces, with suspected caries lesions Laser fluorescence on occlusal surfaces of primary teeth (initial-lesion threshold): accuracy similar among LF, LFpen and FC; heterogeneity I2=75%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 7 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 7); accuracy similar among LF, LFpen and FC. Heterogeneity I2=75%. Numeric pooled values not available in the provided… | NR | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard
Population: Primary teeth with occlusal surfaces
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
More advanced caries lesion detection More advanced caries lesion threshold · LFpen, occlusal, primary teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=31%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Sensitivity 0.831 [0.723, 0.909] | 5 studies | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · LFpen, occlusal, primary teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=31%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Specificity 0.864 [0.834, 0.890] | 5 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) More advanced (dentine/cavitated) caries lesions threshold Population: Primary teeth, occlusal surfaces, with suspected caries lesions Pen-type laser fluorescence on occlusal surfaces of primary teeth (more advanced-lesion threshold): pooled DOR intermediate for LFpen among the three methods; heterogeneity I2=31%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 7 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 7); pooled DOR intermediate for LFpen among the three methods. Heterogeneity I2=31%. Numeric pooled values not available… | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LFpen, occlusal, primary teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=0%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Sensitivity 0.719 [0.677, 0.757] | 5 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) Initial caries lesions threshold Population: Primary teeth, occlusal surfaces, with suspected caries lesions Pen-type laser fluorescence on occlusal surfaces of primary teeth (initial-lesion threshold): accuracy similar among the three methods; heterogeneity I2=0%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 7 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 7); accuracy similar among the three methods. Heterogeneity I2=0%. Numeric pooled values not available in the provided… | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LFpen, occlusal, primary teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=0%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Specificity 0.718 [0.637, 0.791] | 5 studies | Ungraded |
Fluorescence camera (FC) vs Reference standard
Population: Primary teeth with occlusal surfaces
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
More advanced caries lesion detection More advanced caries lesion threshold · FC, occlusal, primary teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=80%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Specificity 0.898 [0.867, 0.924] | 2 studies | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · FC, occlusal, primary teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=0%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Sensitivity 0.482 [0.433, 0.531] | 2 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) More advanced (dentine/cavitated) caries lesions threshold Population: Primary teeth, occlusal surfaces, with suspected caries lesions Fluorescence camera on occlusal surfaces of primary teeth (more advanced-lesion threshold): pooled DOR highest for FC among the three methods; heterogeneity I2=80%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 7 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 7); pooled DOR highest for FC among the three methods. Heterogeneity I2=80%. Numeric pooled values not available in the… | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · FC, occlusal, primary teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=0%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Specificity 0.815 [0.713, 0.892] | 2 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) Initial caries lesions threshold Population: Primary teeth, occlusal surfaces, with suspected caries lesions Fluorescence camera on occlusal surfaces of primary teeth (initial-lesion threshold): accuracy similar among the three methods; heterogeneity I2=0%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 7 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 7); accuracy similar among the three methods. Heterogeneity I2=0%. Numeric pooled values not available in the provided… | NR | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · FC, occlusal, primary teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=80%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 7 · same question in other reviews | Sensitivity 0.850 [0.702, 0.943] | 2 studies | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard
Population: Permanent teeth with approximal surfaces
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Initial caries lesion detection Initial caries lesion threshold · LFpen, approximal, permanent teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=93%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 8 · same question in other reviews | Specificity 0.842 [0.756, 0.907] | 2 studies | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · LFpen, approximal, permanent teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=84%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 8 · same question in other reviews | Specificity 0.824 [0.761, 0.875] | 2 studies | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LFpen, approximal, permanent teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=93%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 8 · same question in other reviews | Sensitivity 0.777 [0.706, 0.838] | 2 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) Initial caries lesions threshold Population: Permanent teeth, approximal surfaces, with suspected caries lesions Pen-type laser fluorescence on approximal surfaces of permanent teeth (initial-lesion threshold): only LFpen had sufficient studies to pool; similar values at both thresholds; heterogeneity I2=93%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 8 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 8); only LFpen had sufficient studies to pool; similar values at both thresholds. Heterogeneity I2=93%. Numeric pooled… | NR | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) More advanced (dentine/cavitated) caries lesions threshold Population: Permanent teeth, approximal surfaces, with suspected caries lesions Pen-type laser fluorescence on approximal surfaces of permanent teeth (more advanced-lesion threshold): LFpen showed similar values at both thresholds; heterogeneity I2=84%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 8 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 8); LFpen showed similar values at both thresholds. Heterogeneity I2=84%. Numeric pooled values not available in the… | NR | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · LFpen, approximal, permanent teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=84%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 8 · same question in other reviews | Sensitivity 0.750 [0.641, 0.840] | 2 studies | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard
Population: Primary teeth with approximal surfaces
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
More advanced caries lesion detection More advanced caries lesion threshold · LFpen, approximal, primary teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=89%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 8 · same question in other reviews | Specificity 0.958 [0.947, 0.968] | 5 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) Initial caries lesions threshold Population: Primary teeth, approximal surfaces, with suspected caries lesions Pen-type laser fluorescence on approximal surfaces of primary teeth (initial-lesion threshold): only LFpen had sufficient studies to pool; heterogeneity I2=84%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 8 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 8); only LFpen had sufficient studies to pool. Heterogeneity I2=84%. Numeric pooled values not available in the provided… | NR | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LFpen, approximal, primary teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=84%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 8 · same question in other reviews | Sensitivity 0.354 [0.324, 0.385] | 5 studies | Ungraded |
More advanced caries lesion detection More advanced caries lesion threshold · LFpen, approximal, primary teeth Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=89%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 8 · same question in other reviews | Sensitivity 0.795 [0.730, 0.850] | 5 studies | Ungraded |
Initial caries lesion detection Initial caries lesion threshold · LFpen, approximal, primary teeth Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=84%; no GRADE rating was reported. Source: Results, Synthesis of results; Figure 8 · same question in other reviews | Specificity 0.870 [0.843, 0.895] | 5 studies | Ungraded |
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) More advanced (dentine/cavitated) caries lesions threshold Population: Primary teeth, approximal surfaces, with suspected caries lesions Pen-type laser fluorescence on approximal surfaces of primary teeth (more advanced-lesion threshold): LFpen showed higher pooled DOR at the more advanced threshold; heterogeneity I2=89%. Diagnostic accuracy was not formally graded (GRADE not used). Source: Results (Synthesis of results); Figure 8 (sROC synthesis; image not provided) · same question in other reviews | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 8); LFpen showed higher pooled DOR at the more advanced threshold. Heterogeneity I2=89%. Numeric pooled values not… | NR | Ungraded |
Quantitative light-induced fluorescence (QLF) vs Reference standard (histological examination, operative intervention, or other/visual examination)
Population: Permanent teeth (occlusal and smooth surfaces), with suspected caries lesions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Diagnostic accuracy (sensitivity, specificity, DOR) - not pooled Initial and more advanced caries lesions thresholds Only 3 QLF studies were included, so no pooled estimate of QLF diagnostic accuracy could be calculated (evidence not graded). Source: Results (Synthesis of results), paragraph on QLF · same question in other reviews | Only three articles using QLF were included (all permanent teeth); no meta-analysis could be performed. Individual studies reported high sensitivity or high specificity depending on threshold and surface. | 3 studies | Ungraded |
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination)
Population: Permanent and primary teeth, smooth surfaces, with suspected caries lesions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Diagnostic accuracy (sensitivity, specificity) - not pooled Initial and more advanced caries lesions thresholds Only 2 LF studies assessed smooth surfaces, so no pooled estimate was possible; both reported higher specificity than sensitivity (evidence not graded). Source: Results (Synthesis of results), paragraph on smooth surfaces · same question in other reviews | Only two included studies assessed smooth surfaces (both used LF; one permanent, one primary); no meta-analysis was possible. Both reported specificity higher than sensitivity at both thresholds. | 2 studies | Ungraded |
Included primary studies 75
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Abalos C, 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Abalos C, 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Achilleos EE, 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Akarsu SB, 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Aktan AM, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Anttonen V, 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Apostolopoulou D, 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Attrill DC, 2001 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Bamzahim M, 2002 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Barberia E, 2008 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Baseren NM, 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Bengtson AL, 2005 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Bittar DG, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Braga MM, 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Burin C, 2005 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Chen J, 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Chong M, 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Chong MJ, 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Chu CH, 2010 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Cortes DF, 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Costa AM, 2008 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| de Paula AB, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Deery C, 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Diniz MB, 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Diniz MB, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Diniz MB, 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Francescut P, 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Goel A, 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Heinrich-Weltzien R, 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Huth KC, 2008 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Huth KC, 2010 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Jablonski-Momeni A, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Jablonski-Momeni A, 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kavvadia K, 2008 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kavvadia K, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kawadia K, 2008 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kawadia K, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Khalife MA, 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Krause F, 2007 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kuhnisch J, 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kühnisch J, 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Lussi A, 1999 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Lussi A, 2001 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Lussi A, 2005 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Lussi A, 2006a matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Manton DJ, 2007 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Matos R, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Matos R, 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Mendes FM, 2005 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Mendes FM, 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Neuhaus KW, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Novaes TF, 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Novaes TF, 2010 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Novaes TF, 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Olmez A, 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Ouellet A, 2002 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Pereira AC, 2001 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Pereira AC, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Rando-Meirelles MP, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Rechmann P, 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Reis A, 2004 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Reis A, 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Rocha RO, 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Rocha-Cabral RM, 2008 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Rodrigues JA, 2008 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Rodrigues JA, 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Rodrigues JA, 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Seremidi K, 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Sheehy EC, 2001 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Shi XQ, 2000 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Shi XQ, 2001 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Sridhar N, 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Umemori S, 2010 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Valera FB, 2008 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Virajsilp V, 2005 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |