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Detection of dentin-exposed occlusal/incisal tooth wear using quantitative light-induced fluorescence technology

 Sang-Kyeom Kim  ;  Hoi In Jung  ;  Baek-Il Kim 
 JOURNAL OF DENTISTRY, Vol.103 : 103505, 2020-12 
Journal Title
Issue Date
Dentin exposure ; Quantitative light-induced fluorescence ; Tooth wear
Objectives: To prolong tooth life expectancy, tooth wear resulting in dentin exposure should be detected early. However, the most objective methods are clinically limited. We validated fluorescence parameters for distinguishing enamel from dentin-exposed wear in clinical images. Methods: Quantitative light-induced fluorescence (QLF) images of 73 adults (age range: 22-48 years, mean: 33.81 ± 7.71 years), including 1949 teeth with varying tooth wear degrees, without restorations, caries, or cusp area fractures, were used to calculate the ΔFwear values. Areas-of-interest (AOIs) were selected from QLF images; the ΔFwear values and the tooth wear index (TWI) were calculated for each tooth. The ΔFwear values were compared according to the TWI scores. The optimum ΔFwear values for distinguishing enamel and dentin-exposed wear were determined using the receiver operating characteristic (ROC) curve analysis. Results: Overall, 1949 AOIs were evaluated. The median ΔFwear values for teeth with TWI scores 0, 1, and 2 (5.7 %, 10.3 %, and 17.0 %) differed significantly (P < 0.001). The optimum cutoff ΔFwear values were 12.1 and 14.7 in the anterior and posterior teeth, respectively; the corresponding areas under the ROC values (AUROCs) were 0.86 and 0.93 (sensitivity: 0.79 and 0.85; specificity: 0.79 and 0.85, respectively). The ΔFwear cutoff values for different age groups were within a range (12.7-13.7) and showed high validity (sensitivity, specificity, and AUROC: 0.78, 0.77-0.78, and 0.87-0.88, respectively). Conclusions: At the optimum threshold, the ΔFwear values showed high validity for distinguishing dentin exposure in worn teeth (AUROC: 0.87‒0.93) and could determine pathological tooth wear, particularly in posterior teeth. Clinical significance: We demonstrated the feasibility of using QLF to detect dentin-exposed tooth wear and present optimal thresholds according to age. In addition, we confirmed the possibility using such image data for objective and cost-effective epidemiological investigation and application in tele-dentistry.
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2. College of Dentistry (치과대학) > Dept. of Preventive Dentistry and Public Oral Health (예방치과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Baek Il(김백일) ORCID logo https://orcid.org/0000-0001-8234-2327
Kim, Sang-Kyeom(김상겸) ORCID logo https://orcid.org/0000-0002-6380-5039
Jung, Hoi In(정회인) ORCID logo https://orcid.org/0000-0002-1978-6926
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