J Korean Acad Oral Health.  2014 Jun;38(2):105-110.

In vitro quantification of occlusal caries lesion using QLF-D, ICDAS, and DIAGNOdent

  • 1Department of Preventive and Community Dentistry, Pusan National University School of Dentistry, Pusan National University, Yangsan, Korea. jsh0917@pusan.ac.kr
  • 2Institute of Translational Dental Sciences, Pusan National University, Yangsan, Korea.
  • 3Department of Preventive Dentistry & Public Oral Health, Yonsei University College of Dentistry, Seoul, Korea.


To compare the QLF-D method and the ICDAS and DIAGNOdent techniques for in vitro quantification of occlusal caries and to assess the histological features of the caries.
One hundred and twenty-two extracted permanent teeth were selected, and the site of interest on the occlusal surface was examined using each detection method. The occlusal sites were classified according to the ICDAS II criteria based on the decision taken by two investigators, who have taken the ICDAS E-learning course. The examined site was then measured using the DIAGNOdent, and the peak value was recorded. In addition, by using the QLF-D, the occlusal site was photographed to obtain the DeltaFmax value. After all assessments were performed, the occlusal sites were vertically sectioned in order to assess the histological features. This was considered the gold standard. The histological criteria were graded using a 4-point scale as follows: S=sound (n=21), E1=limited enamel caries (n=27), E2=caries extending to the dento-enamel junction (n=49), D=caries involving the dentine (n=25).
An ICDAS code between 0 and 4 was assigned to all the occlusal sites, and this revealed the QLF-D value, which was between -95 to 0. The DIAGNOdent value was between 8 and 99. The correlation values of QLF-D, ICDAS, and DIAGNOdent with the histological features were 0.68, 0.58, and 0.46, respectively (P<0.01). A highly significant correlation was observed between QLF-D and the gold standard, which showed a moderate correlation and an acceptable correlation was observed with ICDAS (r=0.75, P<0.01). A statistically significant difference was observed in the average QLF-D values of each histological grade i.e., -28.5 (S), -53.7 (E1), -68.1 (E2), and -84.4 (D).
The QLF-D showed a significant correlation with the ICDAS and histological features. Therefore, visual inspection with QLF-D would improve the detection accuracy and ensure early diagnosis of dental caries.


DIAGNOdent; Early caries detection; ICDAS; Occlusal caries; QLF-D; Quantification
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