Reliability and validity of FluoreCam for white-spot lesion detection: An in vitro study.

AIM: In the present study, we tested the reliability and validity of a new light fluorescence device, the FluoreCam.

METHODS: Twenty-five human teeth were sectioned mesiodistally into halves. Group 1 (n=30) included specimens with either sound enamel or natural white-spot lesions (WSL). Group 2 (n=20) included specimens with sound enamel used to create artificial WSL. Using the FluoreCam, baseline scans of enamel surfaces were obtained under standardized conditions. Group1 was scanned again the next day. Group 2 specimens were covered with an acid-resistant nail polish, leaving a 2 × 6-mm enamel window exposed, immersed in Queiroz-solution (64 hours, 37°C/pH5 with agitation), and then scanned again. Random error of the repeated measurements (reliability) was determined using method errors and intraclass correlations (ICC). Systematic error and the ability to detect demineralization (validity) were tested using Wilcoxon signed-rank test.

RESULTS: Method errors for Group 1 replicates were .39 mm2 (area), .72 pixels (intensity), and 5.69 pixels.mm2 (impact). Group 2 method errors were consistently slightly higher than those of group 1. FluoreCam showed highly reliable measurements for group 1 (ICC: 0.93-0.98) and group 2 (ICC: 0.87-0.97). There were no statistically-significant systematic errors for either group (P>.05). In group 2, enamel demineralization was statistically significant in area (P<.001), intensity (P=.001), and impact (P<.001).

CONCLUSION: FluoreCam is highly reliable and valid for in vitro assessments of enamel demineralization.