M Beerens

26 CHAPTER 2 At the department of orthodontics at the Academic Centre for Dentistry (ACTA) all patients are photographed using quantitative light induced fluorescence (QLF) as part of a caries prevention programme. These QLF photos have proven useful in monitoring of the development of caries lesion after conclusion of orthodontic treatment (Boersma et al. , 2005; Mattousch et al. , 2007; Beerens et al. , 2010). However, QLF is a time-consuming and expensive method and, hence, not generally available in orthodontic practice. In this retrospective study we aimed to assess the use of ICDAS and visual transitiononphotographsandQLFforclinicalcariesdetection.Thediscriminatory accuracy of assessing routine digital oral photographs and QLF images in monitoring incidence and severity of WSL are compared from immediately post-orthodontic fixed appliance treatment to 12 months thereafter. The tested hypothesis is that changes in white spot lesions from immediately post-orthodontic treatment to 1 year follow-up, using ICDAS or visual transition (VT) scoring on clinical oral photography and QLF imaging, have comparable accuracy in discriminating changes in lesion severity. MATERIALS AND METHODS This retrospective study was performed to assess the discriminatory power of three methods to detect caries lesions and assess caries lesion progression and regression seen on clinical and QLF photographs obtained from subjects immediately after removal of the full fixed appliances (T1) and 1 year thereafter (T2). QLF photographs used were obtained as part of a caries clinical trial aimed at regression of white spot lesions after orthodontic treatment (Beerens et al. , 2010). The medical ethical committee of the University Medical Centre of the Free University Amsterdam, the Netherlands, approved this study protocol (MEC 07/213). Clinical photographs used are routinely made before, during and after orthodontic treatment at the department of orthodontics. Clinical and QLF photographs were scored on all buccal surfaces in the upper and lower jaw from second pre-molar to second pre-molar. Clinical photographs were assessed using ICDAS scores adapted for photographs as described below on post-debond and 1-year photographs independently as well as by visual transition scores (VT) comparing the post-debond and 1 year