M Beerens

WSL ASSESSED ON CLINICAL PHOTOGRAPHY AND BY QLF 2 35 is not accurate. Scoring ICDAS in clinical setting could be influenced by bias and time pressure. By using photographs, side-by-side comparison is possible. Data captured from clinical photographs has the advantage of assessing data longitudinally and at a convenient time, out of the clinical setting. Furthermore, QLF images enable quantification of lesion severity parameters with high precision and repeatability. For post-orthodontic lesions, the ICDAS detection system on photographs does not have discriminatory power to assess distinct lesion changes within ICDAS score 2. Most of the post-orthodontic lesions were ICDAS score 2. The longitudinal changes in these non-cavitated lesions determine clinical treatment planning. If these lesions cavitate, they need curative treatment. If these lesions remain as an early caries decalcification, they may be treated using minimal intervention techniques. Scoring lesions by visual transition showed a higher discriminative power in lesion severity over time for lesions with ICDAS score 2. ICDAS does not provide enough discriminative information on the behaviour of buccal lesions over time nor does QLF imaging. This has already been stated by the National Institute of Health, which stated in 2001 that current diagnostic practices are inadequate to achieve the next level of caries management in which non-cavitated lesions are identified early so that they can be managed by nonsurgical methods (Health., 2001). A study reported by Almosa et al. (Almosa et al. , 2014) showed the usefulness of scoring lesions by means of ICDAS on oral photographs. This can be attributed to the fact that they included open cavities in their research. Scoring clinical photographs and quantitative light induced fluorescence assessment both suggested regression of WSL after debonding of fixed orthodontic appliances. The visual transition evaluation suggested more discrimination of the behaviour of existing white spot lesions than found using ICDAS scores or QLF imaging.