Clinical Effectiveness of Different Methods for Detection Occlusal Caries

Objectives: The aim of this study was clinically evaluate the effectiveness of the VistaProof fluorescence camera, Vista Cam digital intraoral micro camera and ICDAS visual criterion in detecting caries lesions in occlusal surfaces.
Methods: One hundred seven posterior teeth of adult patients were examined visually and by means of digital radiographs by an examiner who rated them according to the presence or absence of occlusal caries. This evaluation was considered the gold standard. The teeth were then evaluated by the ICDAS, fluorescence and magnified digital image by other examiner. The effectiveness of the methods was estimated by sensitivity, specificity, positive and negative likelihood ratio. For each method was constructed ROC curve and its area (AUROC) was estimated.
Results: There was exceptional discrimination capacity for intraoral image (AUROC=0.93) and for ICDAS (AUROC=0.91) and no significant statistical difference between them (z=0.35, p=0.73). The fluorescence showed acceptable discrimination capacity (AUROC=0.78), but lower than the others. The positive likelihood ratio found for the fluorescence was only 2.32, while for intraoral image was 20.58 and the ICDAS, 58.11.
Conclusions: It can be concluded that the both methods and ICDAS presented adequate clinical performance, with best effectiveness for ICDAS and intraoral image.