EVALUATION OF DIFFERENT DIAGNOSTIC METHODS ON DETECTION OF INCIPIENT OCCLUSAL CARIES LESIONS

Objectives: The aim of this study was to evaluate the diagnostic performance of laser fluorescence (DIAGNOdent Pen), alternating current impedance spectroscopy technique (CarieScan Pro) and fluorecence camera (VistaProof) with visual examination and histological validation and repeat the examinations by three different examiners and determine the inter-examiner reliability of the detection methods.
Methods: Extracted 102 human molar teeth were selected. Teeth were embeded in a mold. Visual inspection was performed using ICDAS-II criterias. Then occlusal surfaces were evaluated with DIAGNOdent Pen, CarieScan Pro and VistaProof with three examiners and the datas were recorded. For histological validation, teeth were divided in two from the fissures marked as caries suspected with diamond disk. Each site was examined under a stereomicroscope at magnification of 10X and scored. Diagnostic performances of methods were evaluated with Binormal ROC analysis for D1, D2 and D3 thresholds, the compliance of the datas with histological validations were examined with McNemar-Bowker test and inter-examiner reliability of detection methods was assessed using Cohen’s unweighted k values.
Results: When the compliance between methods and histological validation was evaluated; first examiner’s datas were statistically different with histological validation (p<0,05), second examiner’s CarieScan Pro scores and third examiner’s visual examination scores were statistically similar (p=0,081). Incipient enamel lesions were determined more successful with visual inspection by three examiners. All detection methods were presented with statistically signigicant inter-examiner aggrement (p<0,001). For D2 and D3 thresholds, VistaProof for first examiner, visual inspection for second examiner and both visual inspection and VistaProof for third examiner demonstrated statistically high sensitivity and specificity (p<0,05).
Conclusions: Within the limitatons of this study, it can be concluded that diagnostic performance of the methods wasn’t enough for detecting incipient occlusal caries lesions by itself so their performances can be improved by using them with visual inspection as a traditional caries detection method.