Detection of occlusal caries in deciduous teeth using different techniques

The aim of this study is to evaluate the efficiency of visual inspection, radiological examination, laser fluorescence system and electrical resistance methods on caries detection in vitro.

Methods:

In this study, 200 freshly extracted primary second molars used. Immediately after the teeth extracted, they were cleaned and scored by three different observer independently using four different examination methods. After the fourteen days, examination procedures were repeated by same observers. For histological evaluation, teeth were sectioned by a diamond saw under water cooling. Among these sections, the ones which seemed to have the deepest caries were evaluated by stereomicroscope. For statistical evaluation sensitivity, specificity, positive predictive value (+PV), negative predictive value (-PV) and accuracy values were calculated. Cohen’s Kappa and ROC analysis were done, ICC values were calculated.

Results:

In vitro conditions showed that among all methods highest sensitivity, specificity, +PV, -PV,  accuracy values were obtained with ECM IV device.

Kappa values obtained from examination methods and histological sections showed similar levels in DIAGNOdent (k= 0,71-0,77) and ECM (k= 0,69-0,74) devices. These values were higher than other two methods.

For inter-observer agreement, the highest kappa values were obtained from DIAGNOdent (k= 0,76-0,81) and ECM scores (k= 0,80-0,86) and the lowest kappa values were obtained from radiological examination. When the ICC values were considered, for intra observer agreement, both devices showed high reliability but for inter observer agreement, values of DIAGNOdent showed higher reliability compared to ECM IV.

Conclusions:

ECM IV and DIAGNOdent devices were found more successful than traditional methods. But when the cost of the devices and practicality of traditional examination methods are considered, visual inspection and radiological examination seems to be adventageous. When the data obtained from our study are considered, it can be told that ECM IV and DIAGNOdent devices can contribute searches for an ideal examination.