Occlusal caries detection in children using laser fluorescent (DIAGNOdent)

Introduction: Diagnosis of non-overt occlusal decay is challenging and can be highly subjective, and its inherited uncertainties can lead to widely differing treatment decisions. Objectives: The aim of this study was to evaluate the utility of the laser fluorescence device DIAGNOdent as a tool for occlusal caries diagnosis in Sudanese children. Methods: a total number of 223 first and second permanent molar teeth (109 maxillary, 114 mandibular ) of children (age 9-12 years) attending pediatric clinic, Faculty of Dentistry, Khartoum University were examined for detection of early carious lesion  on macroscopically intact occlusal surfaces. The teeth were cleaned and occlusal carious status in a selected site was recorded using both visual examination and DIAGNOdent device. To provide gold standard for carious teeth, the depth of the carious lesion was determined in those sites and were judged visually and with DIAGNOdent device scored values >20 that need operative intervention (62 sites). The statistical significant was set at p value< 0.05. Reproducibility of intra-examiner Kappa values for visual examination and Laser device were calculated. Logistic regression analysis was performed to determine the sensitivity and specificity of the diagnostic methods.. Results: reproducibility of intra-examiner Kappa values for visual examination and Laser device was found to be o.96 and 0.72 respectively. Logistic regression showed that the performance of the  DIAGNOdent device was high sensitive and the performance of the visual inspection was more specific.  Pearson correlation test showed strong positive correlation (r = +0.72) between the measurements of LF device and the clinical lesion depth at 99% confidence interval (P < 0.01).The correlation of LF measurements with clinical lesion depth was better than that with visual examination (r =  + 0.49). Conclusions: Laser device could be used as a valuable adjunct with visual inspection in occlusal caries diagnosis in this group of Sudanese children.