An <i> in-vitro</i> comparison of visual inspection, bite-wing radiography, and laser fluorescence methods for the diagnosis of occlusal caries

Abstract

Purpose: The purpose of this study was to compare accuracy and reproducibility of visual inspection (VI), bitewing (BW) radiography, and laser fluorescence (LF, DIANOdent) methods in the diagnosis of occlusal caries. Materials and Methods: The study was done on 80 extracted permanent premolars that seem to be intact or with primary caries in fissures. Three trained dentist examined the teeth in four stages: VI, BW radiography, LF, and histologic examination. Sensitivity, specificity, positive and negative predictive values, and accuracy of all methods were calculated and compared. For the LF method, using ROC curve and counterpart points on it, we determined upper and lower limits and calculated the parameters. Results: The estimated accuracy was 58.9% for VI and 45.1% for BW radiography methods. Kappa coefficient for interexaminer reproducibility was 57% and 34.1% in VI and BW radiography, respectively. Inter- and intraexaminer reproducibility coefficients of LF methods were 78.4% and 83.6%, respectively. The mean intraexaminer reproducibility coefficient in the VI method was 61.2%. Conclusion: Although accuracy and reproducibility of the LF method were higher than those of the VI and BW radiography, it is better to use this method together with other methods to reduce diagnostic faults.

Keywords

• Visual inspection
• bitewing radiography
• laser fluorescence
• occlusal caries