Abstract
The purpose of this study was to evaluate and compare three diagnostic methods in detecting early caries in occlusal surfaces. Three different methods, namely, visual inspection (VI), electrical caries monitor (ECM) and a caries detector dye (Dye) were used to diagnose occlusal caries in extracted teeth. One hundred sixty-one sites in a total of 42 extracted teeth were examined by three examiners with VI and ECM methods, whereas the Dye method to detect caries was tested by only one examiner. Histological examination of the teeth served as a validating criterion to evaluate the ability of each method to diagnose caries. Of 161 sites, 82, 96 and 96 sites were diagnosed as having caries by the VI, ECM and Dye methods, respectively, compared with 85 sites by histological validation. ECM showed the highest level in sensitivity (85%), followed by VI (67%) and Dye (63%). In the ROC analysis, the areas under ROC reached 0.73, 0.89 and 0.61 for the VI, ECM and Dye methods, respectively. The kappa values ranged from 0.64-0.80 and 0.75-0.82 in intra- and inter-examiners for ECM, respectively, and between 0.53-0.82 and 0.29-0.70 for VI. It was concluded that the ECM method is more valid and reproducible than VI or Dye for the diagnosis of occlusal caries.
