In Vitro Evaluation of Occlusal Caries Detection Methods in Primary and Permanent Teeth: A Comparison of CarieScan PRO, DIAGNOdent Pen, and DIAGNOcam Methods

Abstract

Objective: The aim of this in vitro study was to evaluate the performance of the International Caries Detection and Assessment System (ICDAS)-II, radiographic examination, CarieScan PRO, DIAGNOdent Pen, and DIAGNOcam methods in detecting occlusal carious lesions. Materials and methods: Two hundred forty extracted primary and permanent teeth were assessed using caries detection methods by two examiners and afterward, the teeth were sectioned. The diagnostic methods were evaluated using receiver operating characteristic (ROC) analysis method for D-1, D-2, and D-3 thresholds and kappa analysis were used to assess interexaminer agreement. Results: D-1 thresholds, the areas under the ROC curve (AUC) values of DIAGNOcam method, were higher for both primary and permanent teeth (0.804-0.968). For both primary and permanent teeth, the highest D-2 threshold AUC values were found for ICDAS-II (0.774-0.731) and DIAGNOcam (0.775-0.731) methods. The highest AUC values of D-3 threshold were obtained with DIAGNOcam method for permanent teeth (0.708) and with DIAGNOdent Pen method for primary teeth (0.789). Between examiners, very good agreement was found for the DIAGNOdent Pen method in the primary teeth (kappa = 0.89), and good agreement was found for the DIAGNOcam method in the permanent teeth (kappa = 0.68). The kappa values were moderate for all other methods (0.41-0.57). Conclusions: DIAGNOcam, DIAGNOdent Pen, and visual examination methods may be effective in detecting hidden occlusal caries in primary and permanent teeth.