The detection of early inter proximal caries: DIAGNOdent, conventional and digital radiography

Detection of caries in early stages is necessary for prevention and conservative treatment. The aim of this study was to evaluate the accuracy of laser fluorescence (LF) using DIAGNOdent pen and to compare it with conventional Bite-Wing (BW) and Digital Radiography (DR). In this survey, eighty extracted molars and premolars were mounted in stone blocks to simulate contact points. Proximal surfaces of each tooth were examined with LF. The teeth were also diagnosed using BW and digital radiography. After these procedures, the teeth were histologically prepared and assessed for caries extension as the gold standard. Sensitivity, specificity, positive and negative predictive values and accuracy were calculated for each diagnostic system in comparison with the gold standard. Cut-off points were calculated with ROC analysis. Comparisons between the accuracy of methods were performed using McNemar test. At dentinal caries, LF had the highest sensitivity and specificity (0.82 and 0.84, respectively). For detection of early inter proximal caries, the sensitivity of LF (0.74) and specificity of DR (0.95) were the highest. The LF positive predictive values were the least and negative predictive values were the most. There was no significant difference between conventional and digital radiography in the detection of interproximal caries. DIAGNOdent might be a useful additional tool in detecting early interproximal caries, but due to the false positive responses at decision making for restorative treatments, auxiliary methods should be used.