Evaluation of different Diagnostic Modalities for Diagnosis of Dental Caries: An in vivo Study.

Divya Tomar,Iram Zaidi,Shikha Singh,Muhamad Nishad

doi:10.5005/jp-journals-10005-1385

Abstract

AimThe aim of this study was to compare and evaluate the efficacy of different diagnostic aids for diagnosis of dental caries and to compare the validity in terms of sensitivity and specificity of all four diagnostic modalities for diagnosis of caries.Materials and methodsOcclusal surfaces of 100 primary and permanent molars were examined using the four diagnostic systems (visual, intraoral camera, DIAGNOdent, and DIAGNOdent with dye). These results were compared with operative intervention gold standard. Sensitivity and specificity were calculated for each diagnostic system for both enamel and dentin caries. Interrater agreement was calculated for each diagnostic system using kappa statistics.ResultsFor both enamel and dentin caries, the highest sensitivity values were provided by DIAGNOdent (0.91 and 0.72) and lowest for visual examination on wet surface (0.60 and 0.50). For both enamel and dentin caries, the specificity was found to be highest for intraoral camera on dry surface and lowest for visual examination. The DIAGNOdent gave the highest value of interrater agreement (kappa), i.e., 0.816 as compared with 0.03 for visual examination.ConclusionThe study clearly demonstrated that DIAGNO-dent was the most accurate and valid system tested for the detection of occlusal caries. It has the advantage of quantifying the mineral content, helping to improve the diagnostic efficacy and treatment and accurate assessment of fissures where the visual examination alone is not adequate, thus complementing the traditional dental examination.How to cite this articleZaidi I, Somani R, Jaidka S, Nishad M, Singh S, Tomar D. Evaluation of different Diagnostic Modalities for Diagnosis of Dental Caries: An in vivo Study. Int J Clin Pediatr Dent 2016;9(4):320-325.

Highlights

Preservation of a healthy set of natural teeth along with the maintenance and integrity of the oral tissue is the primary objective of pediatric dentistry
For both enamel and dentin caries, the highest sensitivity values were provided by DIAGNOdent (0.91 and 0.72) and lowest for visual examination on wet surface (0.60 and 0.50)
For both enamel and dentin caries, the specificity was found to be highest for intraoral camera on dry surface and lowest for visual examination

Summary

Introduction

Preservation of a healthy set of natural teeth along with the maintenance and integrity of the oral tissue is the primary objective of pediatric dentistry. This occurs because of delayed diagnosis of caries.[1] In the new era of pediatric dentistry where the paradigm has shifted to preservation and minimal intervention, the importance of finding and treating decay in its earliest stages is universally acknowledged.[2] Throughout both ancient and modern history, mankind tended to accept tooth decay as the main cause of tooth loss.[3] Traditionally, “Seeing is believing” was the approach adopted by Europeans as diagnostic aid, which was modified by Maury in the 19th century with the invention of mouth mirror and probe.[4] visual examination has been the mainstay domain in occlusal caries diagnosis at an early stage for years. It leads to the possibility of extension of lesion or inoculation of the lesion with cariogenic microorganism.[4]

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