title: Assessment of the accuracy of visual examination, bite-wing radiographs and DIAGNOdent on the diagnosis of occlusal caries.
abstract: OBJECTIVE
  This was to evaluate the accuracy of the different methods for diagnosing occlusal caries in vivo, and to compare their performance in primary and permanent teeth.
  
  
  METHODS
  Permanent teeth (199) and primary molars (65) with macroscopically intact occlusal surface, with caries lesions without cavitation (white spot) or with a darkened sulcus were selected. The teeth were examined by the following methods: visual inspection, bite-wing radiographs and DIAGNOdent. The validation method employed for asserting the existence of carious lesion was cavity preparation.
  
  
  RESULTS
  When the total sample was taken into consideration, laser (DIAGNOdent) provided the highest accuracy (74.8%). Even when the total sample was stratified, the laser accuracy was still high for both primary (88.4%) and permanent molars (70.4%). Visual inspection also provided a high accuracy for primary teeth (83.9%). The chi-square test showed a statistically significant difference between permanent and primary teeth considering occlusal caries diagnosis (p=0.0001). The Kappa coefficient showed good inter-examiner reproducibility for all methods. McNemar test revealed that the degree of intra-examiner agreement for visual inspection was lower than for the other methods.
  
  
  CONCLUSIONS
  As visual inspection also showed a high degree of accuracy, the laser method should be used as a complementary method in doubtful cases. Diagnostic methods of occlusal caries, in general, are more efficient in deciduous than in permanent teeth.
authors.affiliation: Dept Paediatric Dentistry, Catholic University of Brasília, Brasillia, DF, Brazil.
authors.forename: A M
authors.initials: AM
authors.lastname: Costa
authors.forename: A C B
authors.initials: AC
authors.lastname: Bezzerra
authors.forename: A B
authors.initials: AB
authors.lastname: Fuks
mesh_terms: D000293:Adolescent; D002648:Child; D003731:Dental Caries / Q000175:diagnosis*; D003737:Dental Cavity Preparation; D006801:Humans; D007834:Lasers / Q000592:standards; D008963:Molar / Q000473:pathology; D015588:Observer Variation; D010808:Physical Examination / Q000592:standards* / Q000706:statistics & numerical data; D016300:Radiography, Bitewing / Q000592:standards* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D014094:Tooth, Deciduous / Q000473:pathology