title: An in-vitro comparison of visual inspection, bite-wing radiography, and laser fluorescence methods for the diagnosis of occlusal caries.
abstract: OBJECTIVE
  The purpose of this study was to compare accuracy and reproducibility of visual inspection (VI), bitewing (BW) radiography, and laser fluorescence (LF, DIANOdent) methods in the diagnosis of occlusal caries.
  
  
  METHODS
  The study was done on 80 extracted permanent premolars that seem to be intact or with primary caries in fissures. Three trained dentist examined the teeth in four stages: VI, BW radiography, LF, and histologic examination. Sensitivity, specificity, positive and negative predictive values, and accuracy of all methods were calculated and compared. For the LF method, using ROC curve and counterpart points on it, we determined upper and lower limits and calculated the parameters.
  
  
  RESULTS
  The estimated accuracy was 58.9% for VI and 45.1% for BW radiography methods. Kappa coefficient for interexaminer reproducibility was 57% and 34.1% in VI and BW radiography, respectively. Inter- and intraexaminer reproducibility coefficients of LF methods were 78.4% and 83.6%, respectively. The mean intraexaminer reproducibility coefficient in the VI method was 61.2%.
  
  
  CONCLUSIONS
  Although accuracy and reproducibility of the LF method were higher than those of the VI and BW radiography, it is better to use this method together with other methods to reduce diagnostic faults.
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. pourhash@sina.tum.ac.ir
authors.forename: S J
authors.initials: SJ
authors.lastname: Pourhashemi
authors.forename: A
authors.initials: A
authors.lastname: Jafari
authors.forename: P
authors.initials: P
authors.lastname: Motahhari
authors.forename: M
authors.initials: M
authors.lastname: Panjnoosh
authors.forename: M J
authors.initials: MJ
authors.lastname: Kharrazi Fard
authors.forename: I
authors.initials: I
authors.lastname: Sanati
authors.forename: M
authors.initials: M
authors.lastname: Sahadfar
authors.forename: M
authors.initials: M
authors.lastname: Pariab
mesh_terms: D001641:Bicuspid; D003731:Dental Caries / Q000175:diagnosis*; D005453:Fluorescence; D006801:Humans; D007834:Lasers; D015588:Observer Variation; D012372:ROC Curve; D016300:Radiography, Bitewing; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity