title: Comparison of validation methods for the diagnosis of occlusal caries in primary molars.
abstract: OBJECTIVE
  To evaluate the reproducibility of 7 validation methods used for caries diagnosis in primary teeth.
  
  
  METHODS
  Seventy-two occlusal sites were selected on 40 primary molars. The sites were evaluated independently by 3 experienced examiners using validation methods that involved direct assessment, i.e. by using a (1) magnifying glass (8×) and (2) stereomicroscope (35×), or indirect assessment i.e. by using (3) photographs, (4) slide projections of photographs, (5) stereomicroscope (35×) photographs, (6) stereomicroscope (35×) slide projections, and (7) projections of polarised light microscope slides. Cohen's kappa coefficients were calculated and subjected to the Kruskal-Wallis test at a significance level of 5%.
  
  
  RESULTS
  The mean inter-examiner kappa values for the validation methods were 0.31-0.51. There were statistically significant differences (p<0.05) between methods 1 and 3, 1 and 4, 2 and 4, 4 and 5, 4 and 6, and 4 and 7. Moderate agreement was observed for all methods except methods 1 and 4, for which the agreement was fair.
  
  
  CONCLUSIONS
  The inter-examiner agreement for all validation methods for caries diagnosis was moderate, except for the method based on indirect assessment by slide projection, which showed low agreement.
authors.affiliation: Departamento de Estomatologia, Universidade Federal de Santa Maria, Rua Floriano Peixoto, RS, Brazil. rarocha@usp.br
authors.forename: M D M
authors.initials: MD
authors.lastname: Oliveira
authors.forename: T K
authors.initials: TK
authors.lastname: Tedesco
authors.forename: T L
authors.initials: TL
authors.lastname: Lenzi
authors.forename: A C
authors.initials: AC
authors.lastname: Guedes Pinto
authors.forename: R O
authors.initials: RO
authors.lastname: Rocha
mesh_terms: D003731:Dental Caries / Q000175:diagnosis*; D006801:Humans; D007909:Lenses; D008853:Microscopy; D008859:Microscopy, Polarization; D008963:Molar / Q000473:pathology*; D015588:Observer Variation; D023861:Photography, Dental; D010808:Physical Examination; D014075:Tooth Discoloration / Q000175:diagnosis; D014094:Tooth, Deciduous / Q000473:pathology*