title: Influence of contact points on the performance of caries detection methods in approximal surfaces of primary molars: an in vivo study.
abstract: This in vivo study aimed to evaluate the influence of contact points on the approximal caries detection in primary molars, by comparing the performance of the DIAGNOdent pen and visual-tactile examination after tooth separation to bitewing radiography (BW). A total of 112 children were examined and 33 children were selected. In three periods (a, b, and c), 209 approximal surfaces were examined: (a) examiner 1 performed visual-tactile examination using the Nyvad criteria (EX1); examiner 2 used DIAGNOdent pen (LF1) and took BW; (b) 1 week later, after tooth separation, examiner 1 performed the second visual-tactile examination (EX2) and examiner 2 used DIAGNOdent again (LF2); (c) after tooth exfoliation, surfaces were directly examined using DIAGNOdent (LF3). Teeth were examined by computed microtomography as a reference standard. Analyses were based on diagnostic thresholds: D1: D 0 = health, D 1 –D 4 = disease; D2: D 0 , D 1 = health, D 2 –D 4 = disease; D3: D 0 –D 2 = health, D 3 , D 4 = disease. At D1, the highest sensitivity/specificity were observed for EX1 (1.00)/LF3 (0.68), respectively. At D2, the highest sensitivity/ specificity were observed for LF3 (0.69)/BW (1.00), respectively. At D3, the highest sensitivity/specificity were observed for LF3 (0.78)/EX1, EX2 and BW (1.00). EX1 showed higher accuracy values than LF1, and EX2 showed similar values to LF2. We concluded that the visual-tactile examination showed better results in detecting sound surfaces and approximal caries lesions without tooth separation. However, the effectiveness of approximal caries lesion detection of both methods was increased by the absence of contact points. Therefore, regardless of the method of detection, orthodontic separating elastics should be used as a complementary tool for the diagnosis of approximal noncavitated lesions in primary molars.
authors.forename: Apoena A
authors.initials: AA
authors.lastname: Ribeiro
authors.forename: Flávia
authors.initials: F
authors.lastname: Purger
authors.forename: Jonas A
authors.initials: JA
authors.lastname: Rodrigues
authors.forename: Patrícia R A
authors.initials: PR
authors.lastname: Oliveira
authors.forename: Adrian
authors.initials: A
authors.lastname: Lussi
authors.forename: Antonio Henrique
authors.initials: AH
authors.lastname: Monteiro
authors.forename: Haimon D L
authors.initials: HD
authors.lastname: Alves
authors.forename: Joaquim T
authors.initials: JT
authors.lastname: Assis
authors.forename: Adalberto B
authors.initials: AB
authors.lastname: Vasconcellos
mesh_terms: D002648:Child; D003731:Dental Caries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000473:pathology; D003804:Dentin / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007834:Lasers; D008963:Molar / Q000000981:diagnostic imaging / Q000473:pathology*; D010808:Physical Examination / Q000706:statistics & numerical data; D016300:Radiography, Bitewing / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D019228:Tooth Crown / Q000000981:diagnostic imaging / Q000473:pathology*; D014080:Tooth Exfoliation / Q000000981:diagnostic imaging / Q000473:pathology; D014094:Tooth, Deciduous / Q000000981:diagnostic imaging / Q000473:pathology*; D055698:Touch Perception / Q000502:physiology; D014796:Visual Perception / Q000502:physiology; D055114:X-Ray Microtomography / Q000706:statistics & numerical data