title: Comparison of three diagnostic techniques for detecting occlusal dental caries in primary molars: An in vivo study.
abstract: OBJECTIVE
  To compare the accuracy and repeatability of three diagnostic systems; visual inspection, bitewing radiography, and CarieScan PRO for occlusal caries diagnosis in primary molars.
  
  
  METHODS
  216 occlusal surfaces of primary molars examined in turn by two examiners using each of three diagnostic systems (visual inspection, bitewing radiography, and CarieScan PRO). Examiners indicated operative intervention (validation method) for 104 teeth which were used for statistical analysis. The validation method was cavity preparation when the two examiners agreed about the presence of dentinal caries. Sensitivity, specificity, likelihood ratio, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each diagnostic technique. Inter- and intra-examiner repeatability was calculated for each diagnostic system using the Cohen's kappa statistics.
  
  
  RESULTS
  Visual inspection showed the highest sensitivity (0.93). The highest sensitivity and NPVs were provided by CarieScan PRO (0.97 and 0.95, respectively) however this was offset by a lower specificity (0.82) compared to other techniques. The CarieScan PRO gave the highest values of Cohen's kappa statistics.
  
  
  CONCLUSIONS
  This study showed low sensitivity but substantial specificity with visual inspection. Bitewing radiography performed poorly overall when compared with the other two systems. The CarieScan PRO technique gave the highest overall combination of sensitivity and specificity for detection of occlusal caries.
authors.affiliation: Department of Pedodontics and Preventive Dentistry, Terna Dental College, Navi Mumbai, Maharashtra, India.
authors.forename: Farhin
authors.initials: F
authors.lastname: Katge
authors.affiliation: Department of Pedodontics and Preventive Dentistry, Terna Dental College, Navi Mumbai, Maharashtra, India.
authors.forename: Mayur
authors.initials: M
authors.lastname: Wakpanjar
authors.affiliation: Department of Pedodontics and Preventive Dentistry, Terna Dental College, Navi Mumbai, Maharashtra, India.
authors.forename: Bhavesh
authors.initials: B
authors.lastname: Rusawat
authors.affiliation: Department of Pedodontics and Preventive Dentistry, Terna Dental College, Navi Mumbai, Maharashtra, India.
authors.forename: Ashveeta
authors.initials: A
authors.lastname: Shetty
mesh_terms: D002648:Child; D003731:Dental Caries / Q000175:diagnosis*; D003732:Dental Caries Activity Tests / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008963:Molar; D010808:Physical Examination; D016300:Radiography, Bitewing; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014094:Tooth, Deciduous