Comparison of different methods for the occlusal dentine caries diagnosis

The aim of this study was to compare the effectiveness of in-vitro methods for the occlusal dentine caries diagnosis. Thirty-eight sites were evaluated on third molars without macroscopic carious cavitation in adult individuals from the city of Barretos (SP), Brazil. Visual inspection (VI), endoscopic evaluation (AcuCam), visual inspection and blunt-tipped exploratory probes (Tactile), conventional bite-wing radiographs (CR), direct bite-wing digital radiograph (DR), and direct digital radiograph with contrast and brightness controled (DRbc) were used by five observers. In order to validate the data, the teeth were sectioned and histologically evaluated. The average sensitivity and specificity values of the methods were respectively:0,25 , 0,96 (VI); 0,15 , 0,92 (AcuCam); 0,17 , 0,95 (Tactile); 0,45 , 0,73 (CR); 0,33 , 0,80 (DR) and 0,35 , 0,84 (DRbc) , the effectiveness of clinical methods (VI, AcuCam and Tactile) as well as that of radiographic methods (CR, DR and DRbc) were comparatively similar. The clinical methods presented a smaller number of false-positive diagnosis than the radiographic methods. It was concluded that visual inspection is an important diagnostic method; conventional bite-wing and digital radiography aid the diagnosis and are equally efficient to diagnose carious lesions in the dentine of teeth without visible cavitation.