An in vitro comparison of different caries-detection methods in primary-molars

Area of Science:

• Dentistry
• Pediatric Dentistry
• Cariology

Background:

• Early and accurate detection of occlusal caries in primary molars is critical.
• Primary teeth are more susceptible to rapid carious development, necessitating effective diagnostic tools.

Purpose of the Study:

• To evaluate and compare the diagnostic performance of four caries detection methods.
• To assess sensitivity, specificity, and accuracy in detecting occlusal caries in primary molars.

Main Methods:

• In vitro study of 88 extracted primary molars.
• Methods used: International Caries Detection and Assessment System II (ICDAS), Midwest Caries I.D (MW), DIAGNOdent pen (LFpen), and Quantitative-Light-Induced-Fluorescence (QLF).
• Histological evaluation served as the gold standard; reproducibility was assessed.

Main Results:

• At the enamel caries threshold (D1), MW had the highest sensitivity, and QLF had the highest specificity.
• At the dentin caries threshold (D3), LFpen showed the highest sensitivity.
• LFpen demonstrated the best overall diagnostic accuracy (AUC 0.823-0.875) and reproducibility.

Conclusions:

• LFpen exhibited the highest overall accuracy and sensitivity for dentin caries.
• MW and QLF showed high sensitivity and specificity, respectively, at the enamel caries threshold.
• ICDAS is a practical, cost-effective option for routine clinical use.