In Vivo and In Vitro performance of Conventional Methods, DIAGNOdent, and an Electronic Caries Monitor for Occlusal Caries Detection in Primary Teeth

PURPOSE: The purpose of this study was to evaluate and compare the clinical and laboratory performances of an electronic caries monitor (ECM-IV) and the DIAGNOdent device with that of conventional methods, including visual (VE) and radiographic examinations (RE), for the detection of occlusal caries in primary teeth. METHODS: Three different observers examined 200 primary molars before extraction (in vivo), immediately after extraction (in vitro 1), and 14 days after extraction (in vitro 2). Examinations were performed visually, radiographically using the DIAGNOdent and ECM-IV devices. RESULTS: Among all the methods, the ECM-IV yielded the highest sensitivity and Az (Area under the ROC curve) values at the enamel (D1) threshold and visual examination for dentin (D3) threshold. For reproducibility, the ECM-IV presented the highest Kappa values at the D1 threshold, and the DIAGNOdent presented the highest Kappa values at the D3 threshold. Both devices presented high intraclass correlation coefficient values, although DIAGNOdent showed higher values than ECM-IV in all stages of the study and for all observers. CONCLUSION: Considering the importance of early identification of caries in primary teeth, the use of the ECM and DIAGNOdent devices, together with conventional examination methods, will increase the rate of identification of occlusal caries during routine clinic visits.