The purpose of this in vivo investigation was to assess the ability of a laser method

R. JACKSON1 , H. EGGERTSSON1 , M. ANDO1 , A. ZANDONA1 , S.A. KELLY1 , B. KATZ1 , S. OFNER1 , G.K. STOOKEY1 , and J.S. WEFEL2 , 1 Indiana University, Indianapolis, USA, 2 University of Iowa, Iowa City, USA (DIAGNOdent, KaVo, Biberach, Germany)

The purpose of this in vivo investigation was to assess the ability of a laser method and a visual examination to detect secondary caries using polarized light microscopy (PLM) as a “gold standard”.

Methods: The investigation was approved by the IUMC Institutional Review Board. A single operator placed 218 amalgam and resin restorations in the deciduous molars of 90 children. The teeth were examined under clinical conditions by two independent examiners. Depending on the size of the restoration, 6-15 points on the margin of each restoration were chosen and recorded on a digital image of the occlusal surface. These points were examined at six-month intervals using both methodologies and the data were recorded. As the teeth exfoliated, 40 were collected for PLM analyses.

Results: Sensitivity and specificity results were calculated for each tooth and these estimates were weighted and modeled by use of generalized estimating equations (GEE). The model adjusted for correlations among teeth in the same subject. For sensitivity, each tooth was weighted by the number of observations that were called carious by PLM. For specificity, each tooth was weighted by the number of observations that were diagnosed as sound by PLM. The estimated sensitivities for the visual examination and DIAGNODENT were 66.7 and 11.1, respectively. The estimated specificities were 76.4 and 93.2, respectively.

Conclusions: Although based on a small number of carious sites, DIAGNOdent was less sensitive relative to PLM than a visual examination. Both techniques displayed reasonable specificity. If these findings hold as more teeth are examined, DIAGNOdent could not be considered useful in the diagnosis of secondary caries. Supported by NIH Grant PO1DE13540-03 Seq #91 - Caries Detection and Diagnosis 10:15 AM-11:30 AM, Thursday, 11 March 2004 Hawaii Convention Center Exhibit Hall 1-2