Diagnostic value of DIAGNOdent in detecting caries under composite restorations of primary molars

Abstract

Background: Direct observation cannot detect caries under restorations; therefore, the aim of

this study was to compare the accuracy of radiographs and DIAGNOdent in detecting caries under

restorations in primary teeth using histologic evaluation.

Materials and Methods: A total of 74 previously extracted primary molars (37 with occlusal

caries and 37 without caries) were used. Class 1 cavity preparations were made on each tooth

by a single clinician and then the preparations were filled with composite resin. The accuracy of

radiographs and DIAGNOdent in detecting caries was compared using histologic evaluation. The

data were analyzed by SPSS version 21 using Chi‑square, Mc Namara statistical tests and receiver

operating characteristic curve. The significance was set at 0.05.

Results: The sensitivity and specificity for DIAGNOdent were 70.97 and 83.72, respectively. Few

false negative results were observed, and the positive predictive value was high (+PV = 75.9) and

the area under curve was more than 0.70 therefore making DIAGNOdenta great method for

detecting caries (P = 0.0001). Two observers evaluated the radiographs and both observers had

low sensitivity (first observer: 48.39) (second observer: 51.61) and high specificity (both observers:

79.07). The +PV was lower than DIAGNOdent and the area under curve for both observers was

less than 0.70. However, the difference between the two methods was not significant.

Conclusion: DIAGNOdent showed a greater accuracy in detecting secondary caries under primary

molar restorations, compared to radiographs. Although DIAGNOdent is an effective method for

detecting caries under composite restorations, it is better to be used as an adjunctive method

alongside other detecting procedures.

Key Words: Careis, diagnosis, laser fluorescence, radiography