Evaluation of the Accuracy of Different Occlusal Caries Detection Methods: A Comparative Study

Aim: The aim of this research was to evaluate the extent and level of accuracy of two different occlusal caries detection techniques. Materials and methods: Freshly extracted 40 permanent human premolars for orthodontic or periodontal reasons were utilized in the study. The current study used two different methods of testing—a visual examination and an air-water syringe. Occlusal surfaces were inspected under a normal dental operatory light. Laser fluorescence examination—the DIAGNOdent (DD) pen tip was positioned perpendicular to the testing location, and the area where the lesion progressed more was recorded by rotating the pen tip. For every site, three readings were taken in a row, and all the teeth underwent both tests. Following section photography and attachment to a stereomicroscope set to ×10 magnification, the samples were validated. The student’s t-test was used for intragroup and intergroup comparisons, with a significance threshold of p < 0.05. Results: On visual examination, with air-drying score was 1.418, and without air-drying was 1.722. On laser fluorescence examination, with air-drying score was 1.142, and without air-drying, it was 1.286. The accuracy, sensitivity, and specificity values were determined using the reference standard. The receiver operating characteristic (ROC) analysis approach was used to calculate the area under the curve (AUC). The diagnostic accuracy was higher (88.4%) in laser fluorescence examination with air-drying, with 93.7% sensitivity and 60.8% specificity. The diagnostic accuracy without air-drying was 85.8% with 88.2% sensitivity and 63.2% specificity. On visual examination, the diagnostic accuracy with air-drying was 84.2% with 90.4% sensitivity and 70.3% specificity. The diagnostic accuracy without air-drying was 75.8% with 74.8% sensitivity and 76.4% specificity. Conclusion: In conclusion, enhanced efficacy in terms of sensitivity and specificity has been demonstrated by both the visual and laser fluorescence (DD) methods. However, the DD laser fluorescence instrument has demonstrated better diagnostic performance for occlusal caries. Clinical significance: Dental caries is a common chronic condition that affects virtually all individuals in developing nations. Early caries detection is essential for successful remineralization and a better prognosis. The subjective nature of visual examination makes it difficult for many healthcare professionals worldwide to diagnose smooth surface caries in their early phases, and newer methods are required to identify them.