Effectiveness of Air Drying and Magnification Methods for Detecting Initial Caries on Occlusal Surfaces Using Three Different Diagnostic Aids

Objective-The aim of this study was to assess the effect of magnification and air-drying on detection of carious lesion. Study Design-44 human extracted premolars were selected with sound occlusal surfaces without frank cavitation. The Diagnostic techniques used were Unaided visual examination, Magnifying Loupes (4.2×) and Stereomicroscope (10×, before and after air-drying) and then the teeth were sectioned bucco-lingually and both the surfaces were examined under Stereomicroscope (50×) to assess the presence or absence of carious lesion in the pit and fissures. The scores were compared to obtain Cohen's kappa coefficient (Reproducibility) and subjected to the Friedman Test and Paired t test. Sensitivity, specificity and positive predictive value used to assess accuracy. Results-On Statistical analysis, visual examination before and after air drying had highest specificity but lowest sensitivity compared to different diagnostic techniques. Magnifying loupes after air-drying had highest sensitivity and lowest specificity compared to other diagnostic techniques. Conclusion-Air drying combined with magnifying aids are cost-effective, reliable method for detection of early carious lesion. If used in pediatric clinical practice, any undesirable pain and discomfort to the patient due to invasive procedures and helps in employing preventive measures.

Stereomicroscope, Magnifying Loupes, Unaided visual examination, Cohen’s Kappa Test, Paired t-test.

1. Gonzalez MC, Ruiz JA, Fajardo MC, Gomez AD, Moreno CS, Ochoa MJ et al. Comparison of the def index with Nyvad’s Caries Diagnostic Criteria in 3- and 4- year-old Colombian Children. Pediatr Dent 25: 132- 136, 2003.

2. Basting RT, Serra MC. Occlusal caries: Diagnosis and noninvasive treat-ments. Quintessence Int 30(3): 174-8, 1999.

3. Welbury R, Duggal M, Hosey MT. Paediatric Dentistry. Oxford Univer-sity Press Inc, New York; 109-16, 2006.

4. Pourshemi SJ, Jafari A, Motahhari P, Panjnoosh M, Kharrazi Fard MJ, Sanati I et al. An in-vitro comparison of visual inspection, bite-wing radiography, and laser fluorescence methods for the diagnosis of occlusal caries. J Indian Soc Pedod Prevent Dent 27(2): 90-93, 2009.

5. Axelsson P, Sweden K. Preventive Materials, Methods and Programs. Quintessence Publishing Co, Slovakia; 369-86, 2004.

6. El-Housseiny AA, Jamjoum H. Evaluation of visual, explorer, and a laser device for detection of early occlusal caries. J Clin Pediatr Dent 26(1): 41- 8, 2001.

7. Koch G, Poulsen S. Pediatric Dentistry – A Clinical Approach. Wiley-Blackwell, United Kingdom; 91-92, 2009.

8. Braga MM, Mendes FM, Ekstrand KR. Detection activity assessment and Diagnosis of dental caries lesions. Dent Clin N Am 54: 479-493, 2010.

9. Axelsson P, Sweden K. Diagnosis and Risk Prediction of Dental Caries. Quintessence Publishing Co Inc, Slovakia; 179-248, 2000.

10. Forgie AH, Pine CM, Pitts NB. The use of magnification in preventive approach to caries detection. Quintessence Int 33(1): 13-16, 2002.

11. Chockalingam PR. Illustrated Paediatric Dentistry. Wolters Kluwer Pvt. Ltd, New Delhi; 187-89, 2014.

12. Angnes G, Angnes V, Grande RHM, Battistella M, Loguercio AD, Reis A. Occlusal caries diagnosis in permanent teeth” an in vitro study. Braz Oral Res 19(4): 243-8, 2005.

13. Fejerskov O, Kidd E. Dental Caries:The Disease and its clinical manage-ment. Blackwell Munksgaard Ltd, Oxford;491-99, 2008.

14. Peker I, Alkurt MT, Bala O, Altunkaynak. The efficiency of operating microscope compared with unaided visual examination, conventional and digital intraoral radiography for proximal caries detection. Int J Dent 2009: 1-6, 2009.

15. Shi XQ, Welander U, Angmar-Mansson B. Occlusal caries detection with KaVo Dd and radiography: an in vitro comparison. Caries Res 34: 151-8, 2000.

16. Pinelli C, Loffredo LCM, Serra MC. Effect of drying on the reproduc-ibility of DIAGNOdent to detect caries-like lesions. Braz Dent J 21(5): 405- 410, 2010.

17. Cortes DF, Ekstrand KR, Elias-Boneta AR, Ellwood RP. An in vitro comparison of the ability of fibre-optic transillumination, visual inspec-tion and radiographs to detect occlusal caries and evaluate lesion depth. Caries Res 34(6): 443-7, 2000.

18. Reis A, Zacg VL Jr, de Lima AC, de Limaa Navarro MF, Grande RH. Occlusal caries detection: a comparison of DIAGNOdent and two conventional diagnostic methods. J Clin Dent 15(3): 76-82, 2004.

19. Costa AM, Bezzerra AC, Fuks AB. Assessment of the accuracy of visual examination, bite-wing radiographs and DIAGNOdent on the diagnosis of occlusal caries. Eur Arch Pardiatr Dent 8(2): 118-22, 2007.

20. Hintz H, Wenzel A, Larsen MJ. Stereomicroscopy, film radiography, microradiography and naked-eye inspection of tooth sections as valida-tion for occlusal caries diagnosis. Caries Res 29(5):359-63, 1995.

21. Erten H, Uctasli MB, Akarslan ZZ, Uzun O, Baspinar E. The assessment of unaided visual examination, intraoral camera and operating microscope for the detection of occlusal caries lesions. Oper Dent 30(2): 190-4, 2005.

22. Reis A, Mendes FM, Angnes V, Angnes G, Grande RHM, Loguercio AD. Performance of methods of occlusal caies detection in permanent teeth under clinical and laboratory conditions. J Dent 34: 89-96, 2006.

23. Haak R, Wicht MJ, hellmich M, Gossmann A, Noack MJ. The validity of proximal caries detection using magnifying visual aids. Caries Res 36(4):249-55, 2002.