Conventional methods of caries detection, including the gold standard of histological examination, have certain disadvantages that must be addressed prior to validating any other diagnostic technique-current or new. Here we evaluated the validity of micro-computed tomography (micro-CT) as an alternative gold-standard technique for caries detection. Sixty teeth with suspected occlusal caries were chosen from a pool of teeth extracted for orthodontic, periodontal, or surgical reasons. Identical reference points were marked on photographs taken for teeth and were used to evaluate each method. Dimensions of caries were assessed by two calibrated examiners using the ICDAS-II visual examination system, bitewing radiographs, and micro-CT. The teeth included in the study were selected randomly from solution before all measurements. For micro-CT, the device was set to 50 kV, 800 µA, pixel size 15 µm (at 1024 × 1024 resolution), and 1° rotation step. NRecon software (SkyScan) was used to obtain reconstructed images. For each diagnostic method, results were compared with histology results using the McNemar test. Receiver operator characteristic (ROC) analysis was also performed for each method (Z-test; p < 0.05). Besides showing a high correlation with histology results, micro-CT yielded the greatest values at the D3 threshold; moreover, accuracy and area under the ROC curve (AUC) values were greatest at the D1threshold. Our results indicate that micro-CT performs as well as or better than histological examination for the purpose of comparing methods for caries detection.

Turkey SUMMARY The aim of this study was to compare the validity of the measurements of the laser fluorescence device, KaVo DIAGNOdent Ò , with the result of polarized light microscopy in the detection of occlusal fissure caries in extracted third molars. Ten impacted, surgically removed, and 25 extracted third molars with macroscopically intact occlusal surfaces were selected. The DIAGNOdent measurements of the occlusal test site were recorded by two observers at intervals of 2 days. The teeth were then sectioned at the specified test sites for histological examinations. Prepared specimens were evaluated under the polarized light microscopy and all images were scored with the caries classification of D1 (sound and fissure lesion in the half of the outer enamel), D2 (enamel decay) and D3 (dentin decay) level (gold standard). The kappa value for the inter-observer repeatability was calculated and the value 0AE83 for the first measurements and 0AE67 for the second measurement were obtained,respectively. Interobserver correct classification percentages were 88AE5 and 77AE1 for the first and second measurements, respectively. The kappa value for intra-observer repeatability was 0AE79 for the first observer and 0AE75 for the second observer. Intra-observer correct classification percentage values were 85AE7 and 82AE8 for the first and second observer, respectively. Value of specificity for the detection of enamel caries at D1 level was 0AE74 and sensitivity values at D2 and D3 levels were 0AE66 and 1AE00, respectively. The present study indicates that the DIAGNOdent Ò provides not only almost perfect agreement but also sufficient repeatability at D1, D2, D3 levels and better specificity at D1 level as well as lower sensitivity at D2 level and excellent sensitivity at D3 level.

Initial enamel demineralization is also seen as a white spot lesion as a result of optical illusion caused by mineral loss in the enamel. Since these lesions can be difficult to diagnose, many methods have been developed for diagnosis. In this review, current methods for diagnosis and treatment planning of white dot lesions are examined.