In vitro Evaluation of Magnification and LED Illumination for Detection of Occlusal Caries in Primary and Permanent Molars Using ICDAS Criteria

Background: Early detection of occlusal caries in children is challenging for the dentists, because of the morphology of pit and fissures. Aim: The aim of the present study was to investigate the use of low-powered magnification (×2.5) and its association with LED headlight illumination for occlusal caries detection in primary and permanent molars using International Caries Detection and Assessment System (ICDAS) criteria.Methods: The occlusal surfaces of 36 extracted teeth (n=18 primary molars, n=18 permanent molars) were examined using ICDAS criteria with unaided visual examination, low-powered magnification and low-powered magnification plus LED headlight illumination. Three examiners evaluated one occlusal site per tooth twice independently with one week interval, using all methods. The teeth (n = 36) were sectioned and examined under light microscopy using Downer’s histological criteria as the gold standard. Results: The weighted kappa values for interand intraexaminer reproducibility for the ICDAS examinations were almost perfect (Kappa values 0.72–0.96) in all three examination methods. The correlation with histology and overall AUC performance (0.96–0.98) of low-powered magnification plus LED headlight illumination was statistically significant in permanent molars. In primary molars, both low-powered magnification (0.82–0.90) and low-powered magnification plus LED headlight illumination (0.87–0.93) showed statistically significant correlation with histology and good to excellent AUC performance OPEN ACCESS