Interrater agreement and reliability assessment of proximal caries detection tools in mixed dentition: An in-vivo study.

OBJECTIVE: This in-vivo study was performed to assess the interrater agreement and reliability of ICDAS (visual), transillumination, radiographic, and laser fluorescence proximal caries detection tools in between primary and adjacently erupted permanent molars. METHOD AND MATERIALS: This study was in accordance with Guidelines for Reporting Reliability and Agreement Studies. Two calibrated examiners assessed the nonobvious noncavitated apparently sound 100 interproximal sites using predefined criteria. Interrater agreement was analyzed as proportion of agreement. Interrater reliability assessment was performed using weighted kappa statistics and intraclass correlation coefficient. RESULTS: The maximum interrater agreement was projected with conventional bitewing radiography (97%), and the minimum with DIAGNOdent pen (84%), with significant difference (P < .001) in the proportion of agreement. All methods showed substantial interrater reliability, except fiber-optic transillumination. Maximum interrater reliability was noticed for ICDAS (International Caries Detection and Assessment System) method with a weighted kappa value of 0.80 (96% CI, 0.58 - 0.93) followed by conventional and digital bitewing radiography, with values of 0.74 (95% CI, 0.51 - 0.96) and 0.73 (95% CI, 0.43 - 0.92) respectively. CONCLUSION: ICDAS and bitewing radiography seem to be the most reliable methods, with a higher proportion of agreement between the examiners compared to the other methods addressed in this study for proximal caries detection.

Clinical evaluation of caries removal in primary teeth using conventional, chemomechanical and laser technique: an in vivo study.

AIM: To evaluate four different techniques of caries excavation in primary teeth in terms of efficacy, efficiency and pain experienced during the procedure. MATERIALS AND METHODS: Sample of 120 teeth from children aged 5 to 9 years were equally divided into 4 groups - Air rotor (group A), Carisolv (group B), Papacarie (group C) and Er:YAG laser (group D). Visual and tactile criteria along with DIAGNOdent pen value was used to evaluate efficacy. Time was recorded to determine efficiency and FLACC scale was used to assess the pain experienced. RESULTS: Air rotor and laser were more effective and efficient method whereas laser and CMCR methods were more comfortable methods. CONCLUSION: Laser irradiation and CMCR methods are comparable to conventional methods in terms of effectiveness and are less painful methods. CLINICAL SIGNIFICANCE: Newer techniques of CMCR and laser irradiation of dentinal caries are minimally invasive methods and are less painful and thus should be more frequently employed in pediatric dentistry.