Aim: This study aimed to compare the diagnostic predictive values of a light induced fluorescence intra oral camera (VistaCam iX) versus visual assessment method (ICDAS-II) in identification of occlusal carious lesion.
Methodology: Occlusal surfaces of 199 molar teeth from 43 adult patients who fulfill the eligibility criteria were examined by two observers using two diagnostic methods. The teeth were firstly assessed visually according to the criteria of the International Caries Detection and Assessment System (ICDAS-II) then by fluorescence camera. Inter observer agreement was measured for ICDAS-II using Kappa and weighted Kappa Values and for the camera using inter class correlation (ICC). Correlation between methods was calculated using Spearman's rank correlation coefficient (rs) and the Receiver Operating Characteristic (ROC curve) between the tested methods was estimated.
Results: Significant positive correlation was found between the ICDAS-II and the camera measurements (rs= 0.8739, P< 0.001). The area under the ROC curve was (0.932, p < 0.001) indicating a great association between the two tested methods when selecting adequate cut-off values for the camera. There was a statistically significant agreement between the two observers for ICDAS-II values (Kappa =0.8125, weighted Kappa = 0.8558). Excellent inter examiner agreement was found between the two observers when using the FC, ICC = 0.9774 (95% CI, 0.789 to 0.889), (p < 0.001).
Conclusion: The camera showed high reliability and agreement with ICDAS-II for initial occlusal caries detection. Sensitivity and specificity values for the camera varied depending on the cut-off value.