PERFORMANCE OF SOME DIAGNOSTIC SYSTEMS IN THE PREDICTION OF OCCLUSAL CARIES IN PERMANENT MOLARS IN 6 AND 11-YEAR-OLD CHILDREN

Objectives: Attempts have been made to develop diagnostic methods whic h enable an early diagnosis of occlusal lesions which are not detectab le by visual inspection. The aim of this study was to compare the perf ormance of visual inspection focused oil finding signs of fissure deca lcification and discoloration, visual inspection upon fibre-optic tran sillumination (FOTI), and electrical conductance measurements (ECMs) i n predicting the onset of occlusal caries in 6- and 11-year-old childr en. Methods: Fifty children aged 5-7 and 11-15 years, having first or second permanent molar teeth that were not exposed to the oral environ ment for more than half a year, participated in the study. Following b aseline data recording, the diagnostic measurement; were repeated six times at 6-month intervals over a period of 2.5 years. Results: Data w ere collected at predefined sites in the fissures. During the study, 2 20 of the 652 sites, i.e. 75 of 197 molars in 31 of the 50 children we re judged to require a sealant or a sealant restoration, Two examiners jointly decided on the decay status at the sites. Survival plots show ed that ECMs were superior to FOTI and fissure discoloration in predic ting the onset of occlusal caries, although the differences were small . Conclusion: ECM is a better predictor of occlusal caries than fissur e discoloration and FOTI, although the differences among the performan ce of the three methods in this study were very small. A cost-effectiv e analysis is envisaged to obtain insight into the practical value of ECMs in the prediction of occlusal caries and, thus, into the effectiv eness of sealant application. (C) 1998 Elsevier Science Ltd. All right s reserved.