Performance of diagnostic systems in occlusal caries detection compared.

Many investigations have been conducted to evaluate existing and new diagnostic systems in the detection of occlusal carious lesions. The performances of these systems are difficult to compare with each other, because of the disadvantages associated with the widely used validity parameters sensitivity and specificity. In this study a meta-analysis was performed to facilitate a comparison between the performances of diagnostic systems which are currently in use in occlusal caries diagnosis. Nine in vitro studies and one in vivo study complied with the selected criteria for inclusion in the analysis. The sensitivity and specificity values obtained from these studies were converted into normal deviate values, and plotted on linearly scaled normal-deviate axes. DZ values, which quantify the performance above chance of a diagnostic test in one single value, were calculated. Averaged DZ values of the diagnostic systems were subsequently compared to each other. The results indicate that electrical resistance measurements and fiber-optic transillumination had a comparatively good, and visual inspection and xeroradiography a poor, performance in occlusal caries diagnosis. All the other radiographic image modalities had intermediate performances.