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This investigation aimed to determine the reliability of two fluorescence methods, DIAGNOdent (DD, KaVo) and QLF/clin (QLF, Inspektor Research Systems), and visual examination (VE) using the criteria of Ekstrand et al. [Caries Res 1997;31:224-231] to detect early occlusal lesions. 99 premolars selected from a pool of teeth kept in thymol water were used. Occlusal surfaces were cleaned and one in- vestigation site in each groove-fossa system was selected and the site examined with DD after air drying. After calibration, VE was performed individually by two examiners. DD and VE were repeated after at least 24 h had elapsed. QLF images were obtained, stored and analyzed (QLF 1.97 h) for the average percent change in fluorescence radiance (.F) with lesion threshold set at 95%. One 80-µm section from each investigation site was obtained. Caries was scored using transmitted light microscopy (E10). 6% of teeth were scored histologically as sound, 68% had caries in the outer half of the enamel, 19% had caries in the inner part of the enamel, and 6% had superficial dentinal caries. Intra-examiner agreement was 90% (almost perfect agreement) for VE. Interexaminer agreement was 94% for both examiners (almost perfect agreement). The DD and QLF readings were transformed to an ordinal scale. With the cut-offs selected for this study, DD was able to detect 37.9% of the lesions while QLF detected 86% and VE 72% of the lesions. There was a trend in .F and DD readings to increase for lesions scored in the outer half of the enamel and inner half of the enamel compared to sound surfaces. Although none of the methods could differentiate between sound and enamel lesions, QLF was better able to detect the very early occlusal enamel lesions. needs in the clinical situation. In conclusion, among the four methods used, ECM demonstrated the best suitability for treatment decisions in non-cavitated, discoloured occlusal fissures. Further data should be collected to achieve a higher significance. |