The intra/inter-examiner reproducibility of the new DIAGNOdent Pen on occlusal sites

Abstract 

Objective

This in vitro study on occlusal sites aimed to assess the intra/inter-examiner reproducibility of the new DIAGNOdent Pen (KaVo, Biberach, Germany) and to prove the assumption that its handling is easy to learn by dental students.

Methods

Two hundred and forty-one sites of 90 occlusal non-cavitated molar surfaces were investigated twice by 2 dentists and 2 undergraduate students with the DIAGNOdent Pen according to manufacturer's instructions. Intra/inter-examiner reproducibility was assessed calculating intra-class correlation coefficients (ICCs) and the range of the 95% limits of agreement by Bland and Altman.

Results

Intra-examiner reproducibility revealed excellent ICCs (0.84–0.92); but the range amounted to 41.2–59.1, which indicate a wide measuring range. The inter-examiner reproducibility using all measurements had to be proved as excellent (ICC 0.84); the range was found in the same order of magnitude as mentioned above (53.2). When measurements were categorised according to treatment related cut-offs a good inter-examiner reproducibility was detected in the interval of <30 (ICC 0.70); an excellent ICC were registered for the interval >30 (ICC 0.51). For both intervals the range values (<30: range 32.3 and >30: range 67.7) exceeded a deviation limit of ±20%. Both students tended to measure slightly more precise compared to the dentists.

Conclusions

This study revealed a wide measuring range of DIAGNOdent Pen readings. Since there were no differences between dentists and students it can be used as adjunct tool by undergraduates as well. Nevertheless, based on the registered reproducibility the DIAGNOdent Pen should be used additionally to visual inspection and dental radiographs.

Keywords: Dental caries, Pits and fissures, Diagnosis, Reproducibility, DIAGNOdent, Laser fluorescence