4. Secondary Caries detection with DD and
DDPen devices
There are not many studies evaluating the
detection capability of DD and DDpen for
secondary caries, reported exclusively on the
occlusal surfaces of permanent dentition. In a
2014 study, four examiners with different clinical
and dental experience reviewed 60 posterior
teeth restored with composite resin, by visual
observation (Ekstrand criteria) and DDPen device.
The reproducibility among the different examiners
was very high (0.954). The researchers concluded
that DDPen is a reliable method for secondary
caries detection and should be combined with
the visual observation for the correct diagnosis of
secondary caries. 45
Kositbowornchai et al. 46 investigated the detection
capability of DD, under occlusal composite
restorations, rather than tooth-resin interface.
From the 100 teeth examined, only half were
decayed and part of the caries was left on the
pulpal wall. All the teeth were restored with
composite resin (Z100 TM, 3 M, St. Paul, MN,
USA) and the steps of etching and bonding
were omitted. The repeatability values between
different examiners (from 0.60 to 0.77) were lower
than that of Hamishaki et al., 45 while for the DD
showed moderate sensitivity (0.74) and specificity
(0.84). AUC value of the DD was moderate to good
(0.79) and higher than that of digital radiography
(0.65). Also there was no statistically significant
difference in detection (p>0.05) between the two
means. So it was suggested that the amount of
fluorescence of composite resins does not affect
the measurements of DD. However, the device
is only recommended as an auxiliary means of
caries detection. These results are similar to an
in