Pit-and-fissure caries lesions contribute greatly to the caries incidence in permanent molar teeth in children. To date, the diagnosis of occlusal caries is still performed mainly by visual inspection, periodically aided by bite-wing radiography. However, in detecting small occlusal carious lesions, these methods perform inadequately, especially in low caries prevalence populations or individuals. The use of electrical conductance measurements (ECMs) has been evaluated to improve the diagnosis of small occlusal carious lesions. The aim of this study was to monitor the electrical conductance of fissure enamel in recently erupted molar teeth and to relate these measurements to the caries status. 50 children aged 5–15 years, having first or second permanent molars that were not exposed to the oral environment for more than 6 months, participated in the study. The diagnostic systems evaluated were visual inspection and ECMs. Following baseline data recording, diagnostic measurements were repeated three times within 18 months. Data were collected at predefined sites in the fissures. 18 months after baseline recording, 179 sites at 60 molar teeth in 27 children were judged to require a sealant based on visual inspection. After removal of carious tissue, two examiners jointly decided on the status of decay as per the criteria: 0=no caries or caries limited to enamel, and 1 = caries involving dentine. The sensitivity of ECM continued to increase with time after a slight initial dip, whereas the specificity continuously increased after baseline measurements as a result of the decreasing amount of false-positive diagnoses. ECMs obtained after each 6-month interval from sites that developed caries were significantly higher than those from sites that remained caries free (all p < 0.02). Furthermore, ECMs obtained from sites that exhibited dentinal caries upon validation were significantly higher than those obtained from sites that showed no caries or caries limited to enamel on validation (p < 0.001). The areas under the receiver operating characteristic curves of visual inspection and ECMs were 0.67 and 0.77, respectively, a difference that was not statistically significant (p > 0.05). It was concluded from this study that ECMs can aid the detection of fissure caries in recently erupted molar teeth. The results imply that an ECM value of 6.5 can be considered as the cut-off between no caries or caries limited to enamel and dentinal caries. Furthermore, ECMs can be used to predict the probability that a sealant or a sealant restoration will be required within 18–24 months after eruption.

Keywords:
Electrical conductance, Enamel maturation, Occlusal caries, diagnosis
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© 1995 S. Karger AG, Basel
1995
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