Introduction: Traditional detection techniques have limits in diagnosing occlusal caries. Thus, more accurate methods are needed. This study evaluates the ability of the Midwest Caries ID (Midwest) to detect caries.
Methods: Two hundred sixty-four extracted, nonrestored premolars and molars were cleaned and stored in 0.2% sodium azide. Teeth were divided into three groups of 88. One examination site on each occlusal surface was chosen. Each site was inspected by a calibrated examiner via visual, Midwest, and histologic exams. First, a visual exam was performed following the International Caries Detection and Assessment guidelines. Next, the same site was inspected using the Midwest device. Finally, the tooth was sectioned mesiodistally through the site. The half with greater caries progression was visualized under a stereomicroscope (64×). Histologic appearance was scored based on the Downer system. Data were analyzed using Kendall tau-b, partial correlation coefficients, and the receiver operating characteristics curve.
Results: Overall, the Midwest scoring assessment correlated with histologic assessments (tau = 0.32; p<0.0001), but the visual exam had a stronger correlation (tau = 0.53; p<0.0001) with the histologic exam. The sensitivity and specificity of the Midwest was also reported at 0.56 and 0.84, compared with 0.92 and 0.43, respectively, for the visual exam.
Conclusions: Midwest Caries ID is a novel caries detection device that has limitations and should not be used as the sole means to detect occlusal caries.