Objectives: The purpose of this study was to compare the efficiency of different diagnostic systems for the detection of caries prior to application of fissure sealant onto occlusal surface of permanent teeth.

Methods: The study was carried out on 1103 teeth in 102 children between the ages of 7 to 13 years. All teeth were assessed by three dentists by using visual-tactile assessment (VTA), visual with magnification (VM), DIAGNOdent (DD), and bitewing radiography (BW). Results were analyzed using McNemar test at 95% significance level.

Results: For all teeth, between VTA-VM and VTA-DD observed significant difference (P<0.05), but not VTA-BW (P>0.05). There was no statistically significant difference between diagnostic systems for each jaw (P>0.05). When diagnostic systems were compared in each tooth group, the differences between VTA-BW, for first premolar and first and second molars, were not statistically significant (P>0.05), whereas differences between VTA-VM and VTA-DD were (P<0.05). Also, for second premolar, differences between diagnostic systems were statistically significant (P<0.05). For upper first premolar and first and second molars, no significant difference was found between VTA-BW (P>0.05) but differences between the others were statistically significant (P>0.05). For upper second premolar, no significant difference was found between diagnostic systems (P>0.05). No significant differences were observed between diagnostic systems for lower first and second premolars and first molar (P>0.05). However, for second molar there were statistically significant differences between VYA-VM and VTA-DD (P<0.05) but not VTA-BW (P>0.05).

Conclusion: When a combination of VTA and either VM or DD is used prior to application of sealant the diagnosis of occlusal caries would improved.

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