Proximal caries lesion detection using the Canary Caries Detection System: an in vitro study

J Investig Clin Dent. 2016 Nov;7(4):383-390. doi: 10.1111/jicd.12163. Epub 2015 May 27.


Objective: This study investigated the accuracy of the Canary System (CS) to detect proximal caries lesions in vitro, and compared it with conventional methods: International Caries Detection and Assessment System (ICDAS) II and bitewing radiography (BW).

Methods: Visible proximal surfaces of extracted human teeth were assessed by ICDAS-II before setting them in five manikin mouth models. Then contacting proximal surfaces in mouth models were assessed by BW and CS. Histological validation with polarized-light microscopy served as a gold standard. Pairwise comparisons were performed on area under the curve (AUC), sensitivity, and specificity of the three methods, and corrected using Bonferroni's method. Sensitivities and specificities were compared using a test of proportions and AUC values were compared using DeLong's method.

Results: The CS presented significantly higher sensitivity (0.933) than ICDAS-II (0.733, P = 0.01) and BW (0.267, P < 0.001), and ICDAS-II higher sensitivity than BW (P < 0.001). There were no significant differences between their specificity values: 0.825 (CS), 0.65 (ICDAS-II), and 0.875 (BW). The AUC of CS (0.862) was significantly higher than of ICDAS-II (0.681, P < 0.001) and BW (0.577, P < 0.001).

Conclusion: The CS demonstrated greater accuracy in detecting proximal lesions than ICDAS-II and BW, although without significantly higher specificity.

Keywords: Canary System; ICDAS-II; bitewing radiography; dental caries; proximal.

MeSH terms

  • Bicuspid / diagnostic imaging
  • Bicuspid / pathology
  • Cuspid / diagnostic imaging
  • Cuspid / pathology
  • Dental Caries / diagnosis*
  • Dental Caries / diagnostic imaging
  • Dental Caries / pathology
  • Dental Caries Activity Tests / methods*
  • Dental Caries Activity Tests / statistics & numerical data
  • Dental Enamel / diagnostic imaging
  • Dental Enamel / pathology
  • Dental Materials / chemistry
  • Diagnosis, Differential
  • Humans
  • Incisor / diagnostic imaging
  • Incisor / pathology
  • Molar / diagnostic imaging
  • Molar / pathology
  • Observer Variation
  • Radiography, Bitewing / methods
  • Reproducibility of Results
  • Sensitivity and Specificity


  • Dental Materials