Matos 2011.

Study characteristics
Patient Sampling	Method of sampling: randomly selected from available patients Included conditions: "children seeking dental treatment at the School of Dentistry of the University of São Paulo were selected" Teeth: primary, molars Sealants: not reported Surface: occlusal
Patient characteristics and setting	Age: 4 to 12 years Sex: 30 male, 38 female Ethnicity: not reported Country: Brazil Setting: dental hospital patients Number of participants/teeth/sites: 383 teeth in 68 participants Prevalence: enamel 0.91, dentine 0.05
Index tests	Category of test: DIAGNOdent pen and VistaProof Sequence of test(s): visual inspection and radiographic methods, then LF pen, fluorescence camera Examiner training and calibration: yes Teeth cleaning prior to examination: rotating bristle brush and a pumice/water slurry Tooth drying prior to examination: standardized drying time of 5 seconds Threshold applied: DIAGNOdent pen: sound 0–4; enamel lesions > 4; dentine lesion > 34 VistaProof: sound 0–1.1; enamel lesions > 1.1; dentine lesions > 1.4 Device specifics: DIAGNOdent pen: probe tip 2 VitsaProof: "the image of each surface was recorded by the camera software (DBSWIN, Dürr Dental)"
Target condition and reference standard(s)	Category: visual for enamel threshold, excavation and visual used for dentine threshold Sequence of index test and reference standard: following index test, but performed by same examiner during the same appointment Training of examiner: yes Blinding to index test: unclear ‐ the same examiner performed all tests so difficult to blind results Multiple tests: yes Site selection: a drawing of the occlusal surface was made to indicate the selected site Target condition: sound, enamel, dentine
Flow and timing	Participants with index test but no reference standard: 25 for enamel caries as examiners did not agree Participants with reference standard but no index test: 0 Time interval between tests: minimal Participants receiving both tests but excluded from results: 0
Comparative
Notes
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	Yes
Could the selection of patients have introduced bias?		Low risk
Are there concerns that the included patients and setting do not match the review question?			Low concern
DOMAIN 2: Index Test (All)
Were the index test results interpreted without knowledge of the results of the reference standard?	No
If a threshold was used, was it pre‐specified?	No
If multiple tests were applied were different examiners used for each (in vivo)?	No
Could the conduct or interpretation of the index test have introduced bias?		High risk
Are there concerns that the index test, its conduct, or interpretation differ from the review question?			Low concern
DOMAIN 2: Index Test (Green fluorescence)
DOMAIN 2: Index Test (Blue fluorescence)
Were the index test results interpreted without knowledge of the results of the reference standard?	No
If a threshold was used, was it pre‐specified?	No
If multiple tests were applied were different examiners used for each (in vivo)?	No
Could the conduct or interpretation of the index test have introduced bias?		High risk
Are there concerns that the index test, its conduct, or interpretation differ from the review question?			Low concern
DOMAIN 2: Index Test (Red fluorescence)
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	No
Were the reference standard results interpreted without knowledge of the results of the index tests?	Yes
Could the reference standard, its conduct, or its interpretation have introduced bias?		High risk
Are there concerns that the target condition as defined by the reference standard does not match the question?			Low concern
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Yes
Did all patients receive the same reference standard?	No
Were all patients included in the analysis?	No
Could the patient flow have introduced bias?		High risk