Lesion activity assessment

K. R. Ekstrand, Domenick Zero, S. Martignon, N. B. Pitts

Research output: Chapter in Book/Report/Conference proceedingChapter

40 Citations (Scopus)

Abstract

This chapter focusses on the probability of a caries lesion detected during a clinical examination being active (progressing) or arrested. Visual and tactile methods to assess primary coronal lesions and primary root lesions are considered. The evidence level is rated as low (Rw), as there are few studies with proper validation. The major problem is lack of an accepted clinical gold standard. Evidence from high-quality basic research and epidemiological, clinical and intervention studies is therefore discussed. High-quality basic research has mapped the patho-anatomical changes occurring in response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee. The literature suggests that there is a fair agreement between visual/tactile external scripts of caries and the severity/depth of the lesion. The reproducibility of the different systems is, in general, substantial. No single clinical predictor is able to reliably assess activity. However, a combination of predictors increases the accuracy of lesion activity prediction for both primary coronal and root lesions. Three surrogate methods have been used for evaluating lesion activity (construct validity); all have disadvantages. If construct validity is accepted as a 'gold standard', it is possible to assess the activity of primary coronal and root lesions reliably and accurately at one examination by using the combined information obtained from a range of indicators - such as visual appearance, location of the lesion, tactile sensation during probing and gingival health.

Original languageEnglish (US)
Title of host publicationMonographs in Oral Science
Pages63-90
Number of pages28
Volume21
DOIs
StatePublished - 2009

Publication series

NameMonographs in Oral Science
Volume21
ISSN (Print)00770892
ISSN (Electronic)16623843

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ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Ekstrand, K. R., Zero, D., Martignon, S., & Pitts, N. B. (2009). Lesion activity assessment. In Monographs in Oral Science (Vol. 21, pp. 63-90). (Monographs in Oral Science; Vol. 21). https://doi.org/10.1159/000224213

Lesion activity assessment. / Ekstrand, K. R.; Zero, Domenick; Martignon, S.; Pitts, N. B.

Monographs in Oral Science. Vol. 21 2009. p. 63-90 (Monographs in Oral Science; Vol. 21).

Research output: Chapter in Book/Report/Conference proceedingChapter

Ekstrand, KR, Zero, D, Martignon, S & Pitts, NB 2009, Lesion activity assessment. in Monographs in Oral Science. vol. 21, Monographs in Oral Science, vol. 21, pp. 63-90. https://doi.org/10.1159/000224213
Ekstrand KR, Zero D, Martignon S, Pitts NB. Lesion activity assessment. In Monographs in Oral Science. Vol. 21. 2009. p. 63-90. (Monographs in Oral Science). https://doi.org/10.1159/000224213
Ekstrand, K. R. ; Zero, Domenick ; Martignon, S. ; Pitts, N. B. / Lesion activity assessment. Monographs in Oral Science. Vol. 21 2009. pp. 63-90 (Monographs in Oral Science).
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