Validity of caries detection on occlusal surfaces and treatment decisions based on results from multiple caries-detection methods

Antonio Carlos Pereira, Hafsteinn Eggertsson, Esperanza Martinez Mier, Fábio Luiz Mialhe, George Joseph Eckert, Domenick Zero

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

The aim of this in vitro study was to evaluate whether having results available from multiple detection methods influences dentist's treatment decisions for incipient caries lesions on occlusal surfaces. The occlusal surface of 96 extracted permanent molars without frank cavitation was examined by three examiners initially by visual examination alone, following which they chose one of three treatment options: (i) no treatment, (ii) preventive or non-invasive treatment (sealants), and (iii) invasive treatment. Four weeks later the examiners again selected one of the three treatment options for the surfaces, but this time were able to refer to the results from additional caries-detection methods [bitewing radiographs, electric conductance measurement (ECM), quantitative light fluorescence (QLF), and DIAGNOdent] that had been performed in the interim time. Stereomicroscopy was used to evaluate sensitivity, specificity, accuracy, and area under the Receiver Operating Characteristic (ROC) curve (AUC) for the detection methods at the D1 diagnostic threshold. Slight improvement was obtained in the percentage of sites correctly diagnosed, and in the AUC, when referring to the results obtained from all detection methods compared with visual examination alone. However, a drastic effect on the selection of treatment options was observed by having results available from multiple methods, with the choice of invasive treatment increasing substantially. In conclusion, having data available from multiple methods did not improve the accuracy of examiners in detecting early occlusal caries lesions, but it had a great influence on the number of surfaces indicated for operative treatment. The potential decrease in overall specificity while using multiple methods of detection may be of concern in populations with a low prevalence of occlusal caries lesions.

Original languageEnglish (US)
Pages (from-to)51-57
Number of pages7
JournalEuropean Journal of Oral Sciences
Volume117
Issue number1
DOIs
StatePublished - Feb 2009

Fingerprint

Therapeutics
Area Under Curve
Dentists
ROC Curve
Fluorescence
Sensitivity and Specificity
Population
In Vitro Techniques

Keywords

  • Bitewing radiography
  • Decision making
  • Diagnosis
  • Electric conductance measurement
  • Quantitative light fluorescence

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Validity of caries detection on occlusal surfaces and treatment decisions based on results from multiple caries-detection methods. / Pereira, Antonio Carlos; Eggertsson, Hafsteinn; Martinez Mier, Esperanza; Mialhe, Fábio Luiz; Eckert, George Joseph; Zero, Domenick.

In: European Journal of Oral Sciences, Vol. 117, No. 1, 02.2009, p. 51-57.

Research output: Contribution to journalArticle

Pereira, Antonio Carlos ; Eggertsson, Hafsteinn ; Martinez Mier, Esperanza ; Mialhe, Fábio Luiz ; Eckert, George Joseph ; Zero, Domenick. / Validity of caries detection on occlusal surfaces and treatment decisions based on results from multiple caries-detection methods. In: European Journal of Oral Sciences. 2009 ; Vol. 117, No. 1. pp. 51-57.
@article{d7af0910707343269602fe373f3fae8f,
title = "Validity of caries detection on occlusal surfaces and treatment decisions based on results from multiple caries-detection methods",
abstract = "The aim of this in vitro study was to evaluate whether having results available from multiple detection methods influences dentist's treatment decisions for incipient caries lesions on occlusal surfaces. The occlusal surface of 96 extracted permanent molars without frank cavitation was examined by three examiners initially by visual examination alone, following which they chose one of three treatment options: (i) no treatment, (ii) preventive or non-invasive treatment (sealants), and (iii) invasive treatment. Four weeks later the examiners again selected one of the three treatment options for the surfaces, but this time were able to refer to the results from additional caries-detection methods [bitewing radiographs, electric conductance measurement (ECM), quantitative light fluorescence (QLF), and DIAGNOdent] that had been performed in the interim time. Stereomicroscopy was used to evaluate sensitivity, specificity, accuracy, and area under the Receiver Operating Characteristic (ROC) curve (AUC) for the detection methods at the D1 diagnostic threshold. Slight improvement was obtained in the percentage of sites correctly diagnosed, and in the AUC, when referring to the results obtained from all detection methods compared with visual examination alone. However, a drastic effect on the selection of treatment options was observed by having results available from multiple methods, with the choice of invasive treatment increasing substantially. In conclusion, having data available from multiple methods did not improve the accuracy of examiners in detecting early occlusal caries lesions, but it had a great influence on the number of surfaces indicated for operative treatment. The potential decrease in overall specificity while using multiple methods of detection may be of concern in populations with a low prevalence of occlusal caries lesions.",
keywords = "Bitewing radiography, Decision making, Diagnosis, Electric conductance measurement, Quantitative light fluorescence",
author = "Pereira, {Antonio Carlos} and Hafsteinn Eggertsson and {Martinez Mier}, Esperanza and Mialhe, {F{\'a}bio Luiz} and Eckert, {George Joseph} and Domenick Zero",
year = "2009",
month = "2",
doi = "10.1111/j.1600-0722.2008.00586.x",
language = "English (US)",
volume = "117",
pages = "51--57",
journal = "European Journal of Oral Sciences",
issn = "0909-8836",
publisher = "Blackwell Munksgaard",
number = "1",

}

TY - JOUR

T1 - Validity of caries detection on occlusal surfaces and treatment decisions based on results from multiple caries-detection methods

AU - Pereira, Antonio Carlos

AU - Eggertsson, Hafsteinn

AU - Martinez Mier, Esperanza

AU - Mialhe, Fábio Luiz

AU - Eckert, George Joseph

AU - Zero, Domenick

PY - 2009/2

Y1 - 2009/2

N2 - The aim of this in vitro study was to evaluate whether having results available from multiple detection methods influences dentist's treatment decisions for incipient caries lesions on occlusal surfaces. The occlusal surface of 96 extracted permanent molars without frank cavitation was examined by three examiners initially by visual examination alone, following which they chose one of three treatment options: (i) no treatment, (ii) preventive or non-invasive treatment (sealants), and (iii) invasive treatment. Four weeks later the examiners again selected one of the three treatment options for the surfaces, but this time were able to refer to the results from additional caries-detection methods [bitewing radiographs, electric conductance measurement (ECM), quantitative light fluorescence (QLF), and DIAGNOdent] that had been performed in the interim time. Stereomicroscopy was used to evaluate sensitivity, specificity, accuracy, and area under the Receiver Operating Characteristic (ROC) curve (AUC) for the detection methods at the D1 diagnostic threshold. Slight improvement was obtained in the percentage of sites correctly diagnosed, and in the AUC, when referring to the results obtained from all detection methods compared with visual examination alone. However, a drastic effect on the selection of treatment options was observed by having results available from multiple methods, with the choice of invasive treatment increasing substantially. In conclusion, having data available from multiple methods did not improve the accuracy of examiners in detecting early occlusal caries lesions, but it had a great influence on the number of surfaces indicated for operative treatment. The potential decrease in overall specificity while using multiple methods of detection may be of concern in populations with a low prevalence of occlusal caries lesions.

AB - The aim of this in vitro study was to evaluate whether having results available from multiple detection methods influences dentist's treatment decisions for incipient caries lesions on occlusal surfaces. The occlusal surface of 96 extracted permanent molars without frank cavitation was examined by three examiners initially by visual examination alone, following which they chose one of three treatment options: (i) no treatment, (ii) preventive or non-invasive treatment (sealants), and (iii) invasive treatment. Four weeks later the examiners again selected one of the three treatment options for the surfaces, but this time were able to refer to the results from additional caries-detection methods [bitewing radiographs, electric conductance measurement (ECM), quantitative light fluorescence (QLF), and DIAGNOdent] that had been performed in the interim time. Stereomicroscopy was used to evaluate sensitivity, specificity, accuracy, and area under the Receiver Operating Characteristic (ROC) curve (AUC) for the detection methods at the D1 diagnostic threshold. Slight improvement was obtained in the percentage of sites correctly diagnosed, and in the AUC, when referring to the results obtained from all detection methods compared with visual examination alone. However, a drastic effect on the selection of treatment options was observed by having results available from multiple methods, with the choice of invasive treatment increasing substantially. In conclusion, having data available from multiple methods did not improve the accuracy of examiners in detecting early occlusal caries lesions, but it had a great influence on the number of surfaces indicated for operative treatment. The potential decrease in overall specificity while using multiple methods of detection may be of concern in populations with a low prevalence of occlusal caries lesions.

KW - Bitewing radiography

KW - Decision making

KW - Diagnosis

KW - Electric conductance measurement

KW - Quantitative light fluorescence

UR - http://www.scopus.com/inward/record.url?scp=58449085501&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58449085501&partnerID=8YFLogxK

U2 - 10.1111/j.1600-0722.2008.00586.x

DO - 10.1111/j.1600-0722.2008.00586.x

M3 - Article

C2 - 19196318

AN - SCOPUS:58449085501

VL - 117

SP - 51

EP - 57

JO - European Journal of Oral Sciences

JF - European Journal of Oral Sciences

SN - 0909-8836

IS - 1

ER -