The Effect of Combining Radiographs and DIAGNOdent with Visual ...
The Effect of Combining Radiographs and DIAGNOdent with Visual Examination on Detection and Treatment Decisions of NonCavitated Occluso-Dentinal Caries Qasem Alomari, Muawia Qudeimat, Mai Khalaf, Yacoub Al-Tarakemah Faculty of Dentistry, Kuwait University
The aim of this laboratory study was to evaluate the effect of adding radiographs and DIAGNOdent to visual examination on detection and treatment decisions of non-cavitated occluso-dentinal caries. Methods The occlusal surfaces of 160 extracted posterior teeth were examined by four examiners. Three diagnostic methods: visual (V) only, visual with radiograph (VR), and visual with radiograph and DIAGNOdent (VRD) were used with one month interval between each examination. Each examiner was asked to detect the presence of caries (if any) and identify the extent of caries (if present). The examiners were asked to choose one of four treatment options for each tooth: no treatment, fissure sealant, preventive resin restoration or composite/amalgam restoration. The teeth were sectioned and the presence of caries was charted as: 0: no caries; 1: caries confined to enamel; 2: caries in the outer dentin and 3: caries in the inner dentin. Sensitivity, specificity, area under the curve (Az values), rank correlation coefficient, inter-examiner reproducibility, and McNemar χ2 test were calculated. Results The means of the rank correlation coefficients with histology for detection of dentinal caries were: 0.48, 0.23 and 0.44 using V, VR and VRD respectively. The means of Az values ranged from 0.58 to 0.63 with no statistical difference between the three methods. VR had statistically higher specificity and lower sensitivity than V and VRD. The percentages of teeth indicated for restorative treatment were 31, 33 and 41 using V, VR and VRD respectively. The percentages of teeth correctly treated compared with the histology were 69.4, 70.0 and 67.5 using V, VR, VRD respectively. There was no difference in the accuracy of treatment decisions between the three diagnostic methods. Conclusions Visual examination with radiograph had higher specificity and lower sensitivity than visual examination alone or visual examination combined with radiographs and DIAGNOdent. There was no difference in the Az values between visual examination alone, visual examination with radiographs or visual examination combined with radiographs and DIAGNOdent. Visual examination with radiographs had the lowest rank correlation with histology. There was an increase in the number of teeth indicated for treatment when the examiners used radiographs and DIAGNOdent with the visual examination. The number of correct treatment decisions was not different between the three examination points. carious lesions.
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This work was supported by Kuwait University Research Grant No. [DR03/05]
The aim of this laboratory study was to evaluate the effect of adding radiographs and DIAGNOdent to visual examination on detection and treatment decisions of non-cavitated occluso-dentinal caries. Methods The occlusal surfaces of 160 extracted posterior teeth were examined by four examiners. Three diagnostic methods: visual (V) only, visual with radiograph (VR), and visual with radiograph and DIAGNOdent (VRD) were used with one month interval between each examination. Each examiner was asked to detect the presence of caries (if any) and identify the extent of caries (if present). The examiners were asked to choose one of four treatment options for each tooth: no treatment, fissure sealant, preventive resin restoration or composite/amalgam restoration. The teeth were sectioned and the presence of caries was charted as: 0: no caries; 1: caries confined to enamel; 2: caries in the outer dentin and 3: caries in the inner dentin. Sensitivity, specificity, area under the curve (Az values), rank correlation coefficient, inter-examiner reproducibility, and McNemar χ2 test were calculated. Results The means of the rank correlation coefficients with histology for detection of dentinal caries were: 0.48, 0.23 and 0.44 using V, VR and VRD respectively. The means of Az values ranged from 0.58 to 0.63 with no statistical difference between the three methods. VR had statistically higher specificity and lower sensitivity than V and VRD. The percentages of teeth indicated for restorative treatment were 31, 33 and 41 using V, VR and VRD respectively. The percentages of teeth correctly treated compared with the histology were 69.4, 70.0 and 67.5 using V, VR, VRD respectively. There was no difference in the accuracy of treatment decisions between the three diagnostic methods. Conclusions Visual examination with radiograph had higher specificity and lower sensitivity than visual examination alone or visual examination combined with radiographs and DIAGNOdent. There was no difference in the Az values between visual examination alone, visual examination with radiographs or visual examination combined with radiographs and DIAGNOdent. Visual examination with radiographs had the lowest rank correlation with histology. There was an increase in the number of teeth indicated for treatment when the examiners used radiographs and DIAGNOdent with the visual examination. The number of correct treatment decisions was not different between the three examination points. carious lesions.
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This work was supported by Kuwait University Research Grant No. [DR03/05]
