Preliminary investigation into the validity of dentists' decisions to restore occlusal surfaces of permanent teeth

Kay, Elizabeth; Watts, A.; Paterson, Robert C.; Blinkhorn, Anthony S.

doi:10.1111/j.1600-0528.1988.tb01850.x

Cited by 52 publications

(29 citation statements)

References 10 publications

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“…Generally, the participating dentists showed a higher specificity than sensitivity, a pattern also found by Kay et al [1988]. In their study with 10 den tists using the visual technique and 30 teeth, they found an average specificity of 67% and a sensitivity of 57%.…”

Section: Discussionmentioning

confidence: 71%

Validity of Diagnostic and Treatment Decisions of Fissure Caries

Lussi¹

1991

Caries Res

172

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The purpose of this in vitro study was to test the accuracy and the reproducibility of diagnostic and treatment decisions of fissure caries with and without explorer. 34 dentists were asked to diagnose 61 teeth and decide upon possible treatment. The teeth were then histologically prepared and diagnosed. The agreement between histological and clinical diagnoses was assessed. The results showed no difference in diagnostic accuracy between explorer and visual technique only. Sensitivity (62%) and specificity (84%) showed that the dentists were more likely not to treat decayed teeth than to restore sound teeth. The percentage ‘correctly diagnosed teeth’ was approximately 42%. As there was an inherent possibility of a correct diagnosis by chance, this value had to be corrected to 23% (kappa statistics). The percentage of ‘clinically’ correct treatment decisions, however, was 73%. The reproducibility test gave kappa values of 0.47 for diagnostic and 0.44 for treatment decisions. It was concluded that the use of an explorer does not improve the validity of the diagnosis of fissure caries when compared to that of a visual inspection alone.

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Section: Discussionmentioning

confidence: 71%

Validity of Diagnostic and Treatment Decisions of Fissure Caries

Lussi¹

1991

Caries Res

172

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“…That is, they are willing to miss detecting some lesions (low sensitivity and high specificity) in order not to over treat the disease (high sensitivity and low specificity). Ex perienced dentists who have seen the long-term results of restoration placement (the commitment of a tooth to a life time o f restorative treatment) may be more willing to avoid placement of a restoration in a questionably diseased tooth than to place one in a caries-free tooth [Kay et al, 1988]. In contrast, dental students have not had the experience of ob serving teeth over long periods of time and thus have not seen the long-term consequences of restorative treatment.…”

Section: Discussionmentioning

confidence: 93%

Radiographic Evaluation of Occlusal Caries: Effect of Training and Experience

Lazarchik¹,

Firestone²,

Heaven³

et al. 1995

Caries Res

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The purpose of this study was to investigate what effect differing levels of didactic education and clinical experience have on the ability to diagnose occlusal caries from radiographs. Freshman and senior dental students and dental school faculty were asked to evaluate bitewing radiographs for the presence of occlusal caries and for a recommendation for restorative treatment. The agreement between histologic and radiographic diagnosis was assessed by calculating sensitivity, specificity, accuracy, and interexaminer agreement. It was concluded that dental students and faculty did differ in their abilities to evaluate radiographs for occlusal caries, and that education and clinical experience especially affected interexaminer agreement.

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“…It is generally accepted that in the fi eld of caries diagnosis a high specifi city is to be aimed for, as this will reduce unnecessary operative treatment [Kay et al, 1988]. The likelihood ratio unites the values of specifi city and sensitivity simplifying comparison of diagnostic tests or tools but the separate parameters of specifi city and sensitivity should still be considered.…”

Section: Discussionmentioning

confidence: 99%

Effect of Placing a Clear Sealant on the Validity and Reproducibility of Occlusal Caries Detection by a Laser Fluorescence Device: An in vitro Study

et al. 2006

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The principal aim of this in vitro study was to assess the validity and reproducibility of the detection of occlusal caries using laser fluorescence (LF), prior to and following the placement of a clear fissure sealant. It also aimed to compare the manufacturer’s standard cut-off recommendations with those published for in vitro studies and to compare the validity and reproducibility of LF with clinical visual examination (CVE) for the detection of occlusal caries under sealants. Three clinicians independently examined visually and with LF 37 extracted teeth (25 molars, 12 premolars), with a range of clinical caries from apparently sound to cavitated dentinal caries. Examinations were conducted under dental surgery conditions. Subsequently, the teeth were serially sectioned to provide the validating criterion. Following placement of the sealant, the specificity generally increased but there was an associated loss of sensitivity, at both the D₁(enamel and dentine) and D₃ (dentine) diagnostic thresholds. The LF readings were significantly lower after placement of the sealant (p < 0.05). The manufacturer’s recommended cut-offs appear to be the most appropriate to use. The CVE had superior validity and reproducibility when compared to LF. Overall, the placement of a clear sealant does influence the detection of caries by LF but does not prevent the detection of caries by this method.

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Preliminary investigation into the validity of dentists' decisions to restore occlusal surfaces of permanent teeth

Cited by 52 publications

References 10 publications

Validity of Diagnostic and Treatment Decisions of Fissure Caries

Validity of Diagnostic and Treatment Decisions of Fissure Caries

Radiographic Evaluation of Occlusal Caries: Effect of Training and Experience

Effect of Placing a Clear Sealant on the Validity and Reproducibility of Occlusal Caries Detection by a Laser Fluorescence Device: An in vitro Study

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