Restorative Treatment Decision Making with Unaided Visual Examination, Intraoral Camera and Operating Microscope

Abstract

The use of an intraoral camera aided in the treatment of occlusal surfaces of molars. SUMMARYThis study assessed the restorative treatment options of the occlusal surfaces of teeth examined with unaided visual assistance, an intraoral camera and an operating microscope. Sixty-eight extracted human molars were mounted to perform mouth models with a premolar in contact on both sides. Four observers examined the models in a phantom head, which simulated clinical conditions, using three techniques: unaided visual examination, intraoral camera and operating microscope. The observers were asked to assess the occlusal surface of each tooth and make a treatment decision based on the following scale: 1) the occlusal surface being sound and "not needing a restoration," 2) the occlusal surface having a subsurface or enamel lesion. No operative treatment was needed at this visit, but special attention was given to this surface at recall visits: "preventive care-defer treatment" and 3) the surface had a carious lesion and "needed a restoration." The teeth were then sectioned in the mesio-distal direction and examined under a stereomicroscope with 10x magnification to determine the true extent of caries. Statistical analysis was conducted by calculating percentages and kappa values of the restorative treatment scores based on examinations by four observers. According to all the observers' treatment decisions, the kappa values were found to be 0.341 (p<0.001), 0.471 (p<0.001) and 0.345 (p<0.001) for unaided visual examination, intra- As a result of a comparison between the unaided visual examination and operating microscope, the use of an intraoral camera improved the restorative treatment decisions of the occlusal surfaces on posterior teeth.

The Use of a Microscope for Restorative Treatment Decision-making on Occlusal Surfaces

“…A histological evaluation was not made in their study; therefore, one could not estimate the accuracy of the results. Erten and others 15 reported no significant changes in treatment decision-making using an operating microscope at 16x magnification when histological evaluations were made, although there was an increase in true and false diagnosis rates. The current results are similar to the previous two reports.…”

“…10,15 According to this model, all the teeth were asymptomatic, in acceptable occlusion with a DMFT score of 6, and they belonged to non-medicated, healthy patients with reasonably good oral hygiene.…”

The use of clinical photography by UK general dental practitioners

“…Clinical dental photography has a number of uses, which include: [1][2][3][4][5][6][7][8][9][10][11][12] Aim The aim of this study was to assess by means of a postal questionnaire the numbers of general dental practitioners (GDPs) who used clinical photography and for what application. Method The questionnaire was distributed to 1,000 randomly selected dentists in the UK with an explanatory letter and reply paid envelope.…”

Impact of Low Level Magnification on Incipient Occlusal Caries Diagnosis and Treatment Decision Making

“…Its impact on caries detection and treatment decision making has also been studied by various authors [8][9][10][11][12][13], as it is believed to allow for clearer visualisation of minute defects. However, some of these studies used high magnification values [10][11][12], others [9] have not correlated results with a gold standard [8]. To date there is no study reported which correlates the impact of magnification on visual-tactile detection of caries using ICDAS-II and a CPI-TN probe.…”