The Effect of Pit and Fissure Sealants on the Detection of Occlusal Caries in vitro

Abstract

The sensitivity of all OCD methods was low, as well as their correlation to the histological gold standard. Placing OPS further decreased the sensitivity of LF and visual methods, whereas placing CFS had little effect on all OCD methods. It is recommended that tactile detection of occlusal caries should be discontinued, and the probe used only to clean the pits and fissures gently for more accurate visual detection, or prior to pit and fissure sealant placement. Further research into the development of an affordable, robust, accurate and easy to use method for OCD is required.

Diagnosis of the early carious lesion

“…9 Radiography can improve the detection of occlusal lesions when they have progressed into the dentine. 10,11 The visualization of interproximal caries in posterior teeth is complicated by the overlying tooth structure at the marginal ridge, especially in the early stages of the carious lesion.…”

“…15 It has been recommended for at least two decades that this technique be limited or replaced for detection of fissural or smooth surface caries. 9,15,16 This is due to the limited amount of extra information tactile examination provides in addition to what can be gained by using other detection techniques, and also the possible damage that may be done to demineralized enamel during the 'probing' procedure. 9,15,17,18 It is recommended that only a ball-ended probe is used, especially to check enamel surface integrity/roughness.…”

“…28,29 Sensitivity and accuracy have been reported as low, especially for lesions within the enamel, and so radiography should be used in conjunction with other detection methods, such as transillumination. 9,11,30 The validity of results are affected by clinician experience and training, with more experienced clinicians having lower sensitivity and higher specificity when compared to undergraduate students.…”

“…32 Primarily it is used for detection of proximal carious lesions, aiding visual inspection and supplementing radiographic methods, although studies have indicated it can also improve visual detection of occlusal lesions. 9,14,30 Carious lesions limited to the enamel appear as grey shadows, and those in the dentine appear as orange-brown or bluish shadows.…”

Novas possibilidades de manejo e monitoramento de lesões de cárie em superfícies proximais

“…O uso de selantes opacos diminuiu ainda mais a sensibilidade do método visual, enquanto o uso de selantes transparentes também afetou este método de diagnóstico, mas de maneira mais sutil. Após o selamento com selantes opacos, a sensibilidade caiu de 68% para 13% e a especificidade aumentou de 71% para 98% (Manton;Messer, 2007). Além disso, outro estudo in vitro demonstrou que o selante transparente permite o diagnóstico de lesões oclusais de cárie pela inspeção visual, o que o selante opaco não permite (Takamori et al, 2001).…”