Dnj. Ricketts et al., CLINICAL AND RADIOGRAPHIC DIAGNOSIS OF OCCLUSAL CARIES - A STUDY IN-VITRO, Journal of oral rehabilitation, 22(1), 1995, pp. 15-20
Various methods of diagnosing occlusal caries have been described, but
only visual, clinical examination and radiographic examination are co
mmonly used in dental practice. This laboratory study investigated the
ability of 12 examiners to detect the presence or absence of occlusal
caries in 48 extracted molar teeth using these two techniques. The pr
esence or absence of caries was subsequently verified by sectioning th
e teeth. Diagnosis from visual examination was poor, only 48.7% of les
ions in dentine being detected. Radiographic diagnosis was better with
62.2% of dentine lesions being found. However, this increase in sensi
tivity of the diagnosis was accompanied by a decrease in specificity w
ith the number of false positive diagnoses increasing when the radiogr
aph was used. Therefore, although the bite-wing radiograph may be rega
rded as a safety net for the diagnosis of occlusal caries, it must be
interpreted with caution bearing in mind the possibility of false posi
tive diagnoses.