The effect of multiple examinations on the diagnosis of approximal caries and the restoration of approximal surfaces

Objective. The aim of this study was to determine the effect of multiple ex aminations on sensitivity and specificity in the diagnosis and restoration of approximal caries. Study design. In 2 studies, dentists examined bitewing radiographic films f or approximal caries and the need for restoration. To model the clinical si tuation of multiple examinations over time, ail groups of combinations of 2 to 10 dentists were constructed. Mean sensitivity and specificity were det ermined. In addition, 2 new variables were created: the first, "sensitivity any," was calculated by assigning a correct diagnosis for disease if any d entist in the group identified the diseased surface correctly; the second, "specificity all," was calculated by assigning a correct response only when all dentists in the group correctly identify a nondiseased surface. Results. The sensitivity and specificity means were the same for all group sizes. The "sensitivity any" means increased monotonically from group size 1 to group size 10, whereas the "specificity all" means decreased continual ly. There was a statistically significant difference between sensitivity an d "sensitivity any" and between specificity and "specificity all" for ail g roup sizes in both studies. Conclusions. Multiple examinations increase the number of carious surfaces correctly diagnosed and the number of surfaces appropriately restored; howe ver, multiple examinations also increase the number of sound surfaces diagn osed as carious and the number of intact surfaces receiving restorations.