DETECTION, DIAGNOSING, MONITORING AND LOGICAL TREATMENT OF OCCLUSAL CARIES IN RELATION TO LESION ACTIVITY AND SEVERITY - AN IN-VIVO EXAMINATION WITH HISTOLOGICAL VALIDATION

The aims of the present study were to investigate the ability of 3 exp erienced clinicians to detect occlusal carious lesions, assess their d epth, diagnose their activity and define a logical management for each lesion. The material consisted of 35 third molars scheduled for extra ction or surgical removal making it possible to validate the accuracy of the clinical recordings histologically. Examinations were carried o ut at baseline and after 4 months in order to monitor lesion progressi on. At the first visit a radiograph was taken; the number of filled su rfaces was counted and the oral hygiene assessed generally and by disc losing occlusal plaque of the tooth under examination. After cleaning the occlusal surface caries was recorded in a selected investigation s ite using a visual ranked caries scoring system, as well as an electri cal conductance recording (ECM). Apart from counting fillings and taki ng new radiographs the same procedure was performed at the second visi t, which then was followed by extraction of the tooth. After sectionin g the tooth lesion depth was recorded, and lesion activity, based on a cid production, was assessed using methyl red dye. Lesion activity was also judged by means of polarized light microscopic examinations of t he sections. Results showed strong relationships between the visual, E CM and radiographic assessments and both lesion depth and lesion activ ity. In contrast, all other parameters were poorly related to lesion a ctivity. Changes in visual assessments and in conductance readings fro m first to second examination were poorly associated with lesion activ ity. In conclusion, clinicians are able to detect lesions, predict act ivity and severity and define a logical management of occlusal caries on the basis of a single examination.