DETECTION, DIAGNOSING, MONITORING AND LOGICAL TREATMENT OF OCCLUSAL CARIES IN RELATION TO LESION ACTIVITY AND SEVERITY - AN IN-VIVO EXAMINATION WITH HISTOLOGICAL VALIDATION
Kr. Ekstrand et al., DETECTION, DIAGNOSING, MONITORING AND LOGICAL TREATMENT OF OCCLUSAL CARIES IN RELATION TO LESION ACTIVITY AND SEVERITY - AN IN-VIVO EXAMINATION WITH HISTOLOGICAL VALIDATION, Caries research, 32(4), 1998, pp. 247-254
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.