OCCLUSAL RESTORATIVE DECISIONS BASED ON VISUAL INSPECTION - CALIBRATION AND COMPARISON OF DIFFERENT METHODS

The purpose of this in vitro study was to calibrate occlusal restorati ve decision-making based on visual inspection (VI), and to compare it with visual inspection with magnifying (x1.25) lenses (VIM), and fibre -optic transillumination (VIF). Sixty extracted human third molars mou nted in plaster were examined using VI by ten dentists three times dur ing the calibration process. After wash-out periods, the teeth were re -examined by the same dentists using VI, VIM and VIF. The inter-examin er reproducibility for VI, expressed as Kappa (kappa) statistics (kapp a+/-SD), was 0.46+/-0.10 before and 0.59+/-0.11 after the calibration process and remained at the same level after the wash-out period. Intr a-examiner reproducibility was substantially higher for VI (kappa=0.68 +/-0.15) before and after the wash-out period. There were no significa nt changes in restorative treatment decisions based on VIM and VIF whe n compared to VI. The reproducibility between the methods was good for VI vs. VIM (kappa=0.64) and moderate for VI vs. VIF (kappa=0.56). In contrast, the inter-examiner reproducibilities expressed as Kappa were considerably lower for VIM (kappa=0.46+/-0.17) and VIF (kappa=0.42+/- 0.19). It was concluded that the inter-examiner reproducibility can be improved with a calibration process based on a simple feedback method and that inter-examiner variation, especially without calibration, ma y be as important a factor for restorative treatment decisions as the diagnostic method itself.