J Am Dent Assoc. 2018 Feb 20. pii: S0002-8177(17)31029-2. doi: 10.1016/j.adaj.2017.11.001. [Epub ahead of print]
Abstract
BACKGROUND:
A
suspicious occlusal carious lesion (SOCL) can be defined as a lesion
with no cavitation and no radiographic radiolucency but for which caries
is suspected. The authors evaluated whether using a device changed the
percentage of SOCLs that were opened surgically and, among those SOCLs
that were opened, the proportion that had penetrated into dentin.
METHODS:
Eighty-two
dentists participated. In phase 1 of the study, dentists identified
approximately 20 SOCLs, obtained patient consent, and recorded
information about the lesion, treatment or treatments, and depth, if
opened. Dentists were then randomly assigned into 1 of 3 groups: no
device, DIAGNOdent (KaVo), and Spectra (Air Techniques). In phase 2,
dentists enrolled approximately 20 additional patients and recorded the
same phase 1 information while using the assigned device to help make
their treatment decisions. A mixed-model logistic regression was used to
determine any differences after randomization in the proportion of
lesions opened and, if opened, the proportion of lesions that penetrated
into dentin.
RESULTS:
A
total of 1,500 SOCLs were enrolled in each phase. No statistically
significant difference was found in the change in proportion of lesions
receiving invasive treatment from phase 1 to phase 2 across the 3 groups
(P = .33) or in the change in proportion of percentage of opened
lesions that extended into dentin (P = .31).
CONCLUSION:
Caries-detecting
devices in the study did not change substantially dentists' decisions
to intervene or the accuracy of the intervention decision in predicting
lesion penetration into dentin.
Comments