Diagnostic outcome of methods frequently used for caries validation. A comparison of clinical examination, radiography and histology following hemisectioning and serial tooth sectioning

Abstract

The aim of this study was to compare the caries diagnostic outcome of four methods frequently used as validation for dental caries. The diagnostic outcome of clinical examination (CL), radiography (RA), and histology after serial tooth sectioning (HI-serial) on 373 approximal and 158 occlusal surfaces was compared, and furthermore histology after hemi- (HI-hemi) and serial sectioning on another 113 approximal and 53 occlusal surfaces was compared. Two thresholds for each method (CL: (1) sound vs. all caries scores, and (2) non-cavitated vs. cavitated lesions; RA and HI: (1) sound vs. all caries scores, and (2) no dentine vs. dentine lesions) were evaluated. In general, large differences in diagnostic outcomes were observed with the various methods. At threshold 1, CL resulted in significantly more lesions than both RA and HI-serial on approximal surfaces, and than RA on occlusal surfaces. At threshold 2, no significant differences between CL, RA and HI-serial were found on approximal surfaces, but on occlusal surfaces significantly more lesions were diagnosed with RA and HI-serial than with CL. Significantly more occlusal lesions were found by HI-serial than by RA at both thresholds 1 and 2. On approximal surfaces, a similar result was found only at threshold 1. On approximal surfaces, significantly more lesions were diagnosed with HI-serial than with HI-hemi at both thresholds 1 and 2. On occlusal surfaces the same was found only at threshold 1. The intra-observer reproducibility was higher using HI-serial than using RA and CL.