Influence of 2 caries-detecting devices on clinical decision making and lesion depth for suspicious occlusal lesions: A randomized trial from The National Dental Practice-Based Research Network
Sonia K Makhija, James D Bader, Daniel A Shugars, Mark S Litaker, Sanket Nagarkar, Valeria V Gordan, D Brad Rindal, Daniel J Pihlstrom, Rahma Mungia, Cyril Meyerowitz, Gregg H Gilbert, National Dental Practice-Based Research Network (PBRN) Collaborative Group, Sonia K Makhija, James D Bader, Daniel A Shugars, Mark S Litaker, Sanket Nagarkar, Valeria V Gordan, D Brad Rindal, Daniel J Pihlstrom, Rahma Mungia, Cyril Meyerowitz, Gregg H Gilbert, National Dental Practice-Based Research Network (PBRN) Collaborative Group
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.
Practical implications: The caries-detecting devices tested may not improve dentists' clinical decision making for SOCLs.
Keywords: Evidence-based dentistry; caries; dentin.
Conflict of interest statement
The authors declare no conflict of interest and that none have any business or financial interests in the corporations that manufacture or market the Spectra® or DIAGNOdent® devices. The devices used in this study were purchased using grant funds.
Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.
Figures
Source: PubMed