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Subjectivity and examiner experience in diagnosis of residual caries--an in vitro study


Lennon, A M; Wiegand, A; Buchalla, W; Wahl, B; Werner, C; Betke, H; Hannig, C; Rödig, T; Attin, T (2007). Subjectivity and examiner experience in diagnosis of residual caries--an in vitro study. Schweizer Monatsschrift für Zahnmedizin SMfZ, 117(2):123-127.

Abstract

The aim was to evaluate subjectivity (using inter- and intraexaminer repeatability), the effect of examiner experience, and residual caries diagnostic accuracy with visual tactile (VT) criteria and using a caries disclosing agent (CD). Thirty teeth with occlusal caries were excavated by a single operator not involved in the diagnostic part of the study. A test area was marked in each cavity. Four dentists with more than five and five dentists with less than five years' experience rated the marked area twice (a week apart) using VT criteria. A week later, the samples were stained using Caries Detector. The same examiners rated the presence or absence of stain in the marked area twice (a week apart). Undecalcified thin slices were examined for bacteria using light microscopy. Overall kappa for inter-examiner repeatability was higher for CD (0.45) than VT (0.31). In the less experienced group the kappa value was higher for CD (0.41) than for VT (0.23). In the experienced group kappa was lower for CD (0.43) than for VT (0.46). Median kappa for intra-examiner repeatability was higher for caries detector (0.77, 0.53) compared to visual tactile (0.52, 0.34) for the more and less experienced examiners respectively. There was no significant difference between the experienced and the inexperienced group in combined sensitivity and specificity (mean) for VT (0.52, 0.53) or CD (0.60, 0.58). In conclusion: VT was more subjective than CD, except for experienced examiners who had a higher inter-examiner repeatability for VT than CD. Diagnostic accuracy for residual caries does not increase with experience.

The aim was to evaluate subjectivity (using inter- and intraexaminer repeatability), the effect of examiner experience, and residual caries diagnostic accuracy with visual tactile (VT) criteria and using a caries disclosing agent (CD). Thirty teeth with occlusal caries were excavated by a single operator not involved in the diagnostic part of the study. A test area was marked in each cavity. Four dentists with more than five and five dentists with less than five years' experience rated the marked area twice (a week apart) using VT criteria. A week later, the samples were stained using Caries Detector. The same examiners rated the presence or absence of stain in the marked area twice (a week apart). Undecalcified thin slices were examined for bacteria using light microscopy. Overall kappa for inter-examiner repeatability was higher for CD (0.45) than VT (0.31). In the less experienced group the kappa value was higher for CD (0.41) than for VT (0.23). In the experienced group kappa was lower for CD (0.43) than for VT (0.46). Median kappa for intra-examiner repeatability was higher for caries detector (0.77, 0.53) compared to visual tactile (0.52, 0.34) for the more and less experienced examiners respectively. There was no significant difference between the experienced and the inexperienced group in combined sensitivity and specificity (mean) for VT (0.52, 0.53) or CD (0.60, 0.58). In conclusion: VT was more subjective than CD, except for experienced examiners who had a higher inter-examiner repeatability for VT than CD. Diagnostic accuracy for residual caries does not increase with experience.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Preventive Dentistry, Periodontology and Cariology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:July 2007
Deposited On:16 Jun 2008 14:33
Last Modified:05 Apr 2016 12:23
Publisher:Schweizerische Zahnärzte-Gesellschft
ISSN:0256-2855
Additional Information:Free full text article
Official URL:http://www.sso.ch/doc/doc_download.cfm?uuid=95654063D9D9424C41223FC0C46488C5&&IRACER_AUTOLINK&&
PubMed ID:17345999
Permanent URL: http://doi.org/10.5167/uzh-2562

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