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Restorative Dentistry Supporting Your Practice

How accurate are visual methods in detecting carious lesions? A systematic review

Dental team 2This summary is based on the article published in Dental Research Journal: Visual Inspection for Caries Detection: A Systematic Review and Meta-analysis (July 2015)

Gimenez, C. Piovesan, M.M. Braga, D.P. Raggio, C. Deery, D.N. Ricketts, K.R. Ekstrand, and F.M. Mendes

Context

  • Caries detection in daily clinical practice is primarily performed by visual inspection (Bader et al. 2002) because it is a simple technique with no additional costs.
  • Nevertheless, visual examination has some shortcomings, mainly related to its subjective nature (Braga et al. 2010), since examiners can demonstrate inconsistency in the interpretation of clinical characteristics of carious lesions (Bader et al. 2002).
  • Several studies have evaluated the performance of visual inspection in detecting carious lesions, and the range of reported results has been extensive and contradictory.
  • This discrepancy may in part be due to the wide assortment of different classification criteria used for visual inspection and the variation in the conditions in which such examinations are carried out (Ismail 2004).
  • As a result, studies are necessary to investigate how accurate visual inspection really is.

Purpose of the Review

To evaluate the overall accuracy of visual methods for detecting carious lesions and to identify possible sources of heterogeneity among the studies included.

Key Messages

  • Studies using well-established scoring systems showed higher accuracy in detecting carious lesions in the proximal and occlusal surfaces of primary and permanent teeth when compared with studies that did not report the method used or that used their own criteria.
  • The utilization of a validated system allows a more accurate diagnosis of caries lesions since it gives practitioners a guideline to how to characterize the lesions that they identify and it provides a rational shortcut associating with these characteristics.
  • Visual inspection presents good accuracy in the detection of carious lesions in primary and permanent teeth, with a trend for higher specificity than sensitivity.
  • Importantly, the use of detailed and validated methods improves the accuracy of visual inspection for caries.

References

List of references (PDF)

 

 

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