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Validity of Probing for Fissure Caries Diagnosis |
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By C. Penning, J.P.
van Amerongen, R.E. Seef, and J.M. ten Cate Abstract One hundred extracted molar teeth with discolored fissures but without any visible carious cavitation were selected from a large supply, using standardized criteria. The teeth were mounted, placed on a mechanical balance, and probed with a force of 500g in ever fissure, at as many places as possible. Every time the probe was found to stick, the spot was marked. After probing color slides were made of the occlusal faces. Subsequently, the crowns were embedded in epoxy resin. 700um thick sections were cut in a facial-lingual direction with a diamond wheel. From the sections, x-rays were taken which were scored as follows: a measuring grid wad placed on the x-ray image of a section, and the carries score (0-4) for every millimeter was determined. By scoring every section of a tooth in this way, an overview was obtained of the location of all caries lesions in the occlusal surface. By comparing this overview with the color slide of the tooth, the relationship between the sticky spots and the lesions was visualized. The results indicate that only 24% of the caries lesions were discovered by probing for stickiness (low sensitivity), but that the probe seldom stuck in a sound fissure (high specificity,> 99%). Probing proved to be unreliable for the diagnosis of fissure caries. * * * For this reason, we have added the digital x-ray and the laser caries detector, the Diagnodent, to our practice's diagnostic aids.
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