Caries diagnosis with dye-staining at amalgam restoration margins.
OBJECTIVE
To determine the strength of agreement between detection of caries at the margin of amalgam restorations with a caries detector dye, and detection of caries histologically utilizing light/polarizing light microscopy.


METHODS
17 permanent molars with intact amalgam restorations, determined to be caries-free by visual inspection and explorer probing, cleansed with an air/water/abrasive slurry system, and with evidence of amalgam enamel marginal staining from application of a 1% solution of sulforhodamine B caries detector dye were utilized. Longitudinal, undecalcified sections, 80-100 micrometers thick, were prepared including stained and unstained regions of the amalgam/enamel margin of each tooth, providing 34 margins for study. The sections were examined in the light/polarizing light microscope for evidence of marginal caries. The Kappa Index was calculated to determine the strength of agreement between the caries dye method and the light/polarizing light microscopic method of caries diagnosis.


RESULTS
Microscopically, caries was detected in 14 of 34 margins (41%). Agreement for presence of caries was 5 of 34, and for absence of caries 8 of 34 (total agreement 38%). 12 of 17 dye-stained margins were microscopically caries-free, and 9 of 17 unstained margins had caries microscopically. Kappa Index for these findings was 0.23, indicating poor strength of agreement.
Boston
D W
DW
Department of Operative Dentistry, School of Dentistry, Temple University, Philadelphia, PA 19140, USA.
Cotmore
J M
JM
Sperrazza
L
L
D004396:Coloring Agents; D003723:Dental Amalgam; D003731:Dental Caries / Q000175:diagnosis* / Q000209:etiology; D003732:Dental Caries Activity Tests; D003793:Dental Restoration, Permanent / Q000009:adverse effects*; D005069:Evaluation Studies as Topic; D006801:Humans; D008859:Microscopy, Polarization; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012235:Rhodamines
D004396:Coloring Agents; D012235:Rhodamines; C022027:lissamine rhodamine B; D003723:Dental Amalgam