The use of dental radiographs to estimate the probability of cavitation of carious interproximal lesions. Part I: Evidence from the literature.
It is generally recommended that a cavitated, carious lesion be present before an interproximal tooth surface is restored. These lesions often are not clinically visible, however, and must be diagnosed using dental radiographs. Radiographic results can underestimate and overestimate the size of a carious lesion. The purpose of this study was to review and graphically summarize studies that have investigated the relationship between the radiographic image and the presence of a cavitated lesion on the interproximal surfaces of permanent teeth. A search of the literature identified 13 studies, eight of which were suitable for inclusion in our summary. Using the positive and negative likelihood ratios from each study, a graphical summary was developed showing the probability of cavitation based on the radiographic test result and the dentist's pre-radiograph estimate of the probability of cavitation. This graph should allow dentists to more accurately inform their patients of the probability of a cavitated interproximal lesion being present or absent. As a further observation, our findings suggest that to avoid frequent false positive diagnoses, dentists should estimate the probability of cavitation to be at least 30 per cent before they prescribe radiographs for patients who visit them on a regular basis.
Woodward
G L
GL
Leake
J L
JL
D001634:Bibliographies as Topic; D003661:Decision Support Techniques; D003731:Dental Caries / Q000000981:diagnostic imaging* / Q000473:pathology; D018450:Disease Progression; D019317:Evidence-Based Medicine; D006801:Humans; D016013:Likelihood Functions; D016239:MEDLINE; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011861:Radiography, Dental / Q000592:standards* / Q000706:statistics & numerical data*; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity