Decisions on diagnosis and management of approximal caries by final-year dental students.
OBJECTIVE
To investigate the decision-making processes for dental caries from bitewing radiographs of final-year dental students in Mexico City.


METHODS
Five sets of radiographs were converted to slides and projected on a screen under standardized conditions. 143 students were asked to determine separately the presence of all proximal caries, of proximal lesions to be restored in the present course of treatment, and of unreadable surfaces due to technical deficiencies. A gold standard was obtained from two expert clinicians who examined the radiographs under similar conditions.


RESULTS
Misdiagnoses were common. Overdiagnoses became evident at the treatment planning stage where many surfaces were incorrectly planned for restoration. Subjective appraisals of presence of lesions, unreadable surfaces, and surfaces planned for restoration showed substantial variation.


CONCLUSIONS
Students' overall assessment of lesions detected did not differ between restored and unrestored surfaces. However, when compared with the gold standard, their decision-making was found to be better on surfaces which had not been restored previously as opposed to those already restored, both in terms of identification of lesions and in terms of treatment planned for deeper lesions.
Maupomé
G
G
Department of Clinical Dental Sciences, Faculty of Dentistry, University Clinical Dental of British Columbia, Vancouver B.C., Canada.
Sheiham
A
A
D000328:Adult; D000704:Analysis of Variance; D003731:Dental Caries / Q000000981:diagnostic imaging*; D003793:Dental Restoration, Permanent; D003951:Diagnostic Errors; D006801:Humans; D015588:Observer Variation; D016300:Radiography, Bitewing; D013335:Students, Dental