Construct and Predictive Validity of Clinical Caries Diagnostic Criteria Assessing Lesion Activity

Abstract

Even though there is no "gold standard" for determining caries lesion activity, it is nonetheless possible to evaluate the validity of such diagnostic measures. The aim of this study was to estimate the construct and predictive validity of caries lesion activity assessments by means of their ability to reflect known effects of fluoride on caries. A three-year trial of the effect of daily supervised brushing with fluoride toothpaste was carried out among 273 12-year-old children. All children were examined clinically according to diagnostic criteria for activity assessment. The relative risk (fluoride vs. control) for caries lesion transitions among diagnostic categories was calculated. Fluoride inhibited progression of caries at all stages of lesion formation while at the same time enhancing lesion regression. The effects were most pronounced for active non-cavitated lesions. It is concluded that the clinical diagnostic criteria have construct and predictive validity for the assessment of caries lesion activity.

Clinical performance of fluorescence-based methods for detection of occlusal caries lesions in primary teeth

“…Our study evaluated criterion validity using a pH dye indicator, as in other studies published previously. 22,23,28 Conversely, the other study retrospectively evaluated the progression of the lesions with higher red fluorescence using QLF; hence, the predictive validity of the method was assessed. 16 This latter study 16 actually has a superior design to evaluate the validity of methods for caries activity assessment.…”

“…The teeth were then stored at -20°C for up to 1 month. 22 Thereafter, the teeth were sectioned from the sites marked on the drawing using a 0.3-mm-thick diamond saw mounted in a cutting machine (Isomet 5000 Linear Precision Saw, Buehler, Lake Bluff, USA). The histological evaluation after sectioning was the reference standard of the present study.…”

“…The examiners then classified the lesions into inactive, when the sections were stained yellow, or active, when the lesions appeared red or reddish. 22,23 After some training using images from other studies, the examiners performed the evaluations independently, and in case of disagreements, a consensus was reached after a discussion between them.…”

Cariologia Baseada em Evidências eo Processo Ensino-Aprendizagem

“…Pesquisas mostram que há evidências científicas para indicação do ART (afirmativa 1) em preparos cavitários Classe I 10,20 , tanto em dentes decíduos como em permanentes, desde que a cavidade seja de média profundidade, sem histórico de dor, fístula/edema e mobilidade patológica 12 . É considerada opção de tratamento viável a toda a população e deve ser vista como uma medida de saúde pública 21 .…”

“…Isto concorda com o trabalho de Nyvadet al 12 , entendendo-se que o termo "tratamento não operatório" é utilizado para englobar todos os métodos que visam controlar a doença 6 , sem necessariamente uma intervenção operatória/invasiva.…”