The Use of a Microscope for Restorative Treatment Decision-making on Occlusal Surfaces

Abstract

SUMMARYUsing an operating microscope, this study assessed the effect of 16x magnification on the restorative treatment of posterior teeth and compared the results against an unaided visual examination in vitro. Three dentists examined 300 premolars and molars at different times using an unaided visual examination and an operating microscope at 16x magnification. The observers examined the occlusal surfaces of teeth according to a patient model and selected a treatment protocol based on the following scale: 0: No Active Care (NC); 1: Preventive Care (PC) and 2: Operative Care and Preventive Care (OC+PC) advised. According to the results, there was good intra-observer agreement and moderate interobserver agreement with both techniques. No significant difference was found between the treatment using an unaided visual examination and that using an operating microscope. The use of a microscope at 16x magnification did not aid in the restorative treatment decision-making on occlusal surfaces.

Impact of Low Level Magnification on Incipient Occlusal Caries Diagnosis and Treatment Decision Making

“…The values of intra and inter examiner reproducibility [Table/ Fig-7] obtained in this study was lower than that derived in previous studies [11][12][13]. This may be attributed to the difference in histological cutoff and techniques used.…”

“…Its impact on caries detection and treatment decision making has also been studied by various authors [8][9][10][11][12][13], as it is believed to allow for clearer visualisation of minute defects. However, some of these studies used high magnification values [10][11][12], others [9] have not correlated results with a gold standard [8]. To date there is no study reported which correlates the impact of magnification on visual-tactile detection of caries using ICDAS-II and a CPI-TN probe.…”

In VitroEvaluation of ICDAS and Radiographic Examination of Occlusal Surfaces and Their Association With Treatment Decisions

“…Another study reported a good intraexaminer agreement and moderate interexaminer agreement for restorative treatment decision making on occlusal surfaces. 12 However, Maupomé 15 showed in his study lower kappa values for interexaminer agreement (ranging from 0.05 to 0.65) for treatment planning. This variation could be explained by the examiners' decision-making skills, which in his study were senior dental students.…”

“…7 Although visual inspection and radiographic examination are the conventional methods used for caries detection, 8,9 some studies have shown considerable variation among clinicians in their diagnoses, restorative decisions, and treatment plans. [10][11][12][13][14][15][16][17][18][19][20][21] These differences occurred independently of the study conditions, such as in vitro studies, studies in clinical practice settings, or whether bitewing (BW) radiographs were evaluated. 11,22 The variation among dentists could be explained by deficiencies of adjunctive detection tests, due to incorrect or partial understanding of the test's parameters 4 or to variations in observers' clinical experiences and their professional preferences.…”

“…11,22 The variation among dentists could be explained by deficiencies of adjunctive detection tests, due to incorrect or partial understanding of the test's parameters 4 or to variations in observers' clinical experiences and their professional preferences. 12 Caries lesions are diagnosed clinically via subjective assessment of alterations in color, translucence, and dental hardness and/or roughness, depending on whether it is an enamel or dentin lesion. 23,24 Traditional visual caries examinations tend to have high specificity and low sensitivity.…”