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Clinical Oral Investigations
Published in: Clinical Oral Investigations 9/2017

01-12-2017 | Original Article

Radiographic diagnosis of proximal caries—influence of experience and gender of the dental staff

Authors: Margrit-Ann Geibel, S. Carstens, U. Braisch, A. Rahman, M. Herz, A. Jablonski-Momeni

Published in: Clinical Oral Investigations | Issue 9/2017

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Abstract

Objectives

The aim of this study was to examine the influence of experience and gender on the radiographic detection of proximal caries lesions and on therapeutic decisions.

Materials and methods

A survey of 220 examiners (students and employees at three universities and dentists in the field) was taken using a standardized written questionnaire concerning radiographic diagnosis and therapy planning. An expert opinion of four dentists was determined as radiographic reference. A mixed effect logistic regression model was used for statistical evaluation and the odds ratio and p values were calculated (α = 0.05).

Results

Examiners with experience had an almost four times greater chance of a correct assessment, if proximal caries lesion was present or not, than examiners with low experience (OR 3.7 (95% CI 2.4–5.8)). No gender-specific differences were discovered (OR women vs. men 0.9 (95% CI 0.6–1.4)). There was a relationship between the severity of the burnout effect on the x-ray and false positive caries diagnosis. Overall, 43% of respondents would plan invasive treatment in the enamel on a patient at low risk of caries and 78% on a high-risk patient. The results showed that the more experienced practitioners would be more likely to postpone restorative therapy on proximal caries until the lesion reached a later stage.

Conclusions

The results of this study suggest that examiner’s experience influences the radiographic diagnosis of proximal lesions. No gender-specific differences could be found.

Clinical relevance

Examiner’s professional experience is an important factor when radiography is included for detection and treatment planning of proximal lesions.
Literature
1.
Callaghan D, Crocker C (2007) The role of bitewing radiographs—a review of current guidelines. J Ir Dent Assoc 53:92–95PubMed
2.
Poorterman JH, Aartman IH, Kalsbeek H (1999) Underestimation of the prevalence of approximal caries and inadequate restorations in a clinical epidemiological study. Community Dent Oral Epidemiol 27:331–337CrossRefPubMed
3.
Hopcraft MS, Morgan MV (2005) Comparison of radiographic and clinical diagnosis of approximal and occlusal dental caries in a young adult population. Community Dent Oral Epidemiol 33:212–218CrossRefPubMed
4.
Chu CH, Chung BT, Lo EC (2008) Caries assessment by clinical examination with or without radiographs of young Chinese adults. Int Dent J 58:265–268CrossRefPubMed
5.
Gowda S, Thomson WM, Foster Page LA, Croucher NA (2009) What difference does using bitewing radiographs make to epidemiological estimates of dental caries prevalence and severity in a young adolescent population with high caries experience? Caries Res 43:436–441CrossRefPubMed
6.
Young DA (2002) New caries detection technologies and modern caries management: merging the strategies. Gen Dent 50:320–331PubMed
7.
Otis LL, Sherman RG (2005) Assessing the accuracy of caries diagnosis via radiograph. Film versus print. J Am Dent Assoc 136:323–330CrossRefPubMed
8.
Wicht MJ, Haak R, Noack MJ (2008) Wann sollte eine kariöse Läsion invasiv therapiert werden und wann sind prophylaktische Maßnahmen ausreichend? Quintessenz 59:1267–1276
9.
Baelum V, Hintze H, Wenzel A, Danielsen B, Nyvad B (2012) Implications of caries diagnostic strategies for clinical management decisions. Community Dent Oral Epidemiol 40:257–266CrossRefPubMed
10.
Berry HM (1983) Cervical burnout and Mach band: two shadows of doubt in radiologic interpretation of carious lesions. J Am Dent Assoc 106:622–625CrossRefPubMed
11.
Wenzel A, Haiter-Neto F, Gotfredsen E (2007) Risk factors for a false positive test outcome in diagnosis of caries in approximal surfaces: impact of radiographic modality and observer characteristics. Caries Res 41:170–176CrossRefPubMed
12.
Espelid I, Tveit AB (1986) Diagnostic quality and observer variation in radiographic diagnoses of approximal caries. Acta Odontol Scand 44:39–46CrossRefPubMed
13.
Mileman PA, Mulder E, van der Weele L (1992) Factors influencing the likelihood of successful decisions to treat dentin caries from bitewing radiographs. Community Dent Oral Epidemiol 20:175–180CrossRefPubMed
14.
Pitts NB, Ismail AI, Martignon S, Ekstrand K, Douglas GVA, Longbottom C (2014) ICCMS™ guide for practitioners and educators. www.​icdas.​org. Accessed 18 Aug 2015
15.
Vidnes-Kopperud S, Tveit AB, Espelid I (2011) Changes in the treatment concept for approximal caries from 1983 to 2009 in Norway. Caries Res 45:113–120CrossRefPubMed
16.
Mejare I, Sundberg H, Espelid I, Tveit B (1999) Caries assessment and restorative treatment thresholds reported by Swedish dentists. Acta Odontol Scand 57:149–154CrossRefPubMed
17.
Khalaf ME, Alomari QD, Ngo H, Doméjean S (2014) Restorative treatment thresholds: factors influencing the treatment thresholds and modalities of general dentists in Kuwait. Med Princ Pract 23:357–362CrossRefPubMedPubMedCentral
18.
Tveit AB, Espelid I, Skodje F (1999) Restorative treatment decisions on approximal caries in Norway. Int Dent J 49:165–172CrossRefPubMed
19.
Nuttall NM, Pitts NB (1990) Restorative treatment thresholds reported to be used by dentists in Scotland. Br Dent J 169:119–126CrossRefPubMed
20.
Ghasemi H, Murtomaa H, Torabzadeh H, Vehkalahti MM (2008) Restorative treatment threshold reported by Iranian dentists. Community Dent Health 25:185–190PubMed
21.
Traebert J, Wesolowski CI, de Lacerda JT, Marcenes W (2007) Thresholds of restorative decision in dental caries treatment among dentists from small Brazilian cities. Oral Health Prev Dent 5:131–135PubMed
22.
Gilbert GH, Gordan VV, Funkhouser EM, Rindal DB, Fellows JL, Qvist V, Anderson G, Worley D (2013) Caries treatment in a dental practice-based research network: movement toward stated evidence-based treatment. Community Dent Oral Epidemiol 41:143–153CrossRefPubMed
23.
Gordan VV, Garvan CW, Heft MW, Fellows JL, Qvist V, Rindal DB, Gilbert GH (2009) Restorative treatment thresholds for interproximal primary caries based on radiographic images: findings from the Dental Practice-Based Research Network. Gen Dent 57:654–663PubMedPubMedCentral
24.
Kakudate N, Sumida F, Matsumoto Y, Manabe K, Yokoyama Y, Gilbert GH, Gordan VV (2012) Restorative treatment thresholds for proximal caries in dental PBRN. J Dent Res 91:1202–1208CrossRefPubMedPubMedCentral
25.
Riley JL, Gordan VV, Rouisse KM, McClelland J, Gilbert GH (2011) Differences in male and female dentists' practice patterns regarding diagnosis and treatment of dental caries: findings from The Dental Practice-Based Research Network. J Am Dent Assoc 142:429–440CrossRefPubMedPubMedCentral
26.
Tan PL, Evans RW, Morgan MV (2002) Caries, bitewings, and treatment decisions. Aust Dent J 47:138–141CrossRefPubMed
27.
Riordan PJ, Espelid I, Tveit AB (1991) Radiographic interpretation and treatment decisions among dental therapists and dentists in Western Australia. Community Dent Oral Epidemiol 19:268–271CrossRefPubMed
28.
Zadik Y, Levin L (2008) Clinical decision making in restorative dentistry, endodontics, and antibiotic prescription. J Dent Educ 72:81–86PubMed
29.
Gomez J, Ellwood RP, Martignon S, Pretty IA (2014) Dentists' perspectives on caries-related treatment decisions. Community Dent Health 31:91–98PubMed
30.
Swan ES, Lewis DW (1993) Ontario dentists: 2. Bitewing utilization and restorative treatment decisions. J Can Dent Assoc 59:68–70PubMed
31.
Traebert J, Marcenes W, Kreutz JV, Oliveira R, Piazza CH, Peres MA (2005) Brazilian dentists' restorative treatment decisions. Oral Health Prev Dent 3:53–60PubMed
32.
Baraba A, Domejean-Orliaguet S, Espelid I, Tveit AB, Miletic I (2010) Survey of Croatian dentists' restorative treatment decisions on approximal caries lesions. Croat Med J 51:509–514CrossRefPubMedPubMedCentral
33.
Domejean-Orliaguet S, Tubert-Jeannin S, Riordan PJ, Espelid I, Tveit AB (2004) French dentists' restorative treatment decisions. Oral Health Prev Dent 2:125–131PubMed
34.
Tyas MJ, Anusavice KJ, Frencken JE, Mount GJ (2000) Minimal intervention dentistry—a review. FDI Commission Project 1-97. Int Dent J 50:1–12CrossRefPubMed
35.
Espelid I, Tveit AB, Nyvad B (1997) Caries—new knowledge or old truths? The Norwegian Dent J 107:66–74
36.
Benn DK, Clark TD, Dankel DD, Kostewicz SH (1999) Practical approach to evidence-based management of caries. J Am Coll Dent 66:27–35PubMed
37.
38.
Berridge DM, Crouchley R (2011) Multivariate generalized linear mixed models using R. CRC Press, Boca RatonCrossRef
39.
Stroup WW (2012) Generalized linear mixed models: modern concepts, methods and applications. CRC Press, Boca Raton
40.
Hellen-Halme K, Petersson GH (2010) Influence of education level and experience on detection of approximal caries in digital dental radiographs. An in vitro study. Swed Dent J 34:63–69PubMed
41.
Gröndahl HG (1979) Some factors influencing observer performance in radiographic caries diagnosis. Swed Dent J 3:157–172PubMed
42.
Firestone AR, Lussi A, Weems RA, Heaven TJ (1994) The effect of experience and training on the diagnosis of approximal coronal caries from bitewing radiographs. A Swiss-American comparison. Schweiz Monatsschr Zahnmed 104:719–723PubMed
43.
Mileman PA, van den Hout WB (2002) Comparing the accuracy of Dutch dentists and dental students in the radiographic diagnosis of dentinal caries. Dentomaxillofac Radiol 31:7–14CrossRefPubMed
44.
Schwendicke F, Tzschoppe M, Paris S (2015) Radiographic caries detection: a systematic review and meta-analysis. J Dent 43:924–933CrossRefPubMed
45.
Espelid I, Tveit AB (1991) Diagnosis of secondary caries and crevices adjacent to amalgam. Int Dent J 41:359–364PubMed
46.
White SC, Hollender L, Gratt BM (1984) Comparison of xeroradiographs and film for detection of proximal surface caries. J Am Dent Assoc 108:755–759CrossRefPubMed
47.
Espelid I, Tveit AB, Fjelltveit A (1994) Variations among dentists in radiographic detection of occlusal caries. Caries Res 28:169–175CrossRefPubMed
48.
Anissi HD, Geibel MA (2014) Intraoral radiology in general dental practices—a comparison of digital and film-based X-ray systems with regard to radiation protection and dose reduction. ROFO Fortschr Geb Rontgenstr Nuklearmed 186:762–767CrossRefPubMed
49.
Berg BI, Gertsch A, Zeilhofer HF, Schwenzer-Zimmerer K, Berg S, Hassfeld S, Jurgens P (2014) Cone beam computed tomography and radiation dosage: application frequency and knowledge of dentists in Switzerland. Swiss Dent J 124:419–433PubMed
50.
Kohler TG (2012) Systematischer Literaturüberblick und aktueller Gebrauch der röntgenologischen Kariesdiagnostik. Dissertation, University of Munich
51.
Naumann M, Kiessling S, Seemann R (2006) Treatment concepts for restoration of endodontically treated teeth: a nationwide survey of dentists in Germany. J Prosthet Dent 96:332–338CrossRefPubMed
52.
Müller MP, Hänsel M, Stehr SN, Weber S, Koch T (2008) A state-wide survey of medical emergency management in dental practices: incidence of emergencies and training experience. Emerg Med J 25:296–300CrossRefPubMed
53.
Ommerborn MA, Kollmann C, Handschel J, Depprich RA, Lang H, Raab WH (2010) A survey on German dentists regarding the management of craniomandibular disorders. Clin Oral Investig 14:137–144CrossRefPubMed
54.
Hertrampf K, Wenz HJ, Koller M, Wiltfang J (2012) Comparing dentists' and the public's awareness about oral cancer in a community-based study in Northern Germany. J Craniomaxillofac Surg 40:28–32CrossRefPubMed
55.
Hovland EJ, Romberg E, Moreland EF (1980) Nonresponse bias to mail survey questionnaires within a professional population. J Dent Educ 44:270–274PubMed
56.
57.
Xavier CR, Araujo-Pires AC, Poleti ML, Rubira-Bullen IR, Ferreira OJ, Capelozza AL (2011) Evaluation of proximal caries in images resulting from different modes of radiographic digitalization. Dentomaxillofac Radiol 40:338–343CrossRefPubMedPubMedCentral
58.
59.
Dietz LT (2016) Prospektive Gegenüberstellung und Vergleich von digitalisierten analogen und digitalen Panoramaschichtaufnahmen als Ausdruck gemäß DIN 6868–160. Dissertation, University of Ulm
60.
Evans RW, Pakdaman A, Dennison PJ, Howe EL (2008) The caries management system: an evidence-based preventive strategy for dental practitioners. Application for adults. Aust Dent J 53:83–92CrossRefPubMed
61.
Momoi Y, Hayashi M, Fujitani M, Fukushima M, Imazato S, Kubo S, Nikaido T, Shimizu A, Unemori M, Yamaki C (2012) Clinical guidelines for treating caries in adults following a minimal intervention policy—evidence and consensus based report. J Dent 40:95–105CrossRefPubMed
62.
Pitts NB (1983) Monitoring of caries progression in permanent and primary posterior approximal enamel by bitewing radiography. Community Dent Oral Epidemiol 11:228–235CrossRefPubMed
63.
Bottenberg P, Ricketts DN, Van Loveren C, Rahiotis C, Schulte AG (2011) Decision-making and preventive non-surgical therapy in the context of a European Core Curriculum in Cariology. Eur J Dent Educ 15:32–39CrossRefPubMed
64.
Schwendicke F, Stolpe M, Meyer-Lueckel H, Paris S (2015) Detecting and treating occlusal caries lesions: a cost-effectiveness analysis. J Dent Res 94:272–280CrossRefPubMedPubMedCentral
65.
da Silva RP, Meneghim MC, Correr AB, Pereira AC, Ambrosano GMB, Mialhe EL (2012) Variations in caries diagnoses and treatment recommendations and their impacts on the costs of oral health care. Community Dent Health 29:25–28PubMed
66.
Maupome G, Sheiham A (1997) Radiographic criteria employed to diagnose and treat approximal caries by final-year dental students in Mexico City. Community Dent Oral Epidemiol 25:242–246CrossRefPubMed
67.
Bervian J, Tovo MF, Feldens CA, Brusco LC, Rosa FM (2009) Evaluation of final-year dental students concerning therapeutic decision making for proximal caries. Pesqui Odontol Bras 23:54–60
68.
Schwendicke F, Stangvaltaite L, Holmgren C, Maltz M, Finet M, Elhennawy K, Eriksen I, Kuzmiszyn TC, Kerosuo E, Doméjean S (2016) Dentists' attitudes and behaviour regarding deep carious lesion management: a multi-national survey. Clin Oral Investig. doi:10.​1007/​s00784-016-1776-5
69.
Espelid I, Tveit AB, Haugejorden O, Riordan PJ (1985) Variation in radiographic interpretation and restorative treatment decisions on approximal caries among dentists in Norway. Community Dent Oral Epidemiol 13:26–29CrossRefPubMed
Metadata
Title
Radiographic diagnosis of proximal caries—influence of experience and gender of the dental staff
Authors
Margrit-Ann Geibel
S. Carstens
U. Braisch
A. Rahman
M. Herz
A. Jablonski-Momeni
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 9/2017
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-017-2078-2

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