TY - JOUR
T1 - Surface characteristics and lesion depth and activity of suspicious occlusal carious lesions
T2 - Findings from The National Dental Practice-Based Research Network
AU - The National Dental Practice-Based Research Network Collaborative Group
AU - Makhija, Sonia K.
AU - Shugars, Daniel A.
AU - Gilbert, Gregg H.
AU - Litaker, Mark S.
AU - Bader, James D.
AU - Schaffer, Rebecca
AU - Gordan, Valeria V.
AU - Rindal, D. Brad
AU - Pihlstrom, Daniel J.
AU - Mungia, Rahma
AU - Meyerowitz, Cyril
N1 - Publisher Copyright:
© 2017 American Dental Association
PY - 2017/12
Y1 - 2017/12
N2 - Background A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency but in which caries is suspected owing to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). The authors' objective was to quantify the characteristics of SOCLs and their relationship to lesion depth and activity after these lesions were opened surgically. Methods Ninety-three dentists participated in the study. When a consenting patient had an SOCL, information was recorded about the tooth, lesion, treatment provided, and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted χ2 test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster. Results The authors analyzed 1,593 SOCLs. Lesion color varied from yellow/light brown (40%) to dark brown/black (47%), with 13% other colors. Most (69%) of SOCLs had a rough surface when examined with an explorer. Over one-third of the SOCLs (39%) were treated surgically. Of the 585 surgically treated SOCLs, 61% had dentinal caries. There were statistically significant associations between lesion depth and color (P =.03), luster (P =.04), and roughness (P =.01). The authors classified 52% of the patients as being at elevated caries risk. The authors found no significant associations between lesion depth and patient risk (P =.07). Conclusions Although statistically significant, the clinical characteristics studied do not provide accurate guidance for making definitive treatment decisions and result in high rates of false positives. Practical Implications Given that 39% of the opened lesions did not have dentinal caries or were inactive, evidence-based preventive management is an appropriate alternative to surgical intervention.
AB - Background A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency but in which caries is suspected owing to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). The authors' objective was to quantify the characteristics of SOCLs and their relationship to lesion depth and activity after these lesions were opened surgically. Methods Ninety-three dentists participated in the study. When a consenting patient had an SOCL, information was recorded about the tooth, lesion, treatment provided, and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted χ2 test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster. Results The authors analyzed 1,593 SOCLs. Lesion color varied from yellow/light brown (40%) to dark brown/black (47%), with 13% other colors. Most (69%) of SOCLs had a rough surface when examined with an explorer. Over one-third of the SOCLs (39%) were treated surgically. Of the 585 surgically treated SOCLs, 61% had dentinal caries. There were statistically significant associations between lesion depth and color (P =.03), luster (P =.04), and roughness (P =.01). The authors classified 52% of the patients as being at elevated caries risk. The authors found no significant associations between lesion depth and patient risk (P =.07). Conclusions Although statistically significant, the clinical characteristics studied do not provide accurate guidance for making definitive treatment decisions and result in high rates of false positives. Practical Implications Given that 39% of the opened lesions did not have dentinal caries or were inactive, evidence-based preventive management is an appropriate alternative to surgical intervention.
KW - Evidence-based dentistry
KW - carious lesions
KW - dentin
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U2 - 10.1016/j.adaj.2017.08.009
DO - 10.1016/j.adaj.2017.08.009
M3 - Article
C2 - 29055504
AN - SCOPUS:85031747703
SN - 0002-8177
VL - 148
SP - 922
EP - 929
JO - Journal of the American Dental Association
JF - Journal of the American Dental Association
IS - 12
ER -