Variability in caries detection and treatment plans for occlusal surfaces among undergraduate senior dental students

Authors

  • Renato Pereira da Silva Doutorando em Odontologia em Saúde Coletiva FOP/UNICAMP
  • Miguel Morano -Júnior Professores Doutores do Departamento de Odontologia Social –FOP/UNICAMP
  • Fábio Luiz Mialhe Professores Doutores do Departamento de Odontologia Social –FOP/UNICAMP

DOI:

https://doi.org/10.30979/rev.abeno.v9i1.1344

Keywords:

Dental Education. Dental Students. Diagnosis.

Abstract

The changes observed in the pattern of dental caries development have created major difficulties for professionals to detect the presence and extent of the carious lesion precisely, as well as doubts with regard to decisions about treatment. In spite of the importance of this issue, little is known about this problem in the training process of dentistry course students. Therefore, the object of this study was to assess the inter-examiner agreement about carious lesion detection and the treatment decision about occlusal caries, among undergraduate seniors of the dentistry course. Twenty posterior permanent teeth without apparent cavitations were mounted in a dentistry mannequin and radiographed using the bitewing technique. Sixtyone students (76.3%) in the last year of a dentistry course at a public university in the interior of the state of São Paulo = assessed the surfaces by means of clinicalradiographic examination, performed caries detection and suggested a = treatment plan for each surface. Inter-examiner agreement was obtained by means of Kappa statistics. It was observed that the kappa statistic values – inter-examiner agreement  for caries detection (к=0.4), the determining of its activity (к=0.50), and the clinical decision making (к=0.52) were considered moderate for the criteria assessed. The most recommended non-invasive treatment was resinous sealing (35.31%), whereas restorations with light polymerizable resin were the most recommended invasive strategy (71.1%); nevertheless, there were marked differences with regard to the decision taken regarding which strategy to use. The results of this study evidenced the need for implementing teaching/learning strategies based on training/constant calibration of academic students to minimize these variations, contributing to a professional education guided by the philosophy of health promotion. The data collection instrument in this study proved efficient and easy to use for assessing this problem among undergraduates.

Downloads

Download data is not yet available.

References

Amaral DC, Silva DRP. Diagnóstico e tratamento de cárie oclusal sem cavitação. Avaliação da concordância entre examinadores. FOA Rev da Faculd Odontol Anápolis 2000; 2(1):60-63.

Assaf AV, Meneghim MC, Zanin L, Tengan C, Pereira AC. Evaluation of different diag-nostic threshold on dental caries calibration. J. Public. Health Dent 2006; 66(1):17-22.

Bader JD, Shugars DA, Nesbit SP. Comparison of dental school and practicing dentist’s restorative treatment recommendations. J Dent Educ 1995; 59(3):419-424.

Bader JD, Shugars DA. Descriptive models of restorative treatment decisions. J Public Health Dent 1998;58(3):210-9.

Bader JD, Shugars DA, McClure FE. Comparison of restorative treatment recommenda-tions based on patients and patient simulations. Oper Dent 1994; 19(2): 20-25.

Baelum V, Fejerskov, O. Caries diagnosis: a mental resting place on the way to inter-vention? In: Fejerskov O, Kidd E (eds): Dental caries: the disease and its clinical manage-ment. Oxford: Blackwell Munksgaard; 2003. p.101-110.

Beltran-Aguilar EG, Estupiñan-Day S, Baez R: Analysis of prevalence and trends of den-tal caries in the Americas between the 1970s and 1990s. Int Dent J 1999; 49(6): 322-329.

Brennan DS, Spencer AJ. Longitudinal comparison of factors influencing choice of den-tal treatment by private general practitioners. Aust Dent J 2006; 51(2):117-123.,

Brown JP. A New Curriculum Framework for Clinical Prevention and Population Health, with a Review of Clinical Caries Prevention Teaching in U.S. and Canadian Dental Schools. Dent Educ 2007; 71(5): 572-578.

Doméjean-Orliaguet S, Tubert-Jeannin S, Riordan PJ, Espelid I, Tveit AB. French den-tists’ restorative treatment decisions. 1: Oral Health Prev Dent 2004; 2(2):125-31.

Espelid I, Tveit AB. A comparison of radiographic occlusal and approximal caries diag-noses made by 240 dentists. Acta Odontol Scand 2001; 59 (5):285-9.

Forrest, JL, Miller SA. Evidence-based decision making in dental hygiene education, practice, and research. J Dent. Hyg 2001; 75(1): 50-63.

Hugoson A, Koch G, Hallonsten AL, Norderyd J, Aberg A. Caries prevalence and distri-bution in 3-20-years-olds in Jönköping, Sweden, in 1973, 1978, 1983, 1993. Community Dent Oral Epidemiol 2000, 28(2): 83-89.

Ismail AI. Clinical diagnosis of precavitated carious lesions. Community Dent Oral Epi-demiol 1997; 25(1):13-23.., v. 25, n. 1, p. 13-23, Feb. 1997.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33(1): 159-74.

Maupomé GA. comparison of senior dental students and normative standards with regard to caries assessment and treatment decisions to restore occlusal surfaces of per-manent teeth. J Prosthet Dent. 1998; 79(5):596-603.

Meneghim M de C, Tagliaferro EP, Tengan C, Meneghim ZM, Pereira AC, Ambrosano GM, Assaf AV. Trends in caries experience and fluorosis prevalence in 11- to 12-year-old Brazilian children between 1991 and 2004. Oral Health Prev Dent. 2006; 4(3):193-8.

Mota LQ, Lima MGGC, Santos RL, Boudoux KLP, Fernández AF. Diagnóstico de cárie oclusal incipiente. Levantamento realizado com cirurgiões-dentistas da cidade de João Pessoa-PB. Revista da Faculdade de Odontologia da UFBA 2001; 22 (1):51- 4.

Nyvad B, Machiulskiene V, Baelum V. Construct and predictive validity of clinical caries diagnostic criteria assessing lesion activity. J Dent Res 2003 82(2):117-22.

Nyvad B. Diagnosis versus detection of caries. Caries Res 2004; 38(3): 192-98.

Oliveira MAF, Assunção IV, Sá GTC. Diagnóstico e tratamento da superfície oclusal: di-vergências entre examinadores. Rev ABO Nac 1999; 37(5): 279-284. 2

Pereira AC, Meneghim MC, Ambrosano GMB, Mialhe FL, Pardi V, Flório FM. Diagnósti-co de cárie e decisão de tratamento entre cirurgiões-dentistas. Robrac 2000; 9(28):40-4.

Pitts NB, Longbottom C. Preventive Care Advised (PCA)/Operative Care Advised (OCA)--categorising caries by the management option. Community Dent Oral Epidemiol 1995; 23(1): 55-59.

Pitts NB. Modern concepts of caries measurement. J Dent Res 2004; 83(Spec Iss): C43-47.

Schmage P, Nergiz I, Akisli I, Platzer U. Reliability of occlusal caries estimation by stu-dents and clinicians. 81 st General Session of the International Association for Dental Re-search. Poster 1579; 2003.

Silva BB, Domingues MG. Cárie oclusal: análise da variaçäo do diagnóstico clínico e de sua fidelidade radiográfica e macroscópica. Rev Fac Odontol Porto Alegre 1995;36(2):24-5. 27. Tubert-Jeannin S, Doméjean-Orliaguet S, Riordan PJ, Espelid I, Tveit AB. Restorative treatment strategies reported by French university teachers. J Dent Educ 2004; 68(10):1096-103.

Tran LA, Messer LB. Clinicians’ choices of restorative material for children. Aust Dent J 2003; 48(4):221-32.

White BA, Maupomé G. Making clinical decisions for dental care: concepts to consi-der. Spec Care Dentist 2003; 23(5):168- 72.

Published

26-01-2009

How to Cite

da Silva, R. P., -Júnior, M. M., & Mialhe, F. L. (2009). Variability in caries detection and treatment plans for occlusal surfaces among undergraduate senior dental students. Revista Da ABENO, 9(1), 55–61. https://doi.org/10.30979/rev.abeno.v9i1.1344

Issue

Section

Article