The objective of this study was to compare the treatment plan decisions made for intact occlusal surfaces using different diagnostic tools. Clinical photographs and either conventional or digitized radiographs were used to evaluate 33 regions of the occlusal surfaces of 30 extracted permanent molars. The teeth had regions with and without pigmentation. The treatment plan decisions were made by 5 dental faculty members using the two examination methods: 1) visual exam of photographs and conventional radiographs (IV+RXC); and 2) visual exam of photographs and digitized radiographs (IV+DIGORA). The regions were assigned a value of 0 (no treatment needed), 1 (need for sealant but not for restoration), and 2 (need for restoration). The validation of the treatment plans was accomplished through histological examination of tooth sections from each of the regions. The results were analyzed using a Cochran test and a sign test. The sensitivity, determining what percentage of the teeth needed treatment, was very low (23%) for both IV+RXC and IV+DIGORA. The specificity, determining the percentage of teeth with no disease, was much higher: 83% and 86% for IV+RXC and IV+DIGORA, respectively. There was no significant difference in the tratment plan decisions made with either of the diagnostic tools (p<0.05). Based on these data, it can be concluded that both conventional and digitized radiographic methods led to similar treatment plan decisions for intact occlusal surfaces.
Dental caries; Radiography; Radiographic image enhancement
