PubMed · 8120211
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D Bratthall. 1994. Evaluating diagnostic tests--a comment.. https://doi.org/10.1177/00220345940730020201
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In order to develop a method for detection and quantification of initial root surface carious lesions, the use of fluorescein sodium as a fluorescent dye is evaluated. The penetration depth of fluorescein sodium into human roots containing natural carious lesions was measured on approximately 130-microns-thick slices, cut in a direction perpendicular to the pulp. This depth was compared to the lesion depth that was measured on the same slice with transversal microradiography. The results indicate that fluorescein sodium in water penetrates into demineralized layers of root dentine even if a surface layer with a high mineral content is present. The penetration depth is about 1.1 times the microradiographically determined lesion depth.
The usefulness for staining of plaques on teeth was assessed using the preparation Carietest manufactured by Septodont. Carietest is a ready for use green fluid prepared, according to the producer, of blue sulphane and yellow tartrazin. It is applied painting the teeth in any area in which poor oral hygiene is suspected. The preparation was tried out using as reference standard Plakk-festö erythrosin tablets of Hungarian origin. The studied group comprised 25 patients. The range of staining of dental plaques by both preparations was determined using a simplified fuchsin index. The study showed a good suitability of the preparation Carietest for staining of bacterial dental plaques.
The reliability of different investigators' assessment distinguishing carious cavities from caries-free ones was examined in an in vitro study. In 23 recently extracted human teeth caries was completely removed by the principal investigator, while in 17 teeth caries was only incompletely removed. On two occasions at an interval of 2 weeks, 5 investigators established the diagnosis "carious" or "caries-free" after clinical inspection using probe and mirror. Decalcified thin sections were examined in order to determine objectively if a tooth was caries-free or not. On an average, 8 out of 10 carious and 6 out of 10 caries-free cavities were correctly diagnosed. An analysis of the erroneous diagnoses showed that it was deep interproximal lesions that went unnoticed most frequently. Lesions at the enamel-dentin junction were also overlooked. False positive diagnoses were three times more frequent than false negative results. The reliability of caries detection (sensitivity 83.5%) was far higher than reported in the literature.