Occlusal fossae depth of permanent first molars assessed by visual examination: an in vitro approach.

Purpose: Sealant placement commonly is employed in molars with deep fissures to protect the teeth from occlusal caries. Some have advocated the some preventive approach for deep occlusal fossae in permanent molars. The decision of whether or not to place a sealant depends largely on the dentist's assessment of the depth of the occlusal fossae. The purposes of this in vitro study were to: (1) evaluate the morphology and determine the actual depth of occlusal fossae from newly erupted permanent first molars; (2) compare them with depth assessments obtained from visual examination, and (3) characterize how pediatric dentists look at the occlusal surfaces to assess fossae depth.

Methods: Fossa depth of 48 intact permanent molars was measured by a computerized micromeasurement system (Michigan Laser Digitizer) and compared with the depth assessed during a bench-top examination conducted by a panel of pediatric dentists.

Results: The computerized and visual measurements were positively and significantly correlated (r=0.64, P<.001). Agreement as measured by the Kappa statistic was moderate (k=0.46; 95% confidence interval=0.22-0.71; P<.001).

Conclusion: Pediatric dentists' perception of fossa depth in permanent molars correlates moderately well with the actual fossa depth.