Accuracy of tactile assessment in order to detect proximal cavitation of caries lesions in vitro.

Objectives: Discriminating non-cavitated from cavitated proximal lesions without tooth separation is only limitedly possible using visual-radiographic assessment alone. We evaluated how additional tactile assessment might increase the accuracy of this discrimination in vitro.

Methods: Surface integrity of 46 primary molars with proximal lesions extending radiographically into outer third of dentin (ICDAS-codes: 2 n = 34, 3 n = 8 and 5 n = 4) were mounted in groups of two in manikin heads and independently assessed by three examiners using visual-radiographic and additional tactile assessment using a cow-horn-ended explorer with or without gingival displacement. After examination, lesion surfaces were evaluated for possible damage using scanning-electronic microscopy. Analysis of variance (ANOVA) was performed for evaluating if tactile assessment and gingival displacement significantly affected accuracy.

Results: Tactile assessment significantly increased sensitivity of detecting cavities (p < 0.001, ANOVA), but decreased specificity (p < 0.05). Sensitivities/specificities varied between 33 (8)%/96 (1)% and 86 (6)%/84 (5)%. Gingival displacement had no significant impact on accuracy (p > 0.05). Scanning-electron microscopy revealed no cavitation.

Conclusions: In vitro, tactile assessment of proximal surfaces was useful and safe.

Clinical Relevance: Analysis of the cavitation level by using a cow-horn-ended probe might be leading to useful information in addition to bitewing assessment under clinical circumstances.