The management of incipient or suspicious occlusal caries: a decision-tree analysis

–  Objective:  To perform a comprehensive decision‐tree analysis for the management of the suspicious/incipient occlusal lesion on a molar tooth. Methods:  A quantitative decision tree was constructed to assess the expected utility value of three global strategies to dentally manage the incipient or...

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Bibliographic Details
Published in:Community dentistry and oral epidemiology 2008-10, Vol.36 (5), p.392-400
Main Author: Balevi, Ben
Format: Article
Language:English
Subjects:
bite-wings
caries
Cariostatic Agents - therapeutic use
clinical decision making
Decision analysis
decision tree analysis
Decision Trees
Dental care
Dental caries
Dental Caries - diagnosis
Dental Caries - therapy
Dental Caries Activity Tests
Dentistry
diagnostic test
Electrodiagnosis
expected utility value
fluoride
Fluorides, Topical - therapeutic use
Humans
Lasers
Models, Theoretical
Molar
Pit and Fissure Sealants - therapeutic use
Practice Patterns, Dentists
Radiography, Bitewing
sealant
Sensitivity and Specificity
Software
Transillumination
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Summary:–  Objective:  To perform a comprehensive decision‐tree analysis for the management of the suspicious/incipient occlusal lesion on a molar tooth. Methods:  A quantitative decision tree was constructed to assess the expected utility value of three global strategies to dentally manage the incipient or suspicious occlusal carious lesion. Result:  A preventive strategy offered an optimal expected utility value (0.98 utile) compared with the other two strategies of visual inspection (0.84 utile) or referring to one of four diagnostic tests (0.74–0.82 utile). Conclusion:  Although the general conclusion of this analysis agrees with current recommendations, this analysis offers a more complete mathematical model that provides a unified value for each strategy (i.e. expected utility value) thus allowing for complex quantitative comparison between strategies. This paper provides a specific example of how decision‐tree analysis can be a powerful tool in guiding dental practice.
ISSN:0301-5661
1600-0528
DOI:10.1111/j.1600-0528.2007.00419.x