Comparison of photographic and visual assessment of occlusal caries with histology as the reference standard.

BACKGROUND: The purpose of this study was to compare diagnostic performance for the detection of caries using photographs with an established visual examination method and histological sections as the reference standard. METHODS: 50 extracted permanent teeth were assessed for the presence of occlusal caries by 9 examiners using two methods; traditional visual examination developed by BASCD and photographs produced by an intra-oral camera. For both methods, diagnoses were made at "caries into dentine" level. The teeth were histologically sectioned and the diagnostic decisions using visual and photographic assessment were compared to the histological reference standard. Inter- and intra- examiner reliability for the methods was assessed and weighted kappa values were calculated. RESULTS: The visual examination method had a median sensitivity value of 65.6% and a median specificity value of 82.4%. The photographic assessments method had a median sensitivity of 81.3% and a median specificity of 82.4%. CONCLUSIONS: The photographic assessments method had a higher sensitivity for caries detection than the visual examination. The two methods had comparable specificities and good intra- and inter- examiner reliability.

Development of a standardisation device for photographic assessment of dental fluorosis in field studies.

PURPOSE: This study evaluated the agreement between clinical and photographic assessment of dental fluorosis (DF) in 73 children during a field study, using portable equipment and a standardising device. MATERIALS AND METHODS: A dental exam was performed using the Tooth Surface Index of Fluorosis (TSIF). Photographs of the facial aspects of front teeth and from the occlusal aspect of the mandibular posterior teeth were taken. All photographs were taken following a standard operating procedure. Photographs of anterior and posterior teeth were coded and assigned a random study number. Examiners scored photographs as fluorosis cases or non-cases. RESULTS: Agreement among the clinical examiners ranged from good to excellent. Agreement was also good for the repeated photographic evaluations. In total, 22% of the children were diagnosed with DF during a clinical exam, and 19% were diagnosed with DF using the photographs. CONCLUSIONS: Development of this method aided in the photographic assessment of DF. The photographs obtained were a useful tool for documenting DF, to re-train examiners, and to determine intra- and inter-examiner agreement.

Clinical photographs--the gold standard.

This survey was carried out to allow a minimum data set required for intra- and extra-oral photographs to be established. In 1999 a questionnaire was sent to members of the Angle Society of Europe to establish their current clinical practice with regard to extra- and intra-oral photography. The Angle Society was chosen because of their stated commitment to a high standard of record keeping and of clinical care. Results showed that a full series of extra- and intra-oral photographs were taken both before and after treatment, as well as stage photographs during treatment on many cases. The need for each of these photographs will be discussed in some detail, and recommendations will be made as to what would be considered the Gold standard before, during, and after a course of orthodontic treatment.