Comparison of Photographic and Visual Diagnosis of Pigmented Pits and Fissure

Objectives: The minimal intervention in Dentistry is based on the knowledge of all the factors that affect the caries disease process. The field of minimal intervention dentistry is wide, including the detection of lesions as early as possible. Due to the characteristics of pit and fissure lesions early diagnosis is a challenge. The purpose of this study was to compare the decision to take action in pigmented pits and fissure of permanent molar teeth after examination of photographic images in slides size 4:3 and visual method.
Methods: Sixty extracted permanent human molars with pigmented pits and fissure were examinated by 3 previously calibrated examiners (Kappa coefficient: Inter examiner/ visual examination: 1 and 2= 0.85; 1 and 3= 0.65; 2 and 3= 0.78. Inter examiner/ photographic images: 1 and 2= 1; 1 and 3= 0.86; 2 and 3= 0.86) using two methods; visual examination with a magnifying glass 3.5X and photographic images obtained with a digital câmera Nikon D3100 with AF-S Micro NIKKOR 105mm f/2.8 and visualized in a computer screen (Acer®) with presentation screen size 4:3. For visual examination tooth were placed in a manikin simulating the oral cavity and pit and fissure were examined with magnifying glass and mirror. The same teeth were photographed and re-examined by the same examiners in a computer screen. Criteria for evaluation was the choice to make or not a cavity preparation in pigmented pits and fissure.

Results: The data revealed an agreement rate of 83% between visual diagnosis and photographic diagnosis (Kappa: 0.59).
Conclusions: It was concluded that agreement rate between two methods of diagnosis were considered moderate and photographic images can be used as an auxiliary method for diagnosing pigmented pits and fissure.