Pit and Fissure Stain and Its Association with Dentinal Caries

Objective: This in vitro study investigates the relationship, if any, of the shade of pit and fissure stain and underlying caries into dentin.

Methods: Ninety-six extracted molar teeth with varying degrees of pit and fissure stain, but without obvious cavitation, were selected for this study. The darkest area of stain was outlined on a digital photograph of each tooth. A shade guide was developed with nineteen consecutively varying shades of brown; one being the lightest (tan) and nineteen the darkest (black). Three dentists, independently, used this 19-step shade guide and a color-corrected light to evaluate the shade of the stain on the actual tooth in the area outlined on the digital photograph. This evaluation was repeated one week later. Then, minimal intervention with a small round high-speed bur was used to investigate if any of these stained areas overlaid a carious lesion that extended into dentin.

Results: Intra-evaluator agreement for stain shade was good at 0.731 or higher and inter-evaluator agreement was excellent at 0.944. Fourteen teeth were found to have caries into dentin underlying the stained pit or fissure. There was no correlation between pit and fissure stain shade and the presences of caries into dentin. The mean shade value for pit and fissure stain on the 19-step shade guide was 13.12 for those stains that overlaid carious lesions and 13.96 for those that did not. There was no significant difference between the two mean (p=0.519)

Conclusion: In this in vitro study pit and fissure shade was not associated with caries into dentin in non-cavitated teeth.

This study was partially supported by NIDCR grant 007057.