Comparing treatment options for occlusal surfaces utilizing an invasive index

The purpose of this project was to develop an invasive index to: 1) compare the treatments recommended by dentists for the occlusal surfaces of molars; 2) compare the invasive index score of each tooth with the extent of the carious lesion as determined by electrical resistance and histological examination; and 3) compare the relative extent of the total crown destruction resulting from the carious lesion and the cavity preparation. Twenty dentists examined 19 extracted permanent molar teeth using a #23 explorer and selected the most appropriate treatment from the following options: no treatment (score 0), occlusal sealant (score 1), preventive resin (score 2), occlusal amalgam (score 3). The invasive index scores determined for each dentist and each tooth were compared using an analysis of variance. The electrical conductivity of each tooth was measured with an electronic caries detector (Vanguard). Electrical resistance scores were compared to the invasive index scores and to a histological examination. The results demonstrate that the invasive index is a useful means to compare treatments recommended by different dentists. The invasive index suggests there is considerable variation among dentists in the treatment they recommend for occlusal surfaces. Electrical resistance testing did not provide helpful information for treatment planning of questionably carious occlusal surfaces.