Comparison of restorative treatment recommendations based on patients and patient simulations

Restorative treatment recommendations made by dentists examining patients were compared with recommendations made by dentists examining simulations of the same patients. Simulations consisted of unmounted casts, full-mouth radiographs, three still video images of each tooth, periodontal charting, and a written dental history. Each of 117 teeth in five patients was examined by at least three and as many as 13 dentists under simulation and live conditions, with no dentists examining the same patient under both conditions. About three-fourths of teeth receiving a recommendation for treatment from at least one dentist received such a recommendation from at least one dentist examining under each of the two examination conditions. For these teeth, about three-fourths of all dentists examining under each condition recommended treatment. For teeth receiving a recommendation for treatment under only one examination condition, smaller proportions of dentists recommended treatment. Overall, there was three times as much variation in treatment recommendations among dentists in an examination condition than between the "average" treatment recommended by dentists in the two examination conditions.