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Caries diagnosis with dye-staining at amalgam restoration margins
D W Boston1, J M Cotmore, L Sperrazza
1Department of Operative Dentistry, School of Dentistry, Temple University, Philadelphia, PA 19140, USA.
Purpose:
To determine the strength of agreement between detection of caries at the margin of amalgam restorations with a caries detector dye, and detection of caries histologically utilizing light/polarizing light microscopy.
Materials And Methods:
17 permanent molars with intact amalgam restorations, determined to be caries-free by visual inspection and explorer probing, cleansed with an air/water/abrasive slurry system, and with evidence of amalgam enamel marginal staining from application of a 1% solution of sulforhodamine B caries detector dye were utilized. Longitudinal, undecalcified sections, 80-100 micrometers thick, were prepared including stained and unstained regions of the amalgam/enamel margin of each tooth, providing 34 margins for study. The sections were examined in the light/polarizing light microscope for evidence of marginal caries. The Kappa Index was calculated to determine the strength of agreement between the caries dye method and the light/polarizing light microscopic method of caries diagnosis.
Results:
Microscopically, caries was detected in 14 of 34 margins (41%). Agreement for presence of caries was 5 of 34, and for absence of caries 8 of 34 (total agreement 38%). 12 of 17 dye-stained margins were microscopically caries-free, and 9 of 17 unstained margins had caries microscopically. Kappa Index for these findings was 0.23, indicating poor strength of agreement.
