Caries probing CP or tactile examination

Until recently, probe exploration formed part of the diagnostic routine in occlusal caries. Probe entrapment in the grooves and fissures helped in establishing the diagnosis. Although this technique is now contraindicated, some professionals continue to use caries probing (CP). The exploration probe has been evaluated as a diagnostic tool in many studies (Lussi, 1991; Lussi & Francescut, 2003). The sensitivity of CP in the detection of occlusal caries is 0.5-0.6 (Hamilton, 2005), though with high specificity values (Bader et al., 2002). The tip of the probe is unable to reach the bottom of the fissures, because of its thickness and the anatomy of the fissures. The probe tip size varies depending on the manufacturer. This lack of standardization of the tip size can make exploration difficult (Lussi, 1993). In addition, a number of studies (Lussi, 1991; Hibst et al., 2001; Hamilton, 2005) have demonstrated that a sharp-tipped probe can cause damage to recently erupted teeth and produce a cavity in a demineralized zone. As a result, the use of such instruments has been the subject of debate for years. Likewise, CP can transmit Streptococcus mutans from a contaminated fissure to a healthy fissure (Loesche et al., 1979). On the other hand, CP in combination with visual inspection (VI) does not improve the overall diagnostic performance of the exploration in application to caries of pits and fissures (Lussi, 1991; Lussi, 1993; McComb & Tam, 2001). Based on the above, the use of a round-tipped probe or periodontal probe alone would be justified for eliminating remnant material within the fissure before VI, and for evaluating the texture of the surface without penetrating the latter (Zandona & Zero, 2006; Ekstrand et al., 2005; Hamilton, 2005). Other applications would be contraindicated, however.

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