Accuracy of tactile assessment in order to detect proximal cavitation of caries lesions in vitro

  • S. Paris
  • F. Schwendicke
  • V. Soviero
  • H. Meyer-LueckelEmail author
Original Article



Discriminating non-cavitated from cavitated proximal lesions without tooth separation is only limitedly possible using visual-radiographic assessment alone. We evaluated how additional tactile assessment might increase the accuracy of this discrimination in vitro.


Surface integrity of 46 primary molars with proximal lesions extending radiographically into outer third of dentin (ICDAS-codes: 2 n = 34, 3 n = 8 and 5 n = 4) were mounted in groups of two in manikin heads and independently assessed by three examiners using visual-radiographic and additional tactile assessment using a cow-horn-ended explorer with or without gingival displacement. After examination, lesion surfaces were evaluated for possible damage using scanning-electronic microscopy. Analysis of variance (ANOVA) was performed for evaluating if tactile assessment and gingival displacement significantly affected accuracy.


Tactile assessment significantly increased sensitivity of detecting cavities (p < 0.001, ANOVA), but decreased specificity (p < 0.05). Sensitivities/specificities varied between 33 (8)%/96 (1)% and 86 (6)%/84 (5)%. Gingival displacement had no significant impact on accuracy (p > 0.05). Scanning-electron microscopy revealed no cavitation.


In vitro, tactile assessment of proximal surfaces was useful and safe.

Clinical relevance

Analysis of the cavitation level by using a cow-horn-ended probe might be leading to useful information in addition to bitewing assessment under clinical circumstances.


Caries Detection Diagnosis Proximal lesion Explorer Probing 



We thank Mrs. Regina Marquardt for her help with mounting and preparing the teeth as well as generating the SEM images. We are grateful to Dr. Julian Lausch (mentioned as “JL” in the manuscript) who served as an examiner.


This study was funded by the authors and their institutions.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The use of the teeth was ethically approved (D444/10).

Informed consent

Informed consent for the use of the teeth was provided under the ethics approval D444/10.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • S. Paris
    • 1
  • F. Schwendicke
    • 1
  • V. Soviero
    • 2
  • H. Meyer-Lueckel
    • 3
    Email author
  1. 1.Operative and Preventive DentistryCharité – Universitätsmedizin BerlinBerlinGermany
  2. 2.Department of Preventive and Community DentistryUniversidade do Estado do Rio de JaneiroRio de JaneiroBrazil
  3. 3.Department of Restorative, Preventive and Pediatric Dentistry, School of Dental MedicineUniversity of BernBernSwitzerland

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