Abstract
Statement of problem
Current dental diagnostics are image based and cannot detect a structural microgap
defect such as a crack in a tooth. Whether percussion diagnostics can effectively
diagnose a microgap defect is unclear.
Purpose
The purpose of the present study was to determine from a large multicenter prospective
clinical study whether quantitative percussion diagnostics (QPD) could detect structural
damage in teeth and whether a probability of its presence could be provided.
Material and methods
A nonrandomized prospective and multicenter clinical validation study with 224 participants
was performed in 5 centers with 6 independent investigators. The study used QPD and
the normal fit error to determine whether a microgap defect was present in a natural
tooth. Teams 1 and 2 were blinded. Team 1 tested teeth scheduled for restoration with
QPD, and Team 2 disassembled the teeth aided by a clinical microscope, transillumination,
and a penetrant dye. Microgap defects were documented in written and video formats.
Controls were participants without damaged teeth. The percussion response from each
tooth was stored on a computer and analyzed. A total of 243 teeth were tested to provide
approximately 95% power to test the performance goal of 70%, based on an assumed population
overall agreement of 80%.
Results
Regardless of the collection method, tooth geometry, restoration material used, or
restoration type, the data on detecting a microgap defect in a tooth were accurate.
The data also reflected good sensitivity and specificity consistent with previously
published clinical studies. The combined study data showed an overall agreement of
87.5% with a 95% confidence interval (84.2 to 90.3), beyond the 70% predetermined
performance goal. The combined study data determined whether it was possible to predict
the probability of a microgap defect.
Conclusions
The results showed that the data on detecting microgap defects in a tooth site were
consistently accurate and confirmed that QPD provided information to aid the clinician
in treatment planning and early preventative treatment. QPD can also alert the clinician
of probable diagnosed and undiagnosed structural problems via the use of a probability
curve.
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Article info
Publication history
Published online: May 25, 2023
Publication stage
In Press Corrected ProofFootnotes
Funding: Supported by Perimetrics, Inc.
Conflict of Interest: Drs James Earthman and Cherilyn Sheets are the inventors of quantitative percussion diagnostics. They founded Perimetrics, Inc, as a result of their research efforts with this technology and currently maintain a minority stock ownership in the company. Numerous patents have been issued and are pending. Dr Dennis Quan currently works for Perimetrics, Inc as Chief Technology Officer. Dr Jean Wu has no competing interests.
Patient Consent: Informed patient consent has been obtained.
Identification
Copyright
© 2023 by the Editorial Council for The Journal of Prosthetic Dentistry.
