The management of incipient or suspicious occlusal caries: a decision-tree analysis

Objective: To perform a comprehensive decision-tree analysis for the management of the suspicious/incipient occlusal lesion on a molar tooth. Methods: A quantitative decision tree was constructed to assess the expected utility value of three global strategies to dentally manage the incipient or suspicious occlusal carious lesion. Result: A preventive strategy offered an optimal expected utility value (0.98 utile) compared with the other two strategies of visual inspection (0.84 utile) or referring to one of four diagnostic tests (0.74-0.82 utile). Conclusion: Although the general conclusion of this analysis agrees with current recommendations, this analysis offers a more complete mathematical model that provides a unified value for each strategy (i.e. expected utility value) thus allowing for complex quantitative comparison between strategies. This paper provides a specific example of how decision-tree analysis can be a powerful tool in guiding dental practice.