Objective: The aim of this study was to determine the effect of multiple examinations on sensitivity and specificity in the diagnosis and restoration of approximal caries.
Study design: In 2 studies, dentists examined bitewing radiographic films for approximal caries and the need for restoration. To model the clinical situation of multiple examinations over time, all groups of combinations of 2 to 10 dentists were constructed. Mean sensitivity and specificity were determined. In addition, 2 new variables were created: the first, "sensitivity any," was calculated by assigning a correct diagnosis for disease if any dentist in the group identified the diseased surface correctly; the second, "specificity all," was calculated by assigning a correct response only when all dentists in the group correctly identify a nondiseased surface.
Results: The sensitivity and specificity means were the same for all group sizes. The "sensitivity any" means increased monotonically from group size 1 to group size 10, whereas the "specificity all" means decreased continually. There was a statistically significant difference between sensitivity and "sensitivity any" and between specificity and "specificity all" for all group sizes in both studies.
Conclusions: Multiple examinations increase the number of carious surfaces correctly diagnosed and the number of surfaces appropriately restored; however, multiple examinations also increase the number of sound surfaces diagnosed as carious and the number of intact surfaces receiving restorations.