Comparison of diagnostic yields of clinical and radiographic caries examinations in children of different age.
OBJECTIVE
This was to investigate if the pattern of distribution of caries lesions detected by clinical and radiographic examinations at different diagnostic thresholds changed over a 3-year period during the course of eruption of the permanent dentition. It has been hypothesized that the contribution of bitewing radiography to caries detection in posterior teeth may increase when approximal contacts are established during maturation of the dentition.


METHODS
Clinical and radiographic caries recordings were made using the non- cavitated/enamel and cavity/dentine thresholds for caries detection among a group of 12-year-old Lithuanian children with a high caries experience. Examinations were repeated in the same children after 3 years. The bitewing radiographs from both examination sessions were coded to ensure unbiased recordings and were read by a single examiner.


RESULTS
The diagnostic yields of the clinical and radiographic examination methods did not change after the permanent teeth had fully erupted. At both examination sessions the clinical examination resulted in the detection of significantly more lesions than did the radiographic method at the non-cavitated level (43- 47% lesions detected by clinical means only and 2-26% by radiographic means only). Only for approximal surfaces at the cavity/dentine diagnostic threshold did radiographs contribute to more lesions (15-16% lesions detected by clinical means only and 38-41% by radiographic means only). Establishment of approximal contacts in the permanent dentition did not increase the relative diagnostic yields of bite-wing radiography in this study group.


CONCLUSIONS
The contribution of the two methods to caries diagnosis depends more on the diagnostic threshold selected than on the stage of maturation of the dentition.
Clinic of Dental and Oral Diseases, Faculty of Odontology, Kaunas University of Medicine, Kaunas, Lithuania.
V
V
Machiulskiene
B
B
Nyvad
V
V
Baelum
D002648:Child; D003731:Dental Caries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000473:pathology; D003793:Dental Restoration, Permanent; D003804:Dentin / Q000000981:diagnostic imaging / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D015588:Observer Variation; D010808:Physical Examination; D016300:Radiography, Bitewing; D015203:Reproducibility of Results; D019228:Tooth Crown / Q000000981:diagnostic imaging / Q000473:pathology; D014078:Tooth Eruption / Q000502:physiology