title: A prospective comparison between findings from a clinical examination and results of bitewing and panoramic radiographs for dental caries diagnosis in children.
abstract: OBJECTIVE
  To compare the findings of a clinical examination with those from bitewing (BW), panoramic (Pan) and panoramic plus bitewing (PanBW) radiographs for dental caries in children.
  
  
  METHODS
  A population of 39 children, aged 3.8 to 11.9 years, who required radiographs as part of their initial assessment for care in the Department of Paediatric Dentistry (Leeds), was selected. Each subject was examined clinically for dental caries. Subsequently, a paediatric dentist and a specialist in dental radiography read the radiographs.
  
  
  METHODS
  A database in Microsoft Access was used to compare the examiners readings for each radiographic view; agreements were taken to be a consensus. Disagreements were re-viewed by both examiners to arrive at a consensus. Radiographic results were compared with those of the clinical examination.
  
  
  RESULTS
  The clinical examination identified 6.0% (95% CI 4.1 to 7.8, p<0.001) more carious surfaces than Pan. Clinical examinations also identified more carious surfaces than BW 1.2% (95% CI -0.7 to 3.2, p<0.247) and PanBW 0.6% (95% CI -1.1 to 2.3, p<0.533) but these differences were not statistically significant. When occlusal surfaces only were compared, the clinical examination identified significantly more carious occlusal surfaces then BW (15.2%, p<0.001), Pan (17.1%, p<0.001) and PanBW (13.5%, p<0.001). Comparing the approximal surfaces only, the BW and PanBW identified significantly more carious surfaces than the clinical examination, 5.1% (p<0.001) and 4.3% (p<0.001) respectively.
  
  
  CONCLUSIONS
  The use of a clinical examination with PanBW provided the maximum information on dental caries in the primary and mixed dentitions, particularly for approximal surfaces. This is important in planning comprehensive dental care for children.
authors.affiliation: Department of Paediatric Dentistry, Leeds Dental Institute, Leeds, England.
authors.forename: H C
authors.initials: HC
authors.lastname: Clark
authors.forename: M E J
authors.initials: ME
authors.lastname: Curzon
mesh_terms: D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003732:Dental Caries Activity Tests; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D016300:Radiography, Bitewing / Q000706:statistics & numerical data*; D011862:Radiography, Panoramic