title: Evaluation of cavitations in proximal caries lesions at various magnification levels in vitro.
abstract: OBJECTIVE
  The aim of this study was to evaluate the cavitation rate of proximal caries using different magnification aids in vitro.
  
  
  METHODS
  Radiographs of 285 extracted teeth were taken and the proximal surfaces were graded to the criteria R0 (no radiolucency), R1 (radiolucency confined to the outer half of enamel), R2 (inner half of enamel) and R3 (outer half of dentin). Subsequently, the proximal surfaces were checked for the presence of cavitations with the naked eye (NE), and by using 4.3 x magnification eyeglasses (ME), a stereo microscope (SM, 10x), or a scanning electron microscope (SEM, up to 2000 x magnification).
  
  
  RESULTS
  In surfaces with R3 caries, cavitations were visible in 56 of 59 cases with the naked eye. When using SEM, all surfaces revealed cavitations (100%). Regarding the surfaces with R2 lesion, 36 of 46 cases showed cavitations (NE); the corresponding values were 39/46 (ME), 41/46 (SM), and 46/46 (SEM); in the latter, in most cases deep defects could be observed. With regard to R1 lesions, 36/60 (NE), 43/60 (ME), 45/60 (SM), and 58/60 (SEM) cases revealed cavitations. A breakdown of radiographically sound surfaces (R0) was present in some 10% of the examined surfaces (24/261, NE; 33/261, SEM).
  
  
  CONCLUSIONS
  Cavitations (defined as breakdown of the surface) are present in significantly more cases than previously reported. This might be an explanation why even small radiolucencies tend to progress, albeit slowly. Thus, close follow-ups should strongly be recommended when considering a preventive treatment regimen with small radiolucencies.
authors.affiliation: Department of Operative Dentistry and Periodontology, University School of Dental Medicine, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Andrej M
authors.initials: AM
authors.lastname: Kielbassa
authors.forename: Sebastian
authors.initials: S
authors.lastname: Paris
authors.forename: Adrian
authors.initials: A
authors.lastname: Lussi
authors.forename: Hendrik
authors.initials: H
authors.lastname: Meyer-Lueckel
mesh_terms: D003731:Dental Caries / Q000000981:diagnostic imaging* / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D007909:Lenses; D008853:Microscopy; D008855:Microscopy, Electron, Scanning; D011858:Radiographic Magnification; D012680:Sensitivity and Specificity