title: Additional diagnostic value of digital bitewing radiographs in detecting proximal caries in primary molars.
abstract: OBJECTIVE
  The objective of this clinical epidemiologic study was to determine the additional yield of bitewing radiographs compared to clinical examinations in the estimation of proximal caries in primary molars.
  
  
  METHODS
  Clinical data (N = 238) of 5- to 6-year-old children were collected by a calibrated examiner, and digital bitewing radiographs were taken after obtaining informed written consent from the parents. The radiographic examination of proximal surfaces was based on criteria derived from the clinical protocol. A single calibrated examiner recorded the data, and intra-examiner agreement was assessed using kappa statistics. Statistical analysis of data was performed using Chi-square test.
  
  
  RESULTS
  Kappa values for intra-examiner agreement were 0.91 and 0.89 for clinical and radiographic examinations, respectively. Based on clinical judgment alone, the number of carious proximal surfaces was 62.7% (632 surfaces) in males and 58.9% (528 surfaces) in females. When bitewing radiographic judgment was included, this number increased to 80.6% (812 surfaces) in males and 71.9% (644 surfaces) in females.
  
  
  CONCLUSIONS
  The overall value of bitewing radiographs in the present study was 18% and 13% in males and females, respectively. The benefits of digital bitewing radiographs can be used in epidemiologic studies and clinical practice to avoid underestimation of proximal caries.
authors.affiliation: Pediatric Dentistry, NTRUHS, AP, India.
authors.forename: Gunashekhar
authors.initials: G
authors.lastname: Madiraju
mesh_terms: D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008963:Molar / Q000000981:diagnostic imaging*; D016300:Radiography, Bitewing