title: An in vivo comparison of radiographic and clinical examination with separation for assessment of approximal caries in primary teeth.
abstract: OBJECTIVE
  To compare in vivo, clinical examination (CE) and bitewing radiographs (BW) for the detection of cavitations and initial approximal lesions in deciduous molars with validation after temporary separation (TS) and direct visual examination (DE) of the approximal surfaces.
  
  
  METHODS
  Thirty children aged 4 to 8 years without visual cavitations or restorations and with at least one approximal contact. Two calibrated examiners evaluated 355 surfaces of primary molars, which were then validated through TS and DE.
  
  
  RESULTS
  Of the 280 surfaces considered sound by CE, 24.6% were cavitated after separation. Comparing BW and DE, it was observed that, when the radiolucency involved the inner half of dentin, 68.4% of lesions were cavitated. The sensitivity and specificity of CE and BW were 0.14 and 0.43, and 0.80 and 0.75, respectively.
  
  
  CONCLUSIONS
  DE identified a greater number of pre-cavitated lesions and cavities. BW were useful for detection of decayed surfaces, but with low specificity for diagnosis of sound surfaces, while detection of sound or decayed approximal areas by means of CE alone was not possible. The combination of methods was effective in obtaining an accurate diagnosis of caries in the primary dentition.
authors.affiliation: School of Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
authors.forename: T C
authors.initials: TC
authors.lastname: Coutinho
authors.affiliation: Paediatric Dentist in a Private Practice, Rio de Janeiro, Brazil.
authors.forename: C
authors.initials: C
authors.lastname: daRocha Costa
mesh_terms: D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000473:pathology; D003804:Dentin / Q000000981:diagnostic imaging / Q000473:pathology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008963:Molar / Q000000981:diagnostic imaging / Q000473:pathology; D015588:Observer Variation; D010808:Physical Examination / Q000706:statistics & numerical data*; D016300:Radiography, Bitewing / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019228:Tooth Crown / Q000000981:diagnostic imaging / Q000473:pathology*; D014094:Tooth, Deciduous / Q000000981:diagnostic imaging / Q000473:pathology*