title: Association and comparison between visual inspection and bitewing radiography for the detection of recurrent dental caries under restorations.
abstract: OBJECTIVE
  The aim of the present study was to investigate, in posterior teeth, the association between the characteristics of the margins of a restoration visually inspected and the presence, under restorations, of recurrent or residual dental caries detected by radiographic examination. Furthermore, the agreement between visual inspection and radiographs to detect dental caries was assessed.
  
  
  METHODS
  Eighty-five permanent molars and premolars with resin restorations on the interproximal and/or occlusal faces, from 18 patients, were submitted for visual inspection and radiographic examination. The visual inspection involved the criteria of the International Caries Detection and Assessment System (ICDAS). Bitewing radiographs were used for the radiographic examination. Logistic regression was used to analyse the association between the characteristics of the margins of a restoration assessed by visual inspection (absence of dental caries, or early, established, inactive and active lesions) and the presence of recurrent caries detected by radiographs. Kappa coefficients were calculated for determining agreement between the two methods.
  
  
  RESULTS
  The Kappa coefficient for agreement between visual inspection and radiographic examination was 0.19. Established lesions [odds ratio (OR) = 9.89; 95% confidence interval (95% CI): 2.94-33.25; P < 0.05] and lesion activity (OR = 2.57; 95% CI: 0.91-7.27; P < 0.05) detected by visual inspection, were associated with recurrent or residual dental caries detected by radiographs. Restorations with established and active lesions at the margins had a greater chance of exhibiting recurrent or residual lesions in the radiographic examination.
  
  
  CONCLUSIONS
  The present findings demonstrate that restorations with established and active lesions at the margins when visually inspected often require removal and retreatment.
authors.affiliation: Universidade Vale do Rio Verde, Três Corações, Brazil.
authors.forename: José R
authors.initials: JR
authors.lastname: Lino
authors.affiliation: Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.
authors.forename: Joana
authors.initials: J
authors.lastname: Ramos-Jorge
authors.affiliation: Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.
authors.forename: Valéria Silveira
authors.initials: VS
authors.lastname: Coelho
authors.affiliation: Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Ramos-Jorge
authors.affiliation: Universidade Vale do Rio Verde, Três Corações, Brazil.
authors.forename: Marcos R
authors.initials: MR
authors.lastname: Moysés
authors.affiliation: Universidade Vale do Rio Verde, Três Corações, Brazil.
authors.forename: José C R
authors.initials: JC
authors.lastname: Ribeiro
mesh_terms: D001641:Bicuspid / Q000000981:diagnostic imaging / Q000473:pathology; D003188:Composite Resins / Q000737:chemistry; D003731:Dental Caries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003743:Dental Enamel / Q000473:pathology; D003764:Dental Materials / Q000737:chemistry; D003793:Dental Restoration, Permanent; D003804:Dentin / Q000473:pathology; D006801:Humans; D008963:Molar / Q000000981:diagnostic imaging / Q000473:pathology; D010808:Physical Examination; D016300:Radiography, Bitewing; D012008:Recurrence; D018570:Risk Assessment; D013499:Surface Properties
chemical_list: D003188:Composite Resins; D003764:Dental Materials
keywords: Dental caries; radiographic examination; recurrent caries; visual inspection