Screening with Conventional and Digital Bite-Wing Radiography Compared to Clinical Examination Alone for Caries Detection in Low-Risk Children

Abstract

The study compared conventional and digital bite-wing screening, performed in combination with a clinical examination for caries detection, in 16814-year-old children with little caries experience. Radiography revealed 2–3 times more carious lesions than did clinical examination. Conventional and digital radiography detected dentinal caries in only 1.6 and 1.1%, respectively, of the clinically sound surfaces. Conventional, as well as digital radiography revealed caries in 7% of occlusal surfaces suspected of caries after a clinical examination. Of the suspected approximal surfaces, conventional radiography found caries in 25%, and digital radiography in 19%. From these results, it may be appropriate to perform radiographic screening in combination with clinical examination when the purpose is to assess caries prevalence, and as a basis for individual treatment decisions, if treatment is offered to surfaces with enamel lesions. However, if treatment is offered only to surfaces with clinically detected lesions and to surfaces with radiographically perceived dentinal lesions, it may not be appropriate to perform radiographic bite-wing screening, as less than 2% of the treatment-demanding surfaces will be overlooked by clinical examination alone. Instead, selective radiography should be conducted of surfaces suspected clinically as being carious.

A Comparison of Clinical and Radiographic Caries Diagnoses in Posterior Teeth of 12–Year–Old Lithuanian Children

“…Our results show that for comparative purposes it is mandatory that in each individual study the clinical diagnostic threshold is clearly defined. In contrast to other studies [Weerheijm et al, 1992a;Hintze, 1993] we did not find that bite-wing radiography conferred an additional diagnostic benefit to the detection of 'hidden' occlusal caries in young teenagers. Out of 10,227 occlusal surfaces diagnosed clinically as well as radiographically, as few as 92 surfaces appeared clinically sound, but with radiographic evidence of dentin lesions or fillings.…”

“…ertheless, these findings have led to the proposition that the caries scores from both clinical and radiographic examinations should be added [Mann et al, 1989;Rimmer and Pitts, 1990;de Vries et al, 1990;Hintze, 1993;Pitts et al, 1995]. Moreover, in recent years a concern has been raised that an increasing number of dentin caries lesions, particularly in occlusal surfaces, cannot be detected by clinical examination alone [Sawle and Andlaw, 1988].…”

Clinical detection of caries in the primary dentition with and without bitewing radiography

“…6 Studies in the permanent dentition suggest that the improvement in caries detection was generally in the order of around 3-5 per cent, and that bitewing radiography probably has greatest value in those populations with the highest caries rates. [9][10][11][12][13] In addition, ''hidden'' occlusal caries which refer to caries that cannot be diagnosed by the visual-tactile techniques can be revealed only by radiographic examination. Although ''hidden'' caries is increasingly recognized as an important clinical entity in paediatric dentistry, its prevalence in the primary dentition has not been reported previously.…”

The Agreement of Paper and Film Printed Panoramic Radiographs in Detection of Dentinal Caries

“…(6)(7)(8)(9)(10)(11)(12)(13)(14) On the other hand, panoramic radiography is widely used for the diagnosis and screening of patients with dental problems; although it is not as useful as periapical radiography for detecting small carious lesions. (15) The studies have revealed that there is good agreement between panoramic radiography and intraoral in detecting dentinal caries.…”