The influence of interdental spacing on the detection of proximal caries lesions in primary teeth

Abstract

The aim of this study was to investigate the influence of interdental spacing on the performance of proximal caries detection methods in primary molars. In addition, aspects related to temporary tooth separation with orthodontic separators were evaluated. The proximal spaces between the posterior primary teeth (n = 344) of 76 children (4-12 years old) were evaluated before and after temporary separation. Stainless steel strips with different standardized thicknesses were used to measure the presence of biological spacing and the spacing obtained after temporary separation with orthodontic rubber rings. First, the presence of proximal caries lesions was assessed by visual inspection, bitewing radiographs and a pen-type laser fluorescence device (DIAGNOdent pen). Visual inspection after temporary separation with separators was the reference standard method in checking the actual presence of caries. Multilevel analyses were performed considering different outcomes: the performance of the methods in detecting caries lesions and the spacing after temporary separation. The spacing did not influence the performance of the caries detection methods. The maximum spacing obtained with temporary tooth separation was 0.80 mm (mean ± standard deviation = 0.46 ± 0.13 mm). The temporary separation was more effective in the upper arch and less effective when an initial biological interdental spacing was present. The biological interdental spacing does not influence the performance of proximal caries detection methods in primary molars, and temporary tooth separation provides spacing narrower than 1.0 mm.

Influence of Contact Points on the Performance of Caries Detection Methods in Approximal Surfaces of Primary Molars: An in vivo Study

“…The only in vivo study in primary teeth that compared diagnostic methods (visual examination, BW and DIAGNOdent pen) used the dental examination as a reference standard [Novaes et al, 2012]. In other words, this is the first in vivo and in vitro study that compares the influence of temporary tooth separation on the visual examination, BW and DIAGNOdent pen, using μCT as the gold standard.…”

“…Another device, designated DIAGNOdent 2190 or the DIAGNOdent pen, was launched on the market in 2005, but few studies have been conducted up to the writing of this article, with the purpose of evaluating its accuracy in vitro Lussi and Hellwig, 2006;Aljehani et al, 2007;Kühnisch et al, 2007a, b;Rodrigues et al, 2008], all being conducted strictly in permanent teeth. In vivo studies conducted on proximal surfaces in primary teeth used the visual clinical examination as a standard method [Novaes et al, 2009[Novaes et al, , 2010[Novaes et al, , 2012. Histological validation was done only in the in vitro study by .…”

A Pilot Study of a Modified Radiographic Technique for Detecting Early Proximal Cavities

“…Novaes et al [2009Novaes et al [ , 2012a assumed that tooth separation with orthodontic rubbers was not a perfect but a functional validation method in primary teeth, which provided spacing narrower than 1.0 mm between primary molars. Hintze et al [1998], however, believed that tooth separation did not have enough reliability to be used as validation for other diagnostic methods in detecting approximal cavitations.…”

Are the Approximal Caries Lesions in Primary Teeth a Challenge to Deal With? — A Critical Appraisal of Recent Evidences in This Field

“…Despite young children usually present wider approximal spaces [38], in most children, the anatomical conditions do not allow that approximal surfaces are cleaned only with brushing, requiring the use of dental floss to remove the biofilm. Besides, the patients' adherence to using dental floss seems to be low [39], mainly regarding children, since they could present less dexterity to flossing and depend on parent's collaboration to remove interproximal biofilm [3,40].…”