An in vivo comparison of radiographic and clinical examination with separation for assessment of approximal caries in primary teeth

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ABSTRACT

Aim

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.

Conclusion

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.

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