Additional information of bitewings to first time clinical examination of caries and restoration status in permanent dentition

Abstract

Objectives

Identifying additional information obtained by X-rays combined with clinical examination concerning primary caries, caries adjacent to restorations and quality of restorations.

Material and methods

A total of 240 adult patients, equally distributed in gender and six age-groups, were randomly selected from an original study population of 4,402 subjects (DANHES). Clinical and radiographical registrations on occlusal and approximal surfaces in posterior teeth were categorized into unrestored surfaces (sound/primary caries) and restored surfaces (without/with caries adjacent to restorations). Material and quality of restorations were also recorded. Chi-square and Fisher-exact tests were used for statistical analyses.

Results

Of potentially 11,520 surfaces, 3,015 occlusal and 5,112 approximal surfaces were analysed. Occlusal: Of 907 unrestored surfaces, 110 had primary caries and 53% were detected radiographically. A total of 183 of 2,108 restored surfaces had caries adjacent to restorations, and 99% were found radiographically. A total of 190 restorations were over/under-extended, and 89% were registered radiographically. Approximal: Of 2,649 unrestored surfaces 648 had primary caries, and 92% were registered radiographically. A total of 565 of 2,463 restored surfaces had caries adjacent to restorations, and 99% were found radiographically. A total of 638 restorations were over/under-extended, and 98% were found radiographically. For all restorations, material and depth influenced quality of restorations and incidence of caries adjacent to restorations. At least one independent variable (gender/age group/tooth-type/jaw/side/mesial-distal surface) influenced frequencies of primary caries, caries adjacent to restorations and quality of restorations.

Conclusions

First-time clinical examination must be supplemented with X-rays to obtain a complete impression of caries status in posterior regions regarding diagnostics of caries, assessment of lesion depth and quality of restorations.

Keywords:

• Primary caries
• caries adjacent to restorations
• occlusal surface
• approximal surface
• caries detection

Acknowledgements

DDS Lotte Junggreen is thanked for her valuable radiographic assessment. Associate professor Dennis Pipenbring is greatly thanked for his valuable assistance in data processing and analyses.

Disclosure statement

The authors declare no conflict of interest.

Data availability statement

The research data that support the findings of this study are not publicly available due to their containing information that could compromise the privacy of research participants.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Health Insurance Foundation; The Danish Foundation for Mutual Efforts in Dental Care; The Danish Dental Association; TRYG Foundation.