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01-11-2019 | Caries | Original Article

Impact of the radiographic method on treatment decisions related to dental caries in primary molars: a before–after study

Authors: Laura R. A. Pontes, Tatiane F. Novaes, Juan S. Lara, Bruna L. P. Moro, Thais Gimenez, Daniela P. Raggio, Mariana M. Braga, Fausto M. Mendes

Published in: Clinical Oral Investigations | Issue 11/2019

Abstract

Objectives

To evaluate the impact of radiographic examination on changes of treatment decision related to dental caries compared to decisions guided by visual inspection alone in primary molars.

Materials and methods

A total of 126 children aged 3–6 years who had sought dental assistance were randomly selected and examined by two calibrated examiners using visual inspection. A treatment plan regarding dental caries was generated based on this assessment. The same examiners then evaluated two bitewing radiographs, creating an additional treatment plan guided by concurrent assessment of both visual and radiographic methods. Occlusal and proximal surfaces of primary molars received a treatment decision as follows: (i) no treatment, (ii) non-operative treatment, and (iii) operative treatment. The frequency of changes in the treatment decision after radiographic examination was calculated, with subsequent Poisson multilevel regression analysis to evaluate variables influencing such changes.

Results

Changes from “no treatment” decided with visual inspection to “non-operative treatment” after radiographic evaluation occurred in 52 surfaces (3.2%), and changes to “operative treatment” were observed in 46 dental surfaces (2.8%). Furthermore, 50 surfaces (6.2%) had their treatment decision changed from non-operative to operative treatment after radiographic assessment. In addition, changes were significantly more frequent in children with higher caries experience, on proximal surfaces and in 1st primary molars.

Conclusions

The impact of radiographic examination on changes in the treatment decision of primary molars made with visual inspection is modest. Changes are more frequent in children with higher caries experience and in proximal surfaces.

Clinical relevance

The benefits of the radiographic method for detecting caries in children, as a protocol in the diagnostic process, seem to be overestimated; the impact of this method on changes in treatment decision made by visual examination alone is low. Radiographs could be, however, useful in particular conditions, such as in children with high caries experience.

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Title: Impact of the radiographic method on treatment decisions related to dental caries in primary molars: a before–after study
Authors: Laura R. A. Pontes
Tatiane F. Novaes
Juan S. Lara
Bruna L. P. Moro
Thais Gimenez
Daniela P. Raggio
Mariana M. Braga
Fausto M. Mendes
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keyword: Caries
Published in: Clinical Oral Investigations / Issue 11/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-02844-w

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Impact of the radiographic method on treatment decisions related to dental caries in primary molars: a before–after study

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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