Clinical-radiographic correlation in occlusal surfaces

Area of Science:

• Dentistry
• Diagnostic Imaging

Background:

• Early detection of occlusal caries in permanent molars is crucial for effective dental treatment.
• Visual examination (VE) and radiographic analysis are common diagnostic methods, but their correlation requires further investigation.

Purpose of the Study:

• To evaluate the correlation between clinical visual examination (VE) and radiographic diagnosis of occlusal surfaces in first permanent molars.
• To compare the effectiveness of VE and bitewing radiographs in detecting caries in pediatric patients.

Main Methods:

• A study involving 56 first permanent molars from 40 children with no apparent macroscopic caries.
• Independent diagnoses performed using visual examination (VE) by one researcher and bitewing radiography by an expert.
• Statistical analysis including Kappa and Kendall's tau-b to assess correlations.

Main Results:

• A very low correlation (Kappa: 0.03) was found between visual examination and radiographic diagnosis.
• Visual examination showed a moderate correlation with past caries history (Kendall's tau-b: 0.333), while radiography did not (Kendall's tau-b: 0.002).
• Radiographic analysis revealed a high prevalence of radiolucencies indicative of caries missed by visual examination.

Conclusions:

• Visual examination alone is insufficient for accurate diagnosis of occlusal caries in first permanent molars.
• Combining VE with other diagnostic procedures and clinical predictors may enhance caries detection.
• Radiographic analysis, specifically bitewing radiographs, demonstrates higher sensitivity for detecting early occlusal caries.