The Influence of Vertical Bitewing Radiographs in Treatment Decision-Making for Primary Molars: A Cross-Sectional...

Area of Science:

• Pediatric Dentistry
• Dental Radiology
• Cariology

Background:

• Dental caries in primary teeth requires accurate detection and treatment planning.
• Visual examination alone may underestimate the extent of caries.
• Vertical bitewing (VBW) radiography offers a potential improvement for caries assessment.

Purpose of the Study:

• To compare the diagnostic accuracy of VBW radiographs versus visual examination for caries detection in primary molars.
• To evaluate the impact of VBW findings on treatment planning decisions for pediatric dental patients.

Main Methods:

• Children aged 5-10 years with high caries risk were examined.
• Treatment decisions were categorized (CT, NRT, RT, TNT) based on visual exam and VBW findings.
• Descriptive and statistical analyses were performed.

Main Results:

• VBW radiography detected dentine caries in 7% of clinically sound surfaces and pulp necrosis signs in nearly 20% of teeth without clinical signs.
• Treatment plans changed for 15.60% of surfaces after VBW examination, notably from restorative to non-restorative treatment or pulpectomy/extraction.
• Proximal surface changes were significantly more frequent than occlusal ones (p < 0.001).

Conclusions:

• VBW radiography enhances the detection of proximal caries in primary molars, though many are enamel-limited.
• VBW findings significantly influence treatment decisions, particularly shifting towards non-restorative treatments or more invasive procedures when pulp involvement is suspected.
• VBW aids in determining caries depth, pulp proximity, and presence of permanent successors, crucial for managing deep caries lesions.