Avaliação da profundidade da cárie proximal nos exames radiográfico convencional e digitalizado / Evaluation of the size of proximal caries in radiography and digitized

Introdução: A cárie dentária é uma doença multifatorial que compreende vários fatores biológicos e sociais. A superfície proximal dos dentes é uma região de difícil visualização que pode esconder pequenas lesões cariosas no esmalte dentário, impossibilitando o diagnóstico através de inspeções visuais e táteis. Objetivo: O objetivo deste trabalho foi avaliar a profundidade da cárie proximal nos exames radiográficos convencionais e digitais, comparando as profundidades das lesões consideradas nestes exames às do exame histológico. Método: Foram utilizados exames radiográficos interproximais de 40 dentes humanos, 20 pré-molares e 20 molares, com alterações clínicas em uma das superfícies proximais, como lesões de mancha branca ou acastanhada e pequenas cavitações. Três profissionais especializados em radiologia odontológica com mais de cinco anos de experiência clínica mediram a profundidade das lesões pelos exames radiográfico e digital das amostras. Para obter os resultados, utilizou-se a técnica de análise de variância (ANOVA). Resultados: Constatou-se um nível de significância de 5% nas mensurações dos exames radiográficos convencionais e digitalizados, mostrando a fidelidade das imagens radiográficas em relação a real profundidade da lesão. Conclusão: Conclui-se que os exames de imagem avaliados foram eficientes na determinação da profundidade das lesões de cárie proximal.

Introduction: Dental caries is a multifactorial disease that comprises several biological and social factors. The proximal surface of the teeth is a region of difficult visualization that can hide small carious lesions in the dental enamel, making diagnosis through visual and tactile inspection infeasible. Objective: The objective of this study was to evaluate the depth of proximal caries in the conventional and digitized radiographic examinations, comparing the depths of the lesions considered in these examinations to those of the histological examination. Method: Interproximal radiographic examinations of 40 human teeth, 20 premolars and 20 molars, with clinical alterations on one of the proximal surfaces, such as white or brown spot lesions and small cavitations, were used. Three professionals specialized in dental radiology with more than five years of clinical experience measured the depth of the lesions by radiographic examination of the samples. To obtain the results, we used the technique of analysis of variance (ANOVA). Results: A level of significance of 5% was found in conventional and digitized radiographic measurements, showing the fidelity of the radiographic images in relation to the actual depth of the lesion. Conclusion: It was concluded that the imaging tests evaluated were efficient in determining the depth of proximal caries lesions.

Evaluation of the effectiveness of clinical and radiographic analysis for the diagnosis of proximal caries for different clinical experience levels: comparing lesion depth through histological analysis

Proximal cavity lesions are difficult to diagnose and are also hard to examine due to their location. Radiographic examination and teeth separation are resources used to help in caries diagnosis. The aim of this study was to evaluate, in different professional experience levels, the effectiveness of clinical and radiographic examinations in diagnosing proximal cavities, comparing lesion depth considered in these examinations to histological examinations. Thirty nine human teeth were used, 20 premolars and 19 molars, with clinical alterations on one proximal surface, such as lesions with either white or brownish stains and small cavitations which showed no clinical signs on the occlusal face, causing the professional insecurity in performing an accurate diagnosis as well as appropriate treatment. Samples were made using x-ray interproximal technique. Forty professionals of different experience levels performed clinical and radiographic examinations of the samples by filling out a form after classifying lesions depth. The samples were later sectioned for a histological analysis. Results showed that there was great variability on answers to examinations, with a low agreement percentage among examiners. After concluding all evaluated examinations, the examiners were not able to come up with an accurate diagnosis of lesions conditions on proximal cavities. The rate of cavitation was greater in lesions found on the external half of dentine, surpassing the amelodentinal limit, and an agreement percentage to conventional and digital x- ray examinations were equivalent.