Elastomeric impression as a diagnostic method of cavitation in proximal dentin caries in primary molars

ABSTRACT

The purpose of this study was to validate the elastomeric impression after temporary tooth separation as a method of cavitation detection in proximal caries lesions in primary molars with outer half dentin radiolucency. Fifty-one children (4-10 years old), presenting radiolucency in the outer half of the dentin at the proximal surfaces of primary molars and proximal anatomic contact with the adjacent tooth (without restoration/cavitated caries lesion) were enrolled in the study. Temporary tooth separation was performed with an orthodontic rubber ring placed around the contact point during 2-3 days. Thereafter, impression of the proximal surfaces was made. The elastomeric impressions were classified as "non-cavitated" or "cavitated" surfaces. Visual inspection after tooth separation was considered as the gold standard. Examiner reliability of visual inspection after tooth separation was determined (kappa 0.92). Impression examination was repeated every 5 participants to evaluate the reproducibility of the method. The frequency of cavitated lesions was 65 percent, and 67 percent of those were inactive. Sensitivity, specificity, positive and negative predictive values were 0.88 percent (95 percentCI 0.73-0.95), 0.89 percent (95 percentCI 0.67-0.97), 0.94 percent (95 percentCI 0.79-0.98) and 0.80 percent (95 percentCI 0.58-0.92), respectively. Impression examination showed total agreement regarding cavitation. The evaluation of elastomeric impression after tooth separation is a useful clinical resource in cavitation detection for clinicians and researchers when visual inspection is doubtful.