67 Clinical vs. Radiographic Caries Detection in Caries-Active Adults

Thursday, March 22, 2012: 8 a.m. - 9:30 a.m.
Presentation Type: Oral Session
A.V. RITTER, Dept. of Operative Dentistry, University of North Carolina, Chapel Hill, NC, M.D. RAMOS, Nova Southeastern University, Chapel Hill, NC, F. ASTORGA, Dept. Operative Dentistry, University of North Carolina, Chapel Hill, NC, D. SHUGARS, School of Dentistry, University of North Carolina, Chapel Hill, NC, and J. BADER, University of North Carolina, Chapel Hill, NC
Objectives: To determine 1:the extent of agreement between clinical (visual-tactile, CE) and radiographic (RE) examinations in detecting presumptive caries lesions on occlusal and proximal surfaces of posterior teeth of UNC Xylitol for Adult Caries Trial (X-ACT) participants; and 2:the additional caries diagnostic yield obtained by adding RE to CE.     Methods:   Data consisted of surface-level clinical and radiographic scores of disease (cavitated and non-cavitated lesions, existing restorations) or non-disease (sound surfaces). Participants (18-80 years old with ≥12 erupted teeth and 1-10 coronal or root caries lesions) received baseline CE by a trained and calibrated examiner, and had interproximal radiographs obtained within 7 months before or after the date of the CE (N=114). Radiographs were assessed independently by two trained and calibrated examiners masked with respect to CE. Kappa statistics provided an estimate of agreement between CE and RE on diseased surfaces. The additional caries diagnostic yield of the RE over CE is the additional presumptive lesions detected radiographically as a percentage of the total number of presumptive lesions detected clinically.     Results:   Surface-level CE-RE agreement (Kappa) and additional diagnostic yield from RE (n=2415 surfaces):  

Surfaces

Caries Lesions Detected

Kappa

Additional

Diagnostic Yield

 

Total CE

(CE alone)

Total RE

(RE alone)

CE=RE

Total

 

 

All

292

(211)

283

(202)

81

494

0.18

69.2%

Occlusal

33

(31)

20

(18)

2

51

0.04

54.6%

Proximal

259

(180)

263

(184)

79

443

0.18

71.0%

  Conclusions: There is poor agreement between CE and RE to detect caries in posterior teeth of caries-active adults. However, a RE performed within 7 months before or after a CE adds substantial caries diagnostic yield in a clinical trial, especially on proximal surfaces.  Supported by NIDCR U01DE018038, U01DE018047, U01DE018048, U01DE018049, and U01DE018050.  This was an X-ACT ancillary study and, as such, was designed, conducted, and analyzed by the co-authors only.  
This abstract is based on research that was funded entirely or partially by an outside source: NIDCR U01DE018038, U01DE018047, U01DE018048, U01DE018049, and U01DE018050

Keywords: Caries, Cariology, Diagnosis and Radiology
Previous Abstract | Next Abstract >>