Establishing Treatment Threshold for Proximal Caries: A Systematic Review
Objective: The decision to restore proximal caries is not disputed whenever cavitation is present. However, assessment of cavitation is problematic because of the difficulty of visualizing proximal surfaces of teeth in contact and the use of an explorer may cause iatrogenic damage to the tooth surface in question. Thus, bitewing (BW) radiographs are the main diagnostic tool for proximal caries detection. The objective of this study was to systematically review the best scientific evidence available to show the correlation between proximal radiolucencies detected on posterior BW radiographs and cavitation in posterior permanent teeth in order to recommend an operative cut off point for treatment.
Method: This review is based on evidence from a search of seven electronic databases and a review of the references from relevant articles. A total of 550 article titles, 68 abstracts and eight complete articles were reviewed by multiple authors. Of these, seven were critically appraised according to a checklist for “assessing a diagnostic or predictive test”. All seven articles were included in the final evidence table.
Results: The evidence suggests that once a lesion is radiographically into dentin the probability of cavitation rises drastically and the necessity to restore becomes apparent.
Conclusions: A lesion that extends into dentin, as seen on a BW radiograph, has a higher probability of cavitation than a lesion which extends only into enamel. However, the clinical decision to restore proximal caries should be tailored to the individual patient, taking into account caries risk, to provide the most beneficial treatment.
Division: IADR/PER General Session
Meeting:2010 IADR/PER General Session (Barcelona, Spain) Location: Barcelona, Spain
Year: 2010 Final Presentation ID:2511 Abstract Category|Abstract Category(s):Cariology Research
Authors
Hong, Claire Wan
( University of Toronto, Toronto, ON, Canada
)
Kirshenblatt, Stacey
( University of Toronto, Toronto, ON, Canada
)
Bullock, Liv
( University of Toronto, Toronto, ON, Canada
)
Picardo, Clive
( University of Toronto, Toronto, ON, Canada
)
Kowsari, Mahsa
( University of Toronto, Toronto, ON, Canada
)
Jhun, Delia
( University of Toronto, Toronto, ON, Canada
)
Jadu, Fatima
( University of Toronto, Toronto, ON, Canada
)
Azarpazhooh, Amir
( University of Toronto, Toronto, ON, Canada
)