Radiographic Diagnoses and Treatment Decisions on Approximal Caries

摘要

Mineral loss which represents a threshold value for radiographic diagnosis, cannot be defined exactly. For clinical use 10% mineral loss in the direction of the X-ray beam may constitute a border line lesion for radiographic detection, and caries lesions without cavitation seemed to be beyond this diagnostic threshold. The degree of caries estimated by using radiographs is fairly closely related to the depth of the tissue changes recorded in the prepared cavity. Radiographic examinations more often lead to underestimation than overestimation of the degree of caries. Radiographic caries diagnoses made at different degrees of penetration toward the pulp showed insignificant variations with respect to quality, but the observers were more confident of caries being present (used more strict criterion) when they scored caries in inner dentin. Consensus on diagnostic criteria and improved diagnostic quality are considerably more important to the quality of therapeutic decisions on approximal caries than viewing conditions and film density. A semi-radiopaque material in Class II fillings seems to offer advantages compared to amalgam in respect of the diagnosis of secondary caries and marginal defects. There is a danger that dentists will restore approximal caries lesions too early and before these can be diagnosed in dentin radiographically. Reprints of seven previously published papers; 87 refs. (ERA citation 13:049644)