Are there hidden caries or is this another limitation of the diagnostic conventional exams?

Valdeci Elias dos Santos Junior, Andreza Cristina de Lima Targino, Arnoldo Vasconcelos de Alencar Filho, Aronita Rosenblatt

Abstract


Objective: To verify the existence of hidden caries and compare the diagnosis agreement among different Examiners between the visual and radiographic exam and computed microtomography images of incipient dental lesions on the occlusal surface of extracted molars.
Methods: Two hundred and fifteen healthy teeth were extracted from the corpses of children with a mean age of 12 years and analysed by visual examination. However, only 11 teeth were included in current study because they showed suggestive caries image when examined by microtomography (micro CT scan). Occlusal sites were examined both visually and by dental radiograph by 3 different dental practitioners and results were compared and validated independently by each Examiner with computed microtomography, henceforth a gold-standard in current investigation. The coefficient of agreement was calculated by Cohen’s kappa test.
Results: the coefficient of agreement among Examiners for the diagnosis by standard microtomography was excellent (K = 0.924) and moderate for both the visual (K=0.515) and the radiographic (K=0.583) examinations. Computed microtomography-produced images allowed the Examiners to visualize radiolucent areas, unseen in previous radiographic images and visual exams, in which there existed communication between enamel and/or dentine and the external environment.
Conclusion: Hidden caries was the product of the conventional exam´s limitations, or rather, the lesion was due to enamel non-collapse. Consequently, conventional exams were not accurate enough to detect the lesions.


Keywords


Computed microtomography; Dental diagnostics; Incipient lesions; Dental caries

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DOI: http://dx.doi.org/10.15448/1980-6523.2015.2.14592

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