Weerheijm K L, Groen H J, Bast A J, Kieft J A, Eijkman M A, van Amerongen W E
Department of Pediatric Dentistry, Academic Centre for Dentistry, Amsterdam, The Netherlands.
Caries Res. 1992;26(4):305-9. doi: 10.1159/000261457.
The occlusal bite-wing radiograph evaluations of 131 14-year-old and of 123 17- and 20-year-old Dutch persons were compared with the clinically collected observations. The clinical observations and the bite-wing radiographs were collected as part of a longitudinal epidemiological survey conducted in 1987 and 1990. Comparison of the evaluations of the first and second molar teeth showed significantly more radiolucencies in all three age groups than expected clinically. Of the clinically judged 'sound' surfaces, 26% in the 14-, 37.5% in the 17- and 50% in the 20-year-old group showed a radiolucency on the bite-wing radiograph. In the 14-, 17- and 20-year-old age group a radiolucency was noticed on the bite-wing radiograph in 32, 44 and 58% of the sealed teeth, respectively. The radiolucencies below the occlusal enamel of sealed teeth were most likely due to the problems in diagnosing occlusal dentine lesions correctly with the clinical diagnostic methods. Therefore not only approximal but also occlusal bite-wing radiograph judgement before sealant application seems to be advisable now. Because of the numbers of clinically undetected lesions it may be advisable to reconsider the criteria for occlusal diagnosis in epidemiological surveys and to judge not only the approximal but also the occlusal surfaces in epidemiological surveys when bite-wing radiographs are available.
对131名14岁以及123名17岁和20岁的荷兰人进行了咬合翼片X线片评估，并与临床收集的观察结果进行了比较。临床观察和咬合翼片X线片是1987年和1990年进行的一项纵向流行病学调查的一部分。对第一和第二磨牙的评估比较显示，在所有三个年龄组中，X线透射区明显多于临床预期。在临床判断为“完好”的表面中，14岁组有26%、17岁组有37.5%、20岁组有50%在咬合翼片X线片上显示有X线透射区。在14岁、17岁和20岁年龄组中，分别有32%、44%和58%的封闭牙在咬合翼片X线片上有X线透射区。封闭牙咬合釉质下方的X线透射区很可能是由于临床诊断方法在正确诊断咬合牙本质病变方面存在问题。因此，现在在应用封闭剂之前，不仅邻面而且咬合翼片X线片的判断似乎都是可取的。由于临床未检测到的病变数量，可能有必要重新考虑流行病学调查中的咬合诊断标准，并且在有咬合翼片X线片时，在流行病学调查中不仅要判断邻面，还要判断咬合面。
