Newman B, Seow W K, Kazoullis S, Ford D, Holcombe T
Southside Health Service District, Queensland Health, Queensland.
Aust Dent J. 2009 Mar;54(1):23-30. doi: 10.1111/j.1834-7819.2008.01084.x.
Inadequate detection of caries in the primary dentition due to non-use of bitewing radiography is commonly encountered in paediatric practice. The present study investigated the increased benefits of using bitewing radiography in addition to the visual-tactile examination technique for detection of primary dentition caries in a non-fluoridated community, and determined the prevalence of "hidden" occlusal caries in the primary dentition.
Primary teeth were scored for caries at the restorative threshold using a visual-tactile technique followed by bitewing radiographic examination in a sample of 611 schoolchildren aged 6.4 +/- 0.5 yrs to 12.1 +/- 0.8 yrs residing in a non-fluoridated city.
Overall, at the restorative threshold, the visual-tactile technique could detect 62 per cent of occlusal caries compared to 74 per cent for bitewing radiography (p < 0.001). The prevalence of "hidden" occlusal caries was 12 per cent. In contrast, for primary molar proximal surface caries, the visual-tactile technique could detect only 43 per cent of caries compared with 91 per cent for bitewing radiography (p < 0.001).
In the primary dentition, use of bitewing radiography increases the detection rate of proximal surface caries substantially. It is recommended that bitewing radiography be included as part of the routine examination of children with proximal surfaces that cannot be visualized.
在儿科临床实践中，由于未使用咬合翼片X线摄影术，导致乳牙龋病检测不充分的情况屡见不鲜。本研究调查了在非氟化社区中，除视觉触觉检查技术外，使用咬合翼片X线摄影术检测乳牙龋病所带来的更多益处，并确定了乳牙“隐匿性”咬合面龋的患病率。
对居住在非氟化城市的611名6.4±0.5岁至12.1±0.8岁的学童进行研究，先用视觉触觉技术对乳牙龋病进行修复阈值评分，随后进行咬合翼片X线摄影检查。
总体而言，在修复阈值时，视觉触觉技术可检测出62%的咬合面龋，而咬合翼片X线摄影术为74%（p<0.001）。“隐匿性”咬合面龋的患病率为12%。相比之下，对于乳磨牙邻面龋，视觉触觉技术仅能检测出43%的龋病，而咬合翼片X线摄影术为91%（p<0.001）。
在乳牙列中，使用咬合翼片X线摄影术可大幅提高邻面龋的检出率。建议将咬合翼片X线摄影术纳入对邻面无法可视化儿童的常规检查之中。
