Woodward G L, Leake J L
J Can Dent Assoc. 1996 Sep;62(9):731-6.
It is generally recommended that a cavitated, carious lesion be present before an interproximal tooth surface is restored. These lesions often are not clinically visible, however, and must be diagnosed using dental radiographs. Radiographic results can underestimate and overestimate the size of a carious lesion. The purpose of this study was to review and graphically summarize studies that have investigated the relationship between the radiographic image and the presence of a cavitated lesion on the interproximal surfaces of permanent teeth. A search of the literature identified 13 studies, eight of which were suitable for inclusion in our summary. Using the positive and negative likelihood ratios from each study, a graphical summary was developed showing the probability of cavitation based on the radiographic test result and the dentist's pre-radiograph estimate of the probability of cavitation. This graph should allow dentists to more accurately inform their patients of the probability of a cavitated interproximal lesion being present or absent. As a further observation, our findings suggest that to avoid frequent false positive diagnoses, dentists should estimate the probability of cavitation to be at least 30 per cent before they prescribe radiographs for patients who visit them on a regular basis.
一般建议在修复邻面牙表面之前，要有一个已形成空洞的龋损存在。然而，这些龋损在临床上往往不可见，必须通过牙科X光片进行诊断。X光片结果可能会低估或高估龋损的大小。本研究的目的是回顾并以图表形式总结那些研究恒牙邻面X光影像与已形成空洞的龋损存在之间关系的研究。文献检索确定了13项研究，其中8项适合纳入我们的总结。利用每项研究的阳性和阴性似然比，绘制了一个图表总结，显示基于X光检查结果和牙医在X光检查前对龋损形成概率的估计得出的龋损形成概率。该图表应能让牙医更准确地告知患者存在或不存在邻面空洞性病变的概率。作为进一步的观察，我们的研究结果表明，为避免频繁出现假阳性诊断，对于定期就诊的患者，牙医在为其开具X光片之前，应估计龋损形成概率至少为30%。
