THE VALUE OF THE ROENTGENOGRAPH IN THE DETECTION OF CARIOUS LESIONS

¹ Department of Pedodontics, College of Dentistry, State University of Iowa, Iowa City, Iowa

1. A detailed clinical method of examination for caries on 429 children has been checked for accuracy by arranging the individuals into different groups, according to varying caries incidence and examination conditions, using the bite-wing film and full-mouth serial roentgenographs. From the data presented it is possible to state that neither a clinical nor roentgenographic examination is adequate in itself if all the caries in a mouth is sought. If the findings are to be used as a basis of treatment, it is imperative that the greatest possible number of lesions be detected. This cannot be done even by the most meticulous clinical examination, such as was followed on the patients discussed in this report. Unless bite-wing films are used in diagnosis, approximately one-third of the patients possess undetected cavities; the use of full-mouth surveys, in addition to clinical and bite-wing examinations, increases the number to approximately 50 per cent. In addition, nearly twice the number of cavities per child are found by the use of the full-mouth survey. On the other hand, if the examination is used as a basis for evaluating the caries picture between groups of children used for experimental studies, the roentgenograph is of such little value in changing the score that it may be considered dispensable.

2. A comparison of groups of children exhibiting high and low total caries pictures was performed in an effort to determine what percentage of additional cavities were contributed by the roentgenograph. Although the less susceptible group demonstrated a greater ratio of enamel caries, about the same total relative increase was noted per child between groups using bite-wing films. A significantly greater number of lesions were found, however, in similarly various groups using the full-mouth survey.

3. No outstanding sex differences were manifest in caries incidence or relative number of cavities found by roentgenograph in any of the comparisons.

4. The number of times a child had been previously examined or the age had no apparent influence upon the number of cavities found by the roentgenograph following the clinical examination.