Resumo

MENDES, Fausto Medeiros et al. Are adjunct methods for the detection of caries lesions in primary teeth really necessary?. Rev. Assoc. Paul. Cir. Dent. [online]. 2014, vol.68, n.1, pp. 53-59. ISSN 0004-5276.

The present study aimed to evaluate, in terms of probability, the impact of performing adjunct methods of caries lesions detection in proximal and occlusal surfaces of primary teeth, compared to the visual inspection. For this, 1,213 proximal surfaces of 126 children and 407 occlusal surfaces of 68 children were examined through visual inspection, radiographic and laser fluorescence methods. The validation for proximal surfaces was performed after temporary separation. In the occlusal surfaces, the reference standard was the confirmation of the presence of the lesion after operative treatment. Using Bayesian analysis, post-test probabilities after performing the visual inspection were calculated. After that, these figures were computed after performing the adjunct caries detection methods. Pre-test probability was 4.2% and 5.2% for proximal and occlusal surfaces, respectively. A negative result obtained with visual inspection reduced the post-test probability to very low values, mainly at occlusal surfaces. On these occasions, even with positive results obtained by adjunct methods, the post-test probability of having a caries lesion was still low (around 50% in case of a positive result obtained by radiographic method in proximal surfaces). Performing radiography to confirm caries lesions detected by visual inspection could increase the confidence concerned the presence of the lesion, avoiding unnecessary operative treatment. Therefore, it was concluded that the adjunct methods do not have great utility in detecting caries lesions in primary teeth, and that the visual inspection performed alone is enough to reach an accurate diagnosis.

Palavras-chave : dental caries; diagnosis; radiography.