Comparação Clínica e Radiográfica de Diagnóstico de Cárie nas Superfícies Interproximais de Molares Decíduos

Objetivo: Comparar dois metodos de diagnostico de carie, exame visual com separacao e exame radiografico, em superficies interproximais de molares deciduos de criancas com alto risco de carie. Metodo: Cento e setenta superficies interproximais de molares deciduos de criancas com idade entre tres e nove anos, que participavam de um programa de prevencao, foram selecionadas. A avaliacao do risco e atividade de carie foi realizada mediante dados da anamnese, indice de higiene oral, indice de sangramento e ceo-s, CPO-S. As superficies foram examinadas por exame clinico visual direto (separacao dental), com o auxilio de espelho e sonda e duas radiografias bitewing. Os dados foram analisados por teste Qui-quadrado (X2) e coeficiente de correlacao de Spearman (p menor que 0,05). Resultados: O exame visual com separacao detectou mais lesoes de carie em comparacao ao exame radiografico. Todas as lesoes cavitadas, diagnosticadas clinicamente, apresentaram imagem radiolucida em esmalte e ou dentina. Houve correlacao positiva entre os dois metodos com relacao a profundidade da lesao (Rho=0,80, p menor que 0,05). Cerca de 123 (72,32%) superficies foram diagnosticadas igualmente em ambos os metodos. Ocorreu diferenca com relacao a idade, ao genero e dente avaliado para a presenca e ausencia de cavitacao (p menor que 0,01). A presenca ou ausencia de imagem radiolucida nao foi estatisticamente diferente com relacao ao dente avaliado (p maior que 0,05). Conclusao: O exame clinico visual direto foi mais sensivel para diagnosticar as lesoes nao-cavitadas. Ambos os metodos foram efetivos para detectar lesao de carie interproximal em molares deciduos com necessidades restauradoras em criancas de alto risco de carie. Objective: To compare two methods of caries diagnosis, visual examination with tooth separation and radiographic examination on interproximal surfaces of primary molars in high-caries-risk children. Method: One hundred and seventy interproximal surfaces of primary molars of children aged three to nine years old attending a prevention program were selected. The evaluation of caries risk and activity was performed based on data from anamnesis, oral hygiene index, bleeding index and dmf-s and DMF-S. The surfaces were examined by direct visual clinical inspection (tooth separation) with the aid of a dental mirror and explorer and two bitewing radiographs. Data were analyzed statistically by the chi-square (X2) test and Spearman's correlation coefficient (p less than 0.05). Results: The visual examination with tooth separation detected more caries lesions than the radiographic examination. All clinically diagnosed cavited lesions exhibited a radiolucent image in enamel and/or dentin. There was positive correlation between both methods with respect to lesion depth (Rho=0.80; p less than 0.05). Approximately 123 (72.32%) surfaces were equally diagnosed using both methods. Statistically significant difference was found for age, gender and tooth type regarding the presence aor absence of cavitation (p less than 0.01). The presence or absence of radiolucent image was not significantly different with respect to the evaluated tooth (p greater than 0.05). Conclusion: Direct visual clinical examination was more sensitive for detecting non-cavited lesions. Both methods were effective for detecting interproximal caries lesion in primary molars with restorative needs in high-caries-risk children.