Mp. Rudolphy et al., VALIDITY OF BITE-WINGS FOR DIAGNOSIS OF SECONDARY CARIES IN TEETH WITH OCCLUSAL AMALGAM RESTORATIONS IN-VITRO, Caries research, 27(4), 1993, pp. 312-316
This investigation was carried out to establish the validity of bite-w
ing radiographs for the diagnosis of secondary caries in teeth with oc
clusal amalgam restorations. One hundred and fifty-nine extracted mola
rs with occlusal amalgam fillings and characteristics that might be in
dicative of the presence of secondary caries were selected. The charac
teristics were a blueish-gray discolouration of enamel, a brownish dis
colouration of the amalgam-enamel margin, marginal breakdown of the re
storation, and/or deep fissures at the margin of the restoration. The
teeth were radiographed in a bucco-lingual direction to obtain images
comparable to bite-wings. Subsequently, the crowns were sectioned (700
mum) and glued on plastic sheets. The sections were recorded radiogra
phically and then examined by independent examiners. Radiolucencies as
well as radiopacities adjacent to the restoration were considered to
be caries. The validation of the bite-wing radiographic diagnosis was
achieved by comparison with the radiographs of the sections. A sensiti
vity of 64% and a specificity of 98% were calculated. Large lesions we
re always visible on the bite-wing radiograph (100%), the majority of
medium-sized lesions (89%) and 40% of small lesions. Small radiopaciti
es were detected more often than small radiolucencies.