Behaviour of approximal carious lesions assessed by clinical examination after tooth separation and radiography: A 2.5-year longitudinal study in young adults

This study aimed to record and monitor over a 2.5-year period the occurrenc e of cavitation and lesion depth progression in approximal surfaces with ra diographic caries at baseline. In total, 66 approximal sites (in 29 student s), where at least one of the contacting surfaces had radiographic caries, were selected to take part in the study. A clinical examination undertaken before and after tooth separation in order to assess the presence/absence o f cavitation was repeated every sixth month. To monitor lesion progression bite-wing radiographs were taken every sixth month, too. After each series of examinations, surfaces judged to be prone for disease progression were r eferred to operative caries treatment. In surfaces with radiographic dentin al caries at baseline the cavitation prevalence following tooth separation found at the various recall examinations ranged from 20 to 44%. In surfaces with radiographic enamel caries at baseline this prevalence ranged from 4 to 8% at the various recall examinations. In dentinal lesions found with an intact surface at baseline, the risk of cavitation development during the first 1.5-year period was assessed to be up to 22%. After this period no ne w cavitations were found in previously intact dentinal lesions. In intact e namel lesions the risk of cavitation formation was found to be 3% during th e first 1-year period. After this period no new cavitations developed in pr eviously intact enamel lesions. Three of 7 lesions, which showed radiograph ic caries progression from the outer one third to the inner two thirds of t he dentine during the observation period, had intact surfaces at baseline. On the basis of these results it is recommended to re-examine carefully int act, dentinal lesions by repeated clinical examination after tooth separati on and by radiography about 1-1.5 years after baseline.