A clinical and microbiological study of approximal carious lesions - Part 1: The relationship between cavitation, radiographic lesion depth, the site-specific gingival index and the level of infection of the dentine

A clinical study was carried out to assess relationship between the presenc e of approximal cavitation, the radiographic depth of the lesion, the site- specific gingival index and the level of infection of the dentine. Adult pa tients assessed as needing operative treatment and presenting with approxim al lesions visible in the outer third of dentine on bite-wing radiographs w ere included in the study. Direct lesion depth measurements were recorded f rom the radiographs and the site-specific gingival index adjacent to the le sion was noted. The presence or absence of a cavity was recorded on an impr ession following tooth separation. During operative treatment samples of de ntine were taken on entry to the lesions to ascertain the level of infectio n of the dentine. Visual evaluation of 54 successfully recorded impressions revealed that 85% were cavitated. Cavitated lesions were found to have hig her site-specific gingival index scores compared to non-cavitated lesions ( p = 0.03). The probability of cavitation was greater for lesions >0.5 mm fr om the enamel-dentine junction on bitewing radiographs (p<0.01). The level of infection of the dentine was significantly higher for cavitated lesions than for non-cavitated lesions (p = 0.02). However, the non-cavitated lesio ns were still infected. Copyright (C) 2001 S. Karger AG, Basel.