Journal
INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY
Volume 29, Issue 4, Pages 422-428Publisher
WILEY
DOI: 10.1111/ipd.12483
Keywords
children; dental caries; diagnosis; restoration; sealant
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Funding
- National Council for the Scientific and Technological Development from the Brazilian Government-CNPq [306852/2016]
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Background Dental caries diagnosis and management have changed over time. Aim To identify the treatment decision-making process performed by paediatric dentists, after caries detection using CAST instrument (Caries Assessment Spectrum and Treatment), for enamel (CAST 3) and non-cavitated dentin caries lesions (CAST 4) before and after analysing radiographic images. Design Seventy-four paediatric dentists were invited to participate. Twelve clinical cases were presented online, and treatment decisions before and after the analysis of bitewing radiographs were evaluated. Results Sixty-one specialists answered the questionnaire. The necessity for radiographs was significantly associated with the presence and depth of the caries lesion (P < 0.0001). CAST 3 lesions were preferentially monitored before and after the radiographic assessment. For CAST 4 lesions limited to the outer half of dentin, treatments indicated before and after radiographic analysis were sealant (33%) and restoration (40%). For the lesions in the inner half of dentin, restoration was the most cited before (45%) and after (84%) radiographs. The radiographic depth was the only significant independent variable when change in the treatment option was analysed by the regression model (P < 0.001). Conclusions Enamel lesions were treated through less invasive treatments. Radiographs influenced the decision, especially for the lesions that involved the inner half of dentin.
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