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ZWR - Das Deutsche Zahnärzteblatt 2007; 116(4): 157-164
DOI: 10.1055/s-2007-981420
Wissenschaft - Kinderzahnheilkunde

© Georg Thieme Verlag Stuttgart · New York

Kariesdiagnostik bei Kindern und Jugendlichen - Stellenwert der Bissflügel-Röntgenaufnahme

The Value of Bitewing Radiographs for Caries Detection in Children and AdolescentsR. Heinrich-Weltzien1 , J. Kühnisch2
  • 1Poliklinik für Präventive Zahnheilkunde, Friedrich-Schiller-Universität Jena
  • 2Poliklinik für Zahnerhaltung und Parodontologie, Ludwig-Maximilians-Universität München
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Publication History

Publication Date:
10 May 2007 (online)

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Die präventiv orientierte Betreuung von Kindern und Jugendlichen fokussiert auf die frühzeitige Kariesdiagnostik, um läsionsbezogen die Entscheidung zwischen einer adäquaten präventiven oder restaurativen Behandlung treffen zu können. Die Indikation zur röntgenologischen approximalen und okklusalen Kariesdiagnostik mit Bissflügel-Röntgenaufnahmen orientiert sich am alterstypischen Kariesbefallsmuster und dem individuellen Kariesrisiko des Patienten. Die Intervalle für ein effektives Kariesmonitoring (Verlaufsbeobachtung approximaler Läsionen) sollten anhand ihrer Anzahl und Ausdehnung, die das Kariesrisiko des Patienten reflektieren, bestimmt werden. Die routinemäßige Anfertigung von Bissflügel-Röntgenaufnahmen ist nicht gerechtfertigt, da der kariesdiagnostische Nutzen für Kinder mit einem niedrigen Kariesrisiko gering ist.

Preventive orientated dental care of children and adolescents focuses on early caries detection to make a lesion related decision between an appropriate preventive or restorative treatment. The indication for approximal and occlusal radiographic caries detection with bitewing radiographs is geared to the age related caries pattern and individual caries risk of the patient. The intervals between bitewing examinations should be based on the number and the extent of approximal lesions reflecting the caries risk of the patient. No radiographs should be taken for routine purposes only as the diagnostic yield of bitewing radiographs for low risk children may be minimal.

Schlüsselwörter

Bissflügel-Röntgenaufnahme - Kariesdiagnostik - Kariesrisiko

Key Words

Bitewing Radiograph - Caries Detection - Caries Risk

Literatur

  • 1 Anderson M, Stecksen-Blicks C, Stenlund H, Ranggard L, Tsilingaridis G, Mejare I. Detection of approximal caries in 5-year-old Swedish children.  Caries Res. 2005;  39 92-99
    CrossrefPubMedGoogle Scholar
  • 2 Clark HC, Curzon MEJ. A prospective comparison between findings from a clinical examination and results of bitewing and panoramic radiographs for dental caries diagnosis in children.  Eur J Paediatric Dent. 2004;  4 203-209
    PubMedGoogle Scholar
  • 3 Creanor SL, Russell JI, Strang DM, Stephen KW, Burchell CK. The prevalence of clinically undetected occlusal dentine caries in Scottish adolescents.  Br Dent J. 1990;  169 126-129
    PubMedGoogle Scholar
  • 4 Vries HC de, Ruiken HM, Koenig KG, Hof MA van't. Radiographic versus clinical diagnosis of approximal carious lesions.  Caries Res. 1990;  24 364-370
    PubMedGoogle Scholar
  • 5 Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde. . Wann sind zur Sicherung von Diagnose und Therapie Röntgenaufnahmen nötig?.  Dtsch Zahnarztl Z. 1993;  48 147
    PubMedGoogle Scholar
  • 6 Dooland M, Smales R. The diagnosis of fissure caries in permanent molar teeth.  J Dent Child. 1982;  49 181-185
    PubMedGoogle Scholar
  • 7 Duggal MS, Curzon ME, Fayle SA, Toumba KJ, Robertson AJ. Restorative techniques in peadiatric dentistry. 2nd ed. London: Martin Dunitz 2002
    Google Scholar
  • 8 Espelid I, Mejàre I, Weerheijm K. EAPD guidelines for use of radiographs in children.  Eur J Paediatr Dent. 2003;  4 40-48
    PubMedGoogle Scholar
  • 9 Espelid I, Tveit AB, Fjelltveit AB. Variations among dentists in radiographic detection of occlusal caries.  Caries Res. 1994;  28 169-175
    PubMedGoogle Scholar
  • 10 European Commission .Radiation Protection 136: European guidelines on radiation protection in dental radiology. The safe use of radiographs in dental practice. Directorate-General for Energy and Transport, Directorate H - Nuclear Safety and Safeguards Unit H.4 - Radiation Protection 2004
    Google Scholar
  • 11 Faculty Selection criteria for dental radiography/ Faculty of General Dental Practitioners (UK). Royal College of Surgeons of England, Faculty of General Dental Practitioners (UK). Royal College of Surgeons of England. London 1998
    Google Scholar
  • 12 Hannigan A, OŽMullane DM, Barry D, Schäfer F, Roberts AJ. A caries susceptibility classification of tooth surfaces by survival time.  Caries Res. 2000;  34 103-108
    CrossrefPubMedGoogle Scholar
  • 13 Heinrich-Weltzien R, Kühnisch J, Weerheijm K, Stößer L. Diagnostik der versteckten Okklusalkaries mit Bissflügel-Aufnahmen.  Dtsch Zahnarztl Z. 2001;  56 476-480
    PubMedGoogle Scholar
  • 14 Heinrich R, Künzel W, Tawfiq H. Approximale Kariesdiagnostik - Vergleich klinischer, faseroptischer und röntgenographischer Diagnostikverfahren.  Dtsch Zahn-Mund-Kieferheilkd. 1991;  79 535-542
    PubMedGoogle Scholar
  • 15 Hintze H, Wenzel A. Clinically undetected dental caries assessed by bitewing screening in children with little caries experience.  Dento-Maxillo-Facial Radiology. 1994;  23 19-23
    PubMedGoogle Scholar
  • 16 Ie YL, Verdonschot EH. Performance of diagnostic systems in occlusal caries detection compared.  Community Dent Oral Epidemiol. 1994;  22 187-191
    CrossrefPubMedGoogle Scholar
  • 17 Kidd EAM, Naylor MN, Wilson FF. The prevalence of clinically undetected and untreated molar occlusal dentine caries in adolescents on the Isle of Wight.  Caries Res. 1992;  26 397-401
    PubMedGoogle Scholar
  • 18 Kidd EA, Pitts NB. A reappraisal of the value of the bitewing radiograph in the diagnosis of posterior approximal caries.  Br Dent J. 1990;  169 195-200
    PubMedGoogle Scholar
  • 19 King NM, Shaw L. Value of bitewing radiographs in detection of occlusal caries.  Community Dent Oral Epidemiol. 1979;  7 218-221
    CrossrefPubMedGoogle Scholar
  • 20 Krone M. Geringe Strahlenbelastung durch Röntgen beim Zahnarzt.  2001;  7 14
    PubMedGoogle Scholar
  • 21 Kühnisch J, Heinrich-Weltzien R, Weerheijm K, Stößer L. Beitrag der Bissflügel-Aufnahme zur Diagnose der Approximalkaries im Seitenzahngebiet.  Dtsch Zahnarztl Z. 2001;  56 594-597
    PubMedGoogle Scholar
  • 22 Marthaler TM. A standardized system of recording dental conditions.  Helv Odont Acta. 1966;  10 1-18
    PubMedGoogle Scholar
  • 23 Mejàre I. Bitewing radiography as an aid in caries diagnosis and treatment decision in children and adolescents.  Oralprophylaxe. 2003;  25 66-71
    PubMedGoogle Scholar
  • 24 Mejàre I, Kallest lC, Stenlund H. Incidence and progression of approximal caries from 11 to 22 years of age in Sweden: A prospective radiographic study.  Caries Res. 1999;  33 93-100
    CrossrefPubMedGoogle Scholar
  • 25 Mejàre I, Kaellestal C, Stenlund H, Johansson H. Caries development from 11 to 22 years of age a prospective radiographic study. Prevalence and distribution.  Caries Res. 1998;  32 10-16
    CrossrefPubMedGoogle Scholar
  • 26 Mejàre I, Stenlund H, Julihn A, Larsson I, Permert L. Influence of approximal caries in primary molars on caries rate for the mesial surface of the first permanent molar in Swedish children from 6 to 12 years of age.  Caries Res. 2001;  35 178-185
    CrossrefPubMedGoogle Scholar
  • 27 Mitropoulos CM. A comparison of fibre-optic transillumination with bite-wing radiographs.  Br Dent J. 1985;  159 21-23
    PubMedGoogle Scholar
  • 28 Peers A, Hill FJ, Mitropoulos CM, Holloway PJ. Validity and reproducibility of clinical examination, fibre-optic transillumination, and bite-wing radiology for the diagnosis of small approximal carious lesions: an in vitro study.  Caries Res. 1993;  27 307-311
    PubMedGoogle Scholar
  • 29 Pine CM, Bosch JJ. Dynamics of and diagnostic methods for detecting small carious lesions.  Caries Res. 1996;  30 381-388
    PubMedGoogle Scholar
  • 30 Pitts NB. The use of bitewing radiographs in the management of dental caries: scientific and practical considerations.  Dento-Maxillo-Facial Radiology. 1996;  25 5-16
    PubMedGoogle Scholar
  • 31 Pitts NB. Clinical diagnosis of dental caries: a European perspective.  J Dent Educ. 2001;  65 972-978
    PubMedGoogle Scholar
  • 32 Poorterman JHG, Aartman ICH, Kalsbeek H. Underestimation of the prevalence of approximal caries and inadequate restorations in a clinical epidemiological study.  Community Dent Oral Epidemiol. 1999;  27 331-337
    CrossrefPubMedGoogle Scholar
  • 33 Poorterman JHG, Aartman ICH, Kieft JA, Kalsbeek H. Value of bite-wing radiographs in a clinical epidemiological study and their effect on the DMFS index.  Caries Res. 2000;  34 159-163
    CrossrefPubMedGoogle Scholar
  • 34 Raadal M, Amarante E, Espelid I. Prevalence, severity and distribution of caries in a group of 5-year-old Norwegian children.  Eur J Paediatr Dent. 2000;  1 13-20
    PubMedGoogle Scholar
  • 35 Sköld UM, Klock B, Rasmusson CG, Torstensson T. Is caries prevalence underestimated in today's caries examination? A study on 16-year-old children in the country of Bohuslan, Sweden.  Swed Dent J. 1995;  19 213-217
    PubMedGoogle Scholar
  • 36 Stecksén-Blicks C, Wahlin YB. Diagnosis of approximal caries in pre-school children.  Swed Dent J. 1983;  7 179-184
    PubMedGoogle Scholar
  • 37 Stenlund H, Mejàre I, Kallestal C. Caries rates related to approximal caries at ages 11-13: a 10-year follow-up study in Sweden.  J Dent Res. 2002;  81 455-458
    PubMedGoogle Scholar
  • 38 Taylor GK, Macpherson LM. An investigation into the use of bitewing radiography in children in Greater Glasgow.  Brit Dent J. 2004;  196 563-568
    CrossrefPubMedGoogle Scholar
  • 39 Vaarkamp J, Bosch JJ ten, Verdonschot EH, Bronkhorst EM. The real performance of bitewing radiography and fibre-optic transillumination in approximal caries diagnosis.  J Dent Res. 2000;  79 1747-1751
    PubMedGoogle Scholar
  • 40 Weerheijm KL, Groen HJ, Bast AJJ, Kieft JA, Eijkman MAJ. Clinically undetected occlusal dentine caries: A radiographic comparison.  Caries Res. 1992;  26 305-309
    CrossrefPubMedGoogle Scholar
  • 41 Weerheijm KL, Gruythuysen RJM, Amerongen WE van. Prevalence of hidden caries.  J Dent Child. 1992;  59 408-412
    PubMedGoogle Scholar
  • 42 Wenzel A, Fejerskov O, Kidd EAM, Joyston-Bechal S, Groeneveld A. Depth of occlusal caries assessed clinically, by conventional film radiographs, and by digitized, processed radiographs.  Caries Res. 1990;  24 327-333
    PubMedGoogle Scholar

Korrespondenzadresse

Prof. Dr. Roswitha Heinrich-Weltzien

Poliklinik für Präventive Zahnheilkunde, Zentrum Zahn-, Mund- und Kieferheilkunde, Friedrich-Schiller-Universität Jena

Bachstr. 18

07740 Jena

Email: Roswitha.Heinrich-Weltzien@med.uni-jena.de

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