This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Kühnisch, J Articles by Heinrich-Weltzien, R PubMed PubMed Citation Articles by Kühnisch, J Articles by Heinrich-Weltzien, R

Frequency of non-carious triangular-shaped radiolucencies on bitewing radiographs

¹ Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians-University of Munich, Germany; ² Schliern, Switzerland; ³ Department of Preventive Dentistry, Friedrich-Schiller-University of Jena, Germany

Dr. Jan Kühnisch, Ludwig-Maximilians-Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336 München, Germany; E-mail: jkuehn{at}dent.med.uni-muenchen.de

Received 20 October 2006; revised 19 December 2006; accepted 21 December 2006

Objectives: The assessment of bitewing radiographs requires knowledge of radiographic anatomy and pathology, and the comprehension of possible effects of superposition which may lead to false positive diagnoses. Based on a clinical case report in which non-carious radiolucencies were discovered on the mesial surfaces of upper molars, this phenomenon, which has not been reported before, was explained. Due to the anatomical characteristics of the rhombic tooth, in particular the crown's receding mesial surface from the mesiobuccal towards the distopalatal side, which is combined with an often prominent palatal cusp and a smaller mesiodistal diameter at the cervical neck, radiolucencies – normally typical caries indicators – can sometimes be observed on the mesial surfaces of upper primary and first permanent molars on bitewings. These triangular-shaped radiolucencies (TSRs) can therefore be attributed to the effects of superposition. The aim of the present epidemiological study was to assess the radiographic frequency of TSRs.

Methods: As part of a clinical–radiographic follow-up examination involving 11–12 year old children (n = 113), both the caries status (World Health Organization (WHO) standard) and the frequency of TSRs were recorded.

Results: TSRs were most frequently present on upper second primary molars (60.3%). 35.5% of the upper first primary molars and 24.8% of the upper first permanent molars displayed TSRs. However, none of the lower primary and/or permanent molars displayed this phenomenon.

Conclusion: In the mesial surface of upper primary and permanent molars where the frequency of TSRs was fairly high, it may be essential to distinguish this change from approximal caries.

Keywords: bitewing radiographs; caries diagnosis; false positive results