Topographic Distribution of Proximal Cavitated Lesions on Primary Mandibular Molars

Introduction: Increased prevalence of proximal caries in primary teeth and its difficult diagnosis makes it necessary to develop newer diagnostic tools for accurate detection of these lesions. International Caries Detection and Assessment System (ICDAS) and its associated International Caries Classification and Management System (ICCMS) is a newer system that uses ICDAS for clinical staging of caries and ICDAS Radiographic score for radiographic staging of carious lesion. Aim: To the topographical distribution of proximal cavitated lesions on the mandibular arch and on primary mandibular molar tooth surface and to determine the extent of the agreement between clinical and radiographic examination in identifying proximal cavitated lesions involving primary mandibular molars. Materials and Methods: An observational study between July 2018-August 2019 in a total of 100 (60 first and 40 second primary molars) primary mandibular molars (D or E) was conducted. Proximal cavitation involving primary mandibular molars were examined both clinically (ICCMS caries merged category scores) and radiographically (ICDAS Radiographic scoring system) and the correlation between both scores were also analysed. Results: First primary molar was observed to have statistically significant prevalence of proximal cavitation (p-value ≤0.001) both clinically and radiographically as compared to second primary molar. Distal surface was observed to have more carious lesions as compared to mesial surface (p-value=0.003). Also, a statistically significant correlation was observed between the clinical and radiographic scores (p-value ≤0.001). Conclusion: Mandibular first primary molar is more prone to proximal cavitation along with chances of distal surface cavitations being higher.