Avaliação radiográfica dos primeiros molares inferiores permanentes de crianças brasileiras de 6 a 12 anos

Abstract

Dental caries is a recurrent multifactorial infectious disease, especially in children, influenced by factors such as a diet rich in sugars, inadequate oral hygiene, and socio-environmental conditions. The lesion begins with enamel demineralization and can progress, requiring invasive treatments. Children's first permanent molars are highly affected, and early detection through clinical and radiographic examinations is essential. The aim of this study was to radiographically evaluate the first permanent lower molars of Brazilian children aged 6 to 12 years. This is a descriptive, cross-sectional observational study using images from a database. A total of 1,800 digital panoramic radiographs obtained between 2020 and 2025 in the five regions of Brazil were evaluated. Of the total, 915 were male (50.83%) and 885 were female (49.17%), with a mean age of 9 years. Teeth 36 and 46 were evaluated for the presence of carious lesions in dentin, carious lesions in dentin and pulp, restorations, fillings, endodontic treatment, and tooth absence, totaling 3,600 teeth. A pilot study was conducted to calculate the sample size and intra-examiner agreement, with 200 radiographs, obtaining a kappa value of 0.988 (p<0.01). Comparisons were made using the McNemar, Chi-square, Mann Whitney, and Linear Regression Model tests. The results indicated no significant difference between the presence of changes on the right and left sides, but significance in terms of the total number of missing teeth (p < 0.05), carious lesions in dentin (p <0.001), carious lesions in dentin and pulp (p = 0.059), restorations (p <0.001), and unhealthy teeth (p <0.001) in each region. The North region obtained significant values for almost all variables regarding the chance of alteration occurring in comparison to the Southeast region, except for the occurrence of periapical lesions and fillings. Age showed a significant association with all variables (p< 0.001). It was concluded that caries is a prevalent problem among Brazilian children, with higher rates in the North and Northeast regions, reflecting possible inequalities in access to oral health care. Age proved to be a determining factor for its progression.