Indicación de radiografías interproximales en adolescentes: una revisión sistemática de guías clínicas.

OBJECTIVES: to identify and to analyse current guidelines/directives on the use of bitewing radiograph among adolescents, evaluating the evidence supporting the parameters used for its indication and for the determination of the time interval prescribed between successive shots for the caries diagnosis. METHODS: A systematic review was conducted in 2022/23, in Spanish, English and Portuguese to identify papers classifiable as “guides”, “guidelines” or “directives” for the use of bitewing radiography. Two reviewers consulted MEDLINE, LILACS, SCOPUS and Google Scholar. Each guideline was analysed according to the Appraisal of Guidelines for Research and Evaluation II (AGREE II). RESULTS: Six guidelines and five documents were included. Five guidelines comply adequately with domain 1 but none of them included patient’s opinions or preferences. They are based on expert opinion, with adequate and clear language. Only two guidelines members declare having no conflicts of interest. While ADA 2012, AAPD 2017, EAPD 2019, ITALIA 2019 suggest using the presence of caries lesions/caries risk assessment as an indicator for taking Rx at the first visit, the others do not present an indicator or do so in all patients and documents indicate key ages for radiographic examination. The frequency varies according to the risk assessment and presence of caries lesion. CONCLUSION: There is no consensus in parameters used for the indication/timing and frequency of radiographs examination, however, the guidelines condemns the indiscriminate use of radiographs. The frequency should be established in relation to the baseline conditions and determining factors present. Frequencies less than 12 months require justification.