Abstract Introduction: In this study, the major criterion used by 69 final-year dental students of Al-Quds University, Palestine, to ascertain the presence of approximal carious lesions through radiographs, and their subsequent treatment plan is outlined. Methods: This study was designed to be cross-sectional, whereby a questionnaire containing schematic radiographic diagrams of approximal carious lesions in molars of deciduous and permanent dentition were depicted. Th e extent of caries was divided into fi ve groups indicating different levels of enamel and dentin involvement: Caries extending to the external one-third of enamel, external two-thirds of enamel, up to the dentino-enamel junction (DEJ), external one-third of dentin, and two-thirds of dentin. Results: The absolute and relative frequencies of the study group′s responses were recorded. Th e treatment decisions taken for caries in deciduous and permanent dentition were neither affected by age nor gender. Of the 69 subjects, 26.1% (18/69) chose to treat the approximal caries when it had spread to the DEJ in the deciduous dentition and 39.1% (27/69) chose to treat caries at the DEJ in the permanent dentition, showing a significant statistical variation in response. When studying the difference in response to treating deciduous and permanent dentitions, treating a lesion at the DEJ and within the outer third of dentin in deciduous dentition was lower than the latter in permanent dentition, with a treatment response of 26.1% (18/69) for deciduous and 39.1% (27/69) for permanent dentition for a lesion at the DEJ, and 24.3% (17/69) in deciduous and 33.3% (23/69) for permanent dentition for a lesion in the outer third of dentin. Conclusion: These results show a significant difference in the choice to treat approximal caries in deciduous and permanent dentitions, indicating a greater preference for treating caries within dentin in permanent dentition than in deciduous dentition.
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