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Poorterman JHG, Weerheijm KL et al. Caries Res 2003; 37: 29–33

Recent studies indicate that much caries may be undetected by clinical examination alone, and that bitewings may be necessary to detect most occlusal caries. In this study, 522 persons aged 17 yrs started a study which led to data from 90 participants being evaluated 6 yrs later.

In first and second molars, 705 occlusal surfaces were examined. Of 175 initially sound fissures, 22% developed a dentine lesion, another 13% were filled, and 2% were sealed but developed caries; of 118 decayed fissures, 38% were filled, 25% showed progression, 13% were filled but were carious at 6 yrs, and 1% were sealed but progressed.

Of 77 sealed sound fissures, 12% were filled, 3% were found to be filled but carious, and 9% were sealed but carious. Of 49 sealed decayed fissures, 35% had been filled, 6% were filled but carious, and 22% had progressed.