Abstract
The objective of this study was to evaluate the clinical ability of Near-Infrared Light-Transillumination (NILT) for approximal dentinal caries detection and to compare with direct digital-radiography (DDR), as well as to determine whether the combination of both techniques improves the diagnostic capacity of the lesions. From 88 patients (over 18 years), 138 posterior teeth (76 molars and 62 premolars), that had approximal caries reached into dentine determined by DDR, were included. Lesion extension and DDR images were scored as follows: D0 = sound surface, D1/D2 = caries restricted to the outer/inner-half of the enamel, and D3/4 = caries restricted to the outer/inner-half of the dentin. Opening of the approximal surface using 0.5 mm-in-diameter diamond-bar was used as gold-standard. The lesion extension was then determined by the following criteria: no dentinal caries (D0/1/2) or dentinal caries (D3/4). Seventy-one lesions were D3 and 67 lesions were D4. Sensitivities of overall/D3/D4 were 98.0/95.7/100.0 (NILT) and 100/100/100 (DDR), respectively. Correlations with gold-standard were 0.92 (NILT) and 0.42 (DDR), respectively. The correlation increased to 0.97 (p = 0.045) on combining NILT and DDR. There was no difference in sensitivity between the methods (p > 0.05); but was differences in the correlation (p < 0.01). It can be concluded that NILT showed sensitivity similar to that of DDR and higher correlation than DDR for approximal dentinal caries detection. Accordingly, it may be used to monitor the progression of caries without exposing the patient to ionizing radiation, this being of particular interest in growing patients and in pregnant women. In this respect, NILT can be an effective diagnostic tool adjunctive to bitewing radiographs in detecting approximal dentinal caries. The combination of NILT and DDR represents an increase in the diagnosis of approximal lesions The proposed diagnostic protocol comprises visual examination, followed by NILT and DDR only if the former technique detects approximal caries.
Highlights
6-score ordinal system registers caries from the initial changes in the enamel to extensive cavities in dentin[12]
Near Infra-red Light Transillumination (NILT) is a photo-optical method for caries detection and diagnosis in posterior teeth, and was first described in 199514. It is a development of the digital imaging fiber-optic transillumination method (DIFOTI) that uses visible light, and which in turn is an evolution of the FOTI method
It is advisable to conduct in vivo studies with a large sample size in order to determine whether the detection capacity of NILT is effectively comparable to that of radiography
Summary
6-score ordinal system registers caries from the initial changes in the enamel to extensive cavities in dentin[12]. It is advisable to conduct in vivo studies with a large sample size in order to determine whether the detection capacity of NILT is effectively comparable to that of radiography If this proves to be the case, approximal caries could be diagnosed and monitored without exposure to ionizing radiation – this being a clear advantage for patients. Many studies have focused on the diagnosis of occlusal caries[1,11,20,21,22], though few authors have addressed approximal caries[13,15,19,23,24] In this respect, the present report describes one of the largest series of patients in an in vivo prospective study assessing an NILT method for the detection of approximal dentinal caries, establishing comparisons with digital bitewing radiographs, and where the true lesion depth is assessed by opening the cavity. We postulated that NILT does not exhibit significant differences with respect to intraoral radiographs in detecting approximal caries with dentinal involvement
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