Abstract
ObjectivesThis in vitro study analysed potential of early proximal caries detection using 3D range data of teeth consisting of near-infrared reflection images at 850 nm (NIRR).Materials and methodsTwo hundred fifty healthy and carious permanent human teeth were arranged pairwise, examined with bitewing radiography (BWR) and NIRR and validated with micro-computed tomography. NIRR findings were evaluated from buccal, lingual and occlusal (trilateral) views according to yes/no decisions about presence of caries. Reliability assessments included kappa statistics and revealed high agreement for both methods. Statistical analysis included cross tabulation and calculation of sensitivity, specificity and AUC.ResultsUnderestimation of caries was 24.8% for NIRR and 26.4% for BWR. Overestimation was 10.4% for occlusal NIRR and 0% for BWR. Trilateral NIRR had overall accuracy of 64.8%, overestimation of 15.6% and underestimation of 19.6%. NIRR and BWR showed high specificity and low sensitivity for proximal caries detection.ConclusionsNIRR achieved diagnostic results comparable to BWR. Trilateral NIRR assessments overestimated presence of proximal caries, revealing stronger sensitivity for initial caries detection than BWR.Clinical relevanceNIRR provided valid complement to BWR as diagnostic instrument. Investigation from multiple angles did not substantially improve proximal caries detection with NIRR.
Highlights
The number of diagnostic methods available to dentists for caries detection has multiplied in recent years
Caries classification based on μCT imaging showed almost perfect agreement between the two investigators (linear wκ 0.99, confidence interval (CI): 0.97–1.00)
The unilateral NIRR imaging revealed an overall accuracy of 76.8%, an overestimation of 10.4% and an underestimation of 25.8%, while the trilateral assessment of NIRR resulted in an overall accuracy of 64.8%, an overestimation of 15.6% and an underestimation of 19.6%
Summary
The number of diagnostic methods available to dentists for caries detection has multiplied in recent years. In the context of new therapeutic approaches, high sensitivity for early caries detection is desirable, necessitating other diagnostic methods. Over the last three decades, numerous techniques have been developed and investigated to meet this challenge. Most techniques, such as quantitative light-induced fluorescence, laser fluorescence, electrical conductance, impedance spectroscopy and photothermal radiometry, are well suited for the assessment of smooth surfaces [7]. Lesions in the proximal region can be visualized by transillumination with visible light or optical coherent tomography (OCT), OCT devices are currently so expensive that there will be no system available for general dental practice under economic conditions in the foreseeable future. There are already commercially available devices for this method, e.g., VistaCam
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