In-vitro validation of near-infrared reflection for proximal caries detection.

Alexander Lederer,Karl‐Heinz Kunzelmann,Friederike Litzenburger,Reinhard Hickel,Katrin Heck

doi:10.1111/eos.12663

Alexander Lederer, Karl‐Heinz Kunzelmann + Show 3 more

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https://doi.org/10.1111/eos.12663

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Abstract

The aim of this study was the in-vitro validation of VistaCam iX HD, which uses near-infrared reflection (NIRR), for proximal caries detection. It was compared with digital bitewing radiography (BWR), and micro-computed tomography (µCT) was used as the reference standard. One-hundred teeth with either sound (n=54) or carious (n=46) proximal surfaces were selected using visual-tactile criteria. Images of these surfaces were generated using BWR and NIRR. Evaluation was performed by two examiners, twice, at an interval of 2weeks. All samples were scanned with a micro-computed tomograph. Thresholds were defined for sound surfaces, and for enamel and dentin lesions, for all methods. Both BWR and NIRR showed moderate sensitivity for the detection of any caries (0.50 for NIRR and 0.53 for BWR). For enamel lesions, sensitivity was lower (0.13 for NIRR and 0.31 for BWR). Specificity was high (≥0.94) in all categories for both methods. Inter-rater reliability ranged from 0.89 to 0.93 and intra-rater reliability from 0.80 to 0.89. Surface evaluation of images generated using NIRR was complicated by overexposed areas; approximately 25% of the images were not clearly interpretable. In conclusion, NIRR and BWR were found to be reproducible methods with comparable diagnostic accuracy. However, NIRR cannot be recommended as a complementary diagnostic method for assessing proximal caries in permanent molars because of problems with image quality and artefacts.

Highlights

Concerning enamel lesions, sensitivity values were even lower, especially for near-infrared reflection (NIRR), while specificity was high for both methods
Three-quarters of the surfaces could be assessed unambiguously. This in-vitro study investigated the diagnostic performance of NIRR for detection of proximal carious lesions in relation to radiographic diagnostics and μCT
It is frustrating for dentists and patients that the two worldwide standard methods – visual inspection and radiological examination – do not permit reliable, early detection of carious enamel lesions, which may result in possible further preventive treatments not being exhausted and invasive therapy not being optimally prevented [22]

Summary

Introduction

LEDERER et al [10] have shown that NIR transillumination performs to, or even better than, digital radiography for proximal caries detection, as its sensitivity values for detection of enamel and dentin lesions were almost twice as high as those of BWR. Another diagnostic tool, which uses light of 850 nm wavelength, is the VistaCam iX HD with the Proxi interchangeable head (Du€rr Dental, Bietigheim-Bissingen, Germany). The null hypothesis of this study was that BWR and NIRR exhibit similar diagnostic performances

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