Diagnosis Of Early Caries Research Articles

Preventive and remineralization agents in pediatric dentistry: review of the literature

Tooth decay, which is most common in childhood, especially in the 2-5 age group, is a health problem that should be addressed as a priority. It has been reported that the application of remineralizing agents to early stage caries reduces early material loss and stops the progression of caries. In studies conducted from the past to the present, various caries preventive agents have been investigated and utilized within the scope of preventive dentistry for the early diagnosis of caries and prevention of carious lesions.

Polarization-Sensitive Optical Coherence Tomography for Monitoring De- and Remineralization of Bovine Enamel In Vitro.

Early caries diagnosis still challenges dentistry. Polarization-sensitive optical coherence tomography (PS-OCT) is promising to detect initial lesions non-invasively in depth-resolved cross-sectional visualization. PS-OCT with determined degree of polarization (DOP) imaging provides an intuitive demineralization contrast. The aim of this study is to evaluate the suitability of DOP-based PS-OCT imaging to monitor controlled de- and remineralization progression for the first time and to introduce it as a valid, non-destructive in vitro detection method. Twelve standardized bovine enamel specimens were divided in different groups and demineralized with hydrochloric acid (HCl) as well as partly remineralized with fluoride over a 14-day pH-cycling experiment. The specimens were stored in artificial saliva and sodium chloride (NaCl), respectively. Progress measurements with PS-OCT were made with polarization-sensitive en faceand B-scan mode for qualitative evaluation. The specimens demineralized in HCl showed the most pronounced surface change (lowest DOP) and the most significant increase in depolarization. Additional fluoride treatment and the storage in artificial saliva resulted in the opposite (highest DOP). Therefore, DOP-based PS-OCT imaging appears to be a valuable technique for visualization and monitoring of enamel demineralization and remineralization processes in vitro. However, these findings need to be confirmed in human teeth ex vivo or in situ.

Accuracy of an intraoral scanner with near-infrared imaging feature in detection of interproximal caries of permanent teeth: An in vivo validation.

This study aimed to evaluate the accuracy of an intraoral scanner with near-infrared imaging (NIRI) feature in the diagnosis of interproximal caries and to compare it with the visual-tactile method (VTM), bitewing radiography (BWR), and panoramic radiography (PR). Six hundred thirty-nine interproximal surfaces (mesial-distal) of posterior teeth from 22 volunteers were examined. Results were scored by VTM, BWR, PR, and NIRI. Lesions were scored as 0 for no-caries, 1 for early-enamel lesion (EEL), and 2 for lesions involving dentino-enamel junction (DEJ). McNemar, Kappa, and Fleis Kappa tests were used to evaluate the agreement levels. Pearson's Chi-square test was used to determine the matching rates after validation. A good level of agreement was observed between examination methods (Ƙ = 0.613; p < 0.001). In pairwise comparisons, a moderate agreement was seen between all the methods for lesions with DEJ involvement, while a statistically good agreement was observed between BWR and NIRI (Ƙ = 0.675; p < 0.001). As a result of validation, the accuracy of NIRI for molars was considered 85.2% and 75.7% for premolars in EELs, 85.2% for molars, and 70% for premolars regarding the lesions involving DEJ. Intraoral scanners with the NIRI feature may be used for diagnosing interproximal caries, especially for permanent molars. Early detection of proximal caries is one of the most essential topics forming the basis of preventive dentistry. This study investigates a caries diagnostic tool integrated into intraoral scanners to diagnose interproximal caries. A caries diagnostic tool integrated into an intraoral scanner may prevent the harmful effects of ionizing radiation in early caries diagnosis and may improve the patient's oral health status.

Microcomputed Tomography Mineral Density Profile as Reference Standard for Early Carious Lesion Activity Assessment

Early caries diagnosis is crucial to treatment decisions in dentistry and requires identification of lesion activity: whether a carious lesion is active (progressively demineralizing) or arrested (progressively remineralizing). This study aimed to identify microtomographic (micro-CT) differences between active and arrested smooth surface enamel lesions, to quantify those micro-CT differences by creating thresholds for ex vivo caries activity assessment to serve as a future reference standard, and to validate those thresholds against the remaining sample. Extracted human permanent teeth (n = 59) were selected for sound surfaces and non-cavitated smooth surface carious lesions. Each surface was then examined for caries activity by calibrated individuals via visual-tactile examination using the International Caries Classification and Management System (ICCMS) activity criteria. Each tooth was scanned via micro-CT and the mineral density was plotted against lesion depth. The area under the curve (AUC) was calculated and represented the loss of density for the outermost 96 μm of enamel. AUC thresholds obtained from micro-CT were established to classify sound, remineralized, and demineralized surfaces against the gold standard examiner’s lesion assessment of sound, inactive, and active lesions, respectively. The established AUC thresholds demonstrated moderate agreement with the assessment in identifying demineralized lesions (k = 0.45), with high sensitivity (0.73) and specificity (0.77). This study demonstrated quantifiable differences among demineralized lesions, remineralized lesions, and sound surfaces, which contributes to the establishment of micro-CT as a reference standard for caries activity that may be used to improve clinical and laboratorial dental caries evaluations.

Comparison of early caries diagnosis methods

Relevance. The question of diagnosing tooth decay and, thus, determining treatment methods is still very topical. There is a large number of techniques available for the diagnosis of dental caries in modern dentistry.Objective. The study aimed to compare different caries diagnosis methods to determine the most effective carious lesion detection.Material and methods. We examined in total 45 subjects, 1248 permanent teeth and 5700 tooth surfaces. The dental examination included three diagnostic techniques for each patient: visual-tactile, ICDAS II and quantitative light-induced fluorescence (QLF). The data were processed and presented graphically using Statistica 12.0 (Stat-Soft) and Microsoft Office Excel 2017 software.Results. According to the DMFS index, in the visual-tactile group, the "D" (decayed) was 3.00 ± 0.02 and the "F" (filled) was 1.93 ± 0.02. Caries intensity in this study group was 6.27 ± 0.58. The ICDAS II examination detected the average caries intensity of 6.93 ± 0.56 (p1-2 &lt; 0.001). There were 3.47 ± 0.02 (p1-2 &lt; 0.001) carious lesions. The "F" score was 2.13 ± 0.01 (p1-2 = 0.024). The QLF diagnostic method showed 7.44 ± 0.54 (p1-3 &lt; 0.001, p2-3 = 0.006) as the mean intensity of caries in permanent teeth; there were 3.84 ± 0.02 (p1-3 &lt; 0.001, p2-3 = 0.015) carious lesions and the "F" was 2.27 ± 0.01 (p1-3 = 0.018, p2-3 = 0.520). The "M" score was 0.27 ± 0.01 (p1-2 = 0.999, p1-3 = 0.999, p2-3 = 0.999), according to all applied techniques.Conclusion. The QLF method had the highest sensitivity and was superior to the visual-tactile method and ICDAS II.

Machine learning-based automatic identification and diagnosis of dental caries and calculus using hyperspectral fluorescence imaging.

Precise diagnosis and identification of early dental caries facilitates timely intervention and reverses the progression of the disease. Developing an objective, accurate and rapid caries and calculus automatic identification method advances clinical application and facilitates the promotion and screening of oral health in the community and family. In this study, based on 122 dental surfaces labeled by professional dentists, hyperspectral fluorescence imaging combined with machine learning algorithms was employed to construct a model for simultaneously diagnosing dental caries and calculus. Model trained by fusion features based on spectra, textures, and colors with the integrated learning algorithm has better performance and stronger generalization capabilities. The experimental results showed that the diagnostic model's accuracy, sensitivity, and specificity for identifying four different caries stages and calculus were 98.6%, 98.4%, and 99.6%, respectively. The proposed method can evaluate the whole tooth surface at the pixel level and provides discrimination enhancement and a quantitative parameter, which is expected to be a new approach for early caries diagnosis.

STUDYING OF CHARACTERISTICS OF THE EMERGENCE OF CARIES IN THE FIRST PERMANENT MOLARS IN CHILDREN IN THE FIRST YEARS AFTER THEIR ERUPTION

The highest percentage of lesions among permanent teeth in childhood occurs on the first permanent molars.&#x0D; Objective of our research was to study the peculiarities of caries development in the first permanent molars in childhood, taking into account their odontoglyphics in the first years after eruption.&#x0D; Materials and methods. The type of pattern of the chewing surface of the teeth was determined according to the schemes of odontoglyphic variants of molars of the upper and lower jaws, proposed by A.P. Hasyuk and Skrypnikov P.M. (2001) of 540 first permanent molars in 155 children aged 6 without pathology.&#x0D; To study the frequency of caries lesions of the first permanent molars, depending on their odontoglyphics, 268 teeth were selected from the examined teeth, which had the most common types of chewing surfaces. The dynamics of the occurrence of fissures caries and the localization of carious foci were studied in these teeth during the 3-year study.&#x0D; Results and discussion. During the 1st year of observation, the increase in caries of the chewing surfaces of the lower molars was 8,36% of the surfaces, of the upper molars – 5,05% of the surfaces. A year later, caries in the blind pits of the vestibular surfaces were diagnosed in the lower molars, and the caries prevalence of these surfaces was 0,58 +- 0,41%. After three years of observation, the prevalence of caries of the chewing surfaces of the upper and lower molars, as well as the vestibular surfaces of the lower molars, increased significantly and amounted to 14,93 +- 2,18%, 23,58 +- 2,71%, and 8,54 +- 1,78%.&#x0D; It was found that shortly after the eruption of the first permanent molars, caries appeared in the pits of their chewing surfaces. With time (after 12-36 months), along with the pits, the furrows of the chewing surface were also affected by caries. But during the full observation period, the number of carious pits was probably higher than the number of affected furrows.&#x0D; Conclusions. The obtained data encourage childrens’ dentists not only to carry out preventive measures in the first permanent molars of children in the early period after their eruption, but also to carry out sanitary and educational work among parents about the need for regular preventive examinations of children with the aim of early diagnosis of caries in the first permanent molars.

Modern instrumental methods for early diagnosis of dental caries

An overview of the existing devices on the world market for detecting foci of demineralization and hidden carious cavities is presented, their capabilities and principle of operation are analyzed. Dental morbidity among the children's population in our country remains high, which is largely due to insufficient attention to the identification and registration of initial foci of enamel demineralization. The study made it possible to evaluate the effectiveness of existing hardware methods for early diagnosis of caries in children and adults.

Accurate identification and detection of occlusal/smooth early caries using thermal-wave radar imaging (TWRI) technique under low temperature rising condition

Dental caries is a worldwide disease, which will cause adverse effects if it is not treated in time. To accurate detect the early caries, a dental caries recognized approach based on infrared thermal diffusion, titled thermal-wave radar imaging (TWRI) technique was utilized to detect dental caries at an early stage in this present study. One-dimensional (1D) thermal-wave model under linear frequency modulation (or -chirp) thermal flux was built and analyzed the chirp thermal-wave diffusion behavior. In addition, simulated caries environment in vitro was designed and proposed for the treatment of artificial dental caries. Four intact tooth tissues were demineralized with this etching agent for different time on the dental occlusal surface. For the safety of the laser application in clinical trials, the relationship between laser power intensity and dental surface temperature rise has been investigated. When the laser power intensity was controlled within 23.3 W under the irradiation area is 2 mm × 2 mm, the surface temperature rise of dental specimen can be dominated within 5 °C. The comparison experiment between TWRI and lock-in thermography was investigated, and TWRI phase represents a high signal-to noise ratio to the early caries. μCT was utilized to 3D tomography for the dental specimen to obtain the actual caries inside the specimen. The experimental results illustrated that TWRI approach can be used as an effective method for early caries diagnosis.

Benefits of Using Fluorescence Induced Theragnosis in Fixed Orthodontic Therapy: Status, Technology and Future Trends

Dental biofilm is often found to be the source of bacteria that releases toxins, peptides, lipopolysaccharides as well as organic acids, which lead to gingival inflammation and tooth caries. Further, the persistent plaque may result in the continued destruction of the surrounding soft and hard tissues. During fixed orthodontic therapy, arch-wires, brackets, and elastic modules have been shown to be sites of significant plaque accumulation, making it difficult for a patient to maintain proper oral hygiene. The problem most dentists face is that they cannot visualize this biofilm completely to be able to carry out efficient plaque removal. Visual assessment is, to date, the most common method for plaque visualization, and various indexes have been demonstrated to be sufficient for quantification of the amount of plaque present. However, the problem is that visual assessments are inconsistent, operator dependent and often subjective, which can lead to inconsistency in results. Fluorescence is one such method that can be explored for its use in effective plaque identification and removal. Literature has it that dentists and patients find it particularly useful for monitoring oral hygiene status during treatment. Fluorescence has the capability of offering clinical orthodontists and researchers a new method of detection of demineralization during orthodontic treatment, furthermore, for efficient removal of orthodontic adhesive cements, fluorescent light may be used in conjunction with high-speed burs to deliver fast, less time consuming, and safer results. The benefit of direct visual treatment using fluorescence enhanced theragnosis is that the patient receives controlled and guided therapy. It has multiple benefits, such as early diagnosis of caries, biofilm identification, and even helps to achieve improved treatment outcomes by better resin selection for esthetic procedures.

Detection Methods for Early Caries Diagnosis: A Systematic Review and Meta-Analysis

The aim was to appraise the evidence on the performance of various means for the detection of incipient caries in vivo. Five databases of published and unpublished research were searched for studies from January 2000 to October 2019. Search terms included “early caries” and “caries detection.” Inclusion criteria involved diagnostic test accuracy studies for early caries detection in permanent and primary teeth. A risk-of-bias assessment was performed using the QUADAS-2 tool. We performed the study selection, data extraction, and risk-of-bias assessment in duplicate. The review protocol was a priori registered in the Open Science Framework. Of the initially 22,964 search results, 51 articles were included. For permanent teeth, when histologic examination was considered as the reference for occlusal surfaces, the sensitivity (Se) range appeared high for the DIAGNOdent Pen (DD Pen) at 0.81–0.89, followed by ICDAS-II at 0.62–1, DIAGNOdent (DD) at 0.48–1, and bitewing radiography (BW) at 0–0.29. The corresponding specificity (Sp) range was: DD Pen 0.71–0.8, ICDAS-II 0.5–0.84, DD 0.54–1, and BW 0.96–1. When operative intervention served as the reference for occlusal surfaces, again, the DD means valued the most promising results on Se: DD 0.7–0.96 and DD Pen 0.55–0.90, followed by ICDAS-II 0.25–0.93, and BW 0–0.83. The Sp range was: DD 0.54–1, DD Pen 0.71–1, ICDAS-II 0.44–1, and BW 0.6–1. For approximal surfaces, the Se was: BW 0.75–0.83, DD Pen 0.6, and ICDAS-II 0.54; the Sp was: BW 0.6–0.9, DD Pen 0.2, and ICDAS-II 1. For primary teeth, under the reference of histologic assessment, the Se range for occlusal surfaces was: DD 0.55–1, DD Pen 0.63–1, ICDAS-II 0.42–1, and BW 0.31–0.96; the respective Sp was: DD 0.5–1, DD Pen 0.44–1, ICDAS-II 0.61–1, and BW 0.79–0.98. For approximal surfaces, the Se range was: DD Pen 0.58–0.63, ICDAS-II 0.42–0.55, and BW 0.14–0.71. The corresponding Sp range was: DD Pen 0.85–0.87, ICDAS-II 0.73–0.93, and BW 0.79–0.98. Se and Sp values varied, due to the heterogeneity regarding the setting of individual studies. Evidently, robust conclusions cannot be drawn, and different diagnostic means should be used as adjuncts to clinical examination. In permanent teeth, visual examination may be enhanced by DD on occlusal surfaces and BW on approximal surfaces. In primary teeth, DD Pen may serve as a supplementary tool across all surfaces.

Imaging modalities to inform the detection and diagnosis of early caries.

Imaging modalities to inform the detection and diagnosis of early caries.

Research and application of new techniques for early diagnosis of caries

The present review paper summarizes the available technical methods for early detection and diagnosis of dental caries lesions, as well as their clinical application range, advantages and disadvantages. Although there are many detection systems supported by new technologies and equipments in clinical practice, current evidence suggests that careful clinical visual and inspection tests, in combination with imagological examination, are still the gold standard for the detection and diagnosis of dental caries.

Assessment of 2D:4D ratio for the early diagnosis of caries and malocclusion in 7-15-year-old children

Background: The ratio between 2nd and 4th digit length is termed as hormonal fingerprintand is used as an indirect marker in many medical diseases.Dental studies pertaining to theimportance of hormonal fingerprint on oral health are very sparse.&#x0D; Aim and objectives: Tostudy the correlation of dental caries and malocclusion with hormonal fingerprints.&#x0D; Materialsand Methods: A total of 100 children of age group 7-15 years and both genders were randomlyselected and included in the present study. The hormonal fingerprint (2D:4D ratio) wasdone bymeasuring the length ratio of the index and ring finger with the help of digital vernier caliper.Caries assessment wascarried out using standard mouth mirrors and Community PeriodontalIndex probes. WHO assessment form (1997) was followed for assessment of dentitionstatus and treatment need.Occlusal characteristics evaluated were molar relation, anteriorand posterior crossbite, open bite, deep bite and lower anterior crowding. The subjects weredivided into high 2D:4D, equal 2D:4D digit ratio and low 2D:4D. All the measurements weredone by two investigators. The data collected were tabulated and statistically analyzed usingChi-square and ANOVA test.&#x0D; Results: Out of 100 children, 34% were males and 66% werefemales. Most of the participants were 7-8 years old (12 males and 15 females). Majority of theparticipants (87% for the right hand and 80% for left hand) had low 2D:4D ratio, only 6% forright and 11% for the left hand had high 2D:4D ratio and the remaining had equal 2D:4D ratio.Statistically insignificantcorrelation between 2D:4D ratio and deft/DMFT score and occlusalstatus of an individualwere found.&#x0D; Conclusion:The insignificant results of 2D:4D ratio with allthe parameters assessed validates that hormonal fingerprints could not be employed as an earlypredictor of caries and malocclusion in an individual.&#x0D; Bangladesh Journal of Medical Science Vol.20(1) 2021 p.154-158

Диагностика кариеса постоянных зубов у детей школьного возраста

Relevance. Early diagnosis of caries of permanent teeth is most effective from the moment of their eruption, as it allows to identify the initial forms of caries. Preventive measures during this period are important because they can prevent the transfer of enamel demineralization to carious defects that already require preparation and filling. Purpose. To increase the effectiveness of methods for early diagnosis of dental caries in children.

Fluorescent diagnostics using aluminum phthalocyanine nanoparticles as a detection method for enamel microcracks

Early diagnosis of caries and enamel microcracks is of great importance for the prevention of the destruction of healthy tooth enamel. It was reported that aluminum phthalocyanine in the form of nanoparticles (nAlPc) can be used for fluorescent diagnostics of tooth enamel microcracks.A model compound with the nAlPc colloid and Protelan MST-35 were prepared for the development of the method of laser-induced fluorescent diagnostics (FD). Two groups of human teeth were used to research the interaction between the nAlPc colloid and the model compound for the detection of microcracks and the areas of accumulation of pathogenic microflora on the enamel surface. A Student’s two-sample unequal variances t-test was used to check whether the means of the coefficient of diagnostics contrast (kdc) between two groups of samples was significantly different. Experimental studies were conducted using a laser electronic spectro-analyser and a fluorescence video imaging system.The results of the studies of the nAlPc colloid interaction with the surface enamel of the tooth enamel ex vivo in the first group showed that in 3 min a low-intensity nAlPc fluorescence was observed. This was due to a slight activation of the surface molecules of nAlPc by a pathogenic microflora. Measurements of the interaction of the model compound (nAlPc colloid with the Protelan MST-35 and supplementary components) with the tooth enamel has shown that the high-intensity AlPc molecule fluorescence appears in the enamel microcracks 3 min after application. The high intensity of the fluorescence is accounted for by a preliminary activation of nAlPc by the surfactant as they meet pathogenic microflora. Statistical analysis of the results revealed a statistically significant difference between the kdc of the studied groups (α = 0.05).It has been concluded that the developed method of laser-induced FD of tooth enamel makes it possible to detect the hidden microcracks on the enamel surface and the hidden accumulation areas of the pathogenic microflora using the model compound.

Aluminum phthalocyanine nanoparticles activation for local fluorescence spectroscopy in dentistry

Early diagnosis of caries and tooth enamel microcracks is of great importance for preventing the destruction of healthy tooth enamel. Inorder to detect microcracks in the enamel and pathogenic microflora foci that can cause caries, nanoform of aluminum phthalocyanine (AlPc) can be used as a marker. In a colloidal solution, the nanoparticles do not fluoresce, unlike their molecular form. To convert the particle into its molecular form, it is necessary to have a solvent or specific environment (bacteria, macrophages, etc.). That is why the hydrophobic nanoparticles of aluminum phthalocyanine (nAlPc) can act as markers for detecting hidden pathogenic microflora during fluorescent diagnostics. Further reduction of the diagnosis time and increase the efficiency can be achieved by using biologically compatible surfactants as additional activators of nAlPc.In order to carry out local fluorescence spectroscopy of enamel microcracks and pathogenic microflora foci on the enamel surface, a model compound containing surfactants, auxiliary components and nAlPc colloid at a concentration of 10 mg/l was prepared.Studies on the interaction of the model compound with nAlPc and Protelan MST-35 with tooth enamel ex vivo have shown this surfactant to be a promising auxiliary activator of the nanoparticles, allowing conducting local fluorescence spectroscopy of the tooth enamel surface 3 min after application. In addition, statistical processing of the results showed the effectiveness of using the model compound for local fluorescence spectroscopy of the enamel surface in order to detect the enamel microcracks and the pathogenic microflora accumulation foci that can lead to the development of a cariogenic process.

Determining Caries Activity Using Oratest Among 12-to 15-year-old Children.

Dental caries is the primary pathological cause of early tooth loss in children, which may lead to malnutrition and other health problems. Identification of patients with active carious lesions and at high risk for caries can help to dramatically decrease the disease prevalence. Thus, recognising the importance of early diagnosis of caries, the present study was carried out to correlate caries with oral microflora using Oratest among 12- to 15-year-old schoolchildren. A total of 100 children were divided into control and test groups (n = 50) according to their DMFT scores. The test group was further divided into subgroup 1 (DMFT = 1-3) and subgroup 2 (DMFT > 3). Oratest, a caries activity test, was performed on all the children. Comparison among the variables was done using ANOVA and the independent sample t-test. Boys had lower DMFT values (1.35 ± 0.2) than did girls (1.67 ± 0.2) (p = 0.38), and the Oratest time was higher among boys (132.8 ± 0.5 min) than girls (126.4 ± 0.5 min) (p = 0.53). The control group had the highest mean Oratest time (172.7 ± 0.3 min), followed by subgroup 1 (97.8 ± 0.2 min), and subgroup 2 had the lowest Oratest time (68.5 ± 14.8 min). A statistically significant negative correlation (r = -0.893) was found between the mean DMFT and the Oratest time (p < 0.001), ie, they were inversely related to each other. An inverse relationship exists between Oratest and DMFT score.

Knowledge, attitude and skills of dental practitioners of Puducherry on minimally invasive dentistry concepts: A questionnaire survey.

Background:Minimally invasive dentistry (MID) encompasses early caries diagnosis through caries risk assessment (CRA), early detection of incipient carious lesion including primary and secondary prevention based on scientific evidence that remineralization of demineralized enamel and dentin is possible if detected early. Although the dental curriculum focuses on the advantages of MID in tooth preservation, this science is not usually translated into practice.Aim:This study aimed to evaluate the knowledge, attitude, and skills of dental practitioners of Puducherry regarding the concepts of MID.Subjects and Methods:Data were collected through an online survey questionnaire based on awareness and practice of MID. Statistical evaluation was done on SPSS by Chi-square test.Results:A total of 126 dentists responded of which only 55% were trained in MID during their undergraduate and internship period, mainly through lectures (49.6%). Nearly 81% agreed that CRA should be conducted for all patients. Almost 42.7% had heard about International Caries Detection and Assessment System, but only 25.9% used a blunt explorer for caries detection. About 13.7% use magnification (loupes/microscope), but majority (84.7%) use radiographs. More than 70% were unaware of newer methods of caries detection. Statistically significant differences were found (P < 0.05) regarding qualification and experience about the effectiveness of Atraumatic Restorative Treatment and sandwich technique for treatment of caries in permanent teeth and high caries-risk children.Conclusion:Although there is knowledge about advantages of MID among dentists of Puducherry, it does not benefit patients, as many practitioners still follow the traditional principles of total caries removal.

Effectiveness of near-infrared transillumination in early caries diagnosis

ABSTRACTEarly caries detection is essential for minimal intervention dentistry, since it could give the opportunity to reverse the process and eliminate or at least postpone the surgical treatment. The aim of the present study was to evaluate the effectiveness of near-infrared transillumination in early caries diagnosis for both occlusal and proximal lesions. Thirty-eight adult patients were included in the study. The results from the visual, radiological and near-infrared transillumination examination for proximal caries lesions were compared. The diagnostic abilities of these methods for occlusal lesions were assayed on 60 teeth. The three methods showed a very high level of correlation when there were caries lesions involving the enamel and dentin. Concerning proximal caries involving only the enamel, the visual--tactile diagnosis proved to be insufficiently sensitive even with the use of magnification. Radiographic examination and near-infrared transillumination correlated significantly, but the latter was more sensitive. Radiographic examination proved to be insufficiently sensitive for occlusal lesions. The results obtained with the near-infrared fluorescence correlated most with the visual–tactile examination. These results suggest that near-infrared transillumination is an effective method for diagnosis of lesions both involving only the enamel and involving the enamel and dentin. It could be used for both occlusal and proximal caries lesions and it could eventually substitute radiographic bitewings, especially in children and pregnant women, due to its efficiency as a diagnostic tool and the absence of radiation.