Fibre-optic Transillumination Research Articles

Assessment of dental caries severity in patients with VDR and СА12 polymorphisms

Background: There has been insufficient research into the genetic predisposition to dental caries. Research on the effect of gene polymorphisms on the incidence of dental diseases and the use of these findings in personalized prevention strategies are of high prognostic value. Aim: To assess the effect of VDR and СА12 polymorphisms on hard tooth tissues in young patients. Materials and Methods: The study examined 100 individuals, of which 59 (25 males and 34 females aged 23 to 25 years) were divided into groups based on the homozygous polymorphism: group 1 — VDR (n=19); group 2 — СА12 (n=32); and group 3 — combined VDR and CA12 (n=8). The DMF index was calculated in each group by fibreoptic transillumination method. Moreover, the pH of mixed saliva and serum 25(OH)D level (ng/mL) were measured. Results: In group 1, the DMF index was 15.11±0.15, with 25(ОН)D deficiency (17.4±0.7 ng/mL). In group 2, the DMF index was 16.99±1.43, with changes in the pH of saliva (6.80±0.01). In group 3, the DMF index was 17.92±1.37, with рН 6.30±0.11 and 25(ОН)D level of 13.7±0.4 ng/mL. Conclusion: Patients with VDR and СА12 polymorphisms had severe dental caries, acidic pH, and a deficiency of serum vitamin В metabolite.

Near-infrared light transillumination (NIR-LT) vs clinical-visual inspection/FOTI to detect interproximal caries lesions in vivo.

To evaluate the ability of near-infrared light transillumination (NIR-LT) to detect interproximal enamel and dentinal caries lesions compared to clinical-visual inspection (VI) aided by fibre-optic transillumination (FOTI). From 170 Finnish adolescents aged 15-17 years, 5294 interproximal surfaces of premolars and molars were examined first clinical-visually aided by FOTI (VI&#43;FOTI) using the International Caries Detection and Assessment System (ICDAS) classification. Subsequently, the surfaces were examined using NIR-LT. The extent of lesions was determined using the modified NIR-LT classification based on the Söchtig criteria. For the analyses, data on upper and lower premolars and molars were combined. Distributions of lesions were presented as frequencies. Differences between VI&#43;FOTI and NIR-LT at the tooth and tooth surface levels were analysed by Chi-square and Fisher's exact tests. Sensitivity and specificity of the NIR-LT method to detect any lesion was performed using VI&#43;FOTI as the gold standard. By VI&#43;FOTI, 92.4% surfaces were classified as sound and by NIR-LT, 88.2%. Enamel caries lesions were found on 7.0% of the surfaces by VI&#43;FOTI and on 11.6% by NIR-LT. Enamel lesions identified by NIR-LT were nearly double for all examined teeth groups, except for lower molars it was 1.3-fold. In 66% of the surfaces, the differences between NIR-LT and VI&#43;FOTI findings were statistically significant (p<0.001). The sensitivity for all teeth of NIR-LT was 48.4% and the specificity was 91.1%. Radiation-free NIR-LT method shows considerable potential as a supplementary method for early detection of caries lesions among low caries prevalence adolescents.

Effect of resin composite shade on digital fiber-optic transillumination imaging in vitro.

Digital imaging fiber-optic transillumination (DIFOTI) devices have been used to detect caries, a technique without using X-rays. However, the effects of resin composites (RCs) shades on the images acquired with DIFOTI devices have not been investigated. Thus, this study aimed to elucidate the influence of RC shade on the images obtained with DIFOTI technique. Three shades (A1, A3, and Opaque) for each of four flowable RCs were filled on a cavity prepared in a left mandibular first premolar obtained from a donated body. Then, transmission images with a DIFOTI device (DIAGNOcam; KaVo, Biberach, Germany) were acquired, and the average lightness values of the images in the RC and enamel were used to calculate differences between those areas. To clarify the influence of the optical translucency and color on DIFOTI images, the color parameters (L*, a* and b*) of each RC were obtained with black and white backgrounds. The color differences between the backgrounds were calculated as transparency parameter (TP) values. The number of repetitions was set to 10. Differences in the lightness value of the shades varied in each RC. The difference in lightness was significantly associated with the TP value and color parameters of L* (p < 0.01), with negative (R = -0.81) and positive (R = 0.84) correlations, respectively. In conclusion, DIFOTI images of RCs with high optical translucency resembled those of the natural tooth structure.

Three Visual-Diagnostic Methods for the Detection of Enamel Cracks: An In Vitro Study.

Tooth fractures are a common cause of tooth loss, frequently starting as enamel cracks. However, methods for the detection of enamel cracks are poorly investigated. The aim of the study was the validation of three clinical methods for the detection of enamel cracks: dental operating microscope (DOM), near-infrared transillumination (NIR), and fiber-optic transillumination (FOTI), with hard-tissue slices serving as controls. A total of 89 extracted teeth, set up as diagnostic models, were investigated, and the maximum crack depth was scored by two examiners. The actual crack depth was determined microscopically (25×) using horizontal sections. The accuracy of each method was analyzed using receiver operating characteristic (ROC) curves. Across all tooth surfaces, the area under the curve (AUC) amounted to 0.57 (DOM), 0.70 (FOTI), and 0.67 (NIR). For crack detection on vestibular/oral surfaces, the AUC was 0.61 (DOM), 0.78 (FOTI), and 0.74 (NIR); for proximal surfaces, it was 0.59 (DOM), 0.65 (FOTI), and 0.67 (NIR). However, the actual crack depth was underestimated with each method (p < 0.001). Under in vitro conditions, FOTI and NIR are suitable for detection of enamel cracks, especially on vestibular and oral tooth surfaces. However, an exact estimation of crack depth is not possible. Therefore, FOTI and NIR seem to be helpful for the clinical detection of enamel cracks.

Chapter 7: Technological Aids and Coronal Caries.

In recent decades, dentistry has developed significantly in all areas. While in the past, caries was mainly treated operatively, the today's management has shifted toward noninvasive, minimal invasive, and, only if needed, invasive treatment options. Aiming at enabling the most noninvasive or conservative treatment option requires early caries detection, which, however, remains challenging. The progression of early or noncavitated caries lesions can nowadays be successfully controlled, as well as lesions arrested by oral hygiene procedures combined with the use of fluorides, sealants, or resin infiltration. Methods such as near-infrared light transillumination, fibre-optic transillumination, digital fibre-optic transillumination, laser fluorescence, or quantitative light fluorescence measurements were introduced in the dental market to provide X-ray-free caries detection, assessment, and monitoring. For approximal surfaces that are not directly visible, bitewing radiography is still the standard in detecting caries lesions. The use of artificial intelligence has become the most recent technological aid for the detection of caries lesions on bitewing radiographs and clinical images and has to be understood as an emerging technology, which requires extensive research in the future. The aim of this chapter is to give an overview of different possibilities to detect coronal caries lesions and suggestions of how to improve this process.

Diagnostic reliability of the Digital Imaging Fiber Optic Transillumination: a review

Diagnostic reliability of the Digital Imaging Fiber Optic Transillumination: a review

The Use of Fiber-optic Transillumination in the Diagnosis of Fracture Line in Teeth: A Method of Standardization in Fracture Strength Studies.

Chanchala HP, Godhi BS, Saha S. The Use of Fiber-optic Transillumination in the Diagnosis of Fracture Line in Teeth: A Method of Standardization in Fracture Strength Studies. Int J Clin Pediatr Dent 2022;15(4):475-477.

Clinical Analysis of the Diagnostic Accuracy and Time of Execution of a Transillumination Caries Detection Method Compared to Bitewing Radiographs.

Purposes: this clinical study evaluated the accuracy and execution time of a digital imaging fiber-optic transillumination (DIFOTI) technique for the detection of approximal caries in posterior teeth compared to intra-oral examination associated with bitewing radiographs. Methods: one hundred patients were selected and submitted to clinical inspection and bitewing radiographs. The outcomes of this process were converted into scores, according to the International Caries Detection and Assessment System (ICDAS): 0—sound tooth; 1, 2, and 3—carious lesion confined within enamel; 4, 5, and 6—dentin carious lesion. Subsequently, an independent investigator acquired digital images of the same teeth using a DIFOTI device (DIAGNOcam, Kavo Dental), which were also converted into ICDAS scores. The time required for executing diagnostic procedures was measured. The clinical sensitivity and specificity of DIFOTI were analyzed by receiver operating characteristic (ROC) curves. The time necessary to perform the diagnostic methods was evaluated by Mann–Whitney U (alfa = 0.05). Results: the overall test accuracy for the DIFOTI-based device ranged from 0.717 to 0.815 (area under the ROC curve) with p < 0.0001 for all ICDAS scores. Bitewing radiographs took almost twice the time required by DIFOTI (p < 0.001). Conclusions: the DIFOTI-based device DIAGNOcam provided accurate detection of approximal caries in posterior teeth, even at early stages. The technique employed for transillumination caries diagnosis by the same device took less time than conventional bitewing radiographs. Clinical Relevance: transillumination devices, such as DIAGNOcam, can be accurately used for caries diagnosis in approximal surfaces of posterior teeth, demanding less clinical time and without radiation-related risks.

Current Novel Caries Diagnostic Technologies: Restorative Dentists' Attitude and Use Preferences.

Early detection of caries lesions is key to a successful restorative dental treatment plan. The aim of this study was to investigate the preferences and attitude of graduate restorative dentistry residents (RDRs) regarding novel caries diagnostic technologies (NCDT) and to provide a brief overview of available technologies for both specialized and general dental practice. This cross-sectional study used an online questionnaire (17 questions) concerning RDRs’ attitude, preferences, and insights regarding five available NCDTs. It was distributed among twenty RDRs at a local government dental school following a review session about NCDTs. Collected responses were analyzed statistically using one-way analysis of variance (ANOVA), chi-squared with Bonferroni correction, and Kruskal-Wallis tests at a 0.05 significance level. Sixty-five percent of RDRs reported an interest in NCDTs as a discussion topic and almost half of them were positive towards their use, however, sixty percent of respondents were hesitant to diagnose caries solely using NCDTs. Fiber-optic-transillumination (FOTI) systems were ranked the best overall and with regard to all the investigated criteria (p < 0.05). Chosen reasons for FOTI included price followed by ease of use. In general, high price rated as the most perceived reason for not choosing a given NCDT followed by low practical applicability. Meanwhile, ease of use followed by relevant application ranked as the main reported reasons to choose an NCDTs.

Shining a light on caries: evaluating the evidence for diagnostic test accuracy of different illumination tests for the detection and diagnosis of enamel caries

Dental caries is a highly prevalent disease which dental practitioners face daily. One of the key aspects of managing this disease when prevention has failed is diagnosis and being able to spot the caries; traditional methods include visual examination and probing for soft tissue. Three modern technologies: optical coherence tomography (OCT), fibre-optic transillumination (FOTI) and near-infrared transillumination (NIR), have been developed and sold by manufacturers to practitioners to aid the process of caries detection, but just how good are these technologies and are they accurate enough to be used in clinical practice? This article summarises the latest research on each of the methods, determines the positives and negatives of each instrument and determines the ability for them to detect caries. The key findings were that NIR has a similar ability to detect caries to bitewing X-rays and could be considered as an alternative to radiographs; FOTI is better for elimination of healthy teeth rather than detecting teeth with caries; and OCT is most sensitive but is not readily available for general practice and can have problems with penetration depth. In summary, all three technologies should be used to supplement traditional methods and not be stand-alone methods of caries detection. The most accessible and useful device currently seems to be NIR but all the devices have different applications outside of caries detection which need to be researched further so that clinicians can best choose which devices they want to use and for which applications.

Diagnosis and Management Approaches for Non-cavitated Carious Dental Lesions- A Narrative Review

Background: Dental caries is one of the most prevalent diseases. Its detection and management should start with a comprehensive treatment plan, with the goals of the elimination of cariogenic bacteria, the reduction of plaque acidogenicity, the encouragement of tooth remineralization, and the repair of damaged teeth. Objectives: The aim of this paper was to review the literature regarding the latest updates on the diagnosis and management approaches of non-cavitated carious dental lesions. Methods: Studies regarding the diagnosis and management of non-cavitated carious dental lesions were included. Results: The subclinical non-cavitated carious lesion might progress to an early enamel lesion, develop into an established dentin lesion, or sometimes end up with a lesion reaching the pulp. The detection and management of caries should be patient-centered, risk-based, and evidence-supported, and should consider the dentists’ expertise and the patients’ needs and preferences. The visual-tactile and radiographic detection of non-cavitated carious lesions are greatly helped by the advances of non-invasive detection tools such as DIAGNOdent, fiber-optic transillumination, quantitative light-induced fluorescence, and DIAGNOcam. Conclusion: Accordingly, non-cavitated carious lesions can be arrested by several non-invasive techniques, which are preferred over the invasive options. The clinicians can use sealants plus fluoride varnish on occlusal surfaces, fluoride varnish or resin infiltration on proximal surfaces, and resin infiltration,fluoride gel, or varnish alone on facial or lingual surfaces to manage non-cavitated carious lesions.

Diagnostic efficacy of light-induced fluorescence method and digital fiber-optic transillumination in the assessment of early caries in children

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Prudel-Babiuch M, Postek-Stefańska L, Babiuch J. Diagnostic efficacy of light-induced fluorescence method and digital fiber-optic transillumination in the assessment of early caries in children. Journal of Stomatology. 2021;74(2):101-109. doi:10.5114/jos.2021.106499. APA Prudel-Babiuch, M., Postek-Stefańska, L., & Babiuch, J. (2021). Diagnostic efficacy of light-induced fluorescence method and digital fiber-optic transillumination in the assessment of early caries in children. Journal of Stomatology, 74(2), 101-109. https://doi.org/10.5114/jos.2021.106499 Chicago Prudel-Babiuch, Magdalena, Lidia Postek-Stefańska, and Jarosław Babiuch. 2021. "Diagnostic efficacy of light-induced fluorescence method and digital fiber-optic transillumination in the assessment of early caries in children". Journal of Stomatology 74 (2): 101-109. doi:10.5114/jos.2021.106499. Harvard Prudel-Babiuch, M., Postek-Stefańska, L., and Babiuch, J. (2021). Diagnostic efficacy of light-induced fluorescence method and digital fiber-optic transillumination in the assessment of early caries in children. Journal of Stomatology, 74(2), pp.101-109. https://doi.org/10.5114/jos.2021.106499 MLA Prudel-Babiuch, Magdalena et al. "Diagnostic efficacy of light-induced fluorescence method and digital fiber-optic transillumination in the assessment of early caries in children." Journal of Stomatology, vol. 74, no. 2, 2021, pp. 101-109. doi:10.5114/jos.2021.106499. Vancouver Prudel-Babiuch M, Postek-Stefańska L, Babiuch J. Diagnostic efficacy of light-induced fluorescence method and digital fiber-optic transillumination in the assessment of early caries in children. Journal of Stomatology. 2021;74(2):101-109. doi:10.5114/jos.2021.106499.

An Intraoral OCT Probe to Enhanced Detection of Approximal Carious Lesions and Assessment of Restorations.

Caries, the world’s most common chronic disease, remains a major cause of invasive restorative dental treatment. To take advantage of the diagnostic potential of optical coherence tomography (OCT) in contemporary dental prevention and treatment, an intraorally applicable spectral-domain OCT probe has been developed based on an OCT hand-held scanner equipped with a rigid 90°-optics endoscope. The probe was verified in vitro. In vivo, all tooth surfaces could be imaged with the OCT probe, except the vestibular surfaces of third molars and the proximal surface sections of molars within a "blind spot" at a distance greater than 2.5 mm from the tooth surface. Proximal surfaces of 64 posterior teeth of four volunteers were assessed by intraoral OCT, visual-tactile inspection, bitewing radiography and fiber-optic transillumination. The agreement in detecting healthy and carious surfaces varied greatly between OCT and established methods (18.2–94.7%), whereby the established methods could always be supplemented by OCT. Direct and indirect composite and ceramic restorations with inherent imperfections and failures of the tooth-restoration bond were imaged and qualitatively evaluated. The intraoral OCT probe proved to be a powerful technological approach for the non-invasive imaging of healthy and carious hard tooth tissues and gingiva as well as tooth-colored restorations.

Diagonosis of dental caries: A conventional and current perspective

The diagnosis of dental caries is a basic skill a dentist must know but it remains difficult to master especiallyin early stages. Caries diagnosis may be done by visual method, tactile method, raidiography, cariesdetecting dyes, fiberoptic transillumination method, electronic caries monitor etc. dental caries diagnosisprimarily done by detection of white spot, discolouration frank cavitations and making use of explorersto feel the catch. Since a long time, Bitewings are most widely used for assessing caries radiographically.Fiber optic transillumination (FOTI) and digital imaging fiber optic transillumination (DIFOTI) makes useof visible light for caries detection. Quantitative Light-Induced Fluorescence (QLF) is based on property ofnatural fluorescence shown by tooth enamel. Electrical conductance technology makes use of the fact thatthere is a differential conductivity between sounds versus demineralized tooth enamel due to changes inporosity, as saliva soaks into the pores of the demineralized enamel and increases the electrical conductivityof the tooth. Alternating current impedance spectroscopy (Carie Scan) uses multiple electrical frequenciesto detect occlusal and smooth surface caries. CAD and PTR/LUM are newer trends being worked upon inthe field of dental caries diagnostics

Diagnostic Validity of Digital Imaging Fiber-Optic Transillumination (DIFOTI) and Near-Infrared Light Transillumination (NILT) for Caries in Dentine.

The objective of the study is to analyse the available evidence for the validity of the transillumination method in the diagnosis of interproximal caries. Bibliographic searches were carried out in three data bases (PubMed, Embase, Scopus) with the key words “Transillumination AND caries”. A total of 11 studies were selected for the qualitative analysis and meta-analysis. In the qualitative analysis, both in vivo and in vitro studies were included. The gold standards were tomography, digital radiography, and clinical visual diagnosis. The meta-analysis determined the sensitivity, specificity, and area below the ROC curve relative to the transillumination method in the diagnosis of caries in dentine. Meta-analysis results obtained for transillumination gave a sensitivity value of 0.69 (confidence interval: 0.54–0.81), a specificity value of 0.89 (confidence interval: 0.61–0.98), while giving an AUC value of 0.79 (confidence interval: 0.67–0.87). Transillumination is a method offering moderate validity in the diagnosis of carious lesions in dentine, there is no strong evidence that may enable us to affirm that transillumination may fully substitute X-rays in the complementary diagnosis of carious lesions

Effect of resin composite filler on digital imaging fiber-optic transillumination.

Using a trans-illumination device that applies digital imaging fiber-optic transillumination (DIFOTI) technology, which involves the use of transmitted near-infrared laser light for inspection, the effect of composite resin (CR) restoration of a tooth on caries detection was evaluated. A cavity was formed in a tooth of the lower jaw cut from the specimen, experimental CRs with various filler rates were filled, and the influence of the filler on the obtained image was investigated. On the near-infrared images, the lightness differences between the CR-restored portion and the tooth portion were measured. The translucency parameter (TP) value and the correlation between the lightness differences and TP value of the CRs were investigated. The experimental results showed that the greater rate of macro-filler is, the lighter image and larger TP value. In other words, CR with hybrid filler to increase the TP value is less likely to affect caries detection by DIFOTI.

Assessment of the Depth of Clinically Detected Approximal Caries Lesions Using Digital Imaging Fiber-Optic Transillumination in Comparison to Periapical Radiographs.

ABSTRACTObjectivesThe aim of present prospective clinical trial was to assess the depth of clinically detected approximal caries lesions using digital imaging fiber-optic transillumination in comparison to periapical radiographs.Material and MethodsOne calibrated examiner diagnosed 31 approximal carious lesions in 10 patients with a mean age of 21.8 (SD 1.1) years. The lesions were assessed using digital imaging fiber-optic transillumination (DIFOTI) and digital periapical radiographs (PA). Depending on the depth of the lesions, scores for demineralisation in PA (R) and DIFOTI (F) images were given by two examiners: R0/F0 - no demineralisation, R1/F1 - demineralisation confined to the outer half of the enamel, R2/F2 - into the inner half of the enamel, 3/3 - along the amelodentinal junction, R3/F3 - into the outer half of dentine, R4/F4 - into the inner part of the dentine. Spearman’s rank correlation coefficient and kappa were calculated.ResultsSpearman’s rank correlation coefficient between DIFOTI and PA was 0.031 (P > 0.05), kappa was 0.077. In 26% of the cases, DIFOTI showed higher scores of demineralisation, relative to PA. In 36% of the cases, PA showed higher scores of demineralisation than DIFOTI. PA showed demineralisation into the outer and inner half of the dentine in 89% of the cases with underlying shadow and in 70% of the cases with opacities.ConclusionsDigital imaging fibre optic transillumination and periapical radiographs produce evaluations of the depth of approximal caries lesions that do not match.

Caries Diagnosis in Dental Practices: Results From Dentists in a Brazilian Community.

The aim of this study was to assess practices related to diagnosis of dental caries among dentists (n=217) from Araraquara, São Paulo State, Brazil. Data on sociodemographic information and practitioner characteristics were collected using a pretested questionnaire, and data on practices related to caries diagnosis were gathered by using a translated and culturally adapted questionnaire from the US National Dental Practice-Based Research Network. Descriptive statistics and regression analyses were used for data analysis. Respondents reported using in most of their patients radiographs (Rx) to diagnose proximal caries (59%), explorer (Ex) for the diagnosis of occlusal caries (64%) and on the margins of existing restorations (79%), as well as air jet (AJ) with drying (92%). Magnification (M) (25%), fiber optic transillumination (FOTI; 14%), and laser fluorescence (LF) (3%) were used in the minority of patients. Regression analysis revealed that the following dentists' characteristics were significantly associated (p<0.05) with the use of diagnostic methods on a greater percentage of their patients: advanced degree (Rx, FOTI), higher percentage of patients with individualized caries prevention (Rx, FOTI, M), more years since dental school graduation (Ex, M), and work in an exclusively private practice model (LF). In conclusion, most Brazilian dentists from Araraquara reported they most commonly use visual, tactile, and radiographic imaging for the diagnosis of dental caries. Some dentists' characteristics, such as time from dental school graduation and having a postgraduation course, were associated with the use of certain diagnostic methods.

In vitro visual and visible light transillumination methods for detection of natural non-cavitated approximal caries.

The objective was to evaluate a visible-light-transillumination (using Digital Imaging Fiber-Optic Transillumination machine: DIFOTI) method using occlusal view (DIFOTI-occl), axial view (buccal and lingual: DIFOTI-axial), and combination of all views (DIFOTI-all) for detecting non-cavitated approximal caries and to compare its performance to visual examination (International Caries Detection and Assessment System: ICDAS). Thirty extracted human premolars were selected (sound to lesions into the outer one-third of the dentine) based on micro-computed tomography (μ-CT). Teeth were mounted in a custom-made device to simulate approximal contact. DIFOTI (Electro-Optical Sciences Inc., Irvington, NY, USA) images were obtained from the occlusal, buccal, and lingual views. DIFOTI image and ICDAS examinations were performed and repeated by three trained/calibrated examiners. Sensitivity, specificity, area under receiver operating characteristics curve (Az), inter- and intra-class correlation coefficients (ICCs), and correlation were determined. Sensitivity/specificity was for DIFOTI-occl: 0.42/0.75, DIFOTI-axial: 0.86/0.93, DIFOTI-all: 0.91/0.69, and for ICDAS: 0.89/0.83. Az for DIFOTI-occl was significantly lower than that of DIFOTI-axial (p < 0.001), DIFOTI-all (p = 0.002), and ICDAS (p = 0.005). Spearman correlation coefficients with μ-CT for DIFOTI-occl (r = 0.39) showed weak association, while DIFOTI-axial (r = 0.80), DIFOTI-all (r = 0.91), and ICDAS (r = 0.90) showed moderate association. ICCs for intra-examiner repeatability/inter-examiner agreement were for DIFOTI-occl (0.64/0.58), DIFOTI-axial (0.92/0.89), DIFOTI-all (0.85/0.83), and ICDAS (0.79/0.72). The results of the current in vitro study suggest that, for detection of non-cavitated approximal caries lesions, DIFOTI performs better using axial than occlusal view. Approximal non-cavitated caries detection is challenging. DIFOTI can observe images from occlusal-, buccal-, and lingual views. DIFOTI and visual (ICDAS) examinations of buccal- and lingual- and all-views are more suitable than those of occlusal view for a detection of non-cavitated approximal caries.

Cracked tooth syndrome in irradiated patients with head and neck cancer

The aim of this study was to assess the presence of enamel craze lines (ECLs), part of the spectrum of the so-called cracked tooth syndrome, on the surface of teeth irradiated in vivo. Forty teeth extracted from patients with head and neck cancer were paired, matched, and equally divided into 4 groups: noncarious irradiated (G1); noncarious control (G2); radiation-related caries (RRC) (G3), and carious control (G4). Samples were examined for ECL detection with a fiberoptic transillumination device and photographed, and ECL mean size, number, and patterns of topographic distribution in tooth crown were determined. Groups were compared accordingly: G1 versus G2; G3 versus G4. We analyzed 538 ECLs, of which 30.1% were found in noncarious irradiated teeth, 19.3% in noncarious controls, 27.6% in RRC, and 23% in carious controls. Non-carious irradiated teeth presented higher quantities of ECL than non-carious control (P < 0.05). Higher incidences of ECLs were identified in specific enamel topographies of anterior G1 and G3 samples (P <.05). There was no correlation between ECL size/numbers and radiation isodose delivery to teeth. Increased incidence of ECLs may indicate weakened enamel structure in irradiated teeth, and this may play a role in the onset and progression of RRC.