Near-infrared Light Transillumination Research Articles

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

Ex vivo investigation on internal tunnel approach/internal resin infiltration and external nanosilver-modified resin infiltration of proximal caries exceeding into dentin.

This ex vivo proof-of-concept study aimed to investigate the effect of nanosilver particles (AgNP) added to a conventional infiltrant resin (Icon) on external penetration into natural proximal enamel caries exceeding into dentin after internal tunnel preparation and internal infiltration. Carious lesions (ICDAS codes 2/3) of extracted human (pre-)molars revealing proximal caries radiographically exceeding into dentin (E2/D1 lesions) were preselected. Then, 48 of those specimens showing demineralized areas transcending the enamel-dentin border as assessed by means of near-infrared light transillumination (DIAGNOcam) were deproteinized (NaOCl, 5%). Using an internal tunnel approach, occlusal cavities central to the marginal ridge were prepared. Excavation of carious dentin, total etch procedure (H3PO4, 40%), and internal resin infiltration (FITC-labeled) followed, along with final restorations (flowable composite resin). Outer lesion surfaces were etched (HCl, 15%) prior to external infiltration (RITC-labeled). Group 1 (control; n = 24) used non-modified infiltrant, while an infiltrant/AgNP mixture (20 nm; 5.5 wt%) was used with experimental Group 2 (n = 24). Non-infiltrated pores of cut lesions were stained (Berberine), and specimens were analyzed using confocal laser scanning microscopy. Compared to the non-filled infiltrant, incorporation of AgNP had no effect on the resin's external penetration. Between the groups, no significant differences regarding internal or external infiltration could be detected, and non-infiltrated lesion areas did not differ significantly (p>0.109; t-test). The internal tunnel preparation in combination with both an internal resin infiltration and an additional external infiltration approach using a nanosilver-modified infiltrant resin leads to increased infiltrated lesion areas, thus occluding and adhesively stabilizing the porous volume of the demineralized enamel. While exerting antimicrobial effects by the nanosilver particles, this approach should have the potential as a viable treatment alternative for proximal lesions extending into dentin, thus avoiding the sacrifice of sound enamel, postponing the frequently inevitable restoration/re-restoration cycle of conventional proximal caries treatment, and improving dental health.

Clinical validation of near-infrared light transillumination for early proximal caries detection using a composite reference standard

ObjectivesThe aim of this in vivo prospective clinical study was to validate a near-infrared light transillumination (NILT) device for the detection of proximal caries lesions and compare it to the established diagnostic method of bitewing radiography (BWR). Materials and methodsA total of 116 interproximal posterior teeth/surfaces without gross cavitation were included and assessed with BWR and NILT. After clinical examination, the teeth with sound surfaces or non-cavitated caries lesions were separated with the use of an orthodontic separation rubber for 24h. Upon removal of the separator a silicon impression was obtained and the teeth surfaces were directly investigated. Intra- and inter-examiner reproducibility, sensitivities (SE) and specificities (SP) as well as the area under ROC curves (AUC) were calculated. ResultsThe SE of NILT was 0.92 in D1 lesions and 1.00 in D2 and D3 lesions, respectively. BWR showed SE values of 0.81 in D1 lesions, 0.74 in D2 and 1.00 in D3 lesions, respectively. However, NILT showed lower values of SP (D1 0.38, D2 0.42 and D3 0.99) compared to BWR (D1 0.65, D2 0.88, D3 1.00). Intra-examiner reproducibility increased for both examiners from the initial examination (0.68 and 0.62) to the recall appointment (0.89 and 0.76) respectively. ConclusionThe performance of NILT in detection of enamel caries was comparable to BWR. NILT could be considered as a useful and reliable tool in clinical practice. However, monitoring of enamel lesions might not be accurate, since a low specificity of NILT at D1,2 level and a tendency to false positive ratings have been shown. Therefore, it is recommended that treatment decisions should not be based on NILT alone. Clinical relevanceThis study might indicate that NILT can be used for routine patient screening but the use of BWR is still important for treatment decisions.

Deep learning for caries lesion detection in near-infrared light transillumination images: A pilot study

ObjectivesIn this pilot study, we applied deep convolutional neural networks (CNNs) to detect caries lesions in Near-Infrared-Light Transillumination (NILT) images. Methods226 extracted posterior permanent human teeth (113 premolars, 113 molars) were allocated to groups of 2 + 2 teeth, and mounted in a pilot-tested diagnostic model in a dummy head. NILT images of single-tooth-segments were generated using DIAGNOcam (KaVo, Biberach). For each segment (on average 435 × 407 × 3 pixels), occlusal and/or proximal caries lesions were annotated by two experienced dentists using an in-house developed digital annotation tool. The pixel-based annotations were translated into binary class levels. We trained two state-of-the-art CNNs (Resnet18, Resnext50) and validated them via 10-fold cross validation. During the training process, we applied data augmentation (random resizing, rotations and flipping) and one-cycle-learning rate policy, setting the minimum and maximum learning rates to 10−5 and 10-3, respectively. Metrics for model performance were the area-under-the-receiver-operating-characteristics-curve (AUC), sensitivity, specificity, and positive/negative predictive values (PPV/NPV). Feature visualization was additionally applied to assess if the CNNs built on features dentists would also use. ResultsThe tooth-level prevalence of caries lesions was 41%. The two models performed similar on predicting caries on tooth segments of NILT images. The marginal better model with respect to AUC was Resnext50, where we retrained the last 9 network layers, using the Adam optimizer, a learning rate of 0.5 × 10−4, and a batch size of 10. The mean (95% CI) AUC was 0.74 (0.66-0.82). Sensitivity and specificity were 0.59 (0.47-0.70) and 0.76 (0.68-0.84) respectively. The resulting PPV was 0.63 (0.51-0.74), the NPV 0.73 (0.65-0.80). Visual inspection of model predictions found the model to be sensitive to areas affected by caries lesions. ConclusionsA moderately deep CNN trained on a limited amount of NILT image data showed satisfying discriminatory ability to detect caries lesions. Clinical significanceCNNs may be useful to assist NILT-based caries detection. This could be especially relevant in non-conventional dental settings, like schools, care homes or rural outpost centers.

Combined Near-Infrarred Light Transillumination and Direct Digital Radiography Increases Diagnostic In Approximal Caries

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.

In vivo performance of near-infrared light transillumination for dentine proximal caries detection in permanent teeth

ObjectiveThe purpose of this in vivo study was to confirm the detection of proximal caries using near-infrared light transillumination (NILTI) (DIAGNOcam) device, and to compare the diagnostic performance of the device with other caries detection methods, including visual examination using the International Caries Detection and Assessment System (ICDAS), bitewing radiography (BW), an LED-based device (Midwest Caries I.D.), and a laser fluorescence device (LFpen). MethodsA total of 974 proximal surface of permanent posterior teeth from 34 patients (19 females and 15 males between the ages of 22–55) were evaluated in the present study. After clinical examination of each proximal surface by an experienced examiner, they were coded according to the ICDAS criteria and subsequently with BW, the NILTI, LED, and LFpen. The proximal dentin caries of 106 were opened based on the combination of visual, NILTI and radiographic assessment and validated; and were treated with restorative materials. The data were analyzed with descriptive statistics and calculation of the sensitivity, specificity, and area under curve (AUC). ResultsThe highest sensitivity values were recorded from NILTI readings (99.1%), followed by BW scores (86.8%). The highest specificity values were recorded from ICDAS (100%). The best AUC values were found from the NILTI readings (0.97), followed by BW (0.93) and ICDAS (0.87). ConclusionThe NILTI device exhibited the best performance in terms of detecting proximal dentin caries.

Assessment of Near-Infrared (780nm) Light Transillumination Accuracy for Detection of Incipient Caries Lesions

The aim of study was to evaluate the accuracy of the near-infrared light transillumination technique used in the detection of the proximal incipient dental caries. The study was performed on 12 medium caries risk subjects (mean age of 26.5). A total number of 312 proximal dental surfaces from the posterior dental group were included in the study. All the proximal surfaces, which had not been restored, or unaffected by cavitated dental caries, were assessed by a near-infrared transillumination camera system using light with a 780nm wavelength (DIAGNOcam, KaVO). Bitewing radiographies were performed for all patients included in study. Visual and tactile examination after tooth separation was performed as gold standard to detect the incipient proximal dental caries (ICDAS scores 02 and 03). Statistical analysis using Chi-square test was performed to compare the diagnostic performance of near-infrared light transillumination and the bitewing radiography. Near-infrared light transillumination showed higher sensitivity (81.80%) when compared to bitewing radiography (65.90%) to detect the non-cavitated proximal enamel caries (ICDAS score 02). Near-infrared light transillumination method showed higher sensitivity (100%) when compared to bitewing radiography (81.50%) to detect the incipient cavitated proximal enamel caries (ICDAS score 03). Specificity values for proximal incipient dental caries (ICDAS codes 02 and 03) were 95.03% for near-infrared light transillumination and 99.18% for bitewing radiography. DIAGNOcam (KaVO) is a reliable tool with high diagnostic accuracy of the incipient dental caries localized on proximal surfaces of the posterior dental group.

Nearinfrared light transillumination for detection of incipient proximal caries in primary molars

To evaluate the practical value of nearinfrared light transillumination (NILT, DIAGNOcam) on detection of incipient proximal caries in primary molars. In this study, 4-9-year-old children with suspicious proximal lesions in primary molars were recruited. The target teeth were examined with clinical examination, bitewing radiograph and DIAGNOcam. And the caries indexes were rated as 0 (no caries), 1 (caries reaching outer 1/2 enamel), 2 (caries reaching inner 1/2 enamel), and 3 (dentine caries). Those primary molars with at least one of the adjacent molars according with the criteria of invasive treatment, i.e. the teeth were diagnosed as caries reaching inner 1/2 enamel or dentine with at least two detection methods, were included. The target teeth with caries index ≥2 accepted the invasive treatment. And the caries status of the adjacent teeth was observed under direct vision and those teeth of caries index ≥2 would also accept the invasive treatment. The relationship of lesions to enamel-dentine junction (EDJ) were recorded and used as reference standard to compare the sensitivity, specificity and accuracy of those three methods in detecting the incipient proximal caries in primary molars. In this study, 36 children with 104 suspicious proximal lesions in primary molars were recruited, of which 5 were diagnosed as no caries, 20 were diagnosed as superficial enamel caries, and 79 accepted invasive treatment, of which 22 were diagnosed as EDJ caries, and 57 as dentine caries. The sensitivity of clinical examination, bitewing radiograph, and DIAGNOcam were 68.69%, 81.82%, 78.79%, respectively. The specificity were 100.00%, 100.00%, 80.00%, and the accuracy were 75.96%, 85.65%, 78.85%, respectively. As for superficial enamel caries, the sensitivity of clinical examination was lowest, only 10%, while DIAGNOcam was 60%, higher than 40% of bitewing radiograph. As for EDJ caries, the sensitivity of bitewing radiograph was highest as 86.36%, followed by DIAGNOcam 72.73% and clinical examination 68.18%. As for dentine caries, the sensitivity of the three detection methods were higher than 85%, of which bitewing radiograph was the highest as 94.74%. The accuracy of DIAGNOcam in detecting incipient proximal caries in primary molars was comparable to that of bitewing radiograph. It was safe, and convenient with no exposure to radiation, which was applicable to be used in pediatric dentistry.

Accuracy of the DIAGNOcam and bitewing radiographs in the diagnosis of cavitated proximal carious lesions in primary molars.

To evaluate the diagnostic abilities of near-infrared light transillumination (using the DIAGNOcam) and bitewing radiographs in detecting cavitated proximal carious lesions in primary molars. The study was a cross-sectional analytical, clinical study. The proximal surfaces of primary molars of healthy 5- to 8-year-old children were radiographically screened for the presence of carious lesions in the enamel or outer third of dentin (D1). Two trained and calibrated examiners evaluated the depth of caries in bitewing radiographs and DIAGNOcam images and then verified the presence of cavitation by direct visual examination using the "International Caries Detection and Assessment System" after temporary tooth separation. A total of 236 proximal lesions were included in the study. Most of the clinically cavitated lesions (51.9%) were D1 radiographically and in outer dentin lesions (scores 3 and 4) by the DIAGNOcam (37% and 48.1%, respectively). Although DIAGNOcam showed higher sensitivity (0.852) compared to the radiographs (0.519), it showed slightly less specificity (0.569) compared to the radiographs (0.579). However, DIAGNOcam showed higher value of the area under the curve (AUC = 0.722; P < 0.001) compared to the radiographic method (AUC = 0.561; P = 0.308). The DIAGNOcam showed higher sensitivity and better accuracy than bitewing radiographs in diagnosing cavitated proximal lesions in primary molars and can be generally considered as an alternative to radiographs to detect cavitation without the hazards of ionizing radiation in children.

Evaluation of occlusal caries detection and assessment by visual inspection, digital bitewing radiography and near-infrared light transillumination

This study compared the diagnostic outcomes of visual inspection (VI), digital bitewing radiography (BWR), and near-infrared light transillumination (NIR-LT, DIAGNOcam, KaVo, Biberach, Germany) for occlusal caries detection and assessment of posterior teeth. This study included 203 patients (mean age 23.0years). All individuals received a meticulous VI. Additionally, BWR and NIR-LT images were collected. All BWR and NIR-LT images were blindly evaluated for the presence of enamel caries lesions (ECLs) and dentin caries lesions (DCLs). The descriptive statistical analyses included calculation of frequencies, cross tabulations, and pairwise comparisons using Pearson chi-square tests. The majority of ECLs/DCLs were detected by VI in this low-risk adult population. The additional diagnostic outcomes in terms of ECLs/DCLs amounted to 5.0% (BWR) and 6.8% (NIR-LT). The combined usage of VI/NIR-LT or VI/BWR identified 95.7 and 94.4% of all ECLs/DCLs on occlusal surfaces, respectively. This comparative diagnostic study showed that VI detected the majority of occlusal caries lesions. Both additional methods showed limited benefits. Due to the valuable features of NIR-LT, i.e., X-ray freeness and clinical practicability, this method might be preferred over X-ray-based methods. Nevertheless, BWRs should be prescribed in clinical situations where insufficient fillings or multiple (deep) caries lesions are diagnosed or where there is a need to assess the caries extension in relation to the pulp. VI has to be understood as caries detection method of choice on occlusal surfaces in low-risk adult population which may help to avoid multiple diagnostic testing, overdiagnosis, and overtreatment.

Insufficient evidence of the superiority of near-infrared light transillumination over bite-wing digital radiograph for detecting early interproximal carious lesions

Baltacioglu IH, Orhan K. Comparison of diagnostic methods for early interproximal caries detection with near-infrared light transillumination: an in vivo study. BMC Oral Health. 2017;17(1):130. https://doi.org/10.1186/s12903-017-0421-2.

Inter- and intraexaminer reliability of bitewing radiography and near-infrared light transillumination for proximal caries detection and assessment.

The purpose of this in vitro study was to evaluate the inter- and intraexaminer reliability of digital bitewing (DBW) radiography and near-infrared light transillumination (NIRT) for proximal caries detection and assessment in posterior teeth. From a pool of 85 patients, 100 corresponding pairs of DBW and NIRT images (~1/3 healthy, ~1/3 with enamel caries and ~1/3 with dentin caries) were chosen. 12 dentists with different professional status and clinical experience repeated the evaluation in two blinded cycles. Two experienced dentists provided a reference diagnosis after analysing all images independently. Statistical analysis included the calculation of simple (κ) and weighted Kappa (wκ) values as a measure of reliability. Logistic regression with a backward elimination model was used to investigate the influence of the diagnostic method, evaluation cycle, type of tooth, and clinical experience on reliability. Altogether, inter- and intraexaminer reliability exhibited good to excellent κ and wκ values for DBW radiography (Inter: κ = 0.60/ 0.63; wκ = 0.74/0.76; Intra: κ = 0.64; wκ = 0.77) and NIRT (Inter: κ = 0.74/0.64; wκ = 0.86/0.82; Intra: κ = 0.68; wκ = 0.84). The backward elimination model revealed NIRT to be significantly more reliable than DBW radiography. This study revealed a good to excellent inter- and intraexaminer reliability for proximal caries detection using DBW and NIRT images. The logistic regression analysis revealed significantly better reliability for NIRT. Additionally, the first evaluation cycle was more reliable according to the reference diagnoses.

Comparison of diagnostic methods for early interproximal caries detection with near-infrared light transillumination: an in vivo study

BackgroundAlthough numerous studies have used digital intraoral imaging, only a few studies have used photo-optical methods for the diagnosis of caries. Moreover, several limitations exist in terms of observers (experience and specialty) and the caries lesion itself. Hence, the aims of this study were to evaluate the diagnostic capability of near-infrared light transillumination (NILT) and PSP-Bitewing radiographs and to compare the interobserver and intraobserver differences in addition to observers’ experience level to detect early interproximal caries lesions in vivo.MethodsA total of 52 untreated posterior teeth with and without varying degrees of early interproximal carious lesions were included. Bitewing radiographs using digital phosphor plates (PSP-Bitewing) and NILT were used to clarify the diagnosis. An oral and maxillofacial radiologist and a restorative dentistry consultant evaluated the images twice. A separate appointment for clinical validation and restoration was made. Kappa coefficients were calculated to assess both intraobserver and interobserver agreements for each evaluation method. Scores obtained from PSP-Bitewing and NILT were compared with the clinical validation via receiver operating characteristic (ROC) analysis.ResultsNo significant differences were found between PSP-Bitewing radiography and NILT for detecting early interproximal carious lesions with high average Az results. Both intraobserver and interobserver agreement values were relatively higher for NILT evaluation. The Az values increased at second evaluations for both caries detection methods.ConclusionsNILT examination has an appropriate sensitivity and diagnostic accuracy for detecting early interproximal caries lesions and can be considered as a method of choice for detecting caries without the use of ionizing radiation.

In vitro performance of near infrared light transillumination at 780-nm and digital radiography for detection of non-cavitated approximal caries

ObjectivesTo evaluate the ability of a Near Infrared Light Transillumination (NILT) device to detect non-cavitated approximal caries lesions; and to compare its performance to Digital Radiography (DR). MethodsThirty human extracted premolars (sound to lesions into the outer one-third of dentin) were selected. Lesion depth was confirmed by micro-computed tomography (μ-CT). Teeth were mounted in a custom-made device to simulate approximal contact. DR and NILT (CariVu™, DEXIS, LLC, Hatfield, PA, USA) examinations were performed and repeated by three trained and calibrated examiners. Sensitivity, specificity, area under ROC curve (Az), inter- and intra-class correlation coefficients (ICCs) for each method, and correlation among the methods were determined. ResultsICCs for intra-/inter-examiner agreement were substantial for NILT (0.69/0.64), and moderate for DR (0.52/0.48). Sensitivity/specificity for NILT and DR were 0.68/0.93 and 0.50/0.64, respectively. Az for NILT was 0.81, while for DR it was 0.61. Spearman correlation coefficient with μ-CT for NILT (0.65, p<0.001) demonstrated moderate association, while that of DR suggested no association (0.19, p=0.289). ConclusionWithin the limitations of this in vitro study, NILT demonstrated a potential for early approximal caries detection. NILT and DR performed the same regarding the accuracy for non-cavitated approximal caries detection; however, NILT was superior to DR in terms of repeatability, agreement and correlation with μ-CT. Clinical significanceA commercial version of NILT was recently introduced as a non-irradiative adjunctive caries detection method. It uses near infrared (NIR) light at 780-nm to transilluminate teeth and captures live images from the occlusal surface. This study demonstrates that NILT can be used as an alternative to radiography for non-cavitated approximal caries detection.

Digital transillumination in caries detection versus radiographic and clinical methods: an in-vivo study

This article aimed to evaluate: (a) the agreement between a near-infrared light transillumination device and clinical and radiographic examinations in caries lesion detection and (b) the reliability of images captured by the transillumination device. Two calibrated examiners evaluated the caries status in premolars and molars on 52 randomly selected subjects by comparing the transillumination device with a clinical examination for the occlusal surfaces and by comparing the transillumination device with a radiographic examination (bitewing radiographs) for the approximal surfaces. Forty-eight trained dental hygienists evaluated and reevaluated 30 randomly selected images 1-month later. A high concordance between transillumination method and clinical examination (kappa = 0.99) was detected for occlusal caries lesions, while for approximal surfaces, the transillumination device identified a higher number of lesions with respect to bitewing (kappa = 0.91). At the dentinal level, the two methods identified the same number of caries lesions (kappa = 1), whereas more approximal lesions were recorded using the transillumination device in the enamel (kappa = 0.24). The intraexaminer reliability was substantial/almost perfect in 59.4% of the participants. The transillumination method showed a high concordance compared with traditional methods (clinical examination and bitewing radiographs). Caries detection reliability using the transillumination device images showed a high intraexaminer agreement. Transillumination showed to be a reliable method and as effective as traditional methods in caries detection.

English

Background: A study has been carried out in order to evaluate in vivo the diagnostic performance of near-infrared light transillumination (NIRT) compared to digital radiographic examination (RE) in the detection of class II carious lesions. Methods: A total of 114 patients were included, and 2957 proximal surfaces were considered. Surfaces were imaged by means of NIRT and radiographed with a photostimulable phosphor system. NIRT and radiographic images were observed by two blinded operators. Their diagnoses were compared with those made while visiting the patients, when visual-tactile, radiographic and NIRT data were matched by expert operators to obtain the reference diagnoses. Sensitivity, specificity and inter-observer consistency were calculated. Results: Throughout the visits, 395 caries were detected. When investigating without clinical information and in a blind manner, RE performed significantly better than NIRT regarding sensitivity analysis (0.591 vs. 0.456, p<0.001), and NIRT performed significantly better than RE regarding specificity analysis (0.980 vs 0.933, p<0.001). However, NIRT showed sensitivity similar to RE when only enamel caries were concerned. With regard to the agreement between the two observers, NIRT performed significantly better than RE (0.901 for RE analysis, 0.989 for NIRT analysis, P<0.001). A high probability of false positives for enamel caries (95% from 0.699 to 0.791) was observed in RE. NIRT was very likely to detect and correct the erroneous positive diagnosis of enamel carious lesions obtained using RE (95% CI for probability from 0.938 to 0.979). Conclusions: NIRT should be used in caries diagnosis in combination with radiographic images. In fact, NIRT can help to correct a false positive diagnosis of enamel caries. Furthermore, NIRT could be used to detect caries in patients for whom non-urgent radiographic exposition is contraindicated and to monitor enamel caries in medically treated patients. Finally, thanks to its three-dimensional images, NIRT can aid in detecting small caries when performing minorly invasive restorative procedures.

In vivo validation of near-infrared light transillumination for interproximal dentin cariesdetection.

The aims of this clinical study were to investigate the diagnostic accuracy of near-infrared light transillumination (NILT) as a novel X-ray-free method for proximal dentin caries detection and to compare this method to established diagnostic methods. A total of 127 interproximal dentin caries lesions without any cavity within visible dentin in posterior teeth from 85 consecutively selected patients were included. Visual and radiographic diagnoses and laser fluorescence measurements were available. NILT images were obtained, and a dentin lesion was predicted if a demineralisation involved the enamel-dentin junction (NILT-EDJ) or a shadow in dentin was detectable (NILT-dentin). Included lesions were opened and validated (reference standard). The statistical analyses included descriptive analyses and calculations of sensitivity, specificity and Az values. The diagnostic accuracy with respect to the reference standard was 1.6% for visual inspection, 66.7% for laser fluorescence, 96.1% for digital radiography, 29.1% for NILT-dentin and 99.2% for NILT-EDJ. Bitewings (Az 0.984) and NILT-EDJ (Az 0.992) performed equally. Given the lack of true negatives in the study, the diagnostic accuracy of NILT achieved the same level as bitewings for the detection of proximal dentin caries. This study might indicate that NILT could reduce the usage of bitewings.

Caries detection and diagnostics with near-infrared light transillumination: Clinical experiences

The aim of this paper was to present the function and potential of diagnosing caries lesions using a recently introduced near-infrared (NIR) transillumination technique (DIAGNOcam, KaVo). The study included 130 adolescents and adults with complete permanent dentition (age > 12). All patients underwent visual examination and, if necessary, bitewing radiographs. Proximal and occlusal surfaces, which had not yet been restored, were photographed by a NIR transillumination camera system using light with a wavelength of 780 nm rather than ionizing radiation. Of the study patients, 85 showed 127 proximal dentin caries lesions that were treated operatively. A cross table shows the correlation of radiography and NIR transillumination. Based on our practical clinical experiences to date, a possible classifi cation of diagnosis is introduced. The main result of our study was that NIR light was able to visualize caries lesions on proximal and occlusal surfaces. The study suggests that NIR transillumination is a method that may help to avoid bitewing radiographs for diagnosis of caries in everyday clinical practice.