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

Abstract

Objectives: 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. Methods: 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. Results: A high concordance between transillumination method and clinical examination (kappa 5 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 5 0.91). At the dentinal level, the two methods identified the same number of caries lesions (kappa 5 1), whereas more approximal lesions were recorded using the transillumination device in the enamel (kappa 5 0.24). The intraexaminer reliability was substantial/almost perfect in 59.4% of the participants. Conclusions: 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.

Clinical performance of the near-infrared imaging system VistaCam iX Proxi for detection of approximal enamel lesions

“… 17 In a recently published study using the device KaVo DIAGNOcam for approximal caries detection, no separation of the teeth was reported. 18 The authors report a high concordance between the transillumination method and clinical examination.…”

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

“…The study published by Lara-Capi 37 compared NILT and radiographic examinations at dentinal level, but this study did not include any gold standard reference method. Both methods identified the same number of carious lesions (kappa = 1), whereas more approximal lesions were recorded using the NILT in enamel (kappa = 0.24).…”

A comparison of diagnosis of early stage interproximal caries with bitewing radiographs and periapical images using consensus reference

“…Many optical devices have been introduced for diagnosing interproximal lesions, and the recent report utilizing the near-infrared transillumination method showed a high concordance with BTW, especially for dentin caries with Cohen's κ coefficient of 0.9, but only 0.24 for enamel caries. 5 The authors also tested Near Infrared Fluorescence Imaging for interproximal enamel caries diagnosis with significantly higher sensitivity than bitewings. 30 However, BTW provide a wealth of information in addition to interproximal caries, such as bone levels, restorative margins, shape and proximity of the pulp, detailed anatomy, and much more, thus BTW remain a standard tool for interproximal caries diagnosis.…”

“…3 Expanding the sensitivity of early caries detection would enhance the achievement of the goal of operative conservatism. There are a number of commercially available optical methods for caries detection, including digital imaging under transillumination, 4,5 quantitative light-induced fluorescence, 6 and laser fluorescence. [7][8][9] Optical diagnostic tools have great potential since they exploit changes in light scattering.…”