The use of transillumination in detecting subclinical extensions of enamel opacities

Abstract

Objective Accurate detection of enamel opacities in reflected light is limited in terms of discriminating between affected and unaffected enamel. The aim of this study was to compare the ability of transilluminated photography in distinction between healthy and unhealthy enamel in comparison with reflected photography. Materials and Methods Patients presenting enamel opacities were selected during their regular dental visits and for each tooth, standardized photographs were taken in transmitted and reflected light. For each lighting condition, the ratio of the opacity surface area to the entire buccal enamel area was calculated. The difference in the ratio of the opacity surface area to the entire buccal enamel area was compared using the Wilcoxon paired test. Results The results of this study showed that the ratio of the opacity surface area to the entire buccal enamel area calculated in transilluminated photography is significantly higher in comparison with its calculation in reflected photography. The means ratios (SD) of the opacity to the entire buccal enamel area are in transmitted light and reflected light respectively 18% (12) and 15% (11). Conclusions In comparison with reflected photography, transilluminated photography significantly increases the ratio of the opacity surface area to the entire buccal enamel area. Transilluminated photography allows better detection of enamel opacities on anterior teeth by aiding clinical discrimination between healthy an unhealthy enamel. Clinical Significance Being simple, noninvasive, painless and without any risk to the patient, transillumination represents a promising imaging method for detecting enamel opacities and for discriminating healthy and unhealthy enamel.

The use of transillumination in mapping demarcated enamel opacities in anterior teeth: A cross‐sectional study

“…Indeed, transillumination increases the contrast between sound and hypomineralized enamel, allowing better assessment of lesion number and better discrimination of hypomineralized lesions on anterior teeth. 18 Besides, as TL images can more accurately detect extension and location of enamel opacities in anterior teeth in comparison with RL images, the use of RL images alone may also lead to underdiagnosis. 18 TL images can also be used to differentiate between homogenous and heterogenous opacity within the lesion body.…”

“…18 Besides, as TL images can more accurately detect extension and location of enamel opacities in anterior teeth in comparison with RL images, the use of RL images alone may also lead to underdiagnosis. 18 TL images can also be used to differentiate between homogenous and heterogenous opacity within the lesion body. 19 The ability of transillumination to highlight differences in opacity is not surprising, as teeth are illuminated from their lingual surfaces and the light passes thought the tooth structure until it reaches the buccal surface.…”

“…17 Recently, it has been suggested that transillumination allows better detection and more lesion body information in comparison with reflected light. 18,19 Although the use of transillumination for assessing the lesion body of MIH lesions has considerable anecdotal support, it is, however, not thoroughly reported in the literature. As the available classifications and scoring systems are based on observation in reflected light condition, in this manuscript we propose to describe and map MIH lesions on permanent anterior teeth using reflected and transilluminated light.…”

Minimally Invasive Therapy for Treating White Spot Lesions on Anterior Teeth in Molar Incisor Hypo Mineralization

“…This simple, non-invasive, and painless method is useful for mapping white enamel lesions in the anterior teeth. It increases the contrast between sound enamel and hypomineralized enamel, allowing a better evaluation of the number of lesions, their boundaries, and their depths [7,9,20].…”

“…Yet, in each case, hypomineralization takes on distinct topographic forms, which affect treatment decision and prognosis. Hence, the importance of meticulous clinical observation of the lesions and the use of specific tools like transillumination [6][7][8][9] to implement targeted therapeutic approach.…”