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

Eirini Stratigaki; Fabian N Jost; Jan Kühnisch; Friederike Litzenburger; Adrian Lussi; Klaus W Neuhaus

doi:10.1016/j.jjodo.2020.100025

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

J Dent. 2020:103S:100025. doi: 10.1016/j.jjodo.2020.100025. Epub 2020 Sep 7.

Authors

Eirini Stratigaki¹, Fabian N Jost², Jan Kühnisch³, Friederike Litzenburger³, Adrian Lussi⁴, Klaus W Neuhaus⁵

Affiliations

¹ Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine, UZB, University of Basel, Switzerland. Electronic address: Eirini.stratigaki@unibas.ch.
² Department of Restorative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
³ Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Germany.
⁴ School of Dental Medicine, University of Bern, Switzerland; Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany.
⁵ Clinic of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland; Department of Dermatology, Inselspital, Bern University Hospital, Bern, Switzerland.

PMID: 34059307
DOI: 10.1016/j.jjodo.2020.100025

Abstract

Objectives: The 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 methods: A 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.

Results: The 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.

Conclusion: The 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 D_1,2 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 relevance: This study might indicate that NILT can be used for routine patient screening but the use of BWR is still important for treatment decisions.

Keywords: Caries detection; Dentine caries; Digital bitewing radiography; Enamel caries; Near-infrared light transillumination; Temporary tooth separation.

MeSH terms

Dental Caries Susceptibility
Dental Caries* / diagnostic imaging
Humans
Prospective Studies
Radiography, Bitewing
Reference Standards
Reproducibility of Results
Sensitivity and Specificity
Transillumination*