Evaluation of two imaging techniques: near-infrared transillumination and dental radiographs for the detection of early approximal enamel caries.

OBJECTIVES The aim of this paper was to evaluate a transillumination (TI) system using near-infrared (NIR) light and bitewing radiographs for the detection of early approximal enamel caries lesions. METHODS Mesiodistal sections of teeth (n = 14) were cut with various thicknesses from 1.5 mm to 4.75 mm. Both sides of each section were included, 17 approximal surfaces with natural enamel caries and 11 surfaces considered intact. The approximal surfaces were illuminated by NIR light and X-ray. Captured images were analysed by two calibrated specialists in radiology, and re-analysed after 6 months using stereomicroscope images as a gold standard. RESULTS The interexaminer reliability (Kappa test statistic) for the NIR TI technique showed moderate agreement on first (0.55) and second (0.48) evaluation, and low agreement for bitewing radiographs on first (0.26) and second (0.32) evaluation. In terms of accuracy, the sensitivity for the NIR TI system was 0.88 and the specificity was 0.72. For the bitewing radiographs the sensitivity ranged from 0.35 to 0.53 and the specificity ranged from 0.50 to 0.72. CONCLUSION In the same samples and conditions tested, NIR TI images showed reliability and the enamel caries surfaces were better identified than on dental radiographs.

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