Abstract
OBJECTIVES: 
The
 purpose of this in vitro study was to evaluate the inter- and 
intra-examiner reliability of digital bitewing (DBW) radiography and 
near-infrared light transillumination (NIRT) for proximal caries 
detection and assessment in posterior teeth.
METHODS: 
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. Twelve dentists with different professional statuses 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.
RESULTS: 
Altogether,
 inter- and intra-examiner 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.
CONCLUSIONS: 
This
 study revealed a good to excellent inter-and intra-examiner 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.
 
 
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