Evaluation of occlusal caries detection and assessment by visual inspection, digital bitewing radiography and near-infrared light transillumination
Abstract
Aim
This
study compared the diagnostic outcomes of visual inspection (VI),
digital bitewing radiography (BWR), and near-infrared light
transillumination (NIR-LT, DIAGNOcam, KaVo, Biberach, Germany) for
occlusal caries detection and assessment of posterior teeth.
Participants and methods
This
study included 203 patients (mean age 23.0 years). All individuals
received a meticulous VI. Additionally, BWR and NIR-LT images were
collected. All BWR and NIR-LT images were blindly evaluated for the
presence of enamel caries lesions (ECLs) and dentin caries lesions
(DCLs). The descriptive statistical analyses included calculation of
frequencies, cross tabulations, and pairwise comparisons using Pearson
chi-square tests.
Results
The
majority of ECLs/DCLs were detected by VI in this low-risk adult
population. The additional diagnostic outcomes in terms of ECLs/DCLs
amounted to 5.0% (BWR) and 6.8% (NIR-LT). The combined usage of
VI/NIR-LT or VI/BWR identified 95.7 and 94.4% of all ECLs/DCLs on
occlusal surfaces, respectively.
Conclusion
This
comparative diagnostic study showed that VI detected the majority of
occlusal caries lesions. Both additional methods showed limited
benefits. Due to the valuable features of NIR-LT, i.e., X-ray freeness
and clinical practicability, this method might be preferred over
X-ray-based methods. Nevertheless, BWRs should be prescribed in clinical
situations where insufficient fillings or multiple (deep) caries
lesions are diagnosed or where there is a need to assess the caries
extension in relation to the pulp.
Clinical relevance
VI
has to be understood as caries detection method of choice on occlusal
surfaces in low-risk adult population which may help to avoid multiple
diagnostic testing, overdiagnosis, and overtreatment.
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