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Comparative Study
. 2017 Apr;46(4):20160417.
doi: 10.1259/dmfr.20160417. Epub 2017 Apr 6.

Digital transillumination in caries detection versus radiographic and clinical methods: an in-vivo study

Cynthia Lara-Capi  1   2 , Maria Grazia Cagetti  1   2 , Peter Lingström  2   3 , Gianfranco Lai  4 , Fabio Cocco  2   4 , Charlotte Simark-Mattsson  3 , Guglielmo Campus  2   4
Affiliations
Comparative Study

Digital transillumination in caries detection versus radiographic and clinical methods: an in-vivo study

Cynthia Lara-Capi et al. Dentomaxillofac Radiol. 2017 Apr.

Abstract

Objectives: This article aimed to evaluate: (a) the agreement between a near-infrared light transillumination device and clinical and radiographic examinations in caries lesion detection and (b) the reliability of images captured by the transillumination device.

Methods: Two calibrated examiners evaluated the caries status in premolars and molars on 52 randomly selected subjects by comparing the transillumination device with a clinical examination for the occlusal surfaces and by comparing the transillumination device with a radiographic examination (bitewing radiographs) for the approximal surfaces. Forty-eight trained dental hygienists evaluated and reevaluated 30 randomly selected images 1-month later.

Results: A high concordance between transillumination method and clinical examination (kappa = 0.99) was detected for occlusal caries lesions, while for approximal surfaces, the transillumination device identified a higher number of lesions with respect to bitewing (kappa = 0.91). At the dentinal level, the two methods identified the same number of caries lesions (kappa = 1), whereas more approximal lesions were recorded using the transillumination device in the enamel (kappa = 0.24). The intraexaminer reliability was substantial/almost perfect in 59.4% of the participants.

Conclusions: The transillumination method showed a high concordance compared with traditional methods (clinical examination and bitewing radiographs). Caries detection reliability using the transillumination device images showed a high intraexaminer agreement. Transillumination showed to be a reliable method and as effective as traditional methods in caries detection.

Keywords: bitewing radiography; dental caries; reproducibility of results; transillumination.

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Figures

Figure 1
Figure 1
A flow chart of the study design.
Figure 2
Figure 2
The maxillary second premolar reveals proximal caries lesions in the dentin on the mesial and distal surfaces (a, b).
Figure 3
Figure 3
The mandibular first molar reveals a proximal lesion in the dentin on the distal surface (a, b).
Figure 4
Figure 4
Comparison of the three detection methods: intraclass coefficient correlation between the transillumination method and the clinical evaluation for the occlusal surfaces (o) and between the transillumination device and bitewings for the approximal, mesial (m) and distal (d) surfaces is reported.
Figure 5
Figure 5
Reliability in the evaluation of images captured using the transillumination device: intraexaminer reliability using a Bland–Altman plot of difference—each small dot is the average value of a single examiner observation, while larger dots are the sum of two or more examiners. The shaded region indicates 95% limits of agreement around the dashed line representing the mean.
See this image and copyright information in PMC

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