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Am J Dent ; 32(2): 74-80, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31094141


PURPOSE: This prospectively designed, non-validated in vivo diagnostic study compared the results of visual examination, digital bitewing (BW) radiography and near-infrared light transillumination ( NIR-LT, DIAGNOcam) on proximal caries detection in posterior teeth. METHODS: A total of 203 subjects (122 men:81 women; mean age, 23.0 years) were included. All subjects were visually examined according to the standards by the World Health Organization and the International Caries Detection and Assessment System. In addition, digital BW radiographs were performed. NIR-LT images were captured from all posterior teeth. All BWs and NIR-LT images were blindly evaluated for the presence of enamel caries lesions ( ECLs) and dentin caries lesions ( DCLs). No histological validation was performed due to the impossibility to investigate healthy surfaces and non-cavitated caries lesions invasively. The statistical analysis included both descriptive and exploratory data evaluations. RESULTS: The diagnostic outcome differed for each method. Compared with BW radiography ( 8.0 surfaces) and NIR-LT (10.5 surfaces), visual examination revealed the fewest caries-related findings (4.2 surfaces). BW radiography or NIR-LT detected either 86.2% or 89.6% of all ECLs/DCLs in posterior teeth alone. When combining visual examination with NIR-LT, 70.9% of all ECLs/DCLs were similarly detected; when visual examination and BW radiography were combined, this proportion was lower ( 52.6%). CLINICAL SIGNIFICANCE: This study confirmed that visual examination alone led to an underestimation of the caries burden on proximal sites in posterior teeth. The novel near-infrared light transillumination might be a useful additional caries detection and diagnostic method.

Cárie Dentária , Transiluminação , Adulto , Cárie Dentária/diagnóstico por imagem , Feminino , Humanos , Masculino , Radiografia Interproximal , Radiografia Dentária Digital , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
Clin Oral Investig ; 22(7): 2431-2438, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29915930


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.

Cárie Dentária/diagnóstico , Feminino , Alemanha , Humanos , Masculino , Exame Físico , Estudos Prospectivos , Radiografia Interproximal , Transiluminação/métodos , Adulto Jovem