Diagnostic validity of early proximal caries detection using near-infrared imaging technology on 3D range data of posterior teeth

Abstract Objectives This in vitro study analysed potential of early proximal caries detection using 3D range data of teeth consisting of near-infrared reflection images at 850 nm (NIRR). Materials and methods Two hundred fifty healthy and carious permanent human teeth were arranged pairwise, examined with bitewing radiography (BWR) and NIRR and validated with micro-computed tomography. NIRR findings were evaluated from buccal, lingual and occlusal (trilateral) views according to yes/no decisions about presence of caries. Reliability assessments included kappa statistics and revealed high agreement for both methods. Statistical analysis included cross tabulation and calculation of sensitivity, specificity and AUC. Results Underestimation of caries was 24.8% for NIRR and 26.4% for BWR. Overestimation was 10.4% for occlusal NIRR and 0% for BWR. Trilateral NIRR had overall accuracy of 64.8%, overestimation of 15.6% and underestimation of 19.6%. NIRR and BWR showed high specificity and low sensitivity for proximal caries detection. Conclusions NIRR achieved diagnostic results comparable to BWR. Trilateral NIRR assessments overestimated presence of proximal caries, revealing stronger sensitivity for initial caries detection than BWR. Clinical relevance NIRR provided valid complement to BWR as diagnostic instrument. Investigation from multiple angles did not substantially improve proximal caries detection with NIRR.

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Transillumination and HDR Imaging for Proximal Caries Detection

Journal of Dental Research ◽

10.1177/0022034518759957 ◽

2018 ◽

Vol 97 (7) ◽

pp. 844-849 ◽

Cited By ~ 6

Author(s):

A. Lederer ◽

K.H. Kunzelmann ◽

R. Hickel ◽

F. Litzenburger

Keyword(s):

Near Infrared ◽

Dynamic Range ◽

Caries Detection ◽

Micro Computed Tomography ◽

Human Teeth ◽

Rater Reliability ◽

Proximal Caries ◽

Dentin Caries ◽

Demineralized Enamel

The purpose of this study was to develop an in vitro model for the validation of near-infrared transillumination (NIRT) for proximal caries detection, to enhance NIRT with high-dynamic-range imaging (HDRI), and to compare both methods, using micro-computed tomography (µCT) as a reference standard. Both proximal surfaces of 53 healthy or decayed permanent human teeth were examined using the Diagnocam (DC) (KaVo) and NIRT with HDRI (NIRT-HDRI). NIRT was combined with HDRI to improve the diagnostic performance by reducing under- and overexposed image areas. For NIRT-HDRI, an exposure series was captured and merged into a single HDR image. A classification was applied according to lesion depth. All surfaces were assessed twice by 2 trained examiners, and additionally with µCT for validation. The Kappa statistic was used to calculate inter-rater reliability and agreement between DC and NIRT-HDRI. Inter-rater reliability (weighted Kappa, wκ) showed very good agreement for the DC (0.90) and NIRT-HDRI (0.96). The overall agreement (wκ) was almost perfect (0.85). In the individual categories (0 to 4), the agreement (simple Kappa) ranged from almost perfect (category 4) to moderate (1 and 2) to substantial (categories 0 and 3). Sensitivity and specificity of sound surfaces, enamel, and dentin caries ranged from 0.57 to 0.99 and were similar for both methods in the different categories. NIRT-HDRI had a higher sensitivity for sound surfaces and enamel caries, as well as a higher specificity for dentin caries. Regarding the obtained images, HDRI allowed for the detection of caries within a greater range of luminance levels, resulting in a more detailed visualization of structures without under- or overexposure. However, HDRI this did not improve the diagnostics significantly. Distinguishing between a processed demineralized enamel and dentin lesions appears to be a problem specific to NIRT and cannot be balanced using HDRI.

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Inter- and intraexaminer reliability of bitewing radiography and near-infrared light transillumination for proximal caries detection and assessment

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20170292 ◽

2018 ◽

pp. 20170292 ◽

Cited By ~ 4

Author(s):

Friederike Litzenburger ◽

Katrin Heck ◽

Vinay Pitchika ◽

Klaus W Neuhaus ◽

Fabian N Jost ◽

...

Keyword(s):

Near Infrared ◽

Infrared Light ◽

Caries Detection ◽

Near Infrared Light ◽

Proximal Caries ◽

Bitewing Radiography ◽

Intraexaminer Reliability

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The quality of etched enamel in different regions and tooth types and its significance in bonding and the development of white spot lesions

The Angle Orthodontist ◽

10.2319/090120-761.1 ◽

2021 ◽

Author(s):

Elisabeth C. Barnhart ◽

Phillip M. Campbell ◽

Amal Noureldin ◽

Katie Julien ◽

Peter H. Buschang

Keyword(s):

White Spot ◽

Cervical Region ◽

White Spot Lesions ◽

Micro Computed Tomography ◽

Human Teeth ◽

Posterior Teeth ◽

Material Density ◽

Anterior Teeth ◽

Before And After

ABSTRACT Objectives To quantify differences in the etch quality of enamel within and between human teeth, which has not previously been attempted. Materials and Methods The buccal right and left halves of 27 extracted human teeth were randomly allocated to scanning electron microscopy (SEM) or micro–computed tomography (μCT) for evaluation. The buccal surfaces were pumiced, etched with 37% phosphoric acid gel etchant for 15 seconds, rinsed, and air dried. Each tooth was divided into three regions (incisal, middle, and cervical) and viewed after etching at 1200× magnification with SEM. The μCT scans were taken before and after etching to calculate apparent and material mineral densities. Results SEM showed greater aprismatic enamel and poorer etch quality (ie, significantly less percentage enamel) for the posterior than anterior teeth and for the cervical region than for the incisal and middle regions of all teeth. Although there were no density differences prior to etching, μCT demonstrated that etching increased material density significantly more for the anterior than posterior teeth. Prior to etching, the enamel in the cervical regions was significantly less dense than the enamel in the middle or incisal regions. Etching significantly increased the material density of all three regions, which decreased initial regional differences. After etching, the apparent density of the cervical region remained significantly lower than the densities of the other two regions. Conclusions Based on SEM and μCT, there is greater aprismatic enamel and inferior etch quality in the cervical regions of all tooth types and is clinically significant in explaining the failure of sealant retention and the propensity for white spot lesions.

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Combined Near-Infrarred Light Transillumination and Direct Digital Radiography Increases Diagnostic In Approximal Caries

Scientific Reports ◽

10.1038/s41598-019-50850-5 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 4

Author(s):

Maria Melo ◽

Agustin Pascual ◽

Isabel Camps ◽

Fadi Ata-Ali ◽

Javier Ata-Ali

Keyword(s):

Digital Radiography ◽

Gold Standard ◽

Near Infrared ◽

Infrared Light ◽

Caries Detection ◽

Posterior Teeth ◽

Lesion Extension ◽

Diagnostic Capacity ◽

Approximal Caries ◽

Approximal Surface

Abstract The objective of this study was to evaluate the clinical ability of Near-Infrared Light-Transillumination (NILT) for approximal dentinal caries detection and to compare with direct digital-radiography (DDR), as well as to determine whether the combination of both techniques improves the diagnostic capacity of the lesions. From 88 patients (over 18 years), 138 posterior teeth (76 molars and 62 premolars), that had approximal caries reached into dentine determined by DDR, were included. Lesion extension and DDR images were scored as follows: D0 = sound surface, D1/D2 = caries restricted to the outer/inner-half of the enamel, and D3/4 = caries restricted to the outer/inner-half of the dentin. Opening of the approximal surface using 0.5 mm-in-diameter diamond-bar was used as gold-standard. The lesion extension was then determined by the following criteria: no dentinal caries (D0/1/2) or dentinal caries (D3/4). Seventy-one lesions were D3 and 67 lesions were D4. Sensitivities of overall/D3/D4 were 98.0/95.7/100.0 (NILT) and 100/100/100 (DDR), respectively. Correlations with gold-standard were 0.92 (NILT) and 0.42 (DDR), respectively. The correlation increased to 0.97 (p = 0.045) on combining NILT and DDR. There was no difference in sensitivity between the methods (p > 0.05); but was differences in the correlation (p < 0.01). It can be concluded that NILT showed sensitivity similar to that of DDR and higher correlation than DDR for approximal dentinal caries detection. Accordingly, it may be used to monitor the progression of caries without exposing the patient to ionizing radiation, this being of particular interest in growing patients and in pregnant women. In this respect, NILT can be an effective diagnostic tool adjunctive to bitewing radiographs in detecting approximal dentinal caries. The combination of NILT and DDR represents an increase in the diagnosis of approximal lesions The proposed diagnostic protocol comprises visual examination, followed by NILT and DDR only if the former technique detects approximal caries.

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In vivo performance of near-infrared light transillumination for dentine proximal caries detection in permanent teeth

The Saudi Dental Journal ◽

10.1016/j.sdentj.2019.08.007 ◽

2020 ◽

Vol 32 (4) ◽

pp. 187-193

Author(s):

Ayşe Dündar ◽

Mehmet Ertuğrul Çiftçi ◽

Özlem İşman ◽

Ali Murat Aktan

Keyword(s):

Near Infrared ◽

Infrared Light ◽

Caries Detection ◽

Permanent Teeth ◽

Near Infrared Light ◽

Proximal Caries

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Clinical validation of near-infrared light transillumination for early proximal caries detection using a composite reference standard

Journal of Dentistry: X ◽

10.1016/j.jjodo.2020.100025 ◽

2020 ◽

Vol 4 ◽

pp. 100025

Author(s):

Eirini Stratigaki ◽

Fabian N. Jost ◽

Jan Kühnisch ◽

Friederike Litzenburger ◽

Adrian Lussi ◽

...

Keyword(s):

Near Infrared ◽

Infrared Light ◽

Caries Detection ◽

Clinical Validation ◽

Reference Standard ◽

Near Infrared Light ◽

Proximal Caries ◽

Composite Reference Standard

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In vitro comparison of two types of digital X-ray sensors for proximal caries detection validated by micro-computed tomography

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20200338 ◽

2020 ◽

pp. 20200338

Author(s):

Katrin Heck ◽

Friederike Litzenburger ◽

Verena Ullmann ◽

Lea Hoffmann ◽

Karl-Heinz Kunzelmann

Keyword(s):

Exposure Time ◽

Oxide Semiconductor ◽

Caries Detection ◽

Reference Standard ◽

Micro Computed Tomography ◽

Perfect Agreement ◽

Proximal Caries ◽

X Ray ◽

Cmos Sensor ◽

Significant Difference

Objectives: We aimed to compare the diagnostic accuracy of two intraoral digital X-ray sensors—the charged-coupled device (CCD) and complementary metal-oxide-semiconductor (CMOS)—for proximal caries detection in permanent molar and premolar teeth. Micro-CT served as the reference standard. Methods: 250 samples were mounted in three-dimensional (3D)-printed phantoms, and their proximal surfaces were evaluated by ICDAS criteria directly to create a balanced sample. Bitewing radiography was conducted using 3D-constructed X-ray phantoms with a CCD sensor at a 0.08 s and a CMOS sensor at 0.12 and 0.16 s exposure time. Two examiners determined the diagnostic decisions twice at appropriate intervals. Three diagnostic thresholds for sound surfaces and enamel and dentin caries were defined and presented in a cross-table. Sensitivity and specificity values and overall accuracy were calculated, and receiver operating curves were generated and compared. Reliability assessment was performed using linear weighted κ statistics. Results: The overall accuracies between the reference standard and different sensors and exposure times were 63.1% (CCD), 67.1% (CMOS sensor at 0.12 s) and 70.7% (CMOS sensor at 0.08 s). High specificity but low sensitivity values were found for all examination conditions at all thresholds. The area under the curve comparison values revealed no significant difference between sensor types and exposure times. Linear-weighted κ analysis revealed almost perfect agreement for all assessments. Conclusion: No significant difference was found for diagnostic performance of proximal caries detection between the different sensors and exposure times. The increased exposure time did not lead to a significant diagnostic benefit.

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In‐vitro validation of near‐infrared reflection for proximal caries detection

European Journal Of Oral Sciences ◽

10.1111/eos.12663 ◽

2019 ◽

Vol 127 (6) ◽

pp. 515-522 ◽

Cited By ~ 3

Author(s):

Alexander Lederer ◽

Karl‐Heinz Kunzelmann ◽

Katrin Heck ◽

Reinhard Hickel ◽

Friederike Litzenburger

Keyword(s):

Near Infrared ◽

Caries Detection ◽

Proximal Caries ◽

Infrared Reflection

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Clinical Trial of the Canary System for Proximal Caries Detection: A Comparative Study

Current Journal of Applied Science and Technology ◽

10.9734/cjast/2021/v40i3531572 ◽

2021 ◽

pp. 38-50

Author(s):

Janja Jan ◽

Wan Zaripah Wan Bakar ◽

Sapna M. Mathews ◽

E. Uzamere ◽

Linda O. Okoye ◽

...

Keyword(s):

Assessment System ◽

Receiver Operating Curve ◽

Caries Detection ◽

Proximal Caries ◽

Bitewing Radiography ◽

Initial Caries ◽

High Caries Risk ◽

Icdas Ii ◽

Risk Patients ◽

Caries Lesions

Background: Detecting initial caries on the proximal surfaces of teeth in an intact dentition is a problem in dental practice since radiograph has been shown to have poor sensitivity with this stage of caries lesions. Hence there is need for an alternative technology. Objectives: The aim of this study was to investigate the efficacy of the Canary System (CS) to detect proximal caries in a clinical setting, comparing it with bitewing radiography (BWR). Methodology: 33 subjects, age 18 years and above, were recruited from a mixed population of low, moderate, and high caries risk patients. BWR and the CS were used to detect proximal caries lesions in these subjects. Teeth were separated by 48 hours insertion of rubber rings, and the proximal surfaces were examined by direct visual examination using the International Caries Detection and Assessment System II (ICDAS-II) scoring system. The Sensitivity (se), specificity (sp), positive (ppv) and negative predictive (npv) values of the CS and BWR in detecting caries on proximal surfaces were calculated by evaluating each method alone against ICDAS-II system (used as bronze standard). The two methods were compared statistically using their Area Under the Receiver Operating Curve (AUC). The sensitivities and specificities were compared using a test of proportions and AUC values were compared using DeLong’s method of nonparametric testing of AUC values. Results: The se, sp, ppv and npv for the CS are 0.92, 0.78, 0.89, 0.84 respectively, and for BWR are 0.67, 0.54, 0.78, and 0.40 respectively. The AUC of the Canary System (0.77) was statistically significantly higher than the AUC of the radiography (0.53, P < .001). Conclusions: This study demonstrated the efficacy of the Canary System in detecting proximal caries lesions to be greater than that of bitewing radiography. Clinical Significance: The Canary System can be a valuable clinical device for detecting and monitoring proximal caries lesions in clinical practice.

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A comparative study to diagnose the accuracy of E-speed film, complimentary metal oxide semiconductor and storage phosphor systems in the detection of proximal caries: An in vitro study

International Journal of Dental Research ◽

10.14419/ijdr.v4i1.5717 ◽

2016 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Tatapudi Ramesh ◽

Gurugubelli Upendra ◽

Bandaru Sravani Krishna ◽

Sahithi Dathar ◽

Priyankesh Sinha ◽

...

Keyword(s):

Dental Caries ◽

Metal Oxide ◽

Tooth Enamel ◽

Observer Agreement ◽

Oxide Semiconductor ◽

Kappa Statistics ◽

Posterior Teeth ◽

Proximal Caries ◽

Storage Phosphor ◽

And Storage

Background: Dental caries is one of the most commonly encountered conditions in clinical dentistry and these lesions remain undetected when confined to the vicinity of inter-proximal surfaces. Radiography plays a key role in the detection of inter-proximal caries especially in tight contacts.Objectives: The purpose of this study was to compare the diagnostic accuracy of E-speed film, complementary metal oxide semiconductors (CMOS) and storage phosphor systems (PSP) in the detection of proximal caries of the posterior teeth.Methods: Conventional films, CMOS and PSP images were used in detecting proximal caries on mesial and distal surfaces of 63 teeth (126 surfaces). Interpretation of all digital and conventional radiographs were performed and reanalyzed by four observers. The collected data was subjected to statistical analysis using chi square test, weighed kappa statistics and spearman rank correlation coefficient.Results: The PSP images showed more accurate results in identifying normal tooth, enamel caries, dentinal caries and deep dental caries and kappa statistics had represented almost perfect reading of 0.8 – 0.9 for PSP images whereas CMOS images showed substantial reading of 0.6 – 0.7, and for IOPA images it showed moderate reading of 0.5 – 0.6, which stated that the higher inter-observer agreement was obtained for PSP images when compared with images taken by IOPA and CMOS. The intra-observer reliability by kappa statistics had shown highly significant value (0.82) in the present study.Conclusion: Conventional films, CMOS and PSP images had shown almost appropriate results in the detection of proximal caries but PSP receptors were better in disclosing the details more accurately in terms of delineating the actual extent of the lesion pertaining to their high resolution capacity and further their flexibility made them easier during handling the radiograph, when compared with that of rigid CMOS receptors.

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