Advertisement

Clinical Oral Investigations

, Volume 22, Issue 7, pp 2431–2438 | Cite as

Evaluation of occlusal caries detection and assessment by visual inspection, digital bitewing radiography and near-infrared light transillumination

  • Gerrit Schaefer
  • Vinay Pitchika
  • Friederike Litzenburger
  • Reinhard Hickel
  • Jan Kühnisch
Review
  • 312 Downloads

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.

Keywords

Occlusal caries Dentin caries Caries detection Caries diagnostics Near-infrared light transillumination DIAGNOcam 

Notes

Acknowledgements

The study team would like to thank all the participants for their support.

Funding

There was no grant support or funding for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The research protocol was approved by the Ethics Committee of the Medical Faculty of the Ludwig-Maximilians-University of Munich (project number 013-12).

Informed consent

Written informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Baelum V (2010) What is an appropriate caries diagnosis. Acta Odontol Scand 68:65–79CrossRefPubMedGoogle Scholar
  2. 2.
    Poorterman JH, Aartman IH, Kieft JA, Kalsbeek H (2000) Value of bitewing radiographs in a clinical epidemiological study and their effect on the DMFS index. Caries Res 34:159–163CrossRefPubMedGoogle Scholar
  3. 3.
    Poorterman JH, Aartman IH, Kalsbeek H (1999) Underestimation of the prevalence of approximal caries and inadequate restorations in a clinical epidemiological study. Community Dent Oral Epidemiol 27:331–337CrossRefPubMedGoogle Scholar
  4. 4.
    Espelid I, Mejare I, Weerheijm K (2003) EAPD guidelines for use of radiographs in children. Eur J Paediatr Dent 4:40–48PubMedGoogle Scholar
  5. 5.
    American Dental Association Council on Scientific Affairs and U.S. Food and Drug Administration (2012) Dental radiographic examinations: recommendations for patient selection and limiting radiation exposure. http://www.ada.org/en/member-center/oral-health-topics/x-raysGoogle Scholar
  6. 6.
    European Commission. Radiation protection 136. European guidelines on radiation protection in dental radiology. The safe use of radiographs in dental practice. Luxembourg: Office for Official Publications of the European Communities, 2004Google Scholar
  7. 7.
    Weerheijm KL (1997) Occlusal ‘hidden caries. Dent Update 24(5):182–184PubMedGoogle Scholar
  8. 8.
    Kidd EA, Pitts NB (1990) A reappraisal of the value of the bitewing radiograph in the diagnosis of posterior approximal caries. Br Dent J 169:195–200CrossRefPubMedGoogle Scholar
  9. 9.
    Schneiderman A, Elbaum M, Shultz T, Keem S, Greenebaum M, Driller J (1997) Assessment of dental caries with digital imaging fiber-optic transillumination (DIFOTI): in vitro study. Caries Res 31:103–110CrossRefPubMedGoogle Scholar
  10. 10.
    Jones R, Huynh G, Jones G, Fried D (2003) Near-infrared transillumination at 1310-nm for the imaging of early dental decay. Opt Express 11:2259–2265CrossRefPubMedGoogle Scholar
  11. 11.
    Chung S, Fried D, Staninec M, Darling CL (2011) Near infrared imaging of teeth at wavelengths between 1200 and 1600 nm. Proc SPIE Int Soc Opt Eng 7884 pii: 78840XGoogle Scholar
  12. 12.
    Jones R, Huynh G, Jones G, Fried D (2003) Near-infrared transillumination at 1310-nm for the imaging of early dental decay. Opt Express 11:2259–2265CrossRefPubMedGoogle Scholar
  13. 13.
    Fried D, Glena RE, Featherstone JD, Seka W (1995) Nature of light scattering in dental enamel and dentin at visible and near-infrared wavelengths. Appl Opt 34:1278–1285CrossRefPubMedGoogle Scholar
  14. 14.
    Hall A, Girkin JM (2004) A review of potential new diagnostic modalities for caries lesions. J Dent Res 83 (Spec Issue No C):C89-C94Google Scholar
  15. 15.
    Söchtig F, Hickel R, Kühnisch J (2014) Caries detection and diagnostics with near-infrared light transillumination: clinical experiences. Quintessence Int 45:531–538PubMedGoogle Scholar
  16. 16.
    Abdelaziz M, Krejci I (2015) DIAGNOcam—a near infrared digital imaging transillumination (NIDIT) technology. Int J Esthet Dent 10:158–165PubMedGoogle Scholar
  17. 17.
    Kühnisch J, Söchtig F, Pitchika V (2016) In vivo validation of near-infrared light transillumination for interproximal dentin caries detection. Clin Oral Invest 20:821–829CrossRefGoogle Scholar
  18. 18.
    Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP et al for the STARD Group (2003) Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. BMJ 326:41–44Google Scholar
  19. 19.
    WHO (1997) Oral health surveys. Basic methods. 4th edition. Geneva: World Health OrganizationGoogle Scholar
  20. 20.
    Pitts NB (2009) Detection, assessment, diagnosis and monitoring of caries. Monographs in Oral Science, Vol. 21. Basel: S. Karger AGGoogle Scholar
  21. 21.
    Kühnisch J, Goddon I, Berger S, Senkel H, Bücher K, Oehme T, Hickel R, Heinrich-Weltzien R (2009) Development, methodology and potential of the new universal visual scoring system (UniViSS) for caries detection and diagnosis. Int J Environ Res Public Health 6:2500–2509CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Kühnisch J, Bücher K, Henschel V, Albrecht A, Garcia-Godoy F, Mansmann U, Hickel R, Heinrich-Weltzien R (2011) Diagnostic performance of the universal visual scoring system (UniViSS) on occlusal surfaces. Clin Oral Invest 15:215–223CrossRefGoogle Scholar
  23. 23.
    Marthaler TM (1966) A standardized system of recording dental conditions. Helv Odontol Acta 10:1–18PubMedGoogle Scholar
  24. 24.
    Richardson PS, McIntyre IG (1996) The difference between clinical and bitewing detection of approximal and occlusal caries in Royal Air Force recruits. Community Dent Health 13:65–69PubMedGoogle Scholar
  25. 25.
    R Development Core Team (2008) A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL http://www.R-project.orgGoogle Scholar
  26. 26.
    Heinrich-Weltzien R, Kühnisch J, Weerheijm K, Stößer L (2001) Diagnostik der versteckten Okklusalkaries mit Bissflügel-Aufnahmen. Dtsch Zahnärztl Z 56:476–480Google Scholar
  27. 27.
    Poorterman JH, Weerheijm KL (2000) Clinical and radiographic judgement of occlusal caries in adolescents. Eur J Oral Sci 108:93–98CrossRefPubMedGoogle Scholar
  28. 28.
    Hopcraft MS, Morgan MV (2005) Comparison of radiographic and clinical diagnosis of approximal and occlusal dental caries in a young adult population. Community Dent Oral Epidemiol 33:212–218CrossRefPubMedGoogle Scholar
  29. 29.
    Machiulskiene V, Nyvad B, Bealum V (1999) A comparison of clinical and radiographic caries diagnoses in posterior teeth of 12-year-old Lithuanian children. Caries Res 33:340–348CrossRefPubMedGoogle Scholar
  30. 30.
    Machiulskiene V, Nyvad B, Bealum V (2004) Comparison of diagnostic yields of clinical and radiographic caries examinations in children of different age. Eur J Paediatr Dent 5:157–162PubMedGoogle Scholar
  31. 31.
    Jordan R, Micheelis W (2016) Fünfte Deutsche Mundgesundheitsstudie (DMS V) Köln: Deutscher Zahnärzte VerlagGoogle Scholar
  32. 32.
    Gimenez T, Piovesan C, Braga MM, Raggio DP, Deery C, Ricketts DN, Ekstrand KR, Mendes FM (2015) Clinical relevance of studies on the accuracy of visual inspection for detecting caries lesions: a systematic review. Caries Res 49(2):91–98CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Conservative Dentistry and PeriodontologyUniversity Hospital, Ludwig-Maximilians University of MunichMünchenGermany

Personalised recommendations