Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Dentomaxillofac Radiol. 2021 Sep 1;50(6):20210005. doi: 10.1259/dmfr.20210005. Epub 2021 May 6.
The aim of this study was to evaluate the diagnostic potential of near-infrared reflection at 780 nm (NIRR) for early proximal caries detection on the occlusal, buccal and oral surfaces of molars and premolars under simulated, clinically relevant conditions. The findings were validated by micro-computed tomography (µCT).
Bitewing radiography (BWR) was used as a comparative diagnostic method. 250 sound or decayed permanent teeth were examined using NIRR and BWR. The NIRR findings were evaluated using yes/no decisions depending on the presence of caries lesions, as the enamel-dentin junction was not detectable in the majority of samples. All NIRR, BWR and µCT findings were obtained twice by two trained examiners. NIRR images were evaluated both occlusally alone and combined occlusally, lingually and buccally. All findings were presented in a cross-table. Sensitivity, specificity and area under the curve (AUC) values were calculated. Reliability assessment was performed using κ statistics.
Underestimation of caries was observed for NIRR in 26.0% of all surfaces and for BWR in 32.8% of all surfaces. Overestimation was 10.0% for NIRR and 0.4% for BWR. Trilateral NIRR assessment exhibited an overall accuracy of 67.2 %, an underestimation of 13.6% and an overestimation of 19.2%. Trilateral NIRR exhibited 63.0% sensitivity and 69.6% specificity, while BWR exhibited 26.7% sensitivity but 100% specificity for proximal caries detection.
NIRR is not suitable for reliable detection of early proximal caries, even with the application of an ideal setup and optimized conditions.
本研究旨在评估 780nm 近红外反射（NIRR）在模拟临床相关条件下对磨牙和前磨牙的咬合面、颊面和舌面的早期近表面龋的诊断潜力。研究结果通过微计算机断层扫描（µCT）进行验证。
使用咬合片（BWR）作为比较诊断方法。使用 NIRR 和 BWR 检查了 250 颗健康或龋坏的恒牙。根据是否存在龋损，通过 yes/no 决策评估 NIRR 结果，因为在大多数样本中无法检测到牙釉质-牙本质交界处。两名经过培训的检查者两次获得所有 NIRR、BWR 和 µCT 结果。单独评估 NIRR 图像，也可联合评估咬合、舌侧和颊侧。所有结果均以交叉表形式呈现。计算敏感性、特异性和曲线下面积（AUC）值。使用κ统计评估可靠性。
在所有表面中，NIRR 对龋的低估率为 26.0%，在所有表面中，BWR 的低估率为 32.8%。高估率为 NIRR 的 10.0%和 BWR 的 0.4%。三边 NIRR 评估的总体准确性为 67.2%，低估率为 13.6%，高估率为 19.2%。三边 NIRR 对近表面龋的敏感性为 63.0%，特异性为 69.6%，而 BWR 的敏感性为 26.7%，特异性为 100%。
即使采用理想的设置和优化的条件，NIRR 也不适合可靠地检测早期近表面龋。
