Caries
Nicholas DeMeo, DMD (he/him/his)
Pediatric Dental Resident, PGY-2
Children's Hospital Colorado, Aurora, CO
Children's Hospital Colorado
Denver, Colorado, United States
Chaitanya P. Puranik, BDS, MS, MDS, PhD
Assistant Professor and Director of Predoctoral Education
University of Colorado School of Dental Medicine, Aurora, CO, USA
Children's Hospital Colorado and School of Dental Medicine, University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
Kaci Pickett, MS
University of Colorado Denver - Anschutz Medical Campus
Chaitanya P. Puranik, BDS, MS, MDS, PhD
Assistant Professor and Director of Predoctoral Education
University of Colorado School of Dental Medicine, Aurora, CO, USA
Children's Hospital Colorado and School of Dental Medicine, University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
Cristina Leon-Pineda, DMD, MPH, MSDS
Children's Hospital Colorado
Aurora, Colorado, United States
Purpose: The purpose of this randomized clinical control trial was to evaluate the diagnostic efficacy of Near Infrared Transillumination (NIRT) as compared to conventional bitewing radiographs (BW) for diagnosing interproximal carious lesions in children.
Methods: Fifty healthy children (5-9 years old) and parents that accepted study participation were randomly assigned to 2 study arms during routine recall appointment: BW or NIRT images first. Patient-parent preference, behavior, and time for each image were compared. Both BW and NIRT images were visualized in a standard setting and diagnostic images were scored on an ordinal scale by 2 calibrated raters (R1 and R2) for lesion depth. Combined scores were analyzed, and weighted Kappa measured agreement between scores.
Results: Intra-rater reliability (individual rater’s vs. combined score) was excellent for BW (κR1=0.91, κR2=0.80) and moderate-to-substantial for NIRT (κR1=0.64, κR2=0.73). Inter-rater reliability was good for BW (κ=0.75; 95%CI:0.65-0.84) and moderate for NIRT (κ=0.50; 95%CI:0.25-0.49). The overall agreement between NIRT and BW scores was ‘none-to-slight’ (κ=0.26; 95%CI:0.14-0.37). The NIRT was less sensitive but had high specificity with respect to BW (AUC:0.59). The order in which BW and NIRT images were taken did not have any effect on the parent-patient or behavior responses. Both parents (72%) and patients (64%) preferred NIRT over BW images. The median time required for capturing NIRT images (1.7 minutes) was significantly less (P < .001) than for BW (2.4 minutes).
Conclusion: Although NIRT was efficient and had better acceptability, efficacy of BW was better than NIRT images for diagnosing interproximal carious lesions in children.