title: Digital transillumination in caries detection versus radiographic and clinical methods: an in-vivo study.
abstract: OBJECTIVE
  This article aimed to evaluate: (a) the agreement between a near-infrared light transillumination device and clinical and radiographic examinations in caries lesion detection and (b) the reliability of images captured by the transillumination device.
  
  
  METHODS
  Two calibrated examiners evaluated the caries status in premolars and molars on 52 randomly selected subjects by comparing the transillumination device with a clinical examination for the occlusal surfaces and by comparing the transillumination device with a radiographic examination (bitewing radiographs) for the approximal surfaces. Forty-eight trained dental hygienists evaluated and reevaluated 30 randomly selected images 1-month later.
  
  
  RESULTS
  A high concordance between transillumination method and clinical examination (kappa = 0.99) was detected for occlusal caries lesions, while for approximal surfaces, the transillumination device identified a higher number of lesions with respect to bitewing (kappa = 0.91). At the dentinal level, the two methods identified the same number of caries lesions (kappa = 1), whereas more approximal lesions were recorded using the transillumination device in the enamel (kappa = 0.24). The intraexaminer reliability was substantial/almost perfect in 59.4% of the participants.
  
  
  CONCLUSIONS
  The transillumination method showed a high concordance compared with traditional methods (clinical examination and bitewing radiographs). Caries detection reliability using the transillumination device images showed a high intraexaminer agreement. Transillumination showed to be a reliable method and as effective as traditional methods in caries detection.
authors.affiliation: 1 Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.|2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Lara-Capi
authors.affiliation: 1 Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.|2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Cagetti
authors.affiliation: 2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy.|3 Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Lingström
authors.affiliation: 4 Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Sassari, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Lai
authors.affiliation: 2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy.|4 Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Sassari, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Cocco
authors.affiliation: 3 Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Simark-Mattsson
authors.affiliation: 2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy.|4 Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Sassari, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Campus
mesh_terms: D000328:Adult; D001641:Bicuspid; D002138:Calibration; D003731:Dental Caries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007259:Infrared Rays; D008297:Male; D008963:Molar; D016300:Radiography, Bitewing; D015203:Reproducibility of Results; D014172:Transillumination / Q000295:instrumentation / Q000379:methods*
keywords: bitewing radiography; dental caries; reproducibility of results; transillumination