Near-Infrared Transillumination for Occlusal Carious Lesion Detection: A Retrospective Reliability Study

Deep convolutional neural networks for early detection of interproximal caries using bitewing radiographs: A systematic review

OBJECTIVES

To thoroughly review Deep Convolutional Neural Networks for detecting interproximal caries with bitewing radiographs.

DATA

Data was collected from studies that utilized Deep Convolutional Neural Networks (DCNN) focused on the analysis of bitewing radiographs taken with intraoral X-ray units.

SOURCES

A comprehensive literature search was conducted across various scholarly databases including Google Scholar, MDPI, PubMed, ResearchGate, ScienceDirect, and IEEE Xplore, encompassing 2014 to 2024. The risk of bias assessment utilized the current version of the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2).

STUDY SELECTION

After reviewing 291 articles, 10 studies met the criteria and were analyzed. All 10 studies used bitewing radiographs, focusing on deep learning tasks such as segmentation, classification, and detection. The sample sizes varied widely from 112 to 3,989 participants. Convolutional neural networks (CNNs) were the most commonly used model. According to the QUADAS-2 assessment, only 40% of the studies included in this review were found to have a low risk of bias in the reference standard domain.

CLINICAL SIGNIFICANCE

A Deep Convolutional Neural Networks based caries detection system helps in the early identification of caries by analyzing bitewing radiographs and reduces diagnostic errors. By identifying early-stage lesions, patients can undergo minimally invasive treatments instead of more complex procedures, thereby improving patient outcomes in dental care.

CONCLUSION

This systematic review provides an overview of various studies that utilize deep learning models to identify interproximal caries lesions in bitewing radiographs. It highlights the efficacy of YOLOv8 in detecting interproximal caries from bitewing radiographs compared to other Deep CNN models.

Accuracy of an intraoral scanner with near-infrared imaging feature in detection of interproximal caries of permanent teeth: An in vivo validation

OBJECTIVE

This study aimed to evaluate the accuracy of an intraoral scanner with near-infrared imaging (NIRI) feature in the diagnosis of interproximal caries and to compare it with the visual-tactile method (VTM), bitewing radiography (BWR), and panoramic radiography (PR).

MATERIALS AND METHODS

Six hundred thirty-nine interproximal surfaces (mesial-distal) of posterior teeth from 22 volunteers were examined. Results were scored by VTM, BWR, PR, and NIRI. Lesions were scored as 0 for no-caries, 1 for early-enamel lesion (EEL), and 2 for lesions involving dentino-enamel junction (DEJ). McNemar, Kappa, and Fleis Kappa tests were used to evaluate the agreement levels. Pearson's Chi-square test was used to determine the matching rates after validation.

RESULTS

A good level of agreement was observed between examination methods (Ƙ = 0.613; p < 0.001). In pairwise comparisons, a moderate agreement was seen between all the methods for lesions with DEJ involvement, while a statistically good agreement was observed between BWR and NIRI (Ƙ = 0.675; p < 0.001). As a result of validation, the accuracy of NIRI for molars was considered 85.2% and 75.7% for premolars in EELs, 85.2% for molars, and 70% for premolars regarding the lesions involving DEJ.

CONCLUSIONS

Intraoral scanners with the NIRI feature may be used for diagnosing interproximal caries, especially for permanent molars.

CLINICAL SIGNIFICANCE

Early detection of proximal caries is one of the most essential topics forming the basis of preventive dentistry. This study investigates a caries diagnostic tool integrated into intraoral scanners to diagnose interproximal caries. A caries diagnostic tool integrated into an intraoral scanner may prevent the harmful effects of ionizing radiation in early caries diagnosis and may improve the patient's oral health status.

Atlas of Dental Near-Infrared Transillumination Images

Technological improvements have introduced significant innovations in dentistry and broadened the array of tools and techniques in dental care. One technological development that has been widely researched over the past 20 years is the use of Near-Infrared Transillumination (NIRT) imaging for the diagnosis of dental caries. This paper aims to introduce a comprehensive collection of NIRT images, intended as a reference tool for routine dental examinations, dental research, pedagogical activities, and forensic odontology. The collection presents pairwise clinical and NIRT images categorized as follows: (a) healthy teeth, (b) carious teeth, (c) restored teeth, (d) enamel defects, and (e) diverse findings. This atlas could be a valuable tool for the dental community as it is designed as an identification guide of NIRT illustrated dental features.

Polarization-Sensitive Optical Coherence Tomography for Monitoring De- and Remineralization of Bovine Enamel In Vitro

Early caries diagnosis still challenges dentistry. Polarization-sensitive optical coherence tomography (PS-OCT) is promising to detect initial lesions non-invasively in depth-resolved cross-sectional visualization. PS-OCT with determined degree of polarization (DOP) imaging provides an intuitive demineralization contrast. The aim of this study is to evaluate the suitability of DOP-based PS-OCT imaging to monitor controlled de- and remineralization progression for the first time and to introduce it as a valid, non-destructive in vitro detection method. Twelve standardized bovine enamel specimens were divided in different groups and demineralized with hydrochloric acid (HCl) as well as partly remineralized with fluoride over a 14-day pH-cycling experiment. The specimens were stored in artificial saliva and sodium chloride (NaCl), respectively. Progress measurements with PS-OCT were made with polarization-sensitive en faceand B-scan mode for qualitative evaluation. The specimens demineralized in HCl showed the most pronounced surface change (lowest DOP) and the most significant increase in depolarization. Additional fluoride treatment and the storage in artificial saliva resulted in the opposite (highest DOP). Therefore, DOP-based PS-OCT imaging appears to be a valuable technique for visualization and monitoring of enamel demineralization and remineralization processes in vitro. However, these findings need to be confirmed in human teeth ex vivo or in situ.

Detection, Diagnosis, and Monitoring of Early Caries: The Future of Individualized Dental Care

Dental caries remains a significant global health issue. It was highlighted by the World Health Organization's 2022 reports that despite the efforts and scientific advancements in caries detection and management, the situation has only marginally improved over the past three decades. The persistence of this problem may be linked to outdated concepts developed almost a century ago but are still guiding dentists' approach to caries management today. There is a need to reconsider professional strategies for preventing and managing the disease. Contemporary dentistry could benefit from embracing new concepts and technologies for caries detection and management. Dentists should explore, among others, alternative methods for caries detection such as optical-based caries detection. These tools have been established for over a decade and they align with current disease understanding and international recommendations, emphasizing early detection and minimally invasive management. This narrative review presents the current state of knowledge and recent trends in caries detection, diagnosis, monitoring, and management, offering insights into future perspectives for clinical applications and research topics.