Near-infrared imaging in orthodontic intraoral scanners for early interproximal caries detection

Adam Hoxie; Abhinaya Perumbedu; Parth Patel; Jialiu Xie; Kelly Mitchell; Angela Broome; Adalberto Bastos Vasconcellos; Apoena Aguiar Ribeiro

doi:10.1016/j.ajodo.2024.03.013

Near-infrared imaging in orthodontic intraoral scanners for early interproximal caries detection

Am J Orthod Dentofacial Orthop. 2024 May 9:S0889-5406(24)00136-7. doi: 10.1016/j.ajodo.2024.03.013. Online ahead of print.

Authors

Adam Hoxie¹, Abhinaya Perumbedu², Parth Patel², Jialiu Xie³, Kelly Mitchell¹, Angela Broome⁴, Adalberto Bastos Vasconcellos⁵, Apoena Aguiar Ribeiro⁶

Affiliations

¹ Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
² Division of Diagnostic Sciences, Cariology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
³ Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁴ Division of Diagnostic Sciences, Radiology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁵ Division of Comprehensive Oral Health, Operative Dentistry, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁶ Division of Diagnostic Sciences, Cariology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: apoena@email.unc.edu.

PMID: 38727656
DOI: 10.1016/j.ajodo.2024.03.013

Abstract

Introduction: Intraoral scanners commonly used in orthodontic offices now offer near-infrared imaging (NIRI) technology, advertised as a screening tool to identify interproximal caries. This study aimed to evaluate the reliability and validity of NIRI detection of interproximal carious lesions in a common intraoral scanner (iTero Element 5D; Align Technology, San Jose, Calif) with and without bitewing radiograph complement, compared with a microcomputed tomography (micro-CT) reference standard.

Methods: Extracted human posterior teeth (premolars and molars) were selected for early (noncavitated) interproximal carious lesions (n = 39) and sound control surfaces (n = 47). The teeth were scanned via micro-CT for evaluation by 2 blinded evaluators using consensus scoring. The teeth were mounted to simulate anatomic interproximal contacts and underwent a NIRI scan using iTero Element 5D and bitewing radiographs. Two trained, calibrated examiners independently evaluated (1) near-infrared images alone with clinical photograph, (2) bitewing radiograph alone with clinical photograph, and (3) near-infrared images with bitewing radiograph and clinical photograph in combination, after at least a 10-day washout period between each evaluation.

Results: Interrater reliability was highest for NIRI alone (k = 0.533) compared with bitewing radiograph alone (k = 0.176) or in combination (k = 0.256). NIRI alone showed high specificity (0.83-0.96) and moderate sensitivity (0.42-0.63) compared with a micro-CT reference standard. Dentin lesions were significantly more reliably detected than enamel lesions.

Conclusions: After rigorous training and calibration, NIRI can be used with moderate reliability, high specificity, and moderate sensitivity to detect noncavitated interproximal carious lesions.