Validity and Reliability of Intraoral Optical Coherence Tomography and Bitewing Radiography for Detecting Approximal...

Area of Science:

• Dental Diagnostics
• Biomedical Imaging
• Caries Research

Background:

• Approximal carious lesions pose a diagnostic challenge in dentistry.
• Traditional methods like bitewing radiography have limitations in detecting early-stage demineralization.
• Spectral-domain optical coherence tomography (SD-OCT) presents a novel imaging modality for dental applications.

Purpose of the Study:

• To evaluate the diagnostic accuracy of SD-OCT in detecting approximal carious lesions.
• To compare the sensitivity and specificity of SD-OCT with digital radiography (DR).
• To assess the reliability and reproducibility of SD-OCT in a simulated clinical environment.

Main Methods:

• Extracted human teeth with varying caries severity (ICDAS II scores 0-3) were used in an in vitro study.
• Digital radiography (DR) and an intraoral SD-OCT probe were employed for imaging.
• Histology and microtomography (µCT) served as the gold standard for validation.
• Multiple calibrated raters assessed image interpretability and agreement.

Main Results:

• SD-OCT demonstrated higher sensitivity (0.66-0.91) and specificity (0.67-0.92) compared to DR (Sensitivity: 0.46-0.82; Specificity: 0.33-0.58).
• Intrarater agreement for SD-OCT was moderate to substantial, while DR showed fair to substantial agreement.
• Interrater agreement was fair to substantial for SD-OCT and slight to substantial for DR.

Conclusions:

• SD-OCT is a more sensitive tool than DR for detecting early approximal carious lesions in a simulated clinical setting.
• The diagnostic performance of SD-OCT was not compromised in terms of specificity or reproducibility.
• Further clinical investigations are warranted to validate these promising findings in real-world patient care.