A Randomized Clinical Trial Comparing Near-Infrared Imaging and Panoramic Radiography for Caries Detection

Although dental caries is largely preventable, it remains a primary global health concern due to its high prevalence and incidence, as noted by the World Health Organization. Early detection is crucial for prevention, minimization of intervention, and oral health promotion.

This study aims to evaluate the most effective diagnostic method for detecting existing caries lesions in patients attending our clinic through a randomized clinical trial.

Fifty-four patients underwent both panoramic radiography and near-infrared reflectance imaging (NIRI) for caries detection. A maxillofacial radiologist and a prosthodontist independently assessed the images, each conducting two evaluations. Normality was assessed using the Shapiro-Wilk test and skewness and kurtosis values. Statistical tests were used to compare detection rates and interobserver agreement.

Panoramic radiography revealed a mean of 3.26 (radiologist) and 3.30 (prosthodontist) carious lesions, with no significant difference (P = 0.914) and moderate agreement (P < 0.001). NIRI detected significantly more lesions: 6.59 (radiologist) and 6.00 (prosthodontist), showing excellent agreement (P < 0.001) with a small but significant difference (P = 0.023). Both clinicians identified nearly twice as many lesions with NIRI compared to radiography (P < 0.001).

NIRI showed superior performance in early caries detection. Compared to panoramic radiography, NIRI is more sensitive and avoids ionizing radiation, making it safer and more comfortable. Its reliability and patient-friendly nature support its use as a promising tool in routine preventive dental care.