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UBC Theses and Dissertations

Accuracy of diagnosing proximal caries using intra-oral bitewing radiographs and near infra-red imaging (NIRI) technology in iTero element 5D scanners : an in vivo study Arjunan, Sharmila


Objectives: To evaluate the diagnostic accuracy of near infra-red imaging (NIRI) technology of iTero Element 5D intra-oral scanners (index test) by comparing it to bitewing radiography (clinical reference standard) for detecting proximal surface enamel caries (target condition). Methods: We conducted a diagnostic study on 42 consecutive patients (22 males & 20 females) who presented for orthodontic treatment at the University of British Columbia (UBC). Consenting individuals ≥12 years of age received intra-oral digital scanning using iTero Element 5D scanners and full-mouth bitewing radiographs (BWRs). Two experienced pediatric dentists independently evaluated the non-restored proximal surfaces on BWRs and NIRI images for the presence/absence of initial enamel caries. Results: The prevalence of the target condition in the sample population was 5.8%. Of 1110 proximal surfaces included in the analysis, the diagnosis of the target condition was confirmed in 65 surfaces based on BWRs. The index test showed a sensitivity of 60.0%, specificity of 97.7%, positive predictive value of 61.9%, and negative predictive value of 97.5%. The inter- and intra-examiner reliability for BWRs and NIRI images were 0.78, 0.97, 0.85, and 1.0 respectively. The Area Under the Curve (AUC) value for the index test was 0.78 which can be considered acceptable in terms of the test’s ability to distinguish between positive (caries) and negative cases (no caries). Conclusions: The index test showed high specificity and negative predictive value; therefore, it has potential as a non-ionizing screening tool for the detection of proximal surfaces without enamel caries in permanent teeth, particularly in adolescents with a moderate/high caries risk. Acknowledgements: This project was supported by a 2021 Align Research Award (AWD-020121).

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