Abstract
AIM AND BACKGROUND: Caries remains the most prevalent chronic disease on a global scale and is considered a dynamic, reversible process when diagnosed early. If enamel caries is detected in its initial stages, preventive measures and simple restorations can be implemented. While growing evidence supports near-infrared light transillumination (NILT) for detecting caries in permanent teeth, research on its efficacy in primary teeth is limited. Several in vivo studies have been conducted without appropriate validation. This study aims to assess the effectiveness of DIAGNOcam(TM) in detecting occlusal caries at an initial stage and compare it to ICDAS II criteria, DIAGNOdent(TM), and digital radiography using histological validation as a reference standard. MATERIALS AND METHODS: Thirty-five primary molars with early occlusal enamel caries were examined and scored using ICDAS II criteria, DIAGNOdent™, VistaScan™, and DIAGNOcam™. Ground sections of the teeth were prepared for histological validation, and the presence of caries was evaluated using Downer's criteria. RESULTS: DIAGNOcam™ exhibited the highest area under the ROC curve (0.83), with a sensitivity score of 96.7%, specificity of 50%, and an accuracy rate of 91.4%. VistaScan™ exhibited the lowest sensitivity (46.8%) and specificity (33.4%) among all four methods. There was a statistically significant correlation between visual examination, VistaScan™, DIAGNOdent™, and DIAGNOcam™ with histology. Additionally, a statistically significant correlation was observed between visual examination, VistaScan™, and DIAGNOdent™ with DIAGNOcam™. CONCLUSION: DIAGNOcam™ has demonstrated superior performance in detecting early occlusal caries, achieving results nearly comparable to the histological gold standard. NILT has proven to be a valuable tool for clinical practice and can be utilized as an adjunct to visual examination. CLINICAL SIGNIFICANCE: Near-infrared light transillumination plays a significant role in the early diagnosis of dental caries, thereby aiding in facilitating the implementation of preventive measures to curb caries progression in children. HOW TO CITE THIS ARTICLE: Gerard LM, Sridhar N. A Comparative Evaluation of Visual, Laser Fluorescence, Near-infrared Light Transillumination, and Digital Radiography in the Diagnosis of Occlusal Enamel Caries in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2025;18(9):1116-1122.