Optical coherence tomography (OCT) can create cross-sectional images of tooth without X-ray exposure. This study aimed to investigate the diagnostic accuracy of 3D imaging of OCT for proximal caries in posterior teeth. Dental caries remains a highly prevalent disease that affects more than 90 percent of adults. Despite advancements in caries prevention measures, dental caries remains one of the main reasons for invasive restorative treatment of teeth. Early and accurate diagnosis of caries is of fundamental importance of “Minimal Intervention Dentistry”, because it facilitates immediate non-invasive treatment approaches to control the initiation and prevent the progression of caries. In the early stages, the demineralization process can be reversed in the presence of bioavailable calcium, phosphate and fluoride ions in the oral environment. For the surface enamel lesions, infiltration of low-viscosity resin can also be an option as a micro-invasive approach to inhibit further demineralization and to arrest lesion progress. On the other hand, cavitated lesions involving dentin are heavily contaminated and demineralizaed with bacteria, usually require invasive management to restore function and aesthetics. Consequently, cavitation is recognized as one of the major factors for deciding whether and how to intervene the lesion. Since any loss of surface integrity may provide retention sites for dental plaque, lesions with cavitation will most probably active. Currently, visual examination and radiographic identification are the most commonly used diagnostic tools for detecting carious lesions. The International Caries Detection and Assessment System (ICDAS), which is based on visual examination, was introduced as a novel strategy aiding diagnosis and classification of carious lesion size and subsequent treatment decisions. However at posterior teeth, visual examination is hard to assess on proximal surfaces when adjacent teeth are present. Visual examination is not appropriate to detect the slight cavitation of caries even under laboratory conditions. Despite the use of intraoral radiographs is a widespread aid because of the limited access for visual and tactile inspection of posterior teeth, dental radiographs exhibit low sensitivity for the detection of caries because of the superimposition of anatomical structures and artifacts. Incipient proximal caries of tightly contacting surfaces produces a big challenge and results in an unacceptable proportion of false-negative results. The actual extent of carious lesions is underestimated if radiographs are solely relied on for detection. Moreover, a careful optimization of radiation dose and appropriate justification for performing are required by the concept “as low as reasonably achievable” (ALARA) for dental radiographs. Although the hazards caused by dental radiography are relatively small and negligible, many dentists are concerned about the safety of the radiography especially for pregnant women and infants. Recently, near-infrared light transillumination (NILT) device was developed for the detection of initial changes in caries for posterior teeth. NILT shows higher diagnostic performance than radiographs to detect the caries at proximal surface noninvasively in simple manner. Since the presence of cavitation into enamel or dentin is a major factor for the decision of micro invasive or restorative treatment, imaging strategy appears necessary for the proximal surface in posterior teeth.

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Sarah eve

Editorial Assistant

Journal of Oral Hygiene and Health