Inter- and intraexaminer reliability of bitewing radiography and near-infrared light transillumination for proximal caries detection and assessment.

OBJECTIVES: The purpose of this in vitro study was to evaluate the inter- and intraexaminer reliability of digital bitewing (DBW) radiography and near-infrared light transillumination (NIRT) for proximal caries detection and assessment in posterior teeth. METHODS: From a pool of 85 patients, 100 corresponding pairs of DBW and NIRT images (~1/3 healthy, ~1/3 with enamel caries and ~1/3 with dentin caries) were chosen. 12 dentists with different professional status and clinical experience repeated the evaluation in two blinded cycles. Two experienced dentists provided a reference diagnosis after analysing all images independently. Statistical analysis included the calculation of simple (kappa) and weighted Kappa (wkappa) values as a measure of reliability. Logistic regression with a backward elimination model was used to investigate the influence of the diagnostic method, evaluation cycle, type of tooth, and clinical experience on reliability. RESULTS: Altogether, inter- and intraexaminer reliability exhibited good to excellent kappa and wkappa values for DBW radiography (Inter: kappa = 0.60/ 0.63; wkappa = 0.74/0.76; Intra: kappa = 0.64; wkappa = 0.77) and NIRT (Inter: kappa = 0.74/0.64; wkappa = 0.86/0.82; Intra: kappa = 0.68; wkappa = 0.84). The backward elimination model revealed NIRT to be significantly more reliable than DBW radiography. CONCLUSIONS: This study revealed a good to excellent inter- and intraexaminer reliability for proximal caries detection using DBW and NIRT images. The logistic regression analysis revealed significantly better reliability for NIRT. Additionally, the first evaluation cycle was more reliable according to the reference diagnoses.