Accuracy of near-infrared light transillumination (NILT) compared to bitewing radiograph for detection of interproximal caries in the permanent dentition: A systematic review and meta-analysis

Objective: To evaluate the accuracy of the near-infrared light transillumination (NILT) for the detection of interproximal dental caries in permanent dentition when compared to bitewing X-ray (BW). Data: In vivo studies that detected interproximal primary caries in permanent teeth by using NILT and BW were selected. QUADAS-2 was used to assess the risk of bias. Pooled sensitivity and specificity forest plots were calculated, summary receiver operator characteristics (SROC) curves were constructed. The certainty of the evidence was rated using the GRADE system. Sources: Pubmed, Cochrane Library, Web of Science, Scopus, Lilacs/BBO and grey literature databases were surveyed. Study selection: From 1594 retrieved articles, 13 studies were included. Six studies had a low risk of bias and a low level of concern regarding applicability. Four studies had an unclear risk of bias, while three presented a high risk of bias. The meta-analysis of six studies demonstrated that NILT presented good overall accuracy. Of 6110 teeth, 92.3 % (5639) were accurately classified (776 as true positive and 4863 as true negative). The pooled sensitivity was 0.97 (0.96 to 0.98; p = 0.0000; I-2 = 93.2 %) with moderate certainty of evidence, and the pooled specificity was 0.91 (0.91 to 0.92; p = 0.0000; I-2 = 98.3 %) with high certainty of evidence. Symmetric (0.9837) and asymmetric (0.9836) SROC showed a high discrimination and determination effect of NILT. Conclusion: The current literature, with moderate certainty and a middling quality of evidence, demonstrates that NILT presents a reasonably comparable accuracy to that of BW for detecting interproximal carious lesions in the permanent dentition. Clinical significance: Since NILT presented good overall accuracy for the detection of interproximal primary caries, it could be routinely used in dental check-ups, especially in high-risk caries populations and in patients where the use of radiation should be reduced, like pregnant women or children.