{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T05:16:56Z","timestamp":1783142216494,"version":"3.54.6"},"reference-count":35,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015082","name":"Catholic University of Valencia San Vicente M\u00e1rtir","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100015082","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Near-infrared light transillumination (NIRI) has emerged as a radiation-free adjunctive method for proximal caries detection in pediatric dentistry. However, evidence regarding its diagnostic performance in primary dentition remains limited. The aim of this prospective diagnostic accuracy study was to evaluate the diagnostic performance of NIRI for detecting interproximal dentinal caries lesions in primary molars, using bitewing radiography as a pragmatic clinical reference standard. Methods: Thirty-one pediatric patients aged 5\u201312 years were included, contributing 273 interproximal surfaces of primary molars. Clinical examination was performed using ICDAS criteria, while proximal lesions were assessed using bitewing radiography and NIRI integrated into the iTero Element 5D intraoral scanner. For diagnostic accuracy analysis, only dentinal lesions classified as D1\u2013D3 according to the Mej\u00e0re classification were considered positive cases, whereas E0\u2013E2 surfaces were classified as negative. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated. Results: The overall prevalence of caries lesions was 37.4%; however, only 11 surfaces showed dentinal involvement (D1\u2013D3) and were included as positive cases in the diagnostic accuracy analysis. NIRI demonstrated a sensitivity of 81.8% and a specificity of 74.8%. The PPV was 12.0%, whereas the NPV was 99.0%. Overall diagnostic accuracy was 75.1%. A total of 66 false-positive findings and 2 false-negative findings were identified. Conclusions: NIRI demonstrated high sensitivity and excellent negative predictive value for detecting interproximal dentinal caries lesions in primary molars, suggesting potential usefulness as an adjunctive screening tool. However, the low positive predictive value and high number of false-positive findings indicate that positive NIRI findings should be interpreted cautiously and should not be used as a standalone basis for treatment decisions. Further studies using more robust reference standards are required to clarify the clinical significance of NIRI-positive findings.<\/jats:p>","DOI":"10.3390\/children13070890","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:52:24Z","timestamp":1783007544000},"page":"890","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy Study of Near-Infrared Transillumination for Interproximal Dentinal Caries Detection in Primary Teeth"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4146-9345","authenticated-orcid":false,"given":"Andrea","family":"Armengol-Olivares","sequence":"first","affiliation":[{"name":"School of Medicine and Health Sciences, Catholic University of Valencia, 46007 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5722-0547","authenticated-orcid":false,"given":"Laura","family":"Marqu\u00e9s-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Catholic University of Valencia, 46007 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8237-0378","authenticated-orcid":false,"given":"Maria","family":"Carmona-Santamar\u00eda","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Catholic University of Valencia, 46007 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0749-9311","authenticated-orcid":false,"given":"Clara","family":"Maria Ferrer-Serrador","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Catholic University of Valencia, 46007 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8010-774X","authenticated-orcid":false,"given":"Irene","family":"Tormo-G\u00f3mez","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Catholic University of Valencia, 46007 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0977-7759","authenticated-orcid":false,"given":"M\u00f3nica","family":"Fern\u00e1ndez-Maf\u00e9","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Catholic University of Valencia, 46007 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/00004032-200409000-00005","article-title":"Radiation protection principles of NCRP","volume":"87","author":"Kase","year":"2004","journal-title":"Health Phys."},{"key":"ref_2","first-page":"2141","article-title":"The importance of public health in radiology and radiation protection","volume":"10","year":"2021","journal-title":"J. Public Health Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e2018017","DOI":"10.5620\/eht.e2018017","article-title":"Health effects from exposure to dental diagnostic X-ray","volume":"33","author":"Hwang","year":"2018","journal-title":"Environ. Health Toxicol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"American Dental Association Council on Scientific Affairs (2012). The use of cone-beam computed tomography in dentistry. J. Am. Dent. Assoc., 143, 899\u2013902.","DOI":"10.14219\/jada.archive.2012.0295"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3109\/00016357.2014.888757","article-title":"Radiographic display of carious lesions and cavitation in approximal surfaces: Advantages and drawbacks of conventional and advanced modalities","volume":"72","author":"Wenzel","year":"2014","journal-title":"Acta Odontol. Scand."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1002\/j.0022-0337.2005.69.5.tb03941.x","article-title":"Present and future approaches for the control of caries","volume":"69","author":"Anusavice","year":"2005","journal-title":"J. Dent. Educ."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1159\/000016424","article-title":"Caries development from 11 to 22 years of age: A prospective radiographic study. Prevalence and distribution","volume":"32","author":"Stenlund","year":"1998","journal-title":"Caries Res."},{"key":"ref_8","first-page":"146","article-title":"An in vivo comparison of radiographic and directly assessed clinical caries status of posterior approximal surfaces in primary and permanent teeth","volume":"26","author":"Pitts","year":"1992","journal-title":"Caries Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s00247-006-0192-4","article-title":"Practice of ALARA in the pediatric interventional suite","volume":"36","author":"Connolly","year":"2006","journal-title":"Pediatr. Radiol."},{"key":"ref_10","unstructured":"American Academy of Pediatric Dentistry (2018). Prescribing dental radiographs for infants, children, adolescents, and individuals with special health care needs. Pediatr. Dent., 15, 213\u2013215."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"103861","DOI":"10.1016\/j.jdent.2021.103861","article-title":"Reflected near-infrared light versus bite-wing radiography for the detection of proximal caries: A multicenter prospective clinical study conducted in private practices","volume":"116","author":"Metzger","year":"2022","journal-title":"J. Dent."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Baltacioglu, I.H., and Orhan, K. (2017). Comparison of diagnostic methods for early interproximal caries detection with near-infrared light transillumination: An in vivo study. BMC Oral Health, 17.","DOI":"10.1186\/s12903-017-0421-2"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1038\/s41598-021-81872-7","article-title":"Early-stage dental caries detection using near infrared spatial frequency domain imaging","volume":"11","author":"Bounds","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"14224","DOI":"10.1038\/s41598-019-50850-5","article-title":"Combined Near-Infrared Light Transillumination and Direct Digital Radiography Increases Diagnostic Accuracy in Approximal Caries Detection","volume":"9","author":"Melo","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Marmaneu-Menero, A., Iranzo-Cort\u00e9s, J.E., Almerich-Torres, T., Ortol\u00e1-S\u00edscar, J.C., Montiel-Company, J.M., and Almerich-Silla, J.M. (2020). Diagnostic Validity of Digital Imaging Fiber-Optic Transillumination (DIFOTI) and Near-Infrared Light Transillumination (NILT) for Caries in Dentine. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020420"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"034023","DOI":"10.1117\/1.2204603","article-title":"Light scattering properties of natural and artificially demineralized dental enamel at 1310 nm","volume":"11","author":"Darling","year":"2006","journal-title":"J. Biomed. Opt."},{"key":"ref_17","first-page":"74","article-title":"Evaluation of detecting proximal caries in posterior teeth via visual inspection, digital bitewing radiography and near-infrared light transillumination","volume":"32","author":"Schaefer","year":"2019","journal-title":"Am. J. Dent."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"270729","DOI":"10.1155\/2010\/270729","article-title":"Caries Detection Methods Based on Changes in Optical Properties between Healthy and Carious Tissue","volume":"2010","author":"Karlsson","year":"2010","journal-title":"Int. J. Dent."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"214","DOI":"10.23736\/S2724-6329.21.04527-7","article-title":"A comparison of near-infrared imaging with other diagnostic tools for dental caries","volume":"70","author":"Vanella","year":"2021","journal-title":"Minerva Dent. Oral Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1117\/12.469324","article-title":"Attenuation of 1310-nm and 1550-nm laser light through sound dental enamel","volume":"4610","author":"Jones","year":"2002","journal-title":"Proc. SPIE"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1177\/08959374930070021801","article-title":"Advances in methods for diagnosing coronal caries\u2014A review","volume":"7","year":"1993","journal-title":"Adv. Dent. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1364\/AO.34.001278","article-title":"Nature of light scattering in dental enamel and dentin at visible and near-infrared wavelengths","volume":"34","author":"Fried","year":"1995","journal-title":"Appl. Opt."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"17012","DOI":"10.1038\/bdjopen.2017.12","article-title":"Clinical performance of the near-infrared imaging system VistaCam iX Proxi for detection of approximal enamel lesions","volume":"3","author":"Jablonski","year":"2017","journal-title":"BDJ Open"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/eos.12663","article-title":"In vitro validation of near-infrared reflection for proximal caries detection","volume":"127","author":"Lederer","year":"2019","journal-title":"Eur. J. Oral Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00784-021-04032-1","article-title":"Diagnostic validity of early proximal caries detection using near-infrared imaging technology on 3D range data of posterior teeth","volume":"26","author":"Litzenburger","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1038\/s41415-021-3732-2","article-title":"From \u2018ICDAS\u2019 to \u2018CariesCare International\u2019: The 20-year journey building international consensus to take caries evidence into clinical practice","volume":"231","author":"Pitts","year":"2021","journal-title":"Br. Dent. J."},{"key":"ref_27","unstructured":"HDX Intraoral X-Ray System: User Manual, DentalEZ Inc."},{"key":"ref_28","unstructured":"D\u00fcrr Dental, S.E. VistaScan Mini Easy 2.0: Operating Instructions, D\u00fcrr Dental SE."},{"key":"ref_29","unstructured":"Align Technology Inc. (2022). iTero Element\u2122 5D y iTero Element\u2122 5D Plus Bildgebungssysteme Benutzerhandbuch, Alinear Tecnolog\u00eda, Inc.. PN217764Vers.A."},{"key":"ref_30","first-page":"48","article-title":"Part 1: Simple definition and calculation of accuracy, sensitivity and specificity","volume":"3","author":"Baratloo","year":"2015","journal-title":"Emergency"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/s00784-015-1559-4","article-title":"In vivo validation of near-infrared light transillumination for interproximal dentin caries detection","volume":"20","author":"Pitchika","year":"2016","journal-title":"Clin. Oral Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/jopr.13770","article-title":"Performance of the caries diagnosis feature of intraoral scanners and near-infrared imaging technology: A narrative review","volume":"32","author":"Lin","year":"2023","journal-title":"J. Prosthodont"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Schlenz, M.A., Schupp, B., Schmidt, A., W\u00f6stmann, B., Baresel, I., Kr\u00e4mer, N., and Schulz-Weidner, N. (2022). New caries diagnostic tools in intraoral scanners: A comparative in vitro study to established methods in permanent and primary teeth. Sensors, 22.","DOI":"10.3390\/s22062156"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"100025","DOI":"10.1016\/j.jjodo.2020.100025","article-title":"Clinical validation of near-infrared light transillumination for early proximal caries detection using a composite reference standard","volume":"103","author":"Stratigaki","year":"2020","journal-title":"J. Dent."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/7\/890\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T04:38:14Z","timestamp":1783139894000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/7\/890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["children13070890"],"URL":"https:\/\/doi.org\/10.3390\/children13070890","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]}}}