Near infrared imaging (NIRI) technology in

dentistry - iTero Element 5D.

This clinical guide presents the promising features of the iTero Element 5D Imaging System designed with NIRI
technology and its application into every day dentistry. NIRI technology of the iTero Element 5D aids in detection
and monitoring of interproximal caries lesions above the gingiva without using harmful radiation.
Author: Dr. Priyanka Keshav BDS, iTero Global Education

Background
In 2001, the National Institutes of Health Consensus Conference on the detection of such lesions. Moreover, the treatment for early dental
Diagnosis and Management of Dental Caries throughout life stated that decay or caries is shifting away from aggressive cavity preparations
“Dental caries is an infectious, communicable disease resulting in that attempt aggressive removal of demineralized tooth structure
destruction of tooth structure by acid-forming bacteria found in dental toward non-surgical or minimally invasive restorative techniques5.
plaque, an intraoral biofilm, in the presence of sugar. The infection results
in the loss of tooth minerals that begins with the outer surface of the
tooth and can progress through the dentin to the pulp, ultimately Near infrared imaging technology
compromising the vitality of the tooth”1.
Near Infrared Imaging serves as a valuable diagnostic aid in the early
Although largely preventable, dental caries is one of the two biggest detection of interproximal caries. The near infrared (NIR) is the region of
threats to oral health and is amongst the most common chronic diseases the electromagnetic spectrum between 0.7 to 2.0 micrometers (µm)6. The
in the United States. Dental caries is the most common chronic disease in iTero Element 5D Imaging System uses light of wavelength (= 850nm) in
children; it is about five times as common as asthma and seven times as the electromagnetic spectrum which on interaction with the hard tissue of
common as hay fever2. Majorities of adults today live with untreated tooth the tooth provides additional data of its structure. Enamel is transparent
decay in their permanent teeth; this makes the early detection of caries to NIRI due to the reduced scattering co-efficient of light, allowing it to
vital to identify and combat these pathological lesions in the early stages. pass through its entire thickness and present as a dark area, whereas the
The World Health Organization estimates that 60-90% of school children dentin appears bright due to the scattering effect of light caused by the
and nearly 100% of adults have or have had caries3. orientation of the dentinal tubules, any interferences/pathological lesions/
areas of demineralization appear as bright areas in a NIRI image due to
The concept of dental caries has changed significantly over the last the increased scattering within the region.
decade. While the only way of managing caries used to be the complete
removal of the demineralized tissues, today, caries is considered a iTero Element 5D Imaging System is an innovative integrated optical
dynamic process, which, if diagnosed in time, could be reversed. diagnostic aid (uses class 1 laser) and is the first 3D intraoral scanner
The current treatment philosophy is to prevent and detect dental disease with NIRI technology. With one scan, it is possible to view multiple layers
at the earliest stage in order to avoid invasive treatment. With the current of data: 3D model, 2D color images and NIRI images mapped to the 3D
understanding of the nature of dental disease and its process, the model. The user can rotate a 3D model of the teeth on the computer
treatment philosophy is now changing to a more conservative approach monitor and without looking at the patient to evaluate it from different
and the concept of minimal intervention is gaining popularity in modern angles and review the corresponding color and NIRI images at the same
dentistry throughout the world. Early caries detection is essential for time to gather a comprehensive view of the situation. The system digitally
minimal intervention dentistry because it could give the opportunity to captures the 3D geometry and color of the patient's intraoral
reverse the process and eliminate or at least postpone the surgical dental structures using a proprietary optical, non-contact, focus
treatment. The ideal caries detection device should be able to detect detection technique.
the caries from the earliest stages, when the organic matrix is still not
damaged, to the latest stages of cavitated lesion4. Current conventional The device also includes capabilities of NIRI function that captures data
diagnostic methods rely mainly on visual, tactile methods paired with beneath the tooth surface using NIRI illumination during routine scanning.
radiographs. Each of these methods have significant drawbacks; Visual Incorporating both the NIRI images and the color images captured by the
examination is highly technique sensitive and subjective, and tactile system can aid in the detection of caries. Images are available in real time
methods of examination are unreliable for examining proximal areas due on the screen, can be enlarged, and contrasts can be adjusted based on
to lack of eye contact with the proximal surface itself and some studies preference. Additionally, scans can be saved and viewed later as desired
have indicated that the tip of the probe may cause micro abrasions or paired with tools such as TimeLapse to monitor areas of interest.
of the enamel or damage to areas of remineralization if present.
Optical methods have the advantage that they do not use ionizing
Additonally, radiographs are known to expose the patient to harmful radiation. For this reason, these procedures can be used as often as
ionizing radiation present with technique sensitivity cannot be used desired to monitor caries. Several clinical studies have showed NIRI
frequently. New imaging technologies are in demand for the early sensitivity to be as potent as radiographic examinations and are well
suited for the detection and imaging of interproximal caries7.

*iTero Element 5D is not yet available for sale in the US.*iTero Element 5D is currently available in European Union countries with exception in Switzerland and Norway.
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Literature (NILT) and PSP-Bitewing radiographs and to compare the
interobserver and intraobserver differences in addition to
Numerous studies have been conducted concerning near infrared observers’ experience level to detect early interproximal caries
imaging that can be traced back to the early 1990s. Some noteworthy lesions in vivo
articles have been mentioned as follows:
Methods: A total of 52 untreated posterior teeth with and without
1. Fried D, Glena RE, Featherstone JD, Seka W. Nature varying degrees of early interproximal carious lesions were
of light scattering in dental enamel and dentin at included. Bitewing radiographs using digital phosphor plates
visible and nearinfrared wavelengths. Applied Optics. (PSP-Bitewing) and NILT were used to clarify the diagnosis.
1995;34(7):127812868 An oral and maxillofacial radiologist and a restorative dentistry
consultant evaluated the images twice. A separate appointment
Objective: In this study, Fried et al. measured the optical for clinical validation and restoration was made. Kappa
properties of fully index-matched samples of enamel and dentin coefficients were calculated to assess both intraobserver and
as a step in calculating the distribution of deposited energy interobserver agreements for each evaluation method. Scores
in teeth. The light-scattering properties of dental enamel and obtained from PSP-Bitewing and NILT were compared with
dentin were measured at 543, 632, and 1053 nm between 0° and the clinical validation via receiver operating characteristic
180° in appropriate index-matching baths. From the measured (ROC) analysis.
distributions and comparison with Monte Carlo 1MC2 simulations
of light scattering in these tissues, the optical coefficients, the Results: No significant differences were found between PSP-
nature of the phase function, and the scattering anisotropy were Bitewing radiography and NILT for detecting early interproximal
derived for dentin and enamel at these wavelengths. carious lesions with high average Az results. Both intraobserver
and interobserver agreement values were relatively higher for
Results: In the visible and NIR wavelengths, dentin and enamel NILT evaluation. The Az values increased at second evaluations
weakly absorb light, and light scattering plays an important role for both caries detection methods.
in determining the deposited energy distribution in the tissue.
The scattering and absorption coefficients of enamel compare Conclusion: NILT examination has an appropriate sensitivity
favorably with literature values measured using an integrating and diagnostic accuracy for detecting early interproximal
sphere. The measured scattering and absorption coefficients caries lesions and can be considered as a method of choice for
of dentin are both almost an order of magnitude larger than for detecting caries without the use of ionizing radiation.
enamel. Preliminary, two-dimensional, spatially resolved MC
3. Evaluation of two imaging techniques: near-infrared
simulations using the optical parameters determined in this study
transillumination and dental radiographs for the detection of
indicate that the use of visible and NIR laser beams of, 1-mm
early approximal enamel caries. Maia AM, Karlsson L, Margulis
diameter on the enamel surface may lead to preferential energy
W, Gomes AS.10
deposition near the dentin–enamel interface. This may have
negative consequences such as subsurface heating
Objective: The aim of this paper was to evaluate a
and cracking.
transillumination (TI) system using near-infrared (NIR) light
Relevance: Use of NIRI has been studied in enamel, which shows and bitewing radiographs for the detection of early approximal
high transparency. There is published data available regarding enamel caries lesions.
this technology in teeth, and more specifically in enamel and Methods: Mesiodistal sections of teeth (n = 14) were cut with various
dentin. There is substantial evidence dating from 1990 for the thicknesses from 1.5 mm to 4.75 mm. Both sides of each section were
included, 17 approximal surfaces with natural enamel caries and 11
potential use of NIR light for detecting caries in enamel, due to its
surfaces considered intact. The approximal surfaces were illuminated
high transparency when illuminated by Near Infra-Red light. by NIR light and X-ray. Captured images were analysed by two
calibrated specialists in radiology, and re-analysed after 6 months
2. Comparison of diagnostic methods for early interproximal using stereomicroscope images as a gold standard.
caries detection with near-infrared light transillumination:
an in vivo study Ismail Hakki Baltacioglu and Kaan Orhan9 Results: The interexaminer reliability (Kappa test statistic) for the NIR TI
technique showed moderate agreement on first (0.55) and second (0.48)
Background: Although numerous studies have used digital evaluation, and low agreement for bitewing radiographs on first (0.26)
intraoral imaging, only a few studies have used photo-optical and second (0.32) evaluation. In terms of accuracy, the sensitivity for the
NIR TI system was 0.88 and the specificity was 0.72. For the bitewing
methods for the diagnosis of caries. Moreover, several limitations
radiographs the sensitivity ranged from 0.35 to 0.53 and the specificity
exist in terms of observers (experience and specialty) and the ranged from 0.50 to 0.72.
caries lesion itself. Hence, the aims of this study were to evaluate
the diagnostic capability of near-infrared light transillumination

*iTero Element 5D is not yet available for sale in the US.*iTero Element 5D is currently available in European Union countries with exception in Switzerland and Norway.
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Conclusion: In the same samples and conditions tested, NIR TI Conclusions: NIRT should be used in caries diagnosis in
images showed reliability and the enamel caries surfaces were combination with radiographic images. In fact, NIRT can help to
better identified than on dental radiographs. correct a false positive diagnosis of enamel caries. Furthermore,
NIRT could be used to detect caries in patients for whom
4. Russotto, F, Tirone, F, Salzano, S, Borga, FC, Paolino, D, non-urgent radiographic exposition is contraindicated and to
Ferraro, A, Botasso, S. Clinical evaluation of near-infrared light monitor caries in medically treated patients.
transillumination (NIRT) as an interproximal caries detection
tool in a large sample of patients in a private practice. J Radiol 5. Caries Detecion and Diagnostics with near – infrared light
Imaging. 2016;1(1):1-511 transillumination : Clinical experiences .Friederike Sochtig,
DDS/Reinhard Hickel,DDS./Jan Kuhnisch,DDS,MDS12
Background: A study has been carried out in order to evaluate The aim of the study was to present the function and potential of
in vivo the diagnostic performance of near-infrared light diagnosing caries lesions using a recently introduced near-infrared(NIR)
transillumination (NIRT) compared to digital radiographic transillumination technique (DIAGNOcam, KaVO).
examination (RE) in the detection of class II carious lesions.
Materials and Methods: The study included 130 adolescents
Methods: A total of 114 patients were included, and 2957 proximal and adults with complete permanent dentition (age >12). All
surfaces were considered. Surfaces were imaged by means of NIRT patients underwent visual examination and, if necessary, bitewing
and radiographed with a photostimulable phosphor system. NIRT and radiographs. Proximal and occlusal surfaces, which had not yet
radiographic images were observed by two blinded operators. Their
diagnoses were compared with those made while visiting the patients,
been restored, were photographed by a NIR transillumination
when visual-tactile, radiographic and NIRT data were matched by expert camera system using light of 780nm rather than ionizing radiation.
operators to obtain the reference diagnoses. Sensitivity, specificity and OF the study patients.85 showed 127 proximal dentin caries
inter-observer consistency were calculated. lesions that were treated operatively.

Results: Throughout the visits, 395 caries were detected. When Results: Based on the practical experiences to date by the
investigating without clinical information and in a blind manner, authors, a possible classification of diagnosis was introduced.
RE performed significantly better than NIRT regarding sensitivity The main result of the study was that NIR light was able to
analysis (0.591 vs. 0.456, p<0.001), and NIRT performed visualize caries lesions on proximal and occlusal surfaces.
significantly better than Radiographic examination (RE) regarding
specificity analysis (0.980 vs 0.933,p<0.001). However, NIRT Conclusion: The study suggests that NIR Trans illumination is a
showed sensitivity similar to RE when only enamel caries were method that may help to avoid bitewing radiographs for diagnosis
concerned. With regard to no agreement between the two of caries in everyday clinical practice.
positives for enamel caries (95% from 0.699 to 0.791) was
observed in RE. NIRT was very likely to detect and correct the
erroneous positive diagnosis of enamel carious lesions obtained
using RE (955 CI for probability from 0.938 to 0.979).

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 NIRI - A reflective concept of light and its mechanism of action NIRI as a diagnostic aid for interproximal caries detection
above the gingiva without use of radiation:

Interproximal carious lesions are clinically apparent as a chalky

white discoloration. It is estimated that it takes about 4 years for
an inital proximal lesion to be seen clinically13. Effective diagnosis
of interproximal carious lesions is affected by the natural anatomy
of the tooth, alignment within the arch and technique sensitivity
involved with radiographs.

A study conducted at the University of California (UCLA) School

of Dentistry found that when using traditional film radiographs,
caries presence and depth are misdiagnosed up to 40% of the
time. In addition, healthy teeth are misdiagnosed as having caries
The iTero Element 5D intraoral NIRI image of a healthy tooth
scanner uses light of 850nm that up to 20% of the time.
penetrates into the tooth structure
to produce a NIRI image. Hence, using effective tools that aid in confirming the presence
of a lesion at it's earliest stage can prove to be a major advantage
while treating patients.

Image interpretation - Healthy tooth

Enamel is mostly
transparent
to NIRI and
appears dark

Dentin is mostly
scattering
to NIRI and
appears bright

Image interpretation - Tooth with caries

Healthy enamel
appears dark

Proximal carious
lesions of
the enamel
appear bright

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Case presentation 1:
Healthy tooth structure (maxillary premolar #12)
Figure 1: Image demonstrating the left maxillary premolar #12 as
seen in NIRI. A uniformly dark outer enamel layer with a bright
center indicating the dentin is a classic example of a healthy tooth
structure with no apparent lesions, note the constrast between
the enamel-dentin provides a clear, appreciable demaraction
between the two.

When examined in multiple modes (color view, intraoral camera

view and NIRI) comparisons can be made to aid in differential
diagnosis; in this case, uniform color of the tooth with no apparent
discoloration or loss of structural integrity indicates the presence
of a healthy tooth.

Color view Intraoral camera NIRI Graphic NIRI image

Fig. 1

Case presentation 2:
Healthy tooth #10 with an Invisalign attachment

Figure 2: Image showing (#10) left maxillary lateral incisor with an

Invisalign attachment on the buccal. Inspection of the occlusal
surface under NIRI suggests a healthy tooth structure with no
evidence of carious lesions or enamel demineralization.

Note: The presence of attachments in this case does not have

any negative effect on the NIRI image.

Color view Intraoral camera NIRI Graphic NIRI image

Fig. 2

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Case presentation 3:
Proximal carious lesion (maxillary premolar #13)
Figure 3: A bright spot in the mesial aspect of the left maxillary
premolar indicates the presence of a proximal carious lesion. The
position of #12 (rotated and inclined) in relation to #13 creates a
narrow area which is difficult to clean and may favor accumulation
of food and debris over time. Note in the image from the intraoral
camera there is no evidence of underlying carious activity.

Color view Intraoral camera NIRI Graphic NIRI image

Fig. 3

Case presentation 4:
Proximal carious lesion and composite filling
(Maxillary premolar #13)
Figure 4: A mesial bright spot in the left maxillary premolar (#13)
indicates the presence of a carious lesion. Note the distal of #13
presents with a dark area, on comparison with the color image
from the intraoral camera, the presence of an existing composite
restoration is confirmed.

Color view Intraoral camera NIRI Graphic NIRI

image

Fig. 4

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Case presentation 5:
Proximal carious lesion (maxillary premolar #4
Figure 5: NIRI image of #4 indicates a bright wedge shaped area
advancing towards the DEJ suggesting the presence of
carious activity.

Color view Intraoral camera NIRI Graphic NIRI

image

Fig. 5

Case presentation 6:
Proximal carious lesion (maxillary premolar #12)
Figure 6: NIRI image of #12 indicates the presence of a proximal
carious lesion (distal).

Color view Intraoral camera NIRI Graphic NIRI image

Fig. 6

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Case Presentation 7:
Healthy tooth (maxillary left premolar #12)

Figure 7: Image showing (#12) left maxillary premolar,

corresponding NIRI image suggests a healthy tooth structure
with no evidence of carious lesions or enamel demineralization

Color view Intraoral camera NIRI Graphic NIRI

image

Fig. 7

Case presentation 8:
Dental fluorosis (mandibular left canine #22),
distal interproximal carious lesion (#21)
Figure 8: Dental flurosis is one of the most common disorders
of the enamel presenting with characteristic permanent
discoloration. This case is particularly interesting as is it shows
the ability of NIRI to detect the changes in the structural integrity
of enamel. Note: Instances like these may mimick the presence of
caries, in such instances it is valueable to make comparisons with
color images before arriving at a conclusion. Also seen in this
image is a distal interproximal carious lesion on #21.

Color view Intraoral camera NIRI

Fig. 8

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Case presentation 9:
Bonded mandibular lingual arch wire
Figure 9: Image shows a good example of a bonded lingual arch
wire in the mandibular anteriors. Note: The NIRI image remains
abolsutely clear of any obstacles and ready for interpretation.

Color view Intraoral camera NIRI

Fig. 9

Case presentation 10:

Stains in the mandibular anteriors (lingual)
Figure 10: Stains are commonly seen in the mouth especially
in individuals who have a habit of smoking. The above image
suggests that stains do not have any significant effect on the
resultant NIRI image.

Color view Intraoral camera NIRI

Fig. 10

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Case presentation 11:
Proximal carious lesion (mesial#4 and distal #5) with treatment plan

Figure 11: Image on the left shows a patient scan from a routine
dental check-up appointment. Patient had no visual intraoral signs
of caries or any associated pain. Find below a detailed summary
of the steps taken in the diagnosis and treatment planning which
lead to successfully restoring a proximal carious lesion in #5 in
the early stages completed in a single visit.

Fig. 11

01
Image from the intraoral camera Graphic representation
05
On visual examination, small white Graphic representation of #5
surface spots were present on #5.

Patient did not feel any pain

associated with #5.

06 Treatment procedure photograph

Periapical radiographs Based on the findings from NIRI,
01
02
on removal of superficial tooth
Periapical x-rays were prescribed
structure, brown, decayed
as a part of routine check-up.
carious lesion in the distal
Radiograph suggested no aspect was found.
significant findings.

iTero scan in colour Post treatment photograph

07
03
Based on the findings from
Findings from the scan were
NIRI, on removal of superficial
same as that from the intra
tooth structure, brown, decayed
oral camera.
carious lesion in the distal aspect
was found.

04
NIRI image
The NIRI image of the same area shows
bright spots in the distal area of #5
suggesting the presence of a proximal
carious lesion advancing towards the DEJ.

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Case presentation 12:
Calculus and stains in the mandibular anterior teeth

Figure 12: The formation of calculus can be triggered by multiple

factors; most commonly diet, poor oral hygiene, systemic disease
or medication. The presence of calculus does not have any
significant effect on the tooth in NIRI; Calculus itself presents as
areas of brightness in NIRI.

Color view Intraoral camera NIRI

Fig. 12

Case presentation 13:

Proximal carious lesion in distal of #30 with treatment planning)

Figure 13: Image to the left shows a patient scan from a routine
dental check-up appointment. Patient had no symptoms of caries
or any associated pain. Find below a detailed summary of the
steps taken to aid in the diagnosis and treatment planning which
lead to the finding of a proximal carious lesion in distal of #30.

Fig. 13

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 01
Image from the Intraoral camera 04
NIRI image
On visual examination, mild The NIRI image suggests a bright
discoloration with no apparently conical lesion with its apex directed
surface alterations are seen towards the dentin suggesting the
in#30. #31 shows an existing distal presence of a carious lesion in the
composite restoration. distal of #30.

Also seen in this image is a dark,

undefined area in the distal #31,
suggesting the presence of a
Bitewing Radiographs restoration.
01
02
Bitewing radiographs were
prescribed as a part of routine
check-up. 05
Graphic representation

Graphic representation of #30

Radiographs suggested no
significant findings.

03 OPG
03
An OPG was also taken for this case. Restorative procedure
06

With the NIRI image used as a

reference, the affected tooth
structure was removed and the
presence of an underlying carious
lesion was confirmed.

Limitations of the technology: Current limitations of the

technology are mostly around existing restorations. In the
presence of restorations such as amalgam or composite resins,
NIRI is unable to penetrate through the structure of the tooth.
The insufficient data from the scan in these scenarios causes a
blurry, dark and ill-defined resultant image that is not suitable
for examination.

Instances mimicking interproximal caries: Teeth involving

enamel demineralization conditions such as tooth wear, enamel
hypoplasia and fluorosis (as seen in case 7) may mimic the
presence of interproximal caries under NIRI; some dental
cements (such as oxides and phosphates) may also exhibit the
same behavior on interaction with NIRI, best practices to avoid
misinterpretation in such cases would be to compare the NIRI
images with the color images from the scan and other applicable
examination techniques.

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Case presentation 14:
Composite restoration (mandibular right #29#30)

Figure 14: Composite restoration in the distal of #29 and

mesial of #30 presents as a dark area which is comparitively
dull in constrast when compared with the adjacent structures.
The inabiltiy of Near infrared light to pass through existing
restoration results in the presentation of a dark area.

Color view Intraoral camera NIRI Graphic NIRI image

Fig. 14

Case presentation 15:

Amalgam restoration (maxillary right molar #3)

Figure 15: Exisiting amalgam restorations (as seen to the left).

Amalgam being an alloy creates a highly scattering effect on
Near infrared light resulting in a dark image with ill defined
anatomical landmarks which makes the image unsuitable for
interpretation. In such cases, comparison with other available
data is recommended.

Color view Intraoral camera NIRI Graphic NIRI image

Fig. 15

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13
Conclusion: Constant improvements in dental technology are
shaping the way clinicians practice across the globe. Interactive
technology also serves as an added benefit to patients of all ages
who may be apprehensive about their dental visits.

As seen from all the case presentations in this article, NIRI has
demonstrated to be an effective tool in aiding the diagnosis and
monitoring early stages of interproximal caries above the gingiva
in a wide array of clinical scenarios, ultimately leading towards
the successful management of caries even in its earliest stages.
NIRI, which is non-invasive by nature, can be used as frequently
as required to monitor the patient’s oral health and provide the
patient with chairside education, which enables patients to
appreciate and understand the finer details associated with
their oral health.

The iTero Element 5D imaging system helps turn the concept of

comprehensive dentistry into a reality in every dental practice.

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14
 References
Diagnosis and Management of Dental Caries Throughout Life National Institutes of Health Consensus Development Conference
1

Statement, March 26–28, 2001

2
Oral Health: The Silent Epidemic; the Surgeon Generals Perspective

Regina M. Benjamin, MD, MBA, VADM, USPHS

3
The Global Burden of Oral Diseases and Risks to Oral Health, W.H.o Policy and Practice

4
Dalli M, Çolac H, Hamidi MM. Minimal intervention concept: a new paradigm for operative dentistry. J Invest Clin Dent.
2012;3(3):167–175

5
J. D. B. Featherstone and D. Young, "The need for new caries detection methods," Lasers in Dentistry V, San Jose, CA, Proc. SPIE
3593, 134-140 (1999).

6
: Near-Infrared Imaging of Dental Decay at 1310 nm Daniel Fried, PhD*, Michal Staninec, DDS, Cynthia L. Darling, PhD University of
California San Francisco (UCSF) School of Dentistry, San Francisco, California

7
Effectiveness of Near-Infrared transillumination in early caries diagnosis

Mirela-Marinova – Tokorova

Clinical Evaluation of Near Infrared light transillumination as an interproximal caries detection tool in a large sample of patients in a
private practice – Francesco Russotto,F Tirone,Stepho Salzano, Borga, Ferraro,S.Botasso 2016

DIAGNOcam--a Near Infrared Digital Imaging Transillumination (NIDIT) technology.

Abdelaziz M, Krejci I

Fried D, Glena RE, Featherstone JD, Seka W. Nature of light scattering in dental enamel and dentin at visible and nearinfrared
8

wavelengths. Applied Optics. 1995;34(7):12781286.

9
Comparison of diagnostic methods for early interproximal caries detection with near-infrared light transillumination: an in vivo study
Ismail Hakki Baltacioglu and Kaan Orhan

Evaluation of two imaging techniques: near-infrared transillumination and dental

10
radiographs for the detection of early approximal
enamel caries. Maia AM1, Karlsson L, Margulis W, Gomes AS.

Clinical evaluation of near-infrared light transillumination (NIRT) as an interproximal caries detection tool in a large sample of
11

patients in a private practice Francesco Russotto1 , Federico Tirone1,*, Stefano Salzano1 , Francesco Coero Borga1,*, Davide
Paolino2 , Alberto Ferraro1 , and Samanta Botasso3

Journal of Radiology and Imaging

12
Caries Detecion and Diagnostics with near – infrared light transillumination : Clinical experiences

Friederike Sochtig,DDS/Reinhard Hickel,DDS./Jan Kuhnisch,DDS,MDS

13
Elsevier Textbook of Oral Medicine Oral diagnosis and Oral radiology edition 2, Editiors Ravikiran Ongole BDS,MDS,Praveen BN,
BDS,MDS

White SC, Hollender L, Gratt BM. Comparison of xeroradiographs and film for detection of proximal surface caries. J Am Dent
14

Assoc. 1984;108:755-759.

Special acknowledgement: Align would like to thank Dr. Ingo Baresel, Dr.Olivier Boujenah, Dr. Timo Weihard for their contribution to
this article.

© 2019 Align Technology, Inc. All rights reserved. Invisalign, iTero, iTero Element, iTero elemnent 5D, the iTero logo, among others, are trademarks and/or service marks of Align
Technology, Inc. or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries. www.iTero.com | MKT-0003041 Rev A

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