Early detection of interproximal caries is essential in clinical dental practice because these areas are difficult to access through visual examination. Digital bitewing radiography has long been relied upon as the standard method to visualize interproximal areas without overlap, in accordance with the ALARA (As Low As Reasonably Achievable) principle to minimize X-ray exposure.
Image Quality Evaluation and Detection Accuracy
Digital bitewing radiography offers clear images, good contrast, and high diagnostic quality. However, technological advancements challenge its effectiveness compared to non-radiation methods such as Near-Infrared Light Transillumination (NILT). A relevant study by a Faculty of Dentistry UGM student, Lathifa Dewanti N, under the supervision of drg. Ryna Yanuaryska, Ph.D. and Dr. drg. Rini Widyaningrum, M.Biotech., entitled “Proximal Caries Detection Using Bitewing Radiography Compared with Near-Infrared Light Transillumination,” explains that bitewing radiography remains the standard examination method, although NILT offers higher sensitivity for early caries detection without radiation exposure.
Advantages, Challenges, and Implications
- Advantages of Digital Bitewing: Provides clear and standardized visualization of interproximal anatomy. Digital imaging strengthens clinical interpretation and documentation.
- Challenges and Alternatives: NILT is increasingly popular because it is safe and more sensitive for early detection, although it is less effective in detecting caries that have penetrated into dentin.
- Clinical Implications: In terms of image quality, digital bitewing evaluation must consider contrast, resolution, and clarity of interproximal structures. The integration of technologies such as NILT can complement subtle detection without replacing the standard method.
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Digital bitewing radiography remains the primary and most reliable method for detecting interproximal caries due to its good image quality and ability to clearly display anatomical structures. This reinforces the position of bitewing as the gold standard, while highlighting the limitations of more sensitive, radiation-free alternatives such as NILT.
References
Lathifa Dewanti N, drg. Ryna Yanuaryska, Ph.D., Dr. drg. Rini Widyaningrum, M.Biotech., Deteksi Karies Proksimal Menggunakan Radiografi Bitewing Dibandingkan dengan Near-Infrared Light Transillumination, https://etd.repository.ugm.ac.id/penelitian/detail/207009
Author: Rizky B. Hendrawan | Photo: Freepik
