Fiber-optic transillumination method
Fiber-optic transillumination is a development of a classic diagnostic aid, advocated some 20 years ago, which has never gained wide acceptance. However, it should be a regularly used tool for diagnosis of caries, in the incisor and premolar regions at least, to supplement clinical examination and bitewing radiographs. Fiber-optic transillumination has enjoyed variable success in studies evaluating its performance, possibly because of failure to appreciate that the technique, like any other, requires an extended learning phase.
However, in a recent experimental study, Vaarkamp et al (1997) showed that use of wave length-dependent FOTI allowed quantitative diagnosis of early enamel lesions.
In an earlier study, Verdonschot et al (1991) found that FOTI was more useful than bitewing radiographs for detection of enamel lesions. In another study, Peers et al (1993) evaluated in vitro the validity and reproducibility of clinical examination, FOTI, and bitewing radiographs for the diagnosis of small approximal carious lesions.
The results showed that the validity of FOTI was at least as high as that of bitewing radiographs, and both diagnostic tools were superior to unaided clinical diagnosis.
Although FOTI cannot sensitively detect approximal lesions at the D1 level, it is specific, and its success compared to clinical methods at the D3 level means that FOTI should seriously be considered as an adjunct and used in situations where radiography is not appropriate or feasible. Traditionally advocated for approximal lesions in dentin, FOTI may also have some application in the diagnosis of occlusal lesions. The results to date are equivocal, but Wenzel et al (1992) showed that, compared to visual inspection and various radiographic image modalities, the FOTI method gave, on average, the most accurate diagnosis of noncavitated, occlusal carious lesions of dentin in extracted teeth.
