Clinical performance of a laser fluorescence device for detection of occlusal caries lesions

Abstract

Children and adolescents must be examined often for occlusal caries. Diagnosis of fissure caries is difficult especially when the tooth surface appears seemingly intact. It has been shown that using traditional clinical methods, as little as 20% of teeth with fissure caries under intact surfaces were correctly recognised as such. Therefore, new methods for increasing the accuracy of diagnosis have been sought for years. Recently, a new device, based on fluorescence measurements, was introduced. The purpose of this study was to test the device under in vivo conditions in order to provide recommendations for its use in the dental office. Seven general dental practitioners examined a total of 332 occlusal surfaces in 240 patients. Caries extent was determined for each site after operative intervention (='gold standard'). Clinical inspection and analysis of bitewing radiographs exhibited statistically significant lower sensitivities (31-63%) than did the DIAGNOdent device (sensitivity > or = 92%). It is recommended that the laser device is used in the decision-making process in relation to the diagnosis of occlusal caries as a second opinion in cases of doubt after visual inspection.

Use of laser fluorescence in dental caries diagnosis: a fluorescence x biomolecular vibrational spectroscopic comparative study

“…According to the authors (19), less sensitivity could be explained by the Diagnodent pen device, since the study refers mainly to enamel lesions and not to dentinal ones. In general, all studies agree that Diagnodent performs well when used for dentinal lesions (9).…”

“…This finding reinforces the observation of another study (18), which concluded that the depth of dental caries has greater influence than the mineral loss in Diagnodent readings. The increased values in the Diagnodent readings were probably due to a higher fluorescence, which might be attributed to bacterial metabolic activity (9) and also to the amount of organic matrix (13,18) rather than from disintegration of crystals.…”

“…Diagnodent is a diagnostic device that has a probe that emits light directed on the mineralized surface to be examined. If this surface has some form of structural change, it will emit a fluorescent light that is captured back by the probe and the device will display values ranging from 0 to 99 (9). Diagnodent has been tested extensively, including for detection of occlusal and smooth surface caries, comparing its results with visual inspection, histology, radiography and quantitative light-induced fluorescence (7,9).…”

Caries diagnosis using light fluorescence devices: VistaProof and DIAGNOdent

“…Extensive literature is available on DIAGNOdent and in vitro and in vivo studies have edited cut-off values that correlate with the histological status [15].…”

“…The peak value was recorded. For dentin caries level, the cutoff values were 30 according to the manufacturer's suggestions [15].…”