Predicting Caries by Measuring Its Activity Using Quantitative Light-Induced Fluorescence in vivo: A 2-Year Caries Increment Analysis

Abstract

The aim of this study was to analyse the predictive power of several clinical baseline parameters and the de-/remineralisation properties of in vivo etched sites measured with quantitative light-induced fluorescence (QLF) for subsequent 2-year caries increment. At baseline, in 44 children (8.23 ± 1.5 years) two areas (diameter 2 mm) of the buccal surface of a primary posterior tooth were etched with 36% phosphoric acid gel for 1 and 4 min, respectively. The etched sites were analysed immediately after etching (ΔQ1) and 24 h (ΔQ2) later by QLF. Additionally, caries status (deft/DMFT and initial caries), approximal plaque, bleeding on probing, and the patient’s current use of fluorides were recorded. In the 2-year follow-up, 29 children were re-assessed. After clinical examination, the caries increment was calculated (ΔDMFT) and correlated with the baseline clinical variables and the QLF readings. Results showed a significant positive correlation between ΔQ_{1 min} and the ΔDMFT (r = 0.44, p = 0.02). The ΔDMFT was significantly correlated with the baseline deft (r = 0.56, p = 0.002), cavitated active caries lesions (r = 0.52, p = 0.003), and filled teeth (r = 0.53, p = 0.003). In a regression analysis the use of fluoridated salt (SC = –0.10) and fluoride gel (SC = –0.14) were negatively associated with ΔDMFT. In conclusion, these findings suggest that the demineralisation properties of the etched sites and the outcome of the 24-hour measurements with QLF are significantly associated with caries increment. Previous caries experience strongly correlated with caries increment in this group of children.

Ultrasound May Aware Us about Initial Root Caries Lesion

“…Due to those reasons, detection of early root surface caries and its preventive treatment gain big importance in dentistry [2]. Increments in caries were found to be strongly correlated with immediate or 24 hour immediate measurement of the etched sides [3]. Extensive use of fluoride application decreases the frequency and prevalence of dental caries in developed countries.…”

Detecting Short-Term Changes in the Activity of Caries Lesions with the Aid of New Technologies

“…Since then ICDAS has been validated in caries clinical trials [ 13 – 17 ] and aids for the assessment of caries lesion activity have been introduced [ 18 •, 19 – 23 ]. Attempts to assess lesion activity have been based on: presence of plaque, location of the lesion at a plaque stagnation site, surface roughness and dehydration pattern of lesions [ 22 – 25 ], or a subjects capability to remineralize an etched tooth area within 24 h [ 26 , 27 ]. The validity of methods predicting caries progression over time based on a one-time assessment of lesion activity is low for smooth surfaces to moderate for occlusal surfaces [ 8 , 20 ].…”

Utilização de métodos baseados em fluorescência para avaliação da atividade de lesoes de cárie oclusais em molares decíduos

“…Por outro lado, não houve diferença estatisticamente significante entre nenhum dos métodos quanto à diferenciação de lesões ativas e inativas. Apenas dois trabalhos apontam a avaliação da fluorescência no verde com o QLF como uma variável preditora de atividade e progressão de lesões em superfícies livres de dentes decíduos (Meller et al, 2006;Meller et al, 2012).…”

“…Pode-se dizer ainda que a avaliação longitudinal da evolução ou regressão das lesões poderia ser uma forma de estimar sua atividade (Angmar-Mansson et al, 1998;Meller et al, 2012). No entanto, se fossem utilizados métodos convencionais de diagnóstico, como a inspeção visual tradicional ou o exame radiográfico, mudanças decorrentes à evolução ou paralisação das lesões só seriam detectáveis quando alterações significativas já tivessem ocorrido (Angmar-Mansson; ten Bosch, 2001), o que seria eticamente inaceitável.…”