Quantitative Diagnosis of Small Approximal Caries Lesions Utilizing Wavelength-dependent Fiber-optic Transillumination

Abstract

A b stra c t. The in s tru m e n ts clin ically a v ailab le fo r the diagnosis of approxim al caries lesions are in ad eq u ate to detect lesions early and quantitatively. The aim of this study w as to investigate w h eth er w av elen g th -d ep en d en t light scattering and absorption of carious tissues m ay be utilized for the quantitative diagnosis of these sm all approxim al caries lesions. Seventeen extracted p rem o lar teeth w ere transilluminated at an approximal surface w ith a glass fiber, which transported the light from a halogen light bulb. Seven approximal surfaces contained a naturally developed small white-spot lesion, and 5 surfaces a small discolored lesion. Five teeth were sound. The occlusal surface w as im aged w ith a CCD camera. Light in the blue and red portions of the electrom agnetic spectrum w as selected b y m eans of Schott glass filters. From the o btained im ages, average effectiv e d e c a d ic o p tic a l th ic k n e ss d iffe re n c e s w e re determ ined. These w ere plotted as a function of average mineral loss assessed by means of w avelength-independent m icroradiography. The correlation coefficient betw een the average effective decadic optical thickness difference and average m in e ra l loss w as f -0.79 (95% Cl: 0.47,..0.93). Different sources of variation that influence the observed c o rre la tio n w e re d e fin e d a n d q u a n tifie d . F rom these measurem ents, the correlation coefficient between average effective decadic optical thickness difference and 'tru e ' average mineral loss was estim ated to be £ = 0.92 (95% Cl: 0.77...0.97). The results indicate that early and, in principle, also quantitative diagnosis of approxim al caries lesions is feasible w h en w a v elen g th -d ep en d en t light p ro p ag ation through carious tissues is utilized.

Developments in Caries Diagnosis and Their Relationship to Treatment Decisions and Quality of Care

“…It appears to be very difficult and expensive to create or modify a market. Inevitably, attemps Tveit et al [1994] visual inspection occlusal 0.76 a Ekstrand et al [1997] visual inspection occlusal 0.90 Wenzel and Fejerskov [1992] radiography occlusal 0.54 a Ekstrand et al [1997] radiography occlusal 0.77 Ricketts et al [1996] ERM occlusal 0.62 Ekstrand et al [1997] ERM occlusal 0.82 Vaarkamp et al [1997a] radiography approximal 0.70 Vaarkamp et al [1997a] QOTI approximal 0.87 Vaarkamp et al [1997b] QOTI have to be made to pursue the dissemination of the products developed and evaluated by caries diagnosis researchers to prevent their work from becoming 'l'art pour l'art'. Hence, researchers should collaborate with industry to create a new market.…”

Performance of laser fluorescence devices and visual examination for the detection of occlusal caries in permanent molars

“…Only limited research has so far been performed. [14][15][16] Fluorescence is a property of some manmade and natural materials that absorb energy at certain wavelengths and emit light at longer wavelengths. Several caries detection methods engage fluorescence.…”

Wavelength-Dependent Fibre-Optic Transillumination of Small Approximal Caries Lesions: The Use of a Dye, and a Comparison to Bitewing Radiography

“…Although the diagnostic sensitivity of fibre-optic transil lumination for lesions progressed into the dentine is signif icantly lower than that of bitewing radiography [Vaarkamp et al, 1996a], in previous research it was shown that quanti tative information about an approximal lesion is transferred to the occlusal surface when transilluminating teeth [Vaar kamp et al, 1995], In addition, where the diagnostic per formance of bitewing radiography for incipient lesions is known to be low [Russel and Pitts, 1993;Svenson et al, 1994], small lesions could be detected using wavelength-de pendent fibre-optic transillumination [Vaarkamp et al, 1996b]. Though no distinction could be made between white-spot and discoloured lesions, it remains to be investi gated whether wavelength-dependent fibre-optic transil lumination has a better diagnostic performance than bite wing radiography.…”