DIAGNOdent Readings Research Articles

Evaluation of a new caries detecting dye for primary and permanent carious dentin

This study evaluated the clinical efficacy of a new caries detecting dye using a laser fluorescence device (DIAGNOdent). Primary and permanent teeth with dentin caries were stained with Caries Check (CC), containing 1% acid red in polypropylene glycol (MW=300) or Caries Detector (CD), containing 1% acid red in propylene glycol (MW=76). Primary-CC, primary-CD, permanent-CC and permanent-CD groups were prepared. In the CC groups, stained dentin was completely removed. In the CD groups, pink-stained dentin was retained according to the manufacturers' instructions. Cavities before and after caries removal were measured with the DIAGNOdent. Data were analyzed using ANOVA and Fisher's PLSD multiple comparison test at alpha=0.05. Regression analyses were performed between DIAGNOdent readings and scores obtained from the clinical parameters. For all groups, there were no significant differences in the DIAGNOdent readings before treatment. The DIAGNOdent readings after caries removal were: primary-CC (16.0+/-17.6), primary-CD (9.6+/-5.2), permanent-CC (11.0+/-7.0) and permanent-CD (7.1+/-3.8). Significant differences were identified between the permanent-CC and primary-CD, and permanent-CC and permanent-CD subgroups but not for the primary subgroups. Correlation coefficients between DIAGNOdent readings and clinical parameters were low. When dentin stained with Caries Check was completely removed, the DIAGNOdent readings were higher than those recorded when palely-stained pink dentin was retained with the Caries Detector, with significant difference observed for the permanent teeth. Caries Check may be used clinically to avoid excessive removal of caries-affected or sound dentin in permanent teeth but not in primary teeth.

The influence of toothpastes and prophylaxis pastes on fluorescence measurements for caries detection in vitro

The aim of this study was to test the influence of toothpaste and prophylaxis paste remnants as well as powder remnants on DIAGNOdent readings. A total of 68 sites on the occlusal surface of human molars were used for this study. After a cleaning procedure, saliva was spread on the tooth surface, dried for 3 s, and DIAGNOdent (DD) values were measured. After these measurements were performed, 500 mg of the toothpaste or prophylaxis paste was taken and the occlusal surface was cleaned for 3 s with a slow rotating contra-angle handpiece. The paste was then rinsed off with the 3-in-1 syringe for 3 s using water with air. The DD measurements were taken again and the rinsing for 3 s and fluorescence measurements were repeated. The procedure with the powder using the PROPHYflex 2 was, in principle, the same. Whereas only small differences could be detected on sound surfaces, there was a distinct influence on decayed surfaces. It could be concluded that when the DIAGNOdent device is used in practice and special care in rinsing after cleaning is not taken, it is possible that false readings are registered.

Consistency of DIAGNOdent instruments for clinical assessment of fissure caries

DIAGNOdent (KaVo, Biberach, Germany) has shown high diagnostic accuracy and intra‐operator agreement for caries detection, both in vitro and in vivo. The aims of this study were to compare DIAGNOdent with visual examination (VI) and bitewing radiographs (BW) for clinical assessment of occlusal fissures, and to evaluate inter‐device consistency of clinical recording using four different DIAGNOdent instruments; secondly, to correlate DIAGNOdent readings with microbial culture of the measured site. The subjects were young adults, the material comprising 34 occlusal fissures, scheduled for restorative treatment at the Dental School Clinic of the University of Iceland. Two examiners conducted visual and radiographic assessments. One examiner measured each site with four DIAGNOdent instruments in random order. The fissure was then opened and lesion depth was classified on a 4‐point scale. Bacterial samples were taken from the fissure before and after opening. Intra‐operator agreement was high (r = 0.85–0.98). Inter‐device correlation for the four DIAGNOdent instruments was significant in all cases (r = 0.81–0.92). However, a common cut‐off point could not be determined. There was weak but significant correlation between DIAGNOdent readings and all three classes of lesion depth. Level of infection showed very weak correlation with the DIAGNOdent readings. It was concluded that DIAGNOdent is more reliable in detecting dentinal caries if a proper cut‐off point is used than in indicating actual lesion depth. Readings from the different instruments were not directly comparable, however, owing to the lack of a common cut‐off point.