Fibre-optic Transillumination Research Articles

Effects of exposure reduction on the accuracy of an intraoral photostimulable-phosphor imaging system in detecting incipient proximal caries

Digital imaging systems for use in intraoral radiography are becoming common in clinical practice, although its physical properties such as resolution and available dynamic range may be inferior to conventional film systems. The purpose of this study was to determine the diagnostic accuracy in detecting incipient proximal caries using a digital system with storage phosphor plate (Digora®) in comparison with a conventional intraoral film (Kodak Ektaspeed Plus®). Thirty-one extracted upper premolars were selected. Of the 62 surfaces, 33 had proximal caries with discoloration or incipient lesions, and the rest showed no evidence of caries verified on strict inspection using fiber-optic transillumination. All teeth were radiographed following the paralleling technique (60 kV, 40 cm focus-to-film distance). Exposure was adjusted to Ektaspeed Plus film, while reduced to 1/2, 1/4, and 1/8 on Digora®. The films and digital images were evaluated by three observers, using a confidence rating for the presence of caries. On Digora®, the observers could control contrast and brightness. The results showed that Digora® had better performance in detecting caries than the film, even when the exposure was used for the film, although there were no statistically significant differences. The results suggest that the storage phosphor plate system may be used clinically to diagnose incipient proximal caries, while reducing the exposure to the patient.

Factors involved in validity measurements of diagnostic tests for approximal caries--a meta-analysis.

In this study, a meta-analysis was performed on published validity parameters of visual inspection, radiographic examination and visual inspection upon fibreoptic transillumination (FOTI) in approximal caries diagnosis. It was the objective to investigate the influence of the diagnostic test, the study design and the validation method on reported validity. Sensitivities and specificities reported in the literature were transformed into D2 values, representing the performance of a diagnostic method above chance, or of the observer using it, in a single parameter. Dz values were neither statistically significantly different between visual inspection, radiographic examination and FOTI nor between 'weak' and 'strong' validation methods (p > 0.05). Dz values obtained from in vivo studies were significantly different from those obtained from in vitro studies (p < 0.05), indicating that study design had a significant impact on the measurement of the validity of the evaluated test for approximal caries diagnosis.

Detecting Approximal Dental Caries with Transillumination: A Clinical Evaluation

Independent examinations of 300 patients were conducted to evaluate fiber optic transillumination's performance in caries detection. FOTI was used as an adjunct to clinical and radiographic examinations for caries, restoration or secondary caries of approximal surfaces in maxillary anterior permanent teeth. Clinical and radiographic examinations were significantly more effective.

Advances in Methods for Diagnosing Coronal Caries-a Review

Diagnostic methods for coronal caries in common use include visual inspection, tactile examination with a probe, bite-wing radiography, and often fiber-optic-transillumination (FOTI). Early diagnosis enables small lesions to be identified so that remineralization of lesions by preventive measures can be attempted; in clinical research, it may shorten the time for clinical trials. Quantitative methods may potentially decrease interexaminer variations and facilitate the determination of small progressions or regressions. This review discusses recent advances in the development of such methods, i.e., endoscopic methods, FOTI, light-scattering, laser fluorescence, ultraviolet illumination, penetration of dyes, iodide penetration, electrical resistance, ultrasonic imaging, and improved radiographic imaging techniques. Diagnosis of occlusal surfaces gains from the use of the electrical resistance method (preferable when the emphasis is on finding lesions) or radiography (when the emphasis is on identifying sound surfaces). Digitized radiography with simple contrast enhancement gives some further improvement. Quantitative methods are not yet proven to be good enough to measure small changes. Quantitative methods are not yet proven to be good enough to measure small changes. For occlusal surfaces, the electrical resistance method may be, but this has to be confirmed. For approximal surfaces, digitized radiography and fluorescent dye penetration have to be tested for clinical feasibility. It is concluded that there are many methods in development, but all require clinical testing, and many still need development before clinical use.

Accuracy of visual inspection, fiber-optic transillumination, and various radiographic image modalities for the detection of occlusal caries in extracted non-cavitated teeth.

Occlusal caries lesions may progress into the dentin without this resulting in a macroscopic breakdown of the enamel surface. Imaging methods may therefore be needed to aid in the visual detection of occlusal caries. It was the aim of this study to evaluate diagnostic accuracy in a laboratory set-up of visual inspection (VI), fiber-optic-transillumination (FOTI), conventional radiography (CR), and two digital radiographic image modalities (DRm and DRr) for detection of occlusal caries in clinically non-cavitated teeth. Eighty-one extracted third molars from 18-20-year-old males were assessed by four observers on a five-rank confidence scale by the five methods. Ground sections (500-600 microns) served as validation for true state of disease: 1 = no caries in dentin, 2 = caries just beyond dentino-enamel junction, or 3 = deep dentinal caries, halfway or more to the pulp. ROC analysis was performed on the basis of the confidence rank scale data on two diagnostic thresholds, T1 = caries in dentin (disease state 2+3) and T2 = caries deep in dentin (state 3). On the T1 level, use of the FOTI method gave on average the most accurate diagnosis, closely followed by VI, both performing better than use of radiography. On the T2 level, all five diagnostic methods performed equally well.

Approximal caries diagnosis using fiber‐optic transillumination: a mathematical adjustment to improve validity

Several studies were conducted recently to evaluate the use of Fiber-Optic Trans-Illumination (FOTI) in the diagnosis of approximal carious lesions. All these studies utilized radiographic readings to validate the FOTI diagnoses. Other investigations studied the value of radiographic readings using more solid validating techniques, which made it possible to judge the true state of decay, such as histology, cavity preparation and microradiography. In this study, data from both types of studies were used to estimate the validity of FOTI diagnosis of approximal caries relative to the true status of decay through correction for radiographic misclassification. The results indicate that particularly the sensitivity of FOTI diagnosis has yet to be determined.

A fiber-optic retractor for harvesting the internal mammary artery

A retractor for exposure and dissection of the internal mammary artery incorporating a fiber-optic transillumination system is presented. The device, which can be converted to a standard sternal retractor, has also proved valuable in improving illumination during procedures on the mitral valve and in facilitating dissection of fibrous adhesions from the anterior surface of the heart at reoperation.

Detection of approximal caries in deciduous molars by oral inspection and fiber optic transillumination.

Detection of approximal caries in deciduous molars by oral inspection and fiber optic transillumination.

Localisation of retained roots by fibre-optic transillumination

The rationale for the use of fibre-optic transillumination in the location of residual roots is discussed and the technique is described.

Optical methods for the detection and quantification of caries.

The commonly used clinical methods are inadequate for reliable diagnosis of caries lesions until demineralization is established. By the time a reliable diagnosis can be made, the damage is often irreversible, and restorative methods may be necessary to prevent further progress of the lesions. Early detection of the caries lesion would enable the dentist, by using effective prophylactic measures, to provide remineralization and conservation of the tooth substance rather than restoration of the dentition. Attempts to improve traditional methods or to develop new methods of detecting caries lesions have been numerous. Most of the presently used diagnostic methods require visual observation of an optical signal. Reflected light is used tc detect changes in color, texture, and translucency of the tooth substance. The tools required are a bright light source and a mouth mirror. With special methods utilizing drying, magnification, and photography, the sensitivity of the method can be increased. Various optical methods for the detection and quantification of caries will be discussed - for example, fiber optic transillumination, ultraviolet illumination, the use of various dyes, and fluorescent or non-fluorescent substances to enhance the contrast between the carious and the sound enamel. This presentation will focus on the following two methods: (1) a method that uses visible laser light within the blue-green region as the light source to improve signal-to-noise ratio and increase sensitivity for detection of early caries lesions, and (2) a recently developed quantitative method based on the scattering of light by enamel crystals in relation to their surrounding environment. The possibilities and limitations of the different methods will be critically evaluated. In the near future, optical methods for the detection and quantification of early caries lesions will provide efficient tools for reliable evaluation of caries-preventive measures.

The use of fibre-optic transillumination in the diagnosis of posterior approximal caries in clinical trials.

The need to develop alternative techniques other than bitewing radiographs for the diagnosis of caries in clinical trials is discussed and the use of fibre-optic transillumination (FOTI) proposed. A validation study was conducted in which the teeth of 25, 12- to 13-year-old children were examined using a direct-light source, by FOTI and by bitewing radiographs for the presence of dentinal lesions on posterior approximal surfaces. Taking diagnoses from radiographs as the validating criteria, the sensitivity of FOTI was 0.73 and specificity 0.99. A clinical trial involving 224, 12- to 13-year-old children was established to compare the efficacy of two fluoride dentifrices, FOTI being incorporated into the clinical examination. Use of FOTI increased the discriminatory ability of the clinical examination such that the percent caries change in efficacy detected between the two dentifrices rose from 5 to 10% for the DFS index and from 14 to 19% for DMFT. FOTI is proposed as a valid, efficient alternative to bitewing radiographs in clinical trials of caries-prophylactic agents.

The Application of Blue Polymer Curing Lights for Diagnostic Transillumination

or several years, ultraviolet light has been used to activate the polymerization of composite restorative materials. Re­ cently, resin systems have been devel­ oped that are polymerized by visible light in the blue region of the spectrum. Sev­ eral commercial visible curing lights are available to the dentist for this purpose with fiber optics and right angle probes. Another application of these visible curing lights is as an aid in oral diagnosis. More specifically, these lights have a po­ tential application for use in transillumi­ nation. Fiber-optic transillumination (FOTI) has been used with white light for the detection of caries and calculus, and the examination of existing restora­ tions.1'8 The results of previous studies comparing radiography and trans­ illumination in the detection of caries have been conflicting. A consensus emerged that caries detection with trans­ illumination is routinely successful with only anterior teeth.1'7 However, tech­ niques requiring skill and practice have been developed for detecting interproximal caries between posterior teeth by

Fiberoptic Transillumination for Intravenous Cannulation under General Anesthesia

Bellotti, Gerald A. MD*; Bedford, Robert F. MD†; Arnold, William P. MD† Author Information

Enamel cracks in debonded, debanded, and orthodontically untreated teeth

Using fiber-optic transillumination, a clinical assessment was made of enamel cracks (prevalence, localization, expression, direction) in three groups of adolescents representing debonded, debanded, and orthodontically untreated teeth. The findings indicated that enamel cracks were extremely common in all three groups. Most cracks were not very prominent and could easily be overlooked on routine clinical examination. The majority of cracks were vertical and, with the exception of the mandibular incisors, were most frequently localized in the gingival two-thirds of the facial tooth surfaces. The marked cracks were observed mostly on maxillary canines and central incisors in all groups. Of the few horizontal cracks noted, most were located in maxillary and mandibular central incisors. Clinical implications of the observations are (1) careful bonding and debonding do not result in a significant increase of enamel cracks; (2) whenever pronounced vertical cracks occur on other teeth than maxillary central incisors and canines or many horizontal cracks are observed, the bonding/debonding technique should be re-evaluated; (3) it seems advisable to notify parents/patients of marked cracks before orthodontic treatment is started, in order to avoid problems later when it is difficult or impossible to document their pretreatment existence.

Fibre-optic transillumination of the sinuses: a comparison of the value of radiography and transillumination in antral disease

The development of transillumination of the paranasal sinuses is reviewed. A technique of transillumination with a fibre-optic source is described. In acute sinusitis there was a very significant correlation between radiography and transilluminometry.

Fiberoptic transillumination: A new tool for the pediatric surgeon

Transillumination (TI) is a safe and reliable technique for evaluating masses or the presence of free air in the thorax or abdomen. TI can also be of help in the accurate placement of catheters or needles in the chest, abdomen, bladder, or vessels. Its use in several hundred cases has been documented by this report.

The fracture of human enamel: A mechanical model

Using fiber-optic transillumination, a clinical assessment was made of enamel cracks (prevalence, localization, expression, direction) in three groups of adolescents representing debonded, debanded, and orthodontically untreated teeth. The findings indicated that enamel cracks were extremely common in all three groups. Most cracks were not very prominent and could easily be overlooked on routine clinical examination. The majority of cracks were vertical and, with the exception of the mandibular incisors, were most frequently localized in the gingival two-thirds of the facial tooth surfaces. The marked cracks were observed mostly on maxillary canines and central incisors in all groups. Of the few horizontal cracks noted, most were located in maxillary and mandibular central incisors. Clinical implications of the observations are (1) careful bonding and debonding do not result in a significant increase of enamel cracks; (2) whenever pronounced vertical cracks occur on other teeth than maxillary central incisors and canines or many horizontal cracks are observed, the bonding/debonding technique should be re-evaluated; (3) it seems advisable to notify parents/patients of marked cracks before orthodontic treatment is started, in order to avoid problems later when it is difficult or impossible to document their pretreatment existence.