Laser Fluorescence Device Research Articles

Evaluation of the remineralization potential of self-assembling peptide P11-4 with fluoride compared to fluoride varnish in the management of incipient carious lesions: a randomized controlled clinical trial

ObjectivesThe present trial’s aim was to compare the remineralization potential of self-assembling peptide P11-4 combined with fluoride to that of fluoride varnish.Materials and methodsTwenty-eight participants with 58 incipient carious lesions were enrolled in the present trial. Participants were randomly divided into two groups with 14 participants and 29 incipient lesions in each group. Patients were assigned either to self-assembling peptide combined with fluoride (Curodont Repair Fluoride Plus™) or sodium fluoride varnish (NaF, Bifluorid 10) groups. Both agents were applied according to the manufacturer’s instructions on non-cavitated incipient carious lesions. Lesions were assessed by two calibrated and blinded assessors at baseline, and after one-, three- and six-months using a laser fluorescence device (DIAGNOdent).ResultsAlthough laser fluorescence scores significantly improved in both groups over time (p < 0.05), no notable differences were evident between both groups at one-month (p > 0.05). Yet, at three- and six-months statistically lower laser fluorescence readings were evident in the self-assembling peptide combined with fluoride group in comparison to the fluoride alone group (p < 0.05). There was 60% less risk for caries progression for Curodont Repair Fluoride Plus™ when compared to NaF varnish after six months. Self-assembling peptide combined with fluoride was able to change 65.5% of non-cavitated carious lesions from DIAGNOdent score 3 (11–20) to score 1 (0–4). Fluoride varnish was able to change 13.8% of the lesions from score 3 to score 1 after six months.ConclusionsThe self-assembling peptide combined with fluoride varnish showed higher remineralization potential than fluoride varnish alone for incipient carious lesions over a six-months follow up.Clinical relevanceThe combination of self-assembling peptide P11-4 and fluoride could offer a new tool in managing incipient carious lesions.

Efficacy of ClinproTMXT Varnish surrounding brackets on the enamel surface of white spot lesion.

Orthodontics patients usual develop demineralization and present cavity caries lesions after six months. Minimally invasive procedures have been the goal in modern dental practice. The aim of this study was to evaluate the effect of ClinproTMXT Varnish, on the enamel surface roughness and severity of white spot lesions. Twenty premolars were submitted to bond brackets and experimental induction of demineralization and randomly divided into 2 groups: GI - fluoride varnish (Colgate Duraphat®); GII - Ionomeric Sealant (ClinproTMXT Varnish). The treatment was applied around the brackets. The surface roughness of specimens was analyzed, before treatment and 12 weeks after treatment by laser confocal microscopy, and the severity of the white spot lesion was by laser fluorescence device. The data were analyzed by non-parametric Wilcoxon and Mann-Whitney Test, at 5% significance, roughness percentage reduction was performed. The severity of demineralization decreased in both, GI (p = 0.005) and GII (p = 0.019). Enamel superficial roughness levels decreased in GI and GII. As well as the roughness percentage, being more expressive in the ClinproTMXT Varnish group (85,09%). Colgate Duraphat® or Clinpro™ XT Varnish reduced the severity of the demineralization and decreased the superficial roughness on the enamel. The Clinpro™ XT Varnish was superior to superficial roughness on enamel.

Evaluation of tooth demineralization using laser-fluorescence in dental school patients undergoing orthodontic treatment: A clinical study.

Adverse effects can occur during orthodontic treatment. To evaluate the relationship between prevalence and severity of enamel demineralization using a laser-fluorescence device, with length of orthodontic treatment time. A cross-sectional study was conducted in 60 patients in a university orthodontic clinic. A clinical examination to establish demineralization at four sites on each tooth (premolar to premolar) was performed using the DIAGNOdent pen. The dependent variable was enamel demineralization, from which the prevalence (at least one affected site), extension (percentage of affected teeth) and adjusted average (average of the mean DIAGNOdent values per tooth) were calculated. The length of time for orthodontic treatment was determined in months. Various sociodemographic and clinical covariates were included. Average number of months under orthodontic treatment was 26.37 ± 24.81 months. Prevalence of enamel demineralization was 80.0%, its extension was 21.9% ± 17.2 and adjusted average of DIAGNOdent values was 6.09 ± 1.75. By quadrant, the teeth most affected were 14 (34.4%), 24 (25.0%), 31 (30.2%) and 44 (33.3%). No significant relationship (p> 0.05) was observed between enamel demineralization and length of time under orthodontic treatment. A high prevalence of dental demineralization was observed. In this sample, no relationship was observed between months under treatment and dental demineralization, or with other variables included in the study.

Validation of clinical photography and a laser fluorescence device for assessment of enamel demineralization during multi-bracketed fixed orthodontic treatment

AimTo compare the validity of DIAGNOdent pen™ 2190 and clinical photographs in the diagnosis (presence or absence) and assessment of white spot lesions (WSLs) during multi-bracketed fixed orthodontic treatment. MethodsA total of 1607 readings from 99 patients were obtained using DIAGNOdent pen™ 2190, clinical photographs, and visual assessment criteria to assess WSLs at 6 -, 12- and 18 months after bonding of brackets. Receiver operating characteristic curves were constructed, and areas under the curve (AUC) were calculated to assess the presence or absence of WSLs and distinguish the severity of WSLs as slight or severe. Sensitivities, specificities, and AUC were calculated for outcomes at an alpha of 0.05 and 95% confidence intervals (CIs). ResultsThe values of sensitivity and specificity of DIAGNOdent pen™ 2190 were found to be 0.78 and 0.83, respectively, to distinguish presence/absence of WSLs with good accuracy (AUC= 0.855; 95% CI: 0.820–0.889) and for digital photographs, accuracy was excellent (AUC= 0.973, 95% CI: 0.956–0.991) with sensitivity and specificity of 0.96 and 0.99, respectively. However, the accuracy of DIAGNOdent pen™ 2190 was poor (AUC= 0.543, 95% CI: 0.418–0.668) in delineating slight and severe WSLs with a sensitivity of 0.31 and specificity of 0.83; while the values of sensitivity and specificity for distinguishing slight or severe lesions for clinical photographs were 0.96 and 0.99, respectively with excellent accuracy (AUC=0.978, 95% CI: 0.936–1.000). ConclusionsClinical photographs had better validity than DIAGNOdent pen™ 2190 in diagnosis and assessment of severity of demineralized lesions during multi-bracketed fixed orthodontic treatment.

Oxidising agents and its effect on human dentine fluorescence diagnostic measurements.

The ability to determine the effectiveness of root canal disinfection in real-time prior to the final root filling could significantly influence the management and treatment outcomes of root canal therapy. Laser fluorescence devices can detect bacterial fluorescence in real-time, however since quenching of fluorescence is a possible confounding factor, this study explored the effects of oxidising endodontic irrigants on laser fluorescence in dentine. A total of 78 transverse 2 mm thick sections were prepared from the crowns of sterilised extracted non-functional third molars that had been embedded in acrylic resin. The dentine sections where then treated with different concentrations of sodium hypochlorite and hydrogen peroxide, with or without further rinsing with distilled water wash. Fluorescence values were recorded over 24 h using the DIAGNOdent laser fluorescence device. Both sodium hypochlorite and hydrogen peroxide cause quenching of fluorescence readings of human dentine, with reductions of 30-60% in fluorescence readings. The quenching effect occurred quickly, and recovery to baseline readings took from 1 h to 24 h. Rinsing with water reduced but did not eliminate the quenching effect. The use of laser fluorescence to reliably detect root canal bacteria porphyrins in real-time could significantly influence the management of teeth needing root canal therapy. This study highlighted the quenching effects of some root canal irrigants on human teeth root dentine, a variable that should be considered and controlled prior to using lasers to assist in assessing root canal sterility.

Evaluation of the effectiveness of remineralization preparations used in paediatric dentistry practices

Aim: The goal of preventive dentistry is to intervene prior to the formation of dental caries. This study evaluated the remineralization effects of fluoride varnish, casein phosphopeptide amorphous calcium phosphates (CPP-ACP) and casein phosphopeptide amorphous calcium fluoride phosphates (CPP-ACFP) cream, and tricalcium phosphate (TCP) varnish.&#x0D; Materials and Methodology: Samples with early artificial caries lesions were randomly divided into the following 5 groups with 20 samples in each group: (I) control, (II) fluoride varnish, (III) CPP-ACP cream, (IV) CPP-ACFP cream and (V) TCP varnish. The effectiveness of these remineralization agents was evaluated using a laser fluorescence device (DIAGNOdent), a scanning electron microscope (SEM) and energy dispersive X-ray analysis (EDX).&#x0D; Results: In the pre- and post-treatment evaluations, the DIAGNOdent remineralization measurements were statistically significant in all the groups, except the control group (p &lt; 0.05). In comparison with the DIAGNOdent measurements, the CPP-ACFP group was found to have significantly higher remineralization than the fluoride group (p &lt; 0.05), while no significant differences were found between the other groups (p &gt; 0.05). The EDX analysis evaluated the Ca/P ratio between the groups. These results indicated that the CPP-ACFP group was significantly higher than the control group, the CPP-ACP group and the TCP group (p &lt; 0.05); no significant differences were found between the CPP-ACFP group and the fluoride group (p &gt; 0.05). In SEM imaging, the most extensive mineral accumulation was observed in the CPP-ACFP group.&#x0D; Conclusion: Three analytical methods demonstrated that CPP-ACFP was the most effective remineralization material tested in this study.&#x0D; &#x0D; How to cite this article: Tatar E, Toptancı İR. Evaluation of the effectiveness of remineralization preparations used in paediatric dentistry practices. Int Dent Res 2019;9(3):138-44.&#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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Guest Editorial

Use of alaser fluorescence device for the in vitro activity assessment of incipient caries lesions.

To evaluate the progression of demineralization during orthodontic treatment, the assessment of lesion activity is important in addition to the detection of lesion extent. This study aimed to evaluate the ability of laser fluorescence measurements to differentiate between active and inactive initial lesions in vitro. In all, 63extracted, permanent human teeth were available for the study. On each occlusal investigation site, surface extent and activity of caries lesions were classified visually using ICDAS/ICCMS (International Caries Detection and Assessment System/International Caries Classification and Management System) criteria, following laser fluorescence measurements. Teeth were hemisected and assessed for lesion depth. Methyl red dye was applied to validate lesion activity on the sections. AMann-WhitneyU-test was performed to evaluate differences between laser fluorescence measurements for active and inactive lesions. For visual and laser fluorescence findings, diagnostic accuracy (Az, sensitivity and specificity) were calculated. A total of 19sound surfaces and 44surfaces with ICDAS codes 1/2 were classified visually. The differences in laser fluorescence measurements between active and inactive lesions were not significant for the initial lesions (p > 0.05). Sensitivity/specificity for lesion depth was 90.5/92.3% (Az = 0.894), respectively, for visual assessment and 69.1/76.9% (Az = 0.745), respectively, for laser fluorescence. Sensitivity/specificity for activity assessment was 68.6/85.0% (Az = 0.768) for the visual method. For laser fluorescence measurements, no diagnostic accuracy values could be calculated for caries activity assessment. The visual detection and activity assessment of initial lesions was more suitable than the laser fluorescence method. Based on the results of this in vitro study, use of laser fluorescence cannot be recommended for distinguishing between active and inactive initial caries lesions on occlusal surfaces.

In vivo performance of near-infrared light transillumination for dentine proximal caries detection in permanent teeth

ObjectiveThe purpose of this in vivo study was to confirm the detection of proximal caries using near-infrared light transillumination (NILTI) (DIAGNOcam) device, and to compare the diagnostic performance of the device with other caries detection methods, including visual examination using the International Caries Detection and Assessment System (ICDAS), bitewing radiography (BW), an LED-based device (Midwest Caries I.D.), and a laser fluorescence device (LFpen). MethodsA total of 974 proximal surface of permanent posterior teeth from 34 patients (19 females and 15 males between the ages of 22–55) were evaluated in the present study. After clinical examination of each proximal surface by an experienced examiner, they were coded according to the ICDAS criteria and subsequently with BW, the NILTI, LED, and LFpen. The proximal dentin caries of 106 were opened based on the combination of visual, NILTI and radiographic assessment and validated; and were treated with restorative materials. The data were analyzed with descriptive statistics and calculation of the sensitivity, specificity, and area under curve (AUC). ResultsThe highest sensitivity values were recorded from NILTI readings (99.1%), followed by BW scores (86.8%). The highest specificity values were recorded from ICDAS (100%). The best AUC values were found from the NILTI readings (0.97), followed by BW (0.93) and ICDAS (0.87). ConclusionThe NILTI device exhibited the best performance in terms of detecting proximal dentin caries.

Lasers in caries detection in primary and permanent teeth: a literature review

The present study aims to conduct a descriptive analysis by reviewing in vivo and in vitro studies concerned with the effect of the lasers in caries detection in primary and permanent teeth. The PubMed and Google Scholar had been used to search for articles that focused on the effect of lasers in caries detection in primary and permanent teeth. This literature research was limited to 38 years (January 1980–January 2018). Regarding the effect of lasers in caries detection, caries lesion can be significantly diagnosed and detected by using 655 nm DIAGNOdent laser (laser fluorescence device (LFpen)). The 655 nm DIAGNOdent laser is an effective adjunctive tool to detect and diagnose a caries lesion in primary and permanent teeth.

A comparative quantitative & qualitative assessment in orthodontic treatment of white spot lesion treated with 3 different commercially available materials - In vitro study.

BackgroundTo comparatively evaluate the esthetic improvement of white-spot lesions (WSLs) treated by: BiominF, CPP-ACP paste with fluoride & ICON resin infiltration, using Spectrophotometer & Diagnodent.Material and MethodsThe study was done using 72 sound permanent extracted premolars, divided into four groups (18 teeth per group). After taking the ethical approval the study was commenced. WSLs were created on human premolars and randomly assigned to four groups: Group A: Artificial Saliva, Group B: CPP-ACP with fluoride, Group C: BiominF, Group D: Resin infiltration (Icon). The color change (∆E) of each specimen was measured with a Spectrophotometer (VITA Easy Shade Compact), and fluorescence loss (∆Q) was measured by a laser fluorescence device (DIAGNOdent, Kavo, Biberach, Germany), at different time points after treatment: baseline (0 weeks), 2 weeks, 4 weeks, and 6 weeks.ResultsThe ∆E and ∆Q baseline values for the four groups before the treatments did not differ significantly. Icon treatment improved the WSL color significantly and gave the lowest ∆E (5.12± 3.92) & ∆Q (1.64 ±0.72) compared with other treatments at end of 6 weeks (P< .01). In the BiominF and CPP-ACP with fluoride treatment groups, ∆Q & ∆E showed significant recovery compared with the baseline values (P< .05).ConclusionsWithin the limitations of the study, it can be concluded that all the three remineralizing agents used in the study could effectively remineralize artificial enamel caries and showed improvement in color change and fluoresence as compared to the baseline. Therefore they can be effectively used for the treatment of the white spot lesions. Key words:White spot lesions(WSL), Resin infiltration (ICON), BiominF, CPP-ACP with fluoride.

Evaluation of the Efficacy of Visual, Tactile Method, Caries Detector Dye, and Laser Fluorescence in Removal of Dental Caries and Confirmation by Culture and Polymerase Chain Reaction: An In Vivo Study.

Aim:To determine the degree of association between visual and tactile methods of caries removal compared with caries detector dye and laser fluorescence device (DIAGNOdent), which detects the degree of demineralization; to determine the presence of Streptococcus mutans via culture and polymerase chain reaction (PCR) techniques; and to find a suitable method for caries removal.Materials and Methods:A total of 75 patients were divided into three groups: visual and tactile (Group A), visual and tactile with caries detector dye (Group B), and visual and tactile with caries detector dye along with laser florescence readings (Group C). Caries removal was carried out using visual and tactile methods, caries detector dye, and laser fluorescence, and the samples obtained were subjected to culture and PCR. The data obtained were statistically analyzed using Pearson’s chi-square test, analysis of variance (ANOVA), and Tukey’s post hoc test.Results:Visual and tactile along with caries detector dye and laser florescence (Group C) is the most efficient method for caries removal.Conclusion:Caries detector dye along with visual, tactile examination and laser fluorescence is a valuable and superior tool for clinicians that aids in better caries removal and can prevent the overzealous removal of tooth structure.

Comparison of Diagnostic Validity between Laser Fluorescence Devices in Proximal Caries

Comparison of Diagnostic Validity between Laser Fluorescence Devices in Proximal Caries

Accuracy of pen-type laser fluorescence device and radiographic methods in detecting approximal carious lesions in primary teeth - an invivo study.

The diagnosis of approximal lesions is limited due to the difficulty of direct examination of these areas. To determine the accuracy of pen-type laser fluorescence (LFpen) device, compared to digital bitewing (BW) radiography, in diagnosing approximal carious lesions in posterior primary teeth at cavitation and non-cavitation thresholds. A total of 46 children (aged 3-9years) were assessed and 195 approximal surfaces of 184 primary molars were examined by digital BW and LFpen. Visual-tactile inspection based on the International Caries Detection and Assessment System (ICDAS-II) was used as the reference standard. All examinations were performed by the same examiner. Sensitivity, specificity, and accuracy were calculated. Spearman's correlation coefficients were calculated between LFpen and BW readings and the reference standard. Sensitivity, specificity and AUC were 81.8, 86.7, and 0.84 for BW and 49.1, 87.9, and 0.69 for LFpen both at non-cavitation thresholds. At cavitation thresholds, BW showed higher specificity (96.0), sensitivity (93.0), and AUC (0.98) than did LFpen (72.0, 86.9, and 0.82, respectively), but a lower correlation was indicated by LFpen readings. Bitewing had a better diagnostic accuracy and significantly outperformed LFpen in the detection of non-cavitated lesions. Similar results were obtained by the two methods at the cavitation threshold.

Resin infiltration technique and fluoride varnish on white spot lesions in children: Preliminary findings of a randomized clinical trial.

To clinically assess the efficacy of resin infiltration versus fluoride varnish for arresting white spot lesions (WSLs) on permanent teeth in children. Among the children referred to the our University, Faculty of Dentistry, Department of Pediatric Dentistry, 23 aged between 8-14 with 81 anterior WSLs were included in the study. The participants were randomly assigned to either the resin infiltration group or the fluoride varnish group. WSLs were assessed using a laser fluorescence device (DIAGNOdent pen, Kavo, Germany) and were characterized at baseline, immediately following resin infiltration application and at a 6-month follow-up. For the statistical analyses, the IBM SPSS Statistics 22 (IBM SPSS, Turkey) program was used to assess the findings of the study. Participant retention was 100% at 6 months. There was no significant difference between the two groups when baseline DIAGNOdent (DD) values were compared (P > 0.05). The reduction in 6-month follow-up DD values were statistically significant in both groups relative to baseline values. The 6-month values of the resin infiltration group were statistically lower than those of the fluoride varnish group (P = 0.028, P < 0.05). Resin infiltration and fluoride varnish are clinically feasible and efficacious methods for the treatment of anterior WSLs. The inhibition of caries progression by resin infiltration should now be considered an alternative to fluoride treatment.

In vitro performance of DIAGNOdent laser fluorescence device for dental calculus detection on human tooth root surfaces.

ObjectiveThis study assessed the reproducibility of a red diode laser device, and its capability to detect dental calculus in vitro on human tooth root surfaces.Material and methodsOn each of 50 extracted teeth, a calculus-positive and calculus-free root surface was evaluated by two independent examiners with a low-power indium gallium arsenide phosphide diode laser (DIAGNOdent) fitted with a periodontal probe-like sapphire tip and emitting visible red light at 655 nm wavelength. Laser autofluorescence intensity readings of examined root surfaces were scored on a 0–99 scale, with duplicate assessments performed using the laser probe tip directed both perpendicular and parallel to evaluated tooth root surfaces. Pearson correlation coefficients of untransformed measurements, and kappa analysis of data dichotomized with a >40 autofluorescence intensity threshold, were calculated to assess intra- and inter-examiner reproducibility of the laser device. Mean autofluorescence intensity scores of calculus-positive and calculus-free root surfaces were evaluated with the Student’s t-test.ResultsExcellent intra- and inter-examiner reproducibility was found for DIAGNOdent laser autofluorescence intensity measurements, with Pearson correlation coefficients above 94%, and kappa values ranging between 0.96 and 1.0, for duplicate readings taken with both laser probe tip orientations. Significantly higher autofluorescence intensity values were measured when the laser probe tip was directed perpendicular, rather than parallel, to tooth root surfaces. However, calculus-positive roots, particularly with calculus in markedly-raised ledges, yielded significantly greater mean DIAGNOdent laser autofluorescence intensity scores than calculus-free surfaces, regardless of probe tip orientation. DIAGNOdent autofluorescence intensity values >40 exhibited a stronger association with calculus (36.6 odds ratio) then measurements of ≥5 (20.1 odds ratio) when the laser probe tip was advanced parallel to root surfaces.ConclusionsExcellent intra- and inter-examiner reproducibility of autofluorescence intensity measurements was obtained with the DIAGNOdent laser fluorescence device on human tooth roots. Calculus-positive root surfaces exhibited significantly greater DIAGNOdent laser autofluorescence than calculus-free tooth roots, even with the laser probe tip directed parallel to root surfaces. These findings provide further in vitro validation of the potential utility of a DIAGNOdent laser fluorescence device for identifying dental calculus on human tooth root surfaces.

Evaluation of laser fluorescence in monitoring non-cavitated caries lesion progression on smooth surfaces in vitro.

The aim of this study was to evaluate the performance of a pen-type laser fluorescence (LF) device (LFpen: DIAGNOdent pen) to detect and monitor the progression of caries-like lesions on smooth surfaces. Fifty-two bovine enamel blocks were submitted to three different demineralisation cycles for caries-like lesion induction using Streptococcus mutans, Lactobacillus casei and Actinomyces naeslundii. At baseline and after each cycle, the enamel blocks were analysed under Knoop surface micro-hardness (SMH) and an LFpen. One enamel block after each cycle was randomly chosen for Raman spectroscopy analysis. Cross-sectional micro-hardness (CSMH) was performed at different depths (20, 40, 60, 80 and 100μm) in 26 enamel blocks after the second cycle and 26 enamel blocks after the third cycle. Average values of SMH (±standard deviation (SD)) were 319.3 (±21.5), 80.5 (±31.9), 39.8 (±12.7), and 29.77 (±10.34) at baseline and after the first, second and third cycles, respectively. Statistical significant difference was found among all periods (p<0.01). The LFpen values were 4.3 (±1.5), 7.5 (±9.4), 7.1 (±7.1) and 5.10 (±3.58) at baseline and after the first, second, and third cycles, respectively, among all periods (p<0.05). The CSMH values after the second and third cycles at 20, 40, 60, 80 and 100μm were 182.8 (±69.8), 226.1 (±79.6), 247.20 (±69.36), 262.35 (±66.36) and 268.45 (±65.49), and for the third cycle were 193.7 (±73.4), 239.5 (±81.5), 262.64 (±82.46), 287.10 (±78.44) and 284.79 (±72.63) (n=24 and 23), respectively. No correlation was observed between the LFpen and SMH values (p>0.05). One sample of each cycle was characterised through Raman spectroscopy analysis. It can be concluded that LF was effective in detecting the first demineralisation on enamel; however, the method did not show any effect in monitoring lesion progression after three cycles of in vitro demineralisation.

Evaluation of Diagnodent Accuracy in Detecting Approximal Caries in Primary Molars

Introduction: Detection of caries lesions on approximal surfaces of posterior teeth is difficult, since wide contact points hamper direct visual inspection. Due to the importance of the early detection of dental caries, the aim of this study is to compare the performance of different methods (visual, bitewing radiography and DIAGNOdent) in detecting approximal caries in primary molars. Methods: Thirty six children were selected from patients referred to the pediatric dentistry department of Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Two examiners evaluated 229 approximal surfaces of primary molars using: visual inspection, radiography and a pen-type laser fluorescence device (DIAGNOdent) for the presence of proximal caries. The surfaces were evaluated by 2 other examiners for the presence of white spots or cavitations. Sensitivity, specificity and accuracy (percentage of correct diagnosis) were calculated for each method. The area under the receiver-operating characteristics curve (A z) was calculated for DIAGNOdent device. The inter-examiner reproducibility was calculated using the intra-class correlation coefficient (ICC values) for laser Fluorescence and agreement coefficient for visual and radiographic methods.Results: At white-spot threshold, a DIAGNOdent device presented better performance. At cavitation threshold the radiographic method demonstrated higher sensitivity than visual inspection and DIAGNOdent device .In this threshold, all methods presented high specificities Conclusions: A DIAGNOdent device performs better in white spot threshold. However, radiography shows better performance in detecting more advanced approximal caries lesions.

The diagnostic accuracy of a laser fluorescence device and digital radiography in detecting approximal caries lesions in posterior permanent teeth: an in vivo study

The aim of this in vivo study was to test the diagnostic accuracy of a pen-type laser fluorescence (LFpen) device in detecting approximal caries lesions, in posterior permanent teeth, at the cavitation and non-cavitation thresholds, and compare it with that of digital bitewing radiography. Thirty patients (aged 18–37), who attended the Faculty of Dentistry at Damascus University for a dental examination, were consecutively screened. Ninety approximal surfaces of posterior permanent teeth without frank cavitations, enamel hypoplasia or restorations were selected and examined using the LFpen (DIAGNOdent pen) and digital bitewing radiography. The reference standard was the visual-tactile inspection, after performing temporary tooth separation, using orthodontic rubber rings, placed for 7 days. The status of included approximal surfaces was recorded as intact/sound, with white/brown spots or cavitated. One trained examiner performed all examinations. There were statistically significant differences in LFpen readings between the three types of approximal surface status (P < 0.001). The optimal cut-off values for detecting approximal caries lesions in posterior permanent teeth were >16 and 8 at the cavitation and non-cavitation thresholds respectively. The sensitivity, specificity and accuracy (measured by the area under the receiver-operating characteristic curve) were 100, 85 and 95 and 92, 90 and 95% at the cavitation and non-cavitation thresholds respectively. The intra-class correlation coefficient for intra-examiner reliability was 0.95. The diagnostic accuracy of the LFpen was significantly higher than that of digital bitewing radiography (P < 0.001). The LFpen’s diagnostic performance was accurate and significantly better than digital bitewing radiography in detecting approximal caries lesions, in posterior permanent teeth.

In vitro study to evaluate laser fluorescence device for monitoring the effect of aluminum gallium arsenide laser on noncavitated enamel lesions

Objective: The objective of this study was to evaluate the efficacy of laser fluorescence (LF)-based diagnostic device for monitoring the effect of aluminum gallium arsenide (Al Ga As) laser on noncavitated enamel lesions. Background: Dental caries is a reversible disease, and scope of reversing the carious lesion is increased if it is diagnosed before there is surface cavitation. Variegated remineralization strategies including remineralizing pastes and different lasers have been explored. The efficacy of this surface treatment requires a valid and a reliable assessment tool. LF is one such adjunct to traditional methods of caries detection. Materials and Methods: Twenty-five intact freshly extracted molars were sectioned mesiodistally so as to obtain fifty samples which were coated with nail varnish so that 3 mm × 3 mm of windows are created to maintain uniformity. All sample surfaces were evaluated with LF device so as to obtain the baseline values, these values served as control. All the samples were then acid etched by 30% phosphoric acid for 20 s to simulate surface demineralization. The LF device was used to record the values of demineralized samples. The surfaces of the teeth were then irradiated with Al Ga As laser of 3.5 W for 30 s. The LF device was then used to record the reading. Statistical Analysis Used: Statistical analysis was done using paired t-test to compare control and test groups and calculation of the mean. Results: The demineralized surfaces have recorded statistically significant LF values greater than the untreated control sample values. Post laser irradiation, there is fall of the LF values and these values are closer to that of control. Conclusion: Laser fluorescence can be used as a tool to detect demineralization in situ and monitor changes in enamel surface during demineralization and remineralization phases. Surface treatment with laser irradiation gave values closer to that of control and this does indicate that laser irradiation brings about surface alteration as evaluated by laser fluorescence.