Advanced Diagnostic Aids in Caries Detection

Contributors’ Names: Ahmed El-Demiry, Shaza Shabbour, Mariam Taha, Sherif Hatem, Nour Bassiouni, Lina
Ahmed
Contributors’ Year: Year 3
Introduction Digital Fiber Optic Transillumination (DiFOTI) Near- infrared (INR) transillumination technique (DIAGNOcam) Quantitative light Induced Fluorescence (QLF)
• The prevention of demineralization and the • The use of light to detect early tooth decay without the use of x-
• The technology used in Diagno-cam support the diagnosis of proximal, • Technique: a device irradiates
occlusal and secondary caries. teeth with light in the blue visible
promotion of remineralization of early caries are ray. • Highly precise image quality, even without dental pre-cleaning
• Detect carious lesions and decays near restorations, fractures, wavelength.
major goals of preventive dentistry. However, • These images then can be captured and stored to use at later date which is
cracks and proximal areas. convenient for monitoring caries progression. • Limitations: It only showed
these goals can only be achieved if caries are • Diagno-cam is also known to be comfortable to patients unlike the normal significant results in smooth
• DiFOTI was proven to detect early carious lesions better than
detected at an incipient stage at which traditional clinical examination and x- ray traditional sensors. surfaces (not occlusal and
• Recording assistant shows the right position for the best diagnosis images
implementation of caries preventive regimes • How does it work? in the shortest possible time. interproximal); very expensive and
would enable early carious lesions to be  Use without the operating light and in a dimmed • Free from X-rays: For all patients, all teeth and all procedures not widely available
remineralized before the need for restorative room. • Intuitive to operate and a clear dental chart, including deciduous teeth. • Conclusion: although QLF presents
• Journal of dental research 2019 vol. 98(11) 1227-1233 concludes: Through some advantages, however systematic
intervention. Therefore, the need for other  Light source should be in the smallest diameter data figures depicted from a validation on qualitative overview, an analysis reviews did not find significant
diagnostic aids became a must.  Light probe positioned above the gingival margin in terms of high level variation from normal sensors in the regions of
improvement in caries detection when
 Carious lesions scatter more light than sound tooth interest. A better overview and early detection of caries largely agree in
both proximal and occlusal with very high percentages respectively. compared to visual examination
structure showing a darker lesion in the image
• Recent diagnostic aids include: system
• Contraindications: • QLF has the potential to be a valuable
1. Fiber Optic Transillumination (FOTI)  Large restorations tool for caries diagnosis in clinical
2. Digital Fiber Optic Transillumination (DiFOTI)  Fixed Prosthesis such as crowns practice.
 Subgingival tooth decay localization
3. Laser Fluorescence (DIAGNOdent)
 Calculus or tooth discoloration would show the
4. Near- infrared (INR) transillumination technique same result as a carious lesion. Electronic Caries Measurement (ECM)
(DIAGNOcam)
• Mechanism of electric conductance measurement:
5. Quantitative light Induced Fluorescence (QLF) Based on the differences in electrical conductivity of both carious
6. Electronic Caries Measurement (ECM) and sound tooth structure. Works by 2 methods:
A. Site specific:
applied as an electrode probe into fissures and the electrical
Laser Fluorescence (DIAGNOdent) Quantitative light Induced Fluorescence (QLF) conductance is measured
B. Surface specific:
• Optical Technique • Measures entire occlusal surface after covering it with an
• With this device, the tooth surface is illuminated with pulses of • Uses Natural Fluorescence electrolyte containing medium (saline) where the electrode is
red laser light, and the fluorescence emitted from the surface is placed using a fixed frequency AC current
of teeth to discriminate
analyzed and quantified. • Measured conductance was then converted to four colored
• Caries process alters the amount of fluorescence, which can be between caries and sound
enamel lights (caries meter).
seen as an elevated reading. • Mechanism of electrical impedance measurement:
• It indicates involved areas that often are not detectable visually • Fluorescence radiance of a
Based on the extent of an electric circuit to resist the electric
or by radiographs. Fiber Optic Transillumination (FOTI) carious spot viewed with
current flow when a voltage is applied across two electrodes
• Various in vitro studies show reliability is still a concern QLF is less than that of (carious and sound tooth structure)
• More recent studies have suggested DIAGNOdent may be useful • It is used in caries detection and diagnosis. surrounding enamel • Caries tissue has lower impedance than sound tooth
for detecting secondary caries under composite restorations.
• J Lasers Med Sci. 2013 Autumn; 4(4): 159–167 article
• It consists of placement a light source • Validity and clinical use:
electrical methods of detection show considerable success and
concluded: Considering its sensitivity and specificity reported in through the embrasure; if a carious lesion is • It measures the percentage promising results
the different studies, the DIAGNOdent is an appropriate modality present it will show as a dark shadow.
for caries detection as a complementary method beside other
change of fluorescence
methods and its use alone to obtain treatment plan is not radiance of demineralized
enough. enamel with respect to
surrounding enamel and
relates it directly to amount
of mineral lost during
demineralization.

Laitala M-L, Piipari L, Sämpi N, Korhonen M, Pesonen P, Joensuu T, et al. Validity of Digital Imaging of Fiber-Optic Transillumination in Caries Detection on Proximal Tooth Surfaces. International Journal of Dentistry [Internet]. 2017
Validation of quantitative light-induced fluorescence-digital (QLF-D) for the detection of approximal caries in vitro Hae-Youn Ko a, Si-Mook Kang a , Hee Eun Kim b , Ho-Keun Kwon a , Baek-Il Kim a,
J Lasers Med Sci. 2013 Autumn; 4(4): 159–167 article
Quantitative light-induced fluorescence (QLF) in relation to other technologies and conventional methods for detecting occlusal caries in permanent teeth Antônio Carlos Pereira1, Hafsteinn Eggertsson2, Carlos González-Cabezas3, Domenick T. Zero2, George J. Eckert4, Fábio Luiz Mialhe1
Detection of proximal caries using quantitative light-induced fluorescence-digital and laser fluorescence: a comparative study Hyung-In Yoon,1 Min-Jeong Yoo,2 and Eun-Jin Park 3
Quantitative light-induced fluorescence (QLF): A tool for early occlusal dental caries detection and supporting decision making in vivo IM.R.AlammariabP.W.SmithaE.de Josselin de JongacS.M.Highama