Caries detection and quantification around stained pits and fissures in occlusal tooth surfaces with fluorescence

Abstract

Occlusal discoloration due to staining frequently occurs on the pits and fissures of teeth. Noncariogenic discoloration (non-CD) refers to the attachment of staining chromogens to sound surfaces, whereas cariogenic discoloration (CD) represents the discoloration of porous structures due to bacterial metabolites and mineral loss from the enamel surface. This study evaluated whether it is possible to distinguish between non-CD and CD on stained occlusal surfaces with fluorescence assessed by the quantitative light-induced fluorescence (QLF) technology. Sixty-two extracted human permanent teeth with suspected discolorations on the pit and fissure were examined. The maximum values of fluorescence loss (ΔFmax) and red fluorescence gain (ΔRmax) were calculated using QLF images. Using histology as the gold standard, it was found that 12 teeth were sound (non-CD), while 50 teeth had enamel and dentine caries (CD). The validity tests at the enamel histological caries level, ΔRmax (ρ = 0.80) were strongly correlated with the histology (P < 0.001). At the optimum threshold (105.0) of ΔRmax, it showed high levels of sensitivity and specificity (0.96 and 0.83, respectively). Therefore, QLF can be used to distinguish non-CD from CD on occlusal surfaces using red fluorescence values with high validity.

Evaluation of dental caries detection with quantitative light-induced fluorescence in comparison to different field of view devices

“…Previous studies using the QLF technique mainly focused on red fluorescence for mature and pathogenic plaques 21 , 22 . However, Lee et al first reported, through an in vitro experiment, that the red fluorescence observed in mature pathogenic plaques is also present in occlusal carious lesions 23 . Demineralized early enamel carious lesions contain fewer minerals and higher amounts of organic matter and water than healthy enamel 24 , 25 .…”

Lesion Activity Assessment of Early Caries Using Dye-enhanced Quantitative Light- Induced Fluorescence

“…Previous studies have reported that porphyrin derivatives are mainly used as uorescent dyes for caries lesion assessment with laser uorescence (LF) 36,37,38,39,40 . However, the porphyrin derivatives are not suitable as a uorescent dye for DEQLF, since they already exist in natural caries lesions as bacterial metabolites 20,41,42,43,44 .…”

“…In dentistry, there have been efforts to objectively and quantitatively evaluate caries lesions using optical technologies. Among them, quantitative light-induced uorescence (QLF) technology uses blue visible light of 405 nm to detect oral diseases (e.g., dental caries, dental abrasion, tooth ssure, and pathogenic dental plaque) 16,17,18,19,20,21,22,23 . When an early caries lesion is irradiated with blue visible light, it emits a relatively dark auto uorescence compared to sound enamel due to light scattering by the porous structure of the surface layer 24,25,26 .…”

Practice-based analysis of direct posterior dental restorations performed in a public health service: Retrospective long-term survival in Brazil

“…The high rate of class I cavities involved in this study should be considered since the higher caries risk in adults and adolescents is on proximal surfaces. This aspect can be related to the equivocated diagnosis of occlusal caries [30]. Occlusal discoloration as a diagnostic criterion could lead to a false-positive caries diagnosis and, consequently, the premature indication of restorative procedures, assuming that placing a restoration "fixes" dental caries, which is not true [31].…”