Effect of Placing a Clear Sealant on the Validity and Reproducibility of Occlusal Caries Detection by a Laser Fluorescence Device: An in vitro Study

Abstract

The principal aim of this in vitro study was to assess the validity and reproducibility of the detection of occlusal caries using laser fluorescence (LF), prior to and following the placement of a clear fissure sealant. It also aimed to compare the manufacturer’s standard cut-off recommendations with those published for in vitro studies and to compare the validity and reproducibility of LF with clinical visual examination (CVE) for the detection of occlusal caries under sealants. Three clinicians independently examined visually and with LF 37 extracted teeth (25 molars, 12 premolars), with a range of clinical caries from apparently sound to cavitated dentinal caries. Examinations were conducted under dental surgery conditions. Subsequently, the teeth were serially sectioned to provide the validating criterion. Following placement of the sealant, the specificity generally increased but there was an associated loss of sensitivity, at both the D₁(enamel and dentine) and D₃ (dentine) diagnostic thresholds. The LF readings were significantly lower after placement of the sealant (p < 0.05). The manufacturer’s recommended cut-offs appear to be the most appropriate to use. The CVE had superior validity and reproducibility when compared to LF. Overall, the placement of a clear sealant does influence the detection of caries by LF but does not prevent the detection of caries by this method.

The Influence of Pit and Fissure Sealants on Infrared Fluorescence Measurements

“…These results disagree with those from Deery et al [2006], who showed lower LF measurements after sealing teeth stored in 1% aqueous thymol solution using the same material. This difference could be due to the method of storage.…”

“…However, Anttonen et al [2003], in an in vivo study, and Krause et al [2008] reported that clear sealants did not affect LF measurements. Our results suggest that both devices could be used as an adjunct for caries diagnosis, as already suggested by Deery et al [2006] in relation to occlusal surfaces sealed with a clear sealant. The tendency of values to increase would not be clinically influential.…”

“…Low LF values have also been reported after placement of opaque [Takamori et al, 2001;Hosoya et al, 2004;Krause et al, 2008] and glass ionomer sealants [Hosoya et al, 2004]. Some authors have suggested that the titanium dioxide used as a pigment in opaque resin composites, or even the residual polishing paste left on the surface [Hosoya et al, 2004;Deery et al, 2006;Krause et al, 2008], could absorb either the light emitted by the devices or the fluorescence emitted by the carious tissue. In this study, however, no polishing paste was used.…”

“…Some studies suggest that fissure sealants do not affect LF readings, implying that the device could be used during routine checkups to detect caries under fissure sealants [Takamori et al, 2001;Anttonen et al, 2003;Deery et al, 2006;Krause et al, 2008]. However, other studies have shown contradictory results and problems with this practice [Hosoya et al, 2004;Gostanian et al, 2006].…”

The Effect of Fissure Sealants on the Values of Two Different Caries Detection Devices

“…[8][9][10][11] Previous studies have reported that fissure sealants do not affect LF readings. [12][13][14][15] However, other studies [16][17][18][19] have shown that the presence of sealants and composite filling materials might complicate the interpretation of the LF readings, leading to false-positive results.…”