Emerging technologies for diagnosis of dental caries: The road so far

Abstract

It is now universally recognized that the development of new technologies for early detection and quantitative monitoring of dental decay at an early stage of formation could provide health and economic benefits ranging from timely preventive interventions to reduction in the time required for clinical trials of anticaries agents. The use of technologies as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. This article describes the various technologies available to aid the dental practitioners in detecting dental caries at the earliest stage of its formation, assessing the activities of the detected carious lesion, and quantitatively or qualitatively monitoring of the lesion over time. The need and the importance of these technologies were also discussed. The data discussed are primarily based on published scientific studies and reviews from case reports, clinical trials, and in vitro and in vivo studies. References have been traced manually by MEDLINE® or through manufacturer's websites. While some of the devices are fully developed and commercially available, others are still under development. The devices vary in their modes of action as well as their capability as caries diagnostic aids. It is clear that the differences in caries presentations and behavior in different anatomical sites make it unlikely that any one diagnostic modality will have adequate sensitivity and specificity of detection of carious lesions for all sites; a combination of diagnostic tools will help us diagnose lesions earlier and detect failing restorations sooner, all to avoid more costly, destructive dental procedures and truly take dentistry into the preventive rather than the reactive mode.

Surfing the spectrum – what is on the horizon?

“…Quantitative Light Fluorescence (QLF) utilizes light with a peak intensity of 370-410nm to fluoresce the tooth and the emitted photons are captured by a CCD and digitised 45 . Non-ionising, non-invasive, quick to use, but hydration of the tooth affects the results, with a stronger signal from dehydrated lesions due to increased scattering of the short-length photons 46 .…”

The Importance and Possibilities of Proper Oral Hygiene in Orthodontic Patients

“…The highest prevalence of demineralization was detected by quantitative light induced fluorescence method which is much more sensitive than the simple direct visualization (Boersma, 2005). Inspector's unique analysis software is available to determinate the demineralization (Amaechi, 2009). Sound tooth tissue will show up glowing brightly without reflections, demineralised areas generally have a diffuse outline and are darker at the center which distinguishes them from stains and discoloration.…”

“…The BiLuminator TM can be tremendous help to prevent any damage that may follow the placement of orthodontic brackets. By regularly inspecting teeth it can be ensured that teeth are well cleaned before the brackets are placed and mature plaque will not seen during the orthodontic treatment (Amaechi, 2009).…”

Effectiveness of near-infrared transillumination in early caries diagnosis

“…The device could be applied for both occlusal and proximal lesions and is non-invasive and cost-effective, but there is controversial data concerning its sensitivity compared with radiography and probing [8].…”

“…Quite a lot of studies have used this method for the diagnosis of occlusal and smooth surfaces caries, demineralization and remineralization monitoring [10][11][12][13]. This method has high sensitivity but it cannot distinguish between caries, development anomalies, and stain and calculus [8]. A new device that uses this principle is Sopro-Life [14].…”