Mineral loss in incipient caries lesions quantified with laser fluorescence and longitudinal microradiography: A methodologic study

Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF ® and DIAGNOdent ® ) and autofluorescence (Soprolife ® and VistaCam ® ), electric current/impedance (CarieScan ® ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife ® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife ® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1-minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 -minimally invasive therapy 2) using several clinical cases as examples. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the disease, or keep the oral environment in a state of balance between pathological and preventive factors. Early detection and diagnosis and prediction of lesion activity are of great interest and may change traditional operative procedures substantially. Fluorescence tools with high levels of magnification and observational capacity should guide clinicians towards a more preventive and minimally invasive treatment strategy.

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“…[18][19][20][21] In brief, the QLF system's ability is to accurately determine mineral content of enamel.…”

Section: Combination Of Camera and Fluorescence Systemsmentioning

confidence: 99%

Use of new minimum intervention dentistry technologies in caries management

Tassery

Levallois

Terrer

et al. 2013

Australian Dental Journal

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“…The quantitative light-induced fluorescence (QLF) method that recently came on the market (Inspektor™ Pro) in several countries can readily detect lesions to a depth of approximately 500 μm on smooth and occlusal enamel surfaces. The QLF method has been tested in several in vitro, [32][33][34] in situ, 35 and in vivo 36-41 studies for smooth surface caries lesions. The possibility of adapting the QLF method for occlusal caries diagnosis is under investigation.…”

Section: Introductionmentioning

confidence: 99%

Performance of laser fluorescence devices and visual examination for the detection of occlusal caries in permanent molars

Rechmann

2012

J. Biomed. Opt

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“…A recent in vitro study comparing fluorescence loss in white spot lesions after initial demineralization and after various remineralization protocols has shown that fluorescence loss for the remineralized lesions and the original lesions have the same linear relation with mineral loss. 35 This, together with the fact that natural caries lesions also show the same relation between fluorescence loss and mineral loss, 27 gives us a good indication that QLF is suited for the assessment of the remineralization process as well.…”

Section: A Inspektor Pro™: Quantitative and Qualitative Assessmentmentioning

confidence: 99%

“…While the technique was validated both quantitatively by comparison with mineral loss and lesion depth from transverse or longitudinal microradiography [22][23][24][25][26][27][28] and qualitatively by comparison with visual detection and histology [29][30][31][32][33][34] the true strength of the technique is not its capability to detect lesions but to follow the oral health over time. The images or series of longitudinal images of a tooth over an extended period in time, can be analyzed for GF loss and presence of RF.…”

Section: A Inspektor Pro™: Quantitative and Qualitative Assessmentmentioning

confidence: 99%

Quantified light-induced fluorescence, review of a diagnostic tool in prevention of oral disease

Jong

Higham

Smith

et al. 2009

Journal of Applied Physics

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Diagnostic methods for the use in preventive dentistry are being developed continuously. Few of these find their way into general practice. Although the general trend in medicine is to focus on disease prevention and early diagnostics, in dentistry this is still not the case. Nevertheless, in dental research some of these methods seem to be promising for near future use by the general dental professional. In this paper an overview is given of a method called quantitative light-induced fluorescence or (QLF) in which visible and harmless light excites the teeth in the patient's mouth to produce fluorescent images, which can be stored on disk and computer analyzed. White spots (early dental caries) are detected and quantified as well as bacterial metabolites on and in the teeth. An overview of research to validate the technique and modeling to further the understanding of the technique by Monte Carlo simulation is given and it is shown that the fluorescence phenomena can be described by the simulation model in a qualitative way. A model describing the visibility of red fluorescence from within the dental tissue is added, as this was still lacking in current literature. An overview is given of the clinical images made with the system and of the extensive research which has been done. The QLF™ technology has been shown to be of importance when used in clinical trials with respect to the testing of toothpastes and preventive treatments. It is expected that the QLF™ technology will soon find its way into the general dental practice.

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Mineral loss in incipient caries lesions quantified with laser fluorescence and longitudinal microradiography: A methodologic study

Cited by 63 publications

References 12 publications

Use of new minimum intervention dentistry technologies in caries management

Use of new minimum intervention dentistry technologies in caries management

Performance of laser fluorescence devices and visual examination for the detection of occlusal caries in permanent molars

Quantified light-induced fluorescence, review of a diagnostic tool in prevention of oral disease

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