Detection of in vitro demineralization of primary teeth using quantitative light-induced fluorescence (QLF).

INTRODUCTION With the advent of remineralizing therapies and the new, conservative approach to restoration placement, interest in detecting and monitoring subclinical, precavitated lesions has increased. The increased understanding of clinicians about the processes of primary and secondary prevention and the detection of lesions to which these therapies may be applied, is one of the current goals in caries management. Quantitative light-induced fluorescence (QLF) is a new method for the detection of very early caries. OBJECTIVES To determine the ability of QLF to detect and longitudinally monitor in vitro enamel demineralization. To present the device to the paediatric community and present future in vivo uses of the device. DESIGN An in vitro study with combined in vivo pilot. SAMPLE AND METHODS Twelve previously extracted, caries free, primary molars were selected and prepared. Two teeth were randomly selected as controls. Teeth were prepared by gentle pumicing and coating in an acid-resistant nail-varnish, except for an exposed window on the buccal surface. QLF baseline images were taken and the teeth then exposed to a demineralizing solution. Teeth were removed at regular intervals (24, 48, 72, 96, 120, and 144 h), air-dried and QLF images taken. QLF images were analysed by a single, blinded examiner (to control, to length of exposure). Mineral loss, as measured by DeltaQ, was recorded. RESULTS Demineralization was noted in all experimental teeth by 48 h, and within 24 h in six teeth. The QLF successfully monitored the increase in mineral loss over time (P < 0.05). The detected lesions were not visible clinically until 144 h and then in only the most severe lesions. No demineralization was detected by QLF in control teeth. The device was user- and patient-friendly in vivo, detecting subclinical lesions. CONCLUSION Detection of very early mineral loss and subsequent monitoring of this loss is possible in primary teeth using QLF. The device is well suited to use in paediatric dentistry and offers applications for both clinicians and researchers. The determination of the status of carious lesions (active/inactive) will be possible with readings taken at recall appointments.

[1]  J. Abernathy,et al.  Comparative effectiveness of visual/tactile and simplified screening examinations in caries risk assessment. , 1992, Community dentistry and oral epidemiology.

[2]  E. D. J. D. Jong,et al.  Longitudinal microradiography: a non-destructive automated quantitative method to follow mineral changes in mineralised tissue slices , 1987 .

[3]  A. Wenzel,et al.  Reliability of Visual Examination, Fibre-Optic Transillumination, and Bite-Wing Radiography, and Reproducibility of Direct Visual Examination Following Tooth Separation for the Identification of Cavitated Carious Lesions in Contacting Approximal Surfaces , 1998, Caries Research.

[4]  B. Potter,et al.  Comparison of direct digital and conventional radiography for the detection of proximal surface caries in the mixed dentition. , 2000, Pediatric dentistry.

[5]  N. King,et al.  Value of bitewing radiographs in detection of occlusal caries. , 1979, Community dentistry and oral epidemiology.

[6]  M. H. Veen,et al.  Application of quantitative light-induced fluorescence for assessing early caries lesions , 2000 .

[7]  P. Ashley,et al.  Diagnosis of occlusal caries in primary teeth. , 2008, International journal of paediatric dentistry.

[8]  A. Ismail,et al.  Clinical diagnosis of precavitated carious lesions. , 1997, Community dentistry and oral epidemiology.

[9]  B. Angmar-Mansson,et al.  Advances in Methods for Diagnosing Coronal Caries-a Review , 1993, Advances in dental research.

[10]  G. Stookey,et al.  The Validity and Repeatability of Three Light–Induced Fluorescence Systems: An in vitro Study , 1999, Caries Research.

[11]  I A Pretty,et al.  The effect of ambient light on QLF analyses. , 2002, Journal of oral rehabilitation.

[12]  R M Davies,et al.  Occlusal caries diagnosis: an in vitro histological validation of the Electronic Caries Monitor (ECM) and other methods. , 1998, Journal of dentistry.

[13]  G. Daculsi,et al.  In vitro Caries-like Lesion Formation in F-containing Tooth Enamel , 1983, Journal of dental research.

[14]  B Angmar-Månsson,et al.  Early detection of enamel caries by the luminescence excited by visible laser light. , 1982, Swedish dental journal.

[15]  T. Cutress,et al.  Some characteristics of in vitro caries lesions induced in enamel by fluoride-containing organic acid buffers. , 1983, The New Zealand dental journal.

[16]  B. Clarkson,et al.  A Model for Producing Caries-like Lesions in Enamel and Dentin Using Oral Bacteria in vitro , 1984, Journal of dental research.

[17]  J. M. ten Cate,et al.  Quantification of Formation and Remineralization of Artificial Enamel Lesions with a New Portable Fluorescence Device , 1997, Advances in dental research.

[18]  D. Attrill,et al.  Diagnostics: Occlusal caries detection in primary teeth: a comparison of DIAGNOdent with conventional methods , 2001, British Dental Journal.

[19]  J. Arends,et al.  In vitro Remineralization of in vivo and in vitro Formed Enamel Lesions , 1999, Caries Research.

[20]  J. J. Bosch.  General aspects of optical methods in dentistry. , 1987 .

[21]  B Angmar-Månsson,et al.  A new method for in vivo quantification of changes in initial enamel caries with laser fluorescence. , 1995, Caries research.

[22]  J B Ludlow,et al.  TACT imaging of primary caries. , 1997, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.