Detecting Caries at the Restoration Margins: Clinical Challenge, Technological Solution – The Canary System (original) (raw)
Related papers
2012
Dental secondary caries is the carious lesion developed around existing restoration margins. Many new technologies have been developed for caries detection purposes, but their performance is unsatisfactory for the specific purpose of secondary caries diagnosis. Therefore, the development of a novel technology to detect secondary caries has been highly necessary. The objective of this research was to investigate the ability of photothermal radiometry and modulated luminescence to detect secondary caries: wall lesions and outer lesions. Changes in experimental PTR-LUM signals due to sequential demineralization on vertical walls of sectioned tooth samples were investigated. Another study was conducted to investigate how two different types of secondary caries, wall lesions and outer lesions, affect the PTR-LUM signals. The studies demonstrated that PTR-LUM is sensitive to progressive demineralization and remineralization on vertical walls of sectioned tooth samples, as well as to the presence of wall lesions and outer lesions developed around composite restorations.
Open Dentistry Journal, 2017
Introduction: A clinical study was initiated to investigate a caries detection device (The Canary System (CS)), based on photothermal radiometry and modulated luminescence (PTR-LUM). The primary objective of this study was to determine if PTR-LUM values (in the form of Canary Numbers; CN) correlate with International Caries Diagnostic and Assessment System (ICDAS II) scores and clinical situations. The secondary objectives of this study were to monitor the safety of PTR-LUM, and collect data to determine how CN values could be used to differentiate healthy from decayed tooth surfaces on a normalized scale. Methods: The trial was a four site, non-blinded study. Data was collected from 92 patients, resulting in 842 scanned tooth surfaces over multiple appointments. Surfaces were assessed according to ICDAS II, and further stratified into five clinical situation categories: 1) healthy surface, 2) non-cavitated white and/or brown spots; 3) caries lesions; 4) cavitation and 5) teeth undergoing remineralization therapy. CN data was analyzed separately for smooth and occlusal surfaces. Using a semi-logarithmic graph to plot raw CN (rCN) and normalized (CN) values, rCN data was normalized into a scale of 0-100. Results: Linear correlations (R 2) between CN and ICDAS II groupings for smooth and occlusal surfaces were calculated as 0.9759 and 0.9267, respectively. The mean CN values derived from smooth (20.2±0.6) and occlusal (19±1.0) surfaces identified as healthy had The Open Dentistry Journal, 2017, Volume 11 637 significantly lower CN values (P<0.05) compared with the values from the other clinical situation categories. No adverse events were reported. Conclusion: The present study demonstrated the safety of PTR-LUM for clinical application and its ability to distinguish sound from carious tooth surfaces. A clear shift from the baseline in both PTR and LUM in carious enamel was observed depending on the type and nature of the lesion, and correlated to ICDAS II classification codes, which enabled the preliminary development of a Canary Scale.
The main objective of the study was to investigate the ability of frequency-domain photothermal radiometry (PTR) and modulated luminescence (LUM) to detect secondary caries lesions on the walls of restorations (wall lesions). Changes in experimental PTR-LUM signals due to sequential demineralization on entire vertical walls of sectioned tooth samples were investigated. In addition, transverse micro-radiography (TMR) analysis (used as a gold standard) was conducted to measure the degree of demineralization that occurred in each sample. Statistical correlation between TMR results and PTR-LUM signals was determined using Pearson's correlation coefficient. LUM signals were found to be dominated by the scattered component of the incident laser beam. The more clinically relevant cases of localized demineralization and remineralization on vertical walls were also investigated to examine whether PTR-LUM signals are sensitive to demineralization and remineralization of much smaller areas. The overall results demonstrated that PTR-LUM is sensitive to progressive demineralization and remineralization on vertical walls of sectioned tooth samples.
Caries Detection with Laser Fluorescence Devices. Limitations of Their Use
STOMATOLOGY EDU JOURNAL
Background: Dental caries is one of the most prevalent human diseases worldwide. The modern concept of minimal invasive dentistry includes early detection of incipient caries lesions and its treatment. Several optical and digital detection methods are available. Objective: This literature review presents the utility and limitations of laser fl uorescence caries detection devices DIAGNOdent (DD) and DIAGNOdent Pen (DDpen) (KaVo Dental GmbH, Biberach/ Riβ, Germany) for carious lesions on the occlusal surfaces of the permanent dentition. Data sources: All available in vitro and in vivo studies from Google Scholar, PubMed and Scopus machines corresponding to caries, DIAGNOdent, DIAGNOdent Pen and laser fl uorescence as key words, were reviewed. Data extraction: Certain limitations of the studies were the inadequate analysis of the experimental protocols, the widespread sample use of the third molar, mistakes in sample handling and the limited number of studies evaluating the detection capability of DD and DDPen for secondary caries. Data synthesis: DD and DDPen are useful devices for caries detection on the occlusal tooth surfaces. Their main advantages are the very high reproducibility of measurements (>0.90), the ease of handling and the quantifi cation and monitoring capacity. Their main limitations are the relatively low specifi city for enamel lesions, the necessity of unstained surfaces and absence of plaque and pastes during measurements and the absence of a universal, clinically functional calibration value (COV). Conclusion: Further studies are required for more reliable data analysis and clinical interpretation of the relevant results.
2010
Detection modalities that can evaluate the early stages of dental caries are indispensable. The purpose of this thesis is to evaluate the efficacy of photothermal radiometry and modulated luminescence (PTR-LUM) to non-destructively detect and quantify simulated enamel caries. Two experiments were performed based on the PTR-LUM detection mode: back-propagation or transmission-mode. Artificial demineralized lesions were created in human molars and a subset was further exposed to an artificial remineralizing solution. PTR-LUM frequency scans were performed periodically during de/re-mineralization treatments. PTR data was fitted to a theoretical model based on optical and thermal fluxes in enamel to extract opto-thermophysical parameters. Lesion validation was performed using transverse microradiography (TMR). Optical and thermal properties changed with the development and repair of the caries lesions while theory-derived thicknesses paralleled those determined microradiographically. These trends coupled with the uniqueness-of-fit of the generated parameters illustrate the efficacy of PTR-LUM to non-destructively detect and quantify de/re-mineralized lesions. III Acknowledgements I would like to thank all the lab members at the Center for Advanced Diffusion-Wave Technologies (CADIFT) and Quantum Dental Technologies (QDT) for their insight and support. Specifically, I would like to acknowledge Dr. Raymond Jeon, Dr. Anna Matvienko and Dr. Koneswaran Sivagurunathan for their invaluable assistance, lengthy discussions, suggestions and guidance over the years. Thank you to Dr. Stephen Abrams for his endless motivation and clinical insight into the application and development of caries detection aids. His clinical expertise and knowledge of dental economics are truly invaluable to the dental profession as he continually tries to promote a shift from the traditional-drill, fill and bill‖ approach to dentistry. I would like to express my sincere gratitude toward my supervisors, Dr. Andreas Mandelis and Dr. Yoav Finer for their endless support, leadership and expertise. Thank you to my advisory committee member, Dr. Paul Santerre, for his support and discussions. Thank you to Prof. Mandelis, whose scientific knowledge, perspicacity and motivation made this research project possible and inspired me to meticulously explore the interminable world of quantitative, nondestructive science. I would also like to thank Dr. Bennett Amaechi at the University of Texas Health Science Center at San Antonio for transverse microradiography analysis and his invaluable discussions relating to the experimental protocol and principles of cariology. I would like to acknowledge the following funding agencies for financial support: the Ministry of Research and Innovation (MRI), the Ontario Premier's Discovery Award, the Ontario Research Fund from the Canadian Foundation for Innovation (CFI-ORF) and lastly the Natural Sciences and Engineering Research Council of Canada (NSERC).
Pediatric Dental Journal, 2012
Fluorescence-based devices are adjunct tools for caries detection. Both DIAGNOdent 2095 (LF) and DIAGNOdent 2190 (LF pen) were developed for this application. The purpose of this in vivo study was to compare the relationship between the measurements obtained using the LF and LF pen devices in primary and permanent teeth. The same sample of occlusal and smooth surfaces caries were evaluated by one examiner using both LF and LF pen devices in children. For occlusal caries, measurements were made at 51 sites in primary teeth, and at 83 sites in permanent teeth. For smooth surface caries, measurements were made at 63 sites in primary teeth, and 163 sites in permanent teeth. The values obtained with the LF pen for occlusal caries in primary and permanent teeth (17.6±2.14, 20.6±1.40, respectively) were significantly higher than those obtained with the LF (9.7±1.24, 11.3±0.78). For caries on smooth surfaces, the values obtained with the LF pen for primary and permanent teeth (8.2±1.22, 7.2±0.45) were higher than those obtained with the LF (4.5±0.57, 3.3±0.23). For both occlusal and smooth surface caries, the values were significantly different between the two devices (P<0.01). The Spearman's correlation coefficients comparing the LF and LF pen values for primary and permanent teeth were Rs=0.87 and 0.86 for occlusal caries and 0.80 and 0.74 for smooth surface caries, respectively. Values from both devices showed high correlation coefficients, indicating similar principle of function. However, the actual values were significantly different, which indicated that the values obtained with the two devices did not agree. The LF pen should be used with caution in patients for whom the LF is already being used to manage caries. a laser fluorescence device (LF, DIAGNOdent 2095, KaVo, Biberach, Germany; Fig. 1A) with a pulsed near-infrared diode laser (wavelength 655 nm) was developed for the diagnosis of dental caries. With this device, pulsed laser irradiation of a carious lesion causes the emission of reflected fluorescent light at 700-800 nm 2). The reliability of the device was reported to be similar to that of conventional diagnostic methods used to detect caries in permanent 3-6) and primary teeth 7-11). The apparatus uses two types of tip, type A reveals caries in fissure and type B detects caries on smooth surfaces (Fig. 1B,
Photothermal detection of incipient dental caries: experiment and modeling
Optics East …, 2007
Laser induced photothermal radiometry (PTR) was applied as a safe, non-destructive, and highly sensitive tool for the detection of early tooth surface demineralization. In the experiments, teeth were treated sequentially with an artificial demineralization gel to simulate controlled mineral loss on the enamel surface. Modulated laser light generated infrared blackbody radiation from teeth upon absorption and nonradiative energy conversion. The infrared flux emitted by the treated region of the tooth surface and sub-surface was monitored with an infrared detector twice: before and after treatment. The experiments showed very high sensitivity of the measured signal to incipient changes in the enamel structure, emphasizing the clinical capabilities of the method. In order to analyze the biothermophotonic phenomena in a sample during the photothermal excitation, a theoretical model featuring coupled diffuse-photon-density-wave and thermal-wave fields was developed. The theoretical fits based on the three-layer approach (demineralizad enamel + healthy enamel + dentin) allowed fitting thermal and optical properties of the demineralized layer. The theoretical analysis showed that the dentin layer should be taken into account in the fittings.