title: Laser fluorescence detection of demineralization in artificial occlusal fissures.
abstract: Laser fluorescence (LF) has been used previously to detect early smooth-surface lesions. Although its use for detection of occlusal demineralization has been implicated, it has not been demonstrated. The aim of this study was to determine whether LF could detect demineralization in the base of artificial fissures. To employ LF for detection of occlusal demineralization an apparatus was devised to direct laser light into fissures and simultaneously detect fluorescence from the base of the fissures. Three groups (n = 40/group) of differing fissure types were prepared (straight wall, converging and diverging wall) with either a sound or lesioned base. One half of each group was examined with LF and dye-enhanced LF (DELF); the other half was examined with LF, exposed to plaque, examined with LF and DELF, air-polished and examined with DELF. All images were scored twice as either (1) carious; (2) sound, or (3) undetermined, by a group of 3 examiners. For fissures without plaque, the average sensitivity was higher for DELF (0.76) than for LF (0.54) (p < 0.05). Likewise, the average specificity was higher for DELF (0.64) than for LF (0.29) (p < 0.05). In the presence of plaque, sensitivity was higher for DELF (0.91) compared to LF (0.43); however, specificity was lower for DELF (0.05) compared to LF (0.55). When the fissures were air-polished and then examined with DELF, sensitivity averaged 0.82 (p < 0.05), and specificity increased consistently (average 0.51, p < 0.05). It was concluded that, in the absence of plaque, DELF was a better diagnostic tool than LF for detection of demineralization in artificial fissures.
authors.affiliation: Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis 46202, USA. azandona@iusd.iupui.edu
authors.forename: A G
authors.initials: AG
authors.lastname: Ferreira Zandoná
authors.forename: M
authors.initials: M
authors.lastname: Analoui
authors.forename: B R
authors.initials: BR
authors.lastname: Schemehorn
authors.forename: G J
authors.initials: GJ
authors.lastname: Eckert
authors.forename: G K
authors.initials: GK
authors.lastname: Stookey
mesh_terms: D000818:Animals; D002417:Cattle; D004396:Coloring Agents; D003731:Dental Caries / Q000175:diagnosis / Q000473:pathology; D003743:Dental Enamel / Q000473:pathology*; D003750:Dental Fissures / Q000175:diagnosis* / Q000473:pathology; D003773:Dental Plaque / Q000175:diagnosis / Q000473:pathology; D003777:Dental Prophylaxis; D019793:Fluorescein; D005453:Fluorescence; D007091:Image Processing, Computer-Assisted; D007834:Lasers; D015588:Observer Variation; D012372:ROC Curve; D012680:Sensitivity and Specificity; D017001:Tooth Demineralization / Q000175:diagnosis* / Q000473:pathology
chemical_list: D004396:Coloring Agents; D019793:Fluorescein