title: The effect of distance and tooth structure on laser fluorescence caries detection.
abstract: The DIAGNOdent, a device used in caries detection, uses a laser to excite fluorescence from pigments in carious tooth structure. In clinical use assessing occlusal surfaces, distance and tooth structure may separate the instrument's tip from the fluorescent source.The aim of this in vitro study was to examine the effect of distance and tooth structure on laser fluorescence (LF) readings.In one set of experiments, a porphyrin pigmentin oil suspension was used as a LF signal source. Thin slices of enamel and dentin were obtained from extracted molars. Pigment-induced LF readings were obtained when these slices were placed between the porphyrin pigment and the LF instrument's tip. The effect of either demineralized or intact tooth tissue on pigment-induced LF readings was assessed.In other experiments on extracted molars with small occlusal caries, LF readings were taken from pit/fissure sites before and after removal of the occlusal surface.LF readings are proportional to pigment con-centration and inversely proportional to the distance between the suspension and the instrument's tip. Enamel, demineralized enamel,dentin, and demineralized dentin all caused significant reductions in LF signal, all readings being taken with the same tip-pigment distance. Demineralized enamel (white with intact surface) caused the most reduction.After sectioning of carious teeth, there was a significant increase in LF readings.The results of this study indicate that distance and the presence of tooth structure between the carious lesion and the instrument's tip reduce LF readings. These results indicate that anatomic factors interfere with the LF device's ability to assess occlusal caries. DIAGNOdent readings should not be relied on when making diagnostic decisions.
authors.affiliation: Department of Oral Biology, New Jersey Dental School, Newark, NJ, USA. markowkj@umdnj.edu
authors.forename: K
authors.initials: K
authors.lastname: Markowitz
authors.forename: R M
authors.initials: RM
authors.lastname: Stenvall
authors.forename: M
authors.initials: M
authors.lastname: Graye
mesh_terms: D000293:Adolescent; D000328:Adult; D003731:Dental Caries / Q000175:diagnosis* / Q000473:pathology; D003743:Dental Enamel / Q000473:pathology*; D003750:Dental Fissures / Q000175:diagnosis / Q000473:pathology; D003804:Dentin / Q000473:pathology*; D005453:Fluorescence; D006801:Humans; D007834:Lasers; D008163:Luminescent Measurements / Q000295:instrumentation / Q000379:methods*; D011166:Porphyrins; D017001:Tooth Demineralization / Q000175:diagnosis / Q000473:pathology; D055815:Young Adult
chemical_list: D011166:Porphyrins