IADR Abstract Archives
Assessment of Caries Excavation Techniques Using Visual Examination and QLF-D
Objectives: This pilot study is to assess the extent of caries removal of Atraumatic Restorative Treatment (ART) versus complete excavation in occlusal ICDAS 5 lesions in extracted posterior teeth using QLF-D.
Methods: Ten extracted teeth were selected with occlusal lesions using the International Caries Detection Assessment System (ICDAS) index code 5. Visual assessment, radiographs and Quantitative Light Induced Fluorescence camera (QLF-D) images of teeth were taken before and after caries excavation. In five teeth, caries was removed using a #4 carbide bur. In the other five teeth, soft dentinal caries was removed using a spoon excavator until hard dentine was found. QLF-D images were analyzed later by two examiners for the presence or absence of demineralization. Measurements were correlated between ART, complete excavation, and QLF-D using Spearman's correlation, visual examination, and QLF-D ΔF and ΔFMax values.
Results: After excavation, eight out of ten (80%) teeth were visually determined to be caries free. Two teeth had extensive caries reaching the pulp and were not completely excavated. However, utilizing QLF-D technology, all teeth samples (100%) were found to still have caries. Spearman’s correlation between QLF-D and visual examination was 0.71 for the complete caries removal, which is considered to be an acceptably high correlation between QLF-D and the treatment. While the correlation between QLF-D and Atraumatic Restorative Treatment (ART) was 0.35, which is considered to be a poor correlation.
Conclusions: QLF-D was useful at detecting caries and could be used to assist dental professionals with caries evaluation and excavation. QLF-D was found to be more accurate than visual examination in caries detection. Complete excavation appears to have a better chance at removing more carious tissue than ART by itself. More studies are needed to determine QLF-D's efficacy as a tool in the excavation process.
Methods: Ten extracted teeth were selected with occlusal lesions using the International Caries Detection Assessment System (ICDAS) index code 5. Visual assessment, radiographs and Quantitative Light Induced Fluorescence camera (QLF-D) images of teeth were taken before and after caries excavation. In five teeth, caries was removed using a #4 carbide bur. In the other five teeth, soft dentinal caries was removed using a spoon excavator until hard dentine was found. QLF-D images were analyzed later by two examiners for the presence or absence of demineralization. Measurements were correlated between ART, complete excavation, and QLF-D using Spearman's correlation, visual examination, and QLF-D ΔF and ΔFMax values.
Results: After excavation, eight out of ten (80%) teeth were visually determined to be caries free. Two teeth had extensive caries reaching the pulp and were not completely excavated. However, utilizing QLF-D technology, all teeth samples (100%) were found to still have caries. Spearman’s correlation between QLF-D and visual examination was 0.71 for the complete caries removal, which is considered to be an acceptably high correlation between QLF-D and the treatment. While the correlation between QLF-D and Atraumatic Restorative Treatment (ART) was 0.35, which is considered to be a poor correlation.
Conclusions: QLF-D was useful at detecting caries and could be used to assist dental professionals with caries evaluation and excavation. QLF-D was found to be more accurate than visual examination in caries detection. Complete excavation appears to have a better chance at removing more carious tissue than ART by itself. More studies are needed to determine QLF-D's efficacy as a tool in the excavation process.