IADR Abstract Archives
Clinical Subgingival Calculus Detection with Laser Fluorescence and a Dental Explorer
Objectives: This study evaluated the in vivo diagnostic performance of a laser fluorescence device and a dental explorer for detection of subgingival calculus on human teeth.
Methods: A total of 26 periodontally-hopeless teeth with probing depths of 4-9 mm on all surfaces, and scheduled for extraction, were studied in 12 consenting adults. After removal of supragingival deposits, a visible red laser fluorescence-emitting (655 nm wavelength) device fitted with a probe-like cylindrical sapphire tip (DIAGNOdent Pen and Perio Tip, Kavo Dental Corp.) was circumferentially walked by a trained periodontist examiner around each tooth to probing depth, with maximum laser fluorescence intensity values per tooth surface measured on a 0-99 scale. An 11/12 ODU dental explorer was used by a second periodontist examiner to tactilely detect subgingival calculus deposits on the same tooth surfaces. After non-traumatic extraction, definitive subgingival calculus identification on non-carious root surfaces was established using a dissecting stereomicroscope at 12x magnification. Sensitivity, specificity, and the proportion of correctly classified tooth surfaces relative to the presence or absence of subgingival calculus (accuracy), were calculated to compare the diagnostic performance of the two techniques for in vivo detection of subgingival dental calculus.
Results: The study teeth yielded 75 surfaces with and 26 without subgingival calculus. Mean laser fluorescence intensity values were significantly greater on calculus-positive as compared to calculus-negative root surfaces (55.8 vs. 14.5, P < 0.001, Student’s t-test). Using a fluorescence intensity threshold ≥ 40, the laser fluorescence device exhibited sensitivity = 58.7%, specificity = 92.3%, and accuracy = 67.3% for detection of subgingival calculus, whereas a dental explorer yielded values for sensitivity = 81.3%, specificity = 65.4%, and accuracy = 77.2%.
Conclusions: The visible red laser fluorescence-emitting device demonstrated in vivo lower sensitivity, higher specificity, and slightly less overall accuracy than a dental explorer in subgingival calculus detection on human tooth root surfaces.
Methods: A total of 26 periodontally-hopeless teeth with probing depths of 4-9 mm on all surfaces, and scheduled for extraction, were studied in 12 consenting adults. After removal of supragingival deposits, a visible red laser fluorescence-emitting (655 nm wavelength) device fitted with a probe-like cylindrical sapphire tip (DIAGNOdent Pen and Perio Tip, Kavo Dental Corp.) was circumferentially walked by a trained periodontist examiner around each tooth to probing depth, with maximum laser fluorescence intensity values per tooth surface measured on a 0-99 scale. An 11/12 ODU dental explorer was used by a second periodontist examiner to tactilely detect subgingival calculus deposits on the same tooth surfaces. After non-traumatic extraction, definitive subgingival calculus identification on non-carious root surfaces was established using a dissecting stereomicroscope at 12x magnification. Sensitivity, specificity, and the proportion of correctly classified tooth surfaces relative to the presence or absence of subgingival calculus (accuracy), were calculated to compare the diagnostic performance of the two techniques for in vivo detection of subgingival dental calculus.
Results: The study teeth yielded 75 surfaces with and 26 without subgingival calculus. Mean laser fluorescence intensity values were significantly greater on calculus-positive as compared to calculus-negative root surfaces (55.8 vs. 14.5, P < 0.001, Student’s t-test). Using a fluorescence intensity threshold ≥ 40, the laser fluorescence device exhibited sensitivity = 58.7%, specificity = 92.3%, and accuracy = 67.3% for detection of subgingival calculus, whereas a dental explorer yielded values for sensitivity = 81.3%, specificity = 65.4%, and accuracy = 77.2%.
Conclusions: The visible red laser fluorescence-emitting device demonstrated in vivo lower sensitivity, higher specificity, and slightly less overall accuracy than a dental explorer in subgingival calculus detection on human tooth root surfaces.