Laser fluorescence technique for occlusal caries diagnosis

Objectives: The aim of the study was to compare efficiency of occlusal caries detection performed clinical examination based on the modified scale of Ripa and Wolff and laser fluorescence technique (DIAGNOdent). Methods:The clinical evaluation included 329 posterior teeth (204 premolars and 125 molars) with no fillings or pit and fissure sealants, in 50 patients aging 17 to 25 years with active caries lesions and dental plaque ( A.P.I. more then 30%).Every surface was examined and the results were documented in a four-stage scale, according Ripa and Wolff (1st examination) and using DIAGNOdent (Kavo), employing the scale of Lussi (2nd examination). Next, occlusal surfaces identified in the 1st examination as exhausting criteria of code 2/3 and DIAGNOdent values above 20 (132 teeth) were qualified for treatment using preventive resin restorations (PRR). The diagnosis established during 1st and 2nd examinations was verified during preparation of the lesions concluding the diagnosis of Caries superficialis, Caries media or absence of caries. Input of individual diagnoses in the total material was calculated and results were analyzed using the exact Fisher's test. Results:In the 1st examination 41% of occusal surfaces exhausted criteria of code 2 (suspicion of caries) and 18% of cases corresponded to caries (code 3). In the 2nd examination 18% teeth (values ranging from 21 to 29) required prophylactic or invasive actions (depending on caries risk involved) and 23% teeth (values above 30) were qualified for a conservative treatment. In the course of preparation, presence of caries was disclosed in 95% teeth. Clinical verification reveal no statistically significant differences between diagnostic techniques used to occlusal caries detection. Conclusions: The performed studies showed that neither of the applied diagnostic techniques could exclude erroneous diagnosis of caries. Therefore, in doubtful cases it seems worth while to employ in parallel a few diagnostic techniques.