Cariology
CARIES DETECTION WITH LASER FLUORESCENCE DEVICES. LIMITATIONS OF THEIR USE
Andreas Spaveras 1a , Angeliki Tsakanikou 2b , Frantzeska Karkazi 3c , Maria Antoniadou 1d*
1
2
3
Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, Greece
Department of Operative Dentistry, Dental School, Semmelweis University, Budapest, Hungary
Department of Operative Dentistry, Dental School, Comenius University of Bratislava, Slovakia
DMD, Postgraduate Student
DMD
c
MD Dr
d
DDS, PhD, Assistant Professor
a
b
Received: March 09, 2017
Revised: March 24, 2017
Accepted: April 02, 2017
Published: April 03, 2017
Academic Editor: Dana Cristina Bodnar, DDS, PhD, Professor, “Carol Davila” University of Medicine and Pharmacy Bucharest, Bucharest, Romania
Cite this article:
Spaveras A, Tsakanikou A, Karkazi F, Antoniadou M. Caries detection with laser fluorescence devices. Limitations of their use. Stoma Edu J. 2017;
4(1):46-53.
Abstract
Background: Dental caries is one of the most prevalent human diseases worldwide. The modern
concept of minimal invasive dentistry includes early detection of incipient caries lesions and its
treatment. Several optical and digital detection methods are available.
Objective: This literature review presents the utility and limitations of laser fluorescence caries
detection devices DIAGNOdent (DD) and DIAGNOdent Pen (DDpen) (KaVo Dental GmbH, Biberach/
Riβ, Germany) for carious lesions on the occlusal surfaces of the permanent dentition.
Data sources: All available in vitro and in vivo studies from Google Scholar, PubMed and Scopus
machines corresponding to caries, DIAGNOdent, DIAGNOdent Pen and laser fluorescence as key
words, were reviewed.
Data extraction: Certain limitations of the studies were the inadequate analysis of the experimental
protocols, the widespread sample use of the third molar, mistakes in sample handling and the limited
number of studies evaluating the detection capability of DD and DDPen for secondary caries.
Data synthesis: DD and DDPen are useful devices for caries detection on the occlusal tooth surfaces.
Their main advantages are the very high reproducibility of measurements (>0.90), the ease of
handling and the quantification and monitoring capacity. Their main limitations are the relatively low
specificity for enamel lesions, the necessity of unstained surfaces and absence of plaque and pastes
during measurements and the absence of a universal, clinically functional calibration value (COV).
Conclusion: Further studies are required for more reliable data analysis and clinical interpretation
of the relevant results.
Keywords: caries, DIAGNOdent, DIAGNOdent Pen, laser fluorescence, laser.
1. Introduction
Dental caries is one of the most widespread
human diseases around the world and one of
the most important problems in contemporary
dentistry. The prevalence of dental caries is higher
in the elderly and people of lower socioeconomic
status. Nevertheless, it affects not only children
but also adults. 1 A substantial decline of caries
prevalence has been documented during the last
decades, especially in the western world, primarily
due to multiple fluoride products and the caries
prevention methods available. 2
Nowadays, dental caries in smooth and inter-
proximal surfaces of permanent dentition is not
so frequent as compared to caries in pits and
fissures of the posterior teeth. Most commonly,
occlusal caries occur more often in premolars
and first molars. 3,4 The difficulty of prompt clinical
diagnosis in occlusal areas is due to the anatomical
features of these surfaces as well as the use of
topical fluoride products. Fluoride can prevent
the collapse of the superficial enamel layer and
influence the remineralization process. Therefore,
large d