Validity of diode laser to monitor carious lesions in pits and fissures

Abstract 

Objective

To analyse the DIAGNOdent's performance to longitudinally monitor the arrestment of non-cavitated carious lesions in occlusal surfaces.

Methods

The sample consisted of 15 children (12–13 years old) with 40 active non-cavitated lesions. The protocol for the examinations was: prophylaxis, drying teeth for 30s; clinical examination, examination with DIAGNOdent. Lesions were classified as active or arrested according to this criteria—active lesion: opaque and whitened enamel, and arrested lesion: enamel with shiny, white or dark spot. The cut offs used for DIAGNOdent measurements were: between 0 and 14—sound tissue (stage 1), between 15 and 20—enamel lesion (stage 2) and above 20—dentine lesion (stage 3). The patients were treated with professional plaque removal, topical application of 1.23% of fluoride in gel and oral hygiene instructions. Thirty days after the first session, the lesions were examined (clinical and DIAGNOdent examinations). The lesions that were not arrested after this period were resubmitted to the previous treatment measurements at 14-day intervals until total clinical arrestment.

Results

The Kappa index was 0.75 for the clinical examination and 0.71 for the DIAGNOdent examination. After 60 days, all the 40 initial lesions were arrested. The mean, ±standard deviation, median and range of values with DIAGNOdent of active lesions were respectively 22.34, ±21.41, 15.00 and 0–81.00; after clinical arrestment these values were 20.25, ±18.01, 15.00 and 0–71.00. No significant difference was observed between the two periods.

Conclusion

DIAGNOdent was not capable to monitor changes occurring during the clinical arrestment of lesions.

Keywords: DIAGNOdent, Diagnosis, Caries, Pits and fissures