CLASSIFICATION AND CLASSIFICATION AND DETECTION OF DETECTION OF DENTAL CARIESDENTAL CARIES

PRESENTED BY:PRESENTED BY:

LAXMI ACHARYALAXMI ACHARYA

ROLL NO:2ROLL NO:2

BDS 1BDS 1STST BATCH BATCH

ContentContentCLASSIFICATIONCLASSIFICATION

1.BASED ON 1.BASED ON ANATOMICALANATOMICAL SITE SITE

2.BASED ON 2.BASED ON PROGRESSIONPROGRESSION

3.BASED ON 3.BASED ON VIRGINITYVIRGINITY OF LESION OF LESION

4.BASED ON 4.BASED ON EXTENTEXTENT OF CARIES OF CARIES

5.BASED ON 5.BASED ON PATHWAYPATHWAY OF CARIES SPREAD OF CARIES SPREAD

6.BASED ON 6.BASED ON NUMBERNUMBER OF TOOTH SURFACE INVOLVED OF TOOTH SURFACE INVOLVED 7. BASED ON CHRONOLOGY 8 .RESIDUAL CARIES 9.BASED ON TOOTH SURFACE TO BE RESTORED 10.BLACK’S CLASSIFICATION 11.WHO SYSTEMDETECTION OF CARIES 1.VISUAL-TACTILE METHOD 2.RADIOGRAPHSADVANCESREFERENCESCONCLUSION

Dental caries is an infectious microbiologic Dental caries is an infectious microbiologic disease of the teeth that results in disease of the teeth that results in localized dissolution and destruction of localized dissolution and destruction of the calcified tissue.the calcified tissue.

--SturdevantSturdevant

DEFINITIONDEFINITION

1.BASED ON ANATOMICAL SITE1.BASED ON ANATOMICAL SITE

OCCLUSAL

(PIT AND FISSURE)

ROOT CARIES

SMOOTH SURFACE CARIES(PROXIMAL AND CERVICAL CARIES)

LINEAR ENAMEL CARIES

PIT AND FISSURE CARIESPIT AND FISSURE CARIES Develop in:Develop in:

• Occlusal surface of premolars and molarsOcclusal surface of premolars and molars

• Buccal and lingual surfaces of molarsBuccal and lingual surfaces of molars

• Lingual surfaces of maxillary incisorsLingual surfaces of maxillary incisors

High steep walls and narrow basesHigh steep walls and narrow bases

Enamel in extreme depth – Extremely thin or absentEnamel in extreme depth – Extremely thin or absent

retention of food debris retention of food debris

Shape, morphological variation and depth of pit and Shape, morphological variation and depth of pit and

fissures contributes to their high susceptibility to caries.fissures contributes to their high susceptibility to caries.

Smooth surface cariesSmooth surface caries Develop onDevelop on

• Proximal surfaces of teethProximal surfaces of teeth

• Gingival third of buccal and lingual surfacesGingival third of buccal and lingual surfaces

Usually begin just below the contact pointUsually begin just below the contact point

Early stage – Faint white opacity of enamelEarly stage – Faint white opacity of enamel

Yellow or brown pigmentationYellow or brown pigmentation

Maybe slightly roughenedMaybe slightly roughened

Bordering enamel; bluish whiteBordering enamel; bluish white

Extend buccally and linguallyExtend buccally and lingually

Linear enamel caries ( Linear enamel caries ( odontoclasiaodontoclasia ) is seen ) is seen to occur in the region of the to occur in the region of the neonatal lineneonatal line of of the maxillary anterior teeth. the maxillary anterior teeth.

The line, which represent a metabolic defect The line, which represent a metabolic defect such as hypocalcemia or trauma of birth, such as hypocalcemia or trauma of birth, may predispose to caries, leading to gross may predispose to caries, leading to gross destruction of the labial surface of the teeth.destruction of the labial surface of the teeth.

Morphological aspects of this type of caries Morphological aspects of this type of caries are atypical and results in gross destruction are atypical and results in gross destruction of the labial surfaces incisor teethof the labial surfaces incisor teeth

Linear enamel cariesLinear enamel caries

ROOT SURFACE CARIESROOT SURFACE CARIES It may occur on the tooth root that has It may occur on the tooth root that has

been exposed to the oral environment been exposed to the oral environment and hubitually covered with plaque.and hubitually covered with plaque.

Older patients because older individuals Older patients because older individuals are retaining more of their teeth and are retaining more of their teeth and experiencing gingival recession.experiencing gingival recession.

Caries originating on the root is alarming Caries originating on the root is alarming because because

rapid progression rapid progression often asymptomatic often asymptomatic closer to the pulpcloser to the pulp more difficult to restoremore difficult to restore

2.BASED ON 2.BASED ON PROGRESSIONPROGRESSION

CHRONIC CARIES ARRESTED CARIES

Slow progress and may be arrested after active phases.AdultsSclerosis of dentinal tubulesblack to brown and hard. Pain usually absent.

Rampent caries.Rapid process involving a large number of teeth.lighter colored than the other types, being light brown or grey.

Caries which becomes stationary or static and does not show any tendency for further progression brown pigmentation and induration of the lesion [the so called ‘eburnation of dentin’]Sclerosis of dentinal tubules and secondary dentin formation commonly occur

ACUTE CARIES

3.BASED ON VIRGINITY OF 3.BASED ON VIRGINITY OF

LESIONLESION

Initial attack on the Initial attack on the tooth surface.tooth surface.

Based on the Based on the initial initial locationlocation of the lesion of the lesion on the surface on the surface rather rather than the extent of than the extent of damage.damage.

INITIAL/PRIMARY RECURRENT/SECONDARY

Occurs at the junction of a restoration and the tooth and may progress under the restoration. Poor adaptation of a restoration, which allows for a marginal leakage, inadequate extension of the restoration.

4. BASED ON EXTENT OF 4. BASED ON EXTENT OF CARIESCARIES

INCIPIENT CARIES OCCULT CARIES CAVITATION

Enamel surface is not intact and usually lesion has advanced into dentin.usually remineralization is not possible, and treated by tooth prepation and restoration.

Increased fluid exposure encourages remineralization and slow down progress of the caries in the pit and fissure enamel while the cavitations continues in dentine, intact enamel surfaceThese hidden lesions are called as fluoride bombs or fluoride syndrome.

white when dried.when hydrated it is not detectable. Reversed by remineralization.

limited to enamel.Characterized by virtually intact surface,but a porous surface,that become chalky

5.BASED ON PATHWAY OF 5.BASED ON PATHWAY OF CARIES CARIES SPREAD SPREAD

1.FORWARD CARIES 2.BACKWARD CARIES

When the spread of caries along the DEJ exceeds the caries in contiguous enamel, caries extends into the enamel from the junction.

Caries starts in enamel then it involves the dentin. Wherever the caries cone in enamel is larger or at least the size as that of dentin.

6.BASED ON NUMBER OF 6.BASED ON NUMBER OF TOOTH SURFACE INVOLVEDTOOTH SURFACE INVOLVED

Simple Simple

Compound Compound

Complex Complex

A caries involving only one A caries involving only one tooth surface.tooth surface.

A caries involving two tooth A caries involving two tooth surface.surface.

A caries that involves more A caries that involves more than two tooth surface.than two tooth surface.

7. BASED ON CHRONOLOGY7. BASED ON CHRONOLOGY

EARLY CHILDHOOD CARIES

ADOLESCENT CARIES

ADULT CARIES

EARLY CHILDHOOD CARIESEARLY CHILDHOOD CARIES Early childhood caries Early childhood caries

would include, two would include, two variants: Nursing variants: Nursing caries and rampant caries and rampant caries.caries.

The difference The difference primarily exist in primarily exist in involvement of the involvement of the teeth[ mandibular teeth[ mandibular incisors ] in the incisors ] in the carious process in carious process in rampant caries as rampant caries as opposed to nursing opposed to nursing caries. caries.

TEENAGE CARIES TEENAGE CARIES (ADOLESCENT CARIES(ADOLESCENT CARIES))

variant of rampant caries where the teeth variant of rampant caries where the teeth generally considered immune to decay are generally considered immune to decay are involved.involved.

The caries is also described to be of a The caries is also described to be of a rapidly burrowing type, with a small rapidly burrowing type, with a small enamel opening.enamel opening.

The presence of a large pulp chamber The presence of a large pulp chamber adds to the woes, causing early pulp adds to the woes, causing early pulp involvementinvolvement

ADULT CARIESADULT CARIES With the recession of With the recession of

the gingiva and the gingiva and sometimes decreased sometimes decreased salivary function due to salivary function due to atrophy, atrophy,

Age 55-60 years,Age 55-60 years, Commonly root caries Commonly root caries

and cervical caries and cervical caries Sometime they are also Sometime they are also

associated with a associated with a partial denture clasp.partial denture clasp.

RESIDUAL CARIESRESIDUAL CARIES Residual caries is that which is not Residual caries is that which is not

removed during a restorative procedure, removed during a restorative procedure, either by accident, neglect or intention.either by accident, neglect or intention.

Such caries is not acceptable if at the DEJ Such caries is not acceptable if at the DEJ or on the prepared enamel tooth wall.or on the prepared enamel tooth wall.

It may be acceptable, however, when it is It may be acceptable, however, when it is affected dentin.affected dentin.

9.BASED ON SURFACES TO BE 9.BASED ON SURFACES TO BE RESTORED RESTORED

Most widespread clinical utilization Most widespread clinical utilization

O for occlusal surfacesO for occlusal surfaces

M for mesial surfacesM for mesial surfaces

D for distal surfacesD for distal surfaces

F for facial surfacesF for facial surfaces

B for buccal surfacesB for buccal surfaces

L for lingual surfaceL for lingual surface

Various combinations are also possible, such Various combinations are also possible, such as MOD –for mesio-occluso-distal surfaces.as MOD –for mesio-occluso-distal surfaces.

10.BLACK’S CLASSIFICATION10.BLACK’S CLASSIFICATIONClass I lesionsClass I lesions:: Lesions that begin in the structural defects of Lesions that begin in the structural defects of

teeth such as pits, fissures and defective teeth such as pits, fissures and defective grooves.grooves.

Locations includeLocations include Occlusal surface of molars and premolars.Occlusal surface of molars and premolars. occlusal two thirds of buccal and lingual occlusal two thirds of buccal and lingual

surfaces of molars and premolars. surfaces of molars and premolars. Lingual surfaces of anterior tooth.Lingual surfaces of anterior tooth.

Class II lesions:They are found on the proximal surfaces of the bicuspids and molars

Class III lesions:Class III lesions: Lesions found on the proximal surfaces of anterior Lesions found on the proximal surfaces of anterior

teeth that do not involve or necessitate the removal of teeth that do not involve or necessitate the removal of the incisal angle.the incisal angle.

Class IV lesions:Class IV lesions: Lesions found on the proximal surfaces of anterior Lesions found on the proximal surfaces of anterior

teeth that involve the incisal angle.teeth that involve the incisal angle.

Class V lesionsClass V lesions:: Lesions that are found at the gingival third of the facial Lesions that are found at the gingival third of the facial

and lingual surfaces of anterior and posterior teeth.and lingual surfaces of anterior and posterior teeth.

Class VI (Simon’s modificationClass VI (Simon’s modification):): Lesions involving cuspal tips and incisal edges Lesions involving cuspal tips and incisal edges

of teethof teeth..

11.World health organization 11.World health organization (WHO) system(WHO) system

In this classification the shape and depth of In this classification the shape and depth of the caries lesion scored on a four point the caries lesion scored on a four point scalescale

D1. clinically detectable enamel lesions with D1. clinically detectable enamel lesions with intact (non cavitated) surfacesintact (non cavitated) surfaces

D2. Clinically detectable cavities limited to D2. Clinically detectable cavities limited to enamelenamel

D3. Clinically detectable cavities in dentinD3. Clinically detectable cavities in dentin

D4. Lesions extending into the pulpD4. Lesions extending into the pulp

RADIATION CARIES

In patients with radiation for head and neck

regions

Due to

Xerostomia

Increased viscosity of saliva

Low pH of saliva

ThreeThree types of defects due to irradiation types of defects due to irradiation

TYPE 1:most common type,characterized by TYPE 1:most common type,characterized by caries occuring around the teeth in the caries occuring around the teeth in the cervical region.as caries deepens,there cervical region.as caries deepens,there is amputation of crows.is amputation of crows.

TYPE 2: characterized by the initiation of TYPE 2: characterized by the initiation of caries on all surfaces, eroding away the caries on all surfaces, eroding away the entire coronal structural.entire coronal structural.

TYPE 3: least common type,characterized by TYPE 3: least common type,characterized by color changes in dentin resulting in a color changes in dentin resulting in a diffuse blackening or dark brown diffuse blackening or dark brown discoloration of the crown. discoloration of the crown.

Classification by Mount and Classification by Mount and Hume(1998)Hume(1998)

G J MOUNT CLASSIFICATING J MOUNT CLASSIFICATIN

This new system defines the extent and This new system defines the extent and complexity of a cavity and at the same time complexity of a cavity and at the same time encourages a conservative approach to the encourages a conservative approach to the preservation of natural tooth structure.preservation of natural tooth structure.

This system is designed to utilize the healing This system is designed to utilize the healing capacity of enamel and dentine.capacity of enamel and dentine.

The three The three sitessites of carious lesions: of carious lesions:

Site 1Site 1

Site 2Site 2

Site 3Site 3

Pits, fissuresPits, fissures and enamel defects on occlusal surfaces and enamel defects on occlusal surfaces of posterior teeth or other smooth surfaces.of posterior teeth or other smooth surfaces.

Proximal enamel immediately below areas in Proximal enamel immediately below areas in contact contact with adjacent teethwith adjacent teeth

The The cervical one thirdcervical one third of the crown or following gingival of the crown or following gingival recession, the exposed rootrecession, the exposed root

The The sizessizes of carious lesions of carious lesions

Size o:lesion which can be remineralized after fluoride application.Size o:lesion which can be remineralized after fluoride application.Size1:Size1:MinimalMinimal involvement of dentin just beyond treatment by remineralization involvement of dentin just beyond treatment by remineralization

alone.alone.Size2: Size2: ModerateModerate involvement of dentin. Following cavity preparation, involvement of dentin. Following cavity preparation,

remaining enamel is sound, well supported by dentin and not likely to fail remaining enamel is sound, well supported by dentin and not likely to fail under normal occlusal load. The remaining tooth structure is sufficiently under normal occlusal load. The remaining tooth structure is sufficiently strong to support the restoration.strong to support the restoration.

Site 3: the cavity is enlarged beyond moderate. The remaining tooth

structure is weakened to the extent that cups or incisal edges are split, or are likely to fail or left exposed to occlusal or incisal load. the cavity needs to be further enlarged so that the restoration can be designed to provide support and protection to the remaining tooth structure.

Size4: Extensive caries with bulk loss of tooth structure has already occurred.

SiteSite SizeSize

Pit/fissure 1Pit/fissure 1

Contact area 2Contact area 2

Cervical 3Cervical 3

Minimal 1Minimal 1 Moderate 2Moderate 2 Enlarged 3Enlarged 3 Extensive 4Extensive 4

1.11.1 1.2 1.2 1.31.3 1.41.4

2.12.1 2.22.2 2.32.3 2.42.4

3.13.1 3.23.2 3.33.3 3.43.4

DETECTION DETECTION OF CARIESOF CARIES

VISUAL-TACTILE METHODSVISUAL-TACTILE METHODS

Visual methods: Tactile methods:Tactile methods:Explorers are widely used for the detection Explorers are widely used for the detection

of carious tooth structureof carious tooth structure- Right angled probe- no.6- Right angled probe- no.6- Back action probe- no.17- Back action probe- no.17- Shepherd's crook- no. 23- Shepherd's crook- no. 23- Cowhorn with curved ends- - Cowhorn with curved ends-

no.2no.2 Dental flossDental floss

very popular method, cavitation, surface roughness, opacification discoloration of clean and dried teeth under adequate light source

RADIOGRAPHSRADIOGRAPHS

IOPAIOPA

BITEWINGBITEWING

DIGITAL IMAGINGDIGITAL IMAGING

Either with charge couple device Either with charge couple device technology or storage phosphor screen technology or storage phosphor screen technologytechnology

Less image resolutionLess image resolution Less radiation requiredLess radiation required Image detector is generally largerImage detector is generally larger Image is immediatelly availableImage is immediatelly available Image can be electronically transferredImage can be electronically transferred

DIGITAL RADIOGRAPHYDIGITAL RADIOGRAPHY

XERORADIOGRAPHYXERORADIOGRAPHY

Uses radiographic copying process to Uses radiographic copying process to record image produced by diagnostic record image produced by diagnostic X-rays.X-rays.

Image formation is achieved by a Image formation is achieved by a photoelectrostatic process not by photoelectrostatic process not by photochemical process.photochemical process.

Less radiationLess radiation Edge enhancementEdge enhancement

FiberFiber O Optic transillumination ptic transillumination (FOTI):(FOTI):

SINCE 1970 – Friedman and MarcusSINCE 1970 – Friedman and Marcus Transillumination takes advantage of the opacity of a Transillumination takes advantage of the opacity of a

demineralized tooth structure over more translucent demineralized tooth structure over more translucent healthy structures. healthy structures.

ThThe decalcifi ed area will not let light pass through as e decalcifi ed area will not let light pass through as much as it does in a healthy area, generating a shadow much as it does in a healthy area, generating a shadow corresponding to decay. corresponding to decay.

a carious lesion has a lowered index of light transmission a carious lesion has a lowered index of light transmission in an area of caries and appears as a darkened shadow in an area of caries and appears as a darkened shadow that follows the spread of decay through the dentin. that follows the spread of decay through the dentin.

Illumination is delivered by means of fiberoptics from the Illumination is delivered by means of fiberoptics from the light source to the tooth surface using a fiberoptic light source to the tooth surface using a fiberoptic handpiece.handpiece.

DIGITALLY IMAGED DIGITALLY IMAGED FOTI(DIFOTI)FOTI(DIFOTI)

Introduced by Electro Optical Sciences Introduced by Electro Optical Sciences Irvington,New York.Irvington,New York.

Without the need to use ionizing radiation.Without the need to use ionizing radiation. Light from DIFOTI probe is positioned on Light from DIFOTI probe is positioned on

the tooth to be assessed, then tooth is the tooth to be assessed, then tooth is illuminated and the image on the opposite illuminated and the image on the opposite non- illuminated surface is captured by a non- illuminated surface is captured by a digital electronic CCD camera. digital electronic CCD camera.

Mini D cariesMini D caries

Portable devicePortable device Lightweight, pen sized and cordless Lightweight, pen sized and cordless

device.device. Detect both occlusal and Detect both occlusal and

interproximal caries.interproximal caries. Two signals: audible and visual(green Two signals: audible and visual(green

light turns to red).light turns to red).

LASER FLUORESCENCE LASER FLUORESCENCE DIAGNOdentDIAGNOdent

Based on principle of fluorescence. Based on principle of fluorescence. It uses a laser light source and a fiberIt uses a laser light source and a fiber

optic cable that transmits light to a hand optic cable that transmits light to a hand held probe. Light is absorbed induces held probe. Light is absorbed induces infraredinfrared fluorescence by organic and fluorescence by organic and inorganic materials. Emitted fluorescence inorganic materials. Emitted fluorescence is collected at probe tip, processed and is collected at probe tip, processed and presented on display as an integer presented on display as an integer between 0 and 99between 0 and 99

• Technique: Before using the diagnodent, the unit Technique: Before using the diagnodent, the unit must be calibrated with the selected tip and a must be calibrated with the selected tip and a patient-specific baselinepatient-specific baseline must be established. must be established. Switch on the diagnodent, set the diagnodent so Switch on the diagnodent, set the diagnodent so that the readout confirms the correct position of that the readout confirms the correct position of the unit to the tip selected.the unit to the tip selected.

• TheThe numeric readout on the device (00-99) numeric readout on the device (00-99) indicates theindicates the amount of fluorescence.amount of fluorescence.

• Place the tip on the area to be evaluated. Use a Place the tip on the area to be evaluated. Use a rocking motion with the tip. Note and record the rocking motion with the tip. Note and record the peak value. Based upon in vivopeak value. Based upon in vivo studies, the studies, the following correlations can be made.following correlations can be made.

0-13 No caries

14-20 Enamel caries and preventive care advised

21-30 Dentin caries and preventive or operative care advised depending on the caries risk assessment

>30 Operative care advised

ELECTRONIC RESISTANCE ELECTRONIC RESISTANCE MEASUREMENTSMEASUREMENTS

Low conductance – enamelLow conductance – enamel Pore volume of enamel is larger,electrical Pore volume of enamel is larger,electrical

conductance increases.conductance increases. Conductance of tooth and the resistance are Conductance of tooth and the resistance are

inverely proportional.inverely proportional. Increase conductance or decrease resistance Increase conductance or decrease resistance

indicates presence of hypo or/ indicates presence of hypo or/ demineralization.demineralization.

Increased pore volume is due to formation of Increased pore volume is due to formation of microscopic cavities filled with saliva forms microscopic cavities filled with saliva forms conductive pathways for transmission.conductive pathways for transmission.

The ECM device (Version 4) and its clinical application. (a) The ECM machine, (b) the ECM handpiece, (c) site specific measurement technique, (d) surface specific measurement

technique

Potential of less then 1V is applied, Potential of less then 1V is applied, resistance of above 600,000 ohms resistance of above 600,000 ohms indicates tooth is caries free.indicates tooth is caries free.

Resistance below 250,000 ohms Resistance below 250,000 ohms indicates caries involvind dentin is indicates caries involvind dentin is present.present.

ELECTRONIC CARIES MONITOR(Lode ELECTRONIC CARIES MONITOR(Lode Diagnostic Groningen, Netherlands). Diagnostic Groningen, Netherlands).

ULTRASONICSULTRASONICS Use of sound waves for detection.Use of sound waves for detection. With the use of this instruments,sonic velocity and With the use of this instruments,sonic velocity and

specific acoustic impedance can be determined for the specific acoustic impedance can be determined for the dentin and enamel as well as for the soft tissue and dentin and enamel as well as for the soft tissue and bone.bone.

Velocity of sound on the enamel surfaces has been Velocity of sound on the enamel surfaces has been found to be Vs=3,143,121m/s.found to be Vs=3,143,121m/s.

White spot lesions with no radiolucencies or White spot lesions with no radiolucencies or radiolucencies confined to enamel produce no radiolucencies confined to enamel produce no detectable or weak surface echoes.detectable or weak surface echoes.

Sites with visual cavitation and dentinam Sites with visual cavitation and dentinam radiolucencies produce echoes with substantially radiolucencies produce echoes with substantially higher amplitude.higher amplitude.

Dye penetration methodDye penetration method• Dyes for Dyes for

– In carious dentin, two layers of decalcification can In carious dentin, two layers of decalcification can be identified:be identified:

– One layer which is soft and cannot be One layer which is soft and cannot be remineralizedremineralized

– a second layer, which is hard with intermediate a second layer, which is hard with intermediate calcification and can be remineralized. calcification and can be remineralized.

• It is now clearly established that these dyes doIt is now clearly established that these dyes do not not stain bacteria but instead stain the organic matrix of stain bacteria but instead stain the organic matrix of less mineralized dentin. less mineralized dentin. ThThis make them less specific is make them less specific because dyes dobecause dyes do not stain bacteria nor delineatenot stain bacteria nor delineate (trace an outline)(trace an outline) the bacterial front but stain collagen the bacterial front but stain collagen associated with less mineralized organic matrix.associated with less mineralized organic matrix.

MICRO AIR ABRASIONMICRO AIR ABRASION

19401940 Diagnosis for pit and fissure caries.Diagnosis for pit and fissure caries. Darkened areas in bottom of pitsDarkened areas in bottom of pits Short bursts of alpha alumina powderShort bursts of alpha alumina powder Darkened material is stain or organic plug, Darkened material is stain or organic plug,

quickly eliminate it while leaving allbut a quickly eliminate it while leaving allbut a few ,microns of healthy tooth structure intact.few ,microns of healthy tooth structure intact.

INFRARED CAMERAINFRARED CAMERA

Matsuyama et al (1998)Matsuyama et al (1998) Expanded porosity in subsurface Expanded porosity in subsurface

enamel lesion and water occupies enamel lesion and water occupies the defect.the defect.

Used to measure the temperature Used to measure the temperature drop on the lesion surface caused by drop on the lesion surface caused by evaporation of water in the body of evaporation of water in the body of the lesion.the lesion.

VIDEOSCOPE/ENDOSCOPEVIDEOSCOPE/ENDOSCOPE

Based on observing the fluorescence that occurs Based on observing the fluorescence that occurs when tooth is illuminated with blue light in the when tooth is illuminated with blue light in the wavelength range of 400-500nm.wavelength range of 400-500nm.

Broad band gelatin filterBroad band gelatin filter

White spot lesions appear darker than enamel.White spot lesions appear darker than enamel.

Visualization of small carious lesions in the enamelVisualization of small carious lesions in the enamel

Camera can be used to restore the image.Camera can be used to restore the image.

Integration of camera with the endoscope is called a Integration of camera with the endoscope is called a VIDEOSCOPE.VIDEOSCOPE.

TUNED APERTURE TUNED APERTURE COMPUTED TOMOGRAPHYCOMPUTED TOMOGRAPHY

Visually progress through slices of Visually progress through slices of coronal anatomy and observe the coronal anatomy and observe the regions of interest.regions of interest.

Clinician can isolate and examine Clinician can isolate and examine individual projections of a region, individual projections of a region, limiting information to the depth of limiting information to the depth of interest in the radiographed volume.interest in the radiographed volume.

MAGNETIC RESONANCE MAGNETIC RESONANCE MICRO IMAGINGMICRO IMAGING

Shows a significant value for the disease of the Shows a significant value for the disease of the mineralized dental tissue.mineralized dental tissue.

Detection of early changesDetection of early changes Non-invasive and non-destructiveNon-invasive and non-destructive When a magnetic field is applied, the nuclear spins When a magnetic field is applied, the nuclear spins

align in a finite number of allowed orientations; if align in a finite number of allowed orientations; if this orientations are perturbed by a pulse of radio this orientations are perturbed by a pulse of radio frequency energy, this energy is absorbed and frequency energy, this energy is absorbed and then retransmitted and detected and thus then retransmitted and detected and thus correlated to the amount of demineralization.correlated to the amount of demineralization.

OPTICAL COHERENCE OPTICAL COHERENCE TOMOGRAPHY(0CT)TOMOGRAPHY(0CT)

Utilizes broad bandwidth light Utilizes broad bandwidth light sources and advanced fiber optics to sources and advanced fiber optics to achieve images.achieve images.

Uses reflections of near infrared light Uses reflections of near infrared light to determine not only the presence to determine not only the presence of decay but also the depth of caries of decay but also the depth of caries progression.progression.

OTHER NEWER METHODSOTHER NEWER METHODS

MULTI-PHOTON IMAGINGMULTI-PHOTON IMAGING INFRARED THERMOGRAPHYINFRARED THERMOGRAPHY TERAHERTZ PULSE IMAGINGTERAHERTZ PULSE IMAGING FREQUENCY-DOMAIN INFRARED FREQUENCY-DOMAIN INFRARED

PHOTOTHERMAL RADIOMETRYPHOTOTHERMAL RADIOMETRY MODULATED LASER LUMINESCENCEMODULATED LASER LUMINESCENCE

REFERENCESREFERENCES TEXT BOOK OF PEDODONTICS – 2TEXT BOOK OF PEDODONTICS – 2NDND ADITION ADITION -SHOBHA TANDON-SHOBHA TANDON STURDEVANT’S ART AND SCIENCE OF STURDEVANT’S ART AND SCIENCE OF

OPERATIVE DENTISTRYOPERATIVE DENTISTRY -FIFTH EDITION-FIFTH EDITION ORAL MEDICINE ORAL DIAGNOSIS AND ORAL MEDICINE ORAL DIAGNOSIS AND

ORAL RADIOLOGYORAL RADIOLOGY -2-2NDND EDITION EDITION