Předmět: Autor: Poznámky: Courseware Methods of Caries Well-Timed Diagnostics X-ray Diagnostics...
-
Upload
catherine-errington -
Category
Documents
-
view
218 -
download
0
Transcript of Předmět: Autor: Poznámky: Courseware Methods of Caries Well-Timed Diagnostics X-ray Diagnostics...
Předmět:
Autor:
Poznámky:
Courseware
Methods of Caries Well-Timed DiagnosticsX-ray Diagnostics in Dentistry
Stomatolog Julia Morozova
Operative Dentistry 1 ST1/ZAA35
Caries well-timed diagnostics
• Diagnostics of initial stages of dental caries
• Primary prevention- without preparation
• Secondary prevention- minimal invasive meausures
Caries incipiens: clinical symptoms
• Focus of enamel demineralization• White spot• Surface layer of enamel is maintained
Methods of caries well-timed diagnostics
• Common: • Visual-tactile• Transillumination using dental mirror and source of
light• Detection using dyes
• With special equipment• Radiographic diagnostics• Laser Fluorescence• Quantitative Light-Induced Fluorescence• Fiber Optic Trasillumination• Digital Image Fiber Optic Transillumination• Electronic Caries Monitor• Ultrasonic detection
Methods of caries well-timed diagnostics (requiring special equipment)
Physical effect Application in caries diagnostics
X-rays RTG, RVG, CBCT, CBVT
Laser fluorescence Laser detection of caries (DIAGNOdent)
Electricity Electronic Caries Monitor (ECM)
Ultrasound Ultrasonic detection of caries
Light with different wavelength Quantitative Light-induced Fluorescence (QLF)Fiber Optic Transillumination (FOTI) (Dia Lux)Digital Image Fiber Optic Transillumination (DIFOTI) (DIAGNOcam)
Visual-tactile assessment
• Clean and dry tooth surface• Dental mirror • Dental probe• Perfect illumination• Magnification
Transillumination using dental mirrorand light from unit
• For approximal surfaces of frontal teeth
Detection using dyes
Use:• Caries detection• Detection of necrotic tissues during preparation (dye is
connected with irreversibly destructured collagen fibers)• Finding of root canal entrances in endodontics• Detection of tooth cracks
Radiographic examination
• Intraoral radiograms• Bite-wing (interproximal) projection• Ortopantomogram• Cone beam volumetric tomography
Parallel technique of radiogram making
• The radiogram is the most close to the real situation in the mouth (isometric orthoradial)
• It requares the use of special holders
Carious lesion• Clearing with different size
• Approximal, fissural, root, secondary (reccurent) carious lesions
• It is not deciding examination method for vestibular, oral or occlusal lesions
• The most suitable is the bite-wing technique (premolar, molar)
Bite-wing radiograms evaluation
• D1 -clearing is in the outer half of the enamel
• D2 -clearing is in the inner half of the enamel
• D3 -clearing goes upto enamel-dentin junction
• D4 –clearing is in dentin
Laser Fluorescence (DIAGNOdent)
• Red light at a wavelength of 655 nm• Sound hard dental tissues do not react to this wavelength• Metabolites from cariogennic bacteria create an infrared fluorescence • In special device (DIAGNOdent, KaVo, Germany; Hibst, Gall,
late 1990s) the emitted light is channelled through the handpiece and presented as a number on a display
DIAGNOdent- working procedure
• Careful cleaning of tooth surface• Drying by air stream• Calibration of the device by
application onto sound enamel• Measuring • Allows to detect carious lesions on
the smooth, occlusal as well as approximal surfaces
DIAGNOdent- criteria for evaluation
0 – 4 Sound enamel or caries incipiens (D1)
4 – 10 Decay of inner layer of enamel without damage of enamel-dentin junction (D2)
10 – 18 Decay of external layer of dentin (D3)
>18 Extensive decay of inner layer of dentin (D4)
*A.Lussi, S. Imwinkelried, N.B. Pitts, C. Longbottom, E. Reich. Performance and Reproducibility of a Laser Fluorescence System for Detection of Occlusal Caries in vitro. Caries Res. 1999;33(4):261–266
Quantitative Light-induced Fluorescence (QLF)
• Uses the phenomenon of tooth auto fluorescence • Primary diagnostics as well as check up of necrotic tissues
removing• Soprolife (ActeonGroup, France); InspektorTM Pro (Inspektor
Dental Care, Amsterdam, The Netherlands)
Fiber Optic Transillumination (FOTI)• Uses light transmission through the tooth• Demineralized dental hard tissues scatter and absorb light
more than sound tissue• For enamel and dentin caries detection on occlusal,
approximal and smooth surfaces of anterior and posterior teeth (carious lesions appear darker compared to sound tissue)
• Dia Lux (KaVo, Germany)
Digital Imaging of Fiber Optic Transillumination (DIFOTI)
• Uses the same principles like FOTI• White light is delivered through an optical fiber via handpiece
channelling the image back to a digital camera and visualizing the image on a monitor via computer system
• DIAGNOcam (KaVo, Germany)
DIFOTI (DIAGNOcam): principle of working
• Light with wave length 780 nm• Tooth is light conductor• Digital camera makes black-and-white record on the
computer display• Tooth decay looks like dark shade
DIFOTI: contraindications, limits of using
• Large fillings• Crowns• Subgingival localization of tooth decay• Calculus or tooth discoloration can lead to light
scattering and can be shown like shade
DIFOTI: possibilities
• Primary carious lesions (occlusal and approximal) esp. on distal teeth
• Caries reccurent (upto definite depth)• Cracks or imperfections in supragingival regio
Electronic Caries Measurement (ECM)
• Sound dental hard tissue shows very high electrical resistance or impedance
• Demineralized enamel has lower resistance • Ground-unit • Handpiece • The result is presented on a display as
a number between 1 and 13
Alternating Current Impedance Spectroscopy (ACIST)
• It is based on the same principle of electrical proud as the ECM
• It measures resistance, continuous conduction as well as transverse conductance
• CarieScanTM (IDMoS PLC, Dundee, UK)
Ultrasound diagnostics (Ultrasonic Caries Detector- UCD)
• Sound waves can pass through gases, liquids and solids and boundaries between them
• Images of tissues can be acquired by collecting of the reflected sound waves
• Ultrasonic probe allows to examine inaccessible places• UCD (Novadent Ltd., Lod, Israel)
THANK YOU FOR ATTENTION