Dott. Giuseppe Chiodera

In dentistry, research and development of new materials and technologies reach for better prevention and early treatment of dental diseases.

In this context, the concept of “minimally invasive dentistry” is gaining space, a discipline that has its main goal in the respect of the healthy tooth tissue and has the treatment of primary and secondary lesions at the very early stage as a priority.

Careful diagnostic investigation, correct assessment of the biological risks/benefits and – last but not least – the conservative and highly specific removal of decayed tissue, preliminary measures are very important for the achievement of these results.

It is essential that the diagnostic path start from a proper clinical and radiological investigation through conventional diagnostic tools complemented by innovative tools in order to make otherwise clinically hidden lesions visible.

The observation that the enamel, dentin or decayed tissue, exposed to a laser light, emit a specific spontaneous fluorescence made it possible to develop devices that, using laser technology, allow us to attribute a “grading” to the carious lesion severity, which is a prerequisite for subsequent operational choices, more or less favorable to the intervention, both to monitor the evolution in time of the carious pathology and/or the effectiveness of the treatment.

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Img. 1 – Give your patients the opportunity to understand the diagnosic process, let them do diagnosis with you: they will just love it. Communication is something that we absolutely need and owe our patients, and digital comunication by images is the best solution, as it is easy both to understand and to make our usually non-understandable speeches simple and clear.

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Img. 2 – We’ve been using transillumination on anterior teeth for many years, now: it is easy to show our patients through a mirror how teeth appear transparent with a backlight, but in order to show them the posteriors we need something else, something new.

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Img. 3 There is one device (Diagnocam, Kavo) which uses laser-induced transillumination making us able to obtain an occlusal view, expressed in a gray scale, of the tooth surface. The different dental tissues react to light differently: the enamel is clear, dentin is slightly grayer, while cavities appear much darker. The DiFOTI, Digital Fiber Optic Trans Illumination, technology uses a source that produces a specific wavelenght (near infrared) light.

 

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If we add occlusal vision and lateral vision we get what today gets closer to a real 3D vision.

 

Conclusions

Light is a patient-friendly tecnology, totally safe for the patient and it represent a way to do clear diagnosis and to have a new and easy comunication with patients. It means that we can detect early lesions and monitor them over time and manage the treatment based on the specific risk to develop caries. It is a great opportunity for dentists and patients.

 

Bibliography

  1. Abdelaziz M, Krejci I. DIAGNOcam – a Near Infrared Digital Imaging Transillumination (NIDIT) technology. Int J Esthet Dent. 2015 Spring;10(1):158-65.
  2. Yu JL, Tang RT, Feng L, Dong YM. Digital imaging fiber optic transillumination (DIFOTI) method for determining the depth of cavity. Beijing Da Xue Xue Bao. 2017 Feb 18;49(1):81-85
  3. Young DA, Featherstone JD. Digital imaging fiber-optic trans-illumination, F-speed radiographic film and depth of approximal lesions. J Am Dent Assoc. 2005 Dec;136(12):1682-7.
  4. Astvaldsdóttir A, Ahlund K, Holbrook WP, de Verdier B, Tranæus S. Approximal Caries Detection by DIFOTI: In Vitro Comparison of Diagnostic Accuracy/Efficacy with Film and Digital Radiography. Int J Dent. 2012;2012:326401. doi: 10.1155/2012/326401. Epub 2012 Nov 4.
  5. Yang J, Dutra V. Utility of radiology, laser fluorescence, and transillumination. Dent Clin North Am. 2005 Oct;49(4):739-52, vi. Review.
  6. Söchtig F, Hickel R, Kühnisch J. Caries detection and diagnostics with near-infrared light transillumination: clinical experiences. Quintessence Int. 2014 Jun;45(6):531-8

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