Shear bond strength of repairs in porcelain conditioned with laser

The aim of this study was to evaluate the shear bond strength of repairs in porcelain conditioned with laser. Sixty porcelain discs were made and six groups were formed (n = 10): G1: conditioning with laser with potency 760 mW; G2: conditioning with laser with potency 760 mW and application of 37% phosphoric acid for 15 s; G3: conditioning with laser with potency 900 mW; G4: conditioning with laser with potency 900 mW and application of 37% phosphoric acid for 15 s; G5: application of 37% phosphoric acid for 15 s (group control) and G6: application of 10% hydrofluoric acid for 2 min. The composite resin was insert of incremental layers at the porcelain surface aided with a metal matrix, and photoactivation for 20 s each increment. The specimens were submitted to a thermal cycling by 1000 cycles of 30 s in each bath with temperature between 5 and 55 degrees C. After the thermal cycling, specimens were submitted to the shear bond strength. The results were evaluated statistically through analysis of variance and Tukey's tests with 5% significance. The averages and standard deviation founded were: G1, 11.25 (+/- 3.10); G2, 12.32 (+/- 2.65); G3, 14.02 (+/- 2.38); G4, 13.44 (+/- 2,07); G5, 9.91 (-/+ 2,18); G6, 12.74 (+/- 2.67). The results showed that the femtosecond laser produced a shear bond strength of repairs in porcelain equal to the hydrofluoric acid and significantly superior to the use of phosphoric acid. Microsc. Res. Tech., 2012. (C) 2012 Wiley Periodicals, Inc.

Análise microscópica de incisões realizadas com três diferentes pontas do laser Erbio YAG

The study analised microscopic wound healing of incision made with Er:YAg laser with three different tips. In six Rattus norvegicus, incision was made with Laser Er-YAG (KeyLaser) using tips 2051, 2055 and 2056. The animals were killed at 7 e 14 and the sites of incision are photographed in this time. The parts containing the incision area were prepared for microscopic analysis, performing sections of 7µm and staining with haematoxylin and eosin. Zone of tissue ablation, zone of thermal necrosis, the presence and character of inflammatory cell infiltrate and wound healing were measured. The 2051 tip produced faster and defined edges of the wound. To create wound 1.30 mm in depth lasers tips required at last five passes within the same line of incision. Microscopic analysis shows no difference with use of three different laser tips

Time-dependent effects of chitosan on dentin structures

Complete debridement with smear layer removal are essential measures for achieving a successful outcome of root canal treatment. The aim of this study was to evaluate the effects of chitosan at different concentrations on the removal of the smear layer and on dentin structure after 3 and 5 min of application. Twelve recently extracted maxillary canine teeth were instrumented using the crown-down technique and irrigated with 1% sodium hypochlorite. The specimens were distributed according to the time and concentration of the final irrigating solution: G1: 0.1% chitosan for 3 min; G2: 0.2% chitosan for 3 min; G3: 0.37% chitosan for 3 min; G4: 0.1% chitosan for 5 min; G5: 0.2% chitosan for 5 min; G6: 0.37% chitosan for 5 min. All samples were prepared for SEM analysis. G1 exhibited removal of the smear layer, but not the smear plugs. G2 showed visible and open tubules with slight erosion of the peritubular dentin. Cleaning in G3 was similar to that in G2, however, the erosive effect was greater. There was expansion of the diameter of the tubules in G4; and in G5 and G6, there was severe erosion with deterioration of dentin surface. In conclusion, 0.2% chitosan for 3 min appeared to be efficient for removing the smear layer, causing little erosion of dentin.

Chlorhexidine does not increase immediate bond strength of etch-and-rinse adhesive to caries-affected dentin of primary and permanent teeth

The aim of this study was to evaluate the effect of 2% chlorhexidine digluconate (CHX) on immediate bond strength of etch-and-rinse adhesive to sound (SD) and caries-affected (CAD) primary dentin compared with permanent dentin. Flat dentin surfaces from 20 primary molars (Pri) and 20 permanent molars (Perm) were assigned to 8 experimental groups (n=5) according to tooth type (Pri or Perm), dentin condition (SD or CAD - pH-cycling for 14 days) and treatment (control - C or 60 s application of 2% CHX solution after acid etching - CHX). The bonding system (Adper Single Bond 2) was applied according to manufacturer's instructions followed by resin composite application (Filtek Z250). After 24 h water storage, specimens with cross-section area of 0.8 mm² were prepared for being tested under microtensile test (1 mm/min). Data were submitted to ANOVA and Tukey's post hoc test (α=0.05). Failure mode was evaluated using a stereomicroscope at ×400. Treatment with CHX did not result in higher bond strength values than no pre-treatment (C groups), independently of tooth type. Primary teeth and caries-affected dentin showed significantly lower (p<0.05) bond strength means compared with permanent teeth and sound dentin, respectively. Predominance of adhesive/mixed failure was observed for all groups. CHX did not influence the immediate bond strength to sound or caries-affected dentin of primary and permanent teeth.

Anwendung der konfokalen Laser-Scanning-Mikroskopie zur Charakterisierung der Struktur von Zähnen und von oberflächenmodifiziertem Titan für Knochenimplantate

Zusammenfassung Mittels Fluoreszenzfarbstoffen können Strukturen sichtbar gemacht werden, die auf kon-ventionellem Weg nicht, oder nur schwer darzustellen sind. Besonders in Kombination mit der Konfokalen Laser Scanning Mikroskopie eröffnen sich neue Wege zum spezifischen Nachweis unterschiedlichster Komponenten biologischer Proben und gegebenenfalls deren dreidimensionale Widergabe.Die Visualisierung des Proteinanteils des Zahnhartgewebes kann mit Hilfe chemisch kopplungsfähiger Fluorochrome durchgeführt werden. Um zu zeigen, daß es sich bei dieser Markierung nicht um unspezifische Adsorption des Farbstoffes handelt, wurde zur Kontrolle die Proteinkomponente der Zahnproben durch enzymatischen Verdau beseitigt. Derartig behandelte Präparate wiesen eine sehr geringe Anfärbbarkeit auf.Weiterführend diente diese enzymatische Methode als Negativkontrolle zum Nachweis der Odontoblastenfortsätze im Dentin bzw. im Bereich der Schmelz-Dentin-Grenze. Hiermit konnte differenziert werden zwischen reinen Reflexionsbildern der Dentinkanäle und den Zellausläufern deren Membranen gezielt durch lipophile Fluoreszenzfarbstoffe markiert wurden.In einem weiteren Ansatz konnte gezeigt werden, daß reduzierte und daher nichtfluoreszente Fluoresceinabkömmlinge geeignet sind, die Penetration von Oxidationsmitteln (hier H2O2) in den Zahn nachzuweisen. Durch Oxidation dieser Verbindungen werden fluoreszierende Produkte generiert, die den Nachweis lieferten, daß die als Zahnbleichmittel eingesetzten Mittel rasch durch Schmelz und Dentin bis in die Pulpahöhle gelangen können.Die Abhängigkeit der Fluoreszenz bestimmter Fluorochrome von deren chemischer Um-gebung, im vorliegenden Fall dem pH-Wert, sollte eingesetzt werden, um den Säuregrad im Zahninneren fluoreszenzmikroskopisch darzustellen. Hierbei wurde versucht, ein ratio-metrisches Verfahren zu entwickeln, mit dem die pH-Bestimmung unter Verwendung eines pH-abhängigen und eines pH-unabhängigen Fluorochroms erfolgt. Diese Methode konnte nicht für diese spezielle Anwendung verifiziert werden, da Neutralisationseffekte der mineralischen Zahnsubstanz (Hydroxylapatit) die pH-Verteilung innerhalb der Probe beeinflußen. Fluoreszenztechniken wurden ebenfalls ergänzend eingesetzt zur Charakterisierung von kovalent modifizierten Implantatoberflächen. Die, durch Silanisierung von Titantestkörpern mit Triethoxyaminopropylsilan eingeführten freien Aminogruppen konnten qualitativ durch den Einsatz eines aminspezifischen Farbstoffes identifiziert werden. Diese Art der Funktionalisierung dient dem Zweck, Implantatoberflächen durch chemische Kopplung adhäsionsvermittelnder Proteine bzw. Peptide dem Einheilungsprozeß von Implantaten in den Knochen zugänglicher zu machen, indem knochenbildende Zellen zu verbessertem Anwachsverhalten stimuliert werden. Die Zellzahlbestimmung im Adhäsionstest wurde ebenfalls mittels Fluoreszenzfarbstoffen durchgeführt und lieferte Ergebnisse, die belegen, daß die durchgeführte Modifizierung einen günstigen Einfluß auf die Zelladhäsion besitzt.

Analyse der intrazellulären Freisetzung von Wirkstoffmodellen via konfokaler Laser-Raster-Mikroskopie

In der vorliegenden Arbeit wurde gezeigt, wie man das Potential nanopartikulärer Systeme, die vorwiegend via Miniemulsion hergestellt wurden, im Hinblick auf „Drug Delivery“ ausnutzen könnte, indem ein Wirkstoffmodell auf unterschiedliche Art und Weise intrazellulär freigesetzt wurde. Dies wurde hauptsächlich mittels konfokaler Laser-Raster-Mikrokopie (CLSM) in Kombination mit dem Bildbearbeitungsprogramm Volocity® analysiert.rnPBCA-Nanokapseln eigneten sich besonders, um hydrophile Substanzen wie etwa Oligonukleotide zu verkapseln und sie so auf ihrem Transportweg in die Zellen vor einem etwaigen Abbau zu schützen. Es konnte eine Freisetzung der Oligonukleotide in den Zellen aufgrund der elektrostatischen Anziehung des mitochondrialen Membranpotentials nachgewiesen werden. Dabei war die Kombination aus Oligonukleotid und angebundenem Cyanin-Farbstoff (Cy5) an der 5‘-Position der Oligonukleotid-Sequenz ausschlaggebend. Durch quantitative Analysen mittels Volocity® konnte die vollständige Kolokalisation der freigesetzten Oligonukleotide an Mitochondrien bewiesen werden, was anhand der Kolokalisationskoeffizienten „Manders‘ Coefficients“ M1 und M2 diskutiert wurde. Es konnte ebenfalls aufgrund von FRET-Studien doppelt markierter Oligos gezeigt werden, dass die Oligonukleotide weder beim Transport noch bei der Freisetzung abgebaut wurden. Außerdem wurde aufgeklärt, dass nur der Inhalt der Nanokapseln, d. h. die Oligonukleotide, an Mitochondrien akkumulierte, das Kapselmaterial selbst jedoch in anderen intrazellulären Bereichen aufzufinden war. Eine Kombination aus Cyanin-Farbstoffen wie Cy5 mit einer Nukleotidsequenz oder einem Wirkstoff könnte also die Basis für einen gezielten Wirkstofftransport zu Mitochondrien liefern bzw. die Grundlage schaffen, eine Freisetzung aus Kapseln ins Zytoplasma zu gewährleisten.rnDer vielseitige Einsatz der Miniemulsion gestattete es, nicht nur Kapseln sondern auch Nanopartikel herzustellen, in welchen hydrophobe Substanzen im Partikelkern eingeschlossen werden konnten. Diese auf hydrophobe Wechselwirkungen beruhende „Verkapselung“ eines Wirkstoffmodells, in diesem Fall PMI, wurde bei PDLLA- bzw. PS-Nanopartikeln ausgenutzt, welche durch ein HPMA-basiertes Block-Copolymer stabilisiert wurden. Dabei konnte gezeigt werden, dass das hydrophobe Wirkstoffmodell PMI innerhalb kürzester Zeit in die Zellen freigesetzt wurde und sich in sogenannte „Lipid Droplets“ einlagerte, ohne dass die Nanopartikel selbst aufgenommen werden mussten. Daneben war ein intrazelluläres Ablösen des stabilisierenden Block-Copolymers zu verzeichnen, welches rn8 h nach Partikelaufnahme erfolgte und ebenfalls durch Analysen mittels Volocity® untermauert wurde. Dies hatte jedoch keinen Einfluss auf die eigentliche Partikelaufnahme oder die Freisetzung des Wirkstoffmodells. Ein großer Vorteil in der Verwendung des HPMA-basierten Block-Copolymers liegt darin begründet, dass auf zeitaufwendige Waschschritte wie etwa Dialyse nach der Partikelherstellung verzichtet werden konnte, da P(HPMA) ein biokompatibles Polymer ist. Auf der anderen Seite hat man aufgrund der Syntheseroute dieses Block-Copolymers vielfältige Möglichkeiten, Funktionalitäten wie etwa Fluoreszenzmarker einzubringen. Eine kovalente Anbindung eines Wirkstoffs ist ebenfalls denkbar, welcher intrazellulär z. B. aufgrund von enzymatischen Abbauprozessen langsam freigesetzt werden könnte. Somit bietet sich die Möglichkeit mit Nanopartikeln, die durch HPMA-basierte Block-Copolymere stabilisiert wurden, gleichzeitig zwei unterschiedliche Wirkstoffe in die Zellen zu bringen, wobei der eine schnell und der zweite über einen längeren Zeitraum hinweg (kontrolliert) freigesetzt werden könnte.rnNeben Nanokapseln sowie –partikeln, die durch inverse bzw. direkte Miniemulsion dargestellt wurden, sind auch Nanohydrogelpartikel untersucht worden, die sich aufgrund von Selbstorganisation eines amphiphilen Bock-Copolymers bildeten. Diese Nanohydrogelpartikel dienten der Komplexierung von siRNA und wurden hinsichtlich ihrer Anreicherung in Lysosomen untersucht. Aufgrund der Knockdown-Studien von Lutz Nuhn konnte ein Unterschied in der Knockdown-Effizienz festgestellt werden, je nach dem, ob 100 nm oder 40 nm große Nanohydrogelpartikel verwendet wurden. Es sollte festgestellt werden, ob eine größenbedingte, unterschiedlich schnelle Anreicherung dieser beiden Partikel in Lysosomen erfolgte, was die unterschiedliche Knockdown-Effizienz erklären könnte. CLSM-Studien und quantitative Kolokalisationsstudien gaben einen ersten Hinweis auf diese Größenabhängigkeit. rnBei allen verwendeten nanopartikulären Systemen konnte eine Freisetzung ihres Inhalts gezeigt werden. Somit bieten sie ein großes Potential als Wirkstoffträger für biomedizinische Anwendungen.rn

Performance of laser fluorescence devices, visual and radiographic examination for the detection of occlusal caries in primary molars

The aim of this in vitro study was to compare the performance of two laser fluorescence devices (LF, LFpen), conventional visual criteria (VE), ICDAS and radiographic examination on occlusal surfaces of primary teeth. Thirty-seven primary human molars were selected from a pool of extracted teeth, which were stored frozen at -20°C until use. Teeth were assessed twice by two experienced examiners using laser fluorescence devices (LF and LFpen), conventional visual criteria, ICDAS and bitewing radiographs, with a 2-week interval between measurements. After measurement, the teeth were histologically prepared and assessed for caries extension. The highest sensitivity was observed for ICDAS at D(1) and D(3) thresholds, with no statistically significant difference when compared to the LF devices, except at the D(3) threshold. Bitewing radiographs presented the lowest values of sensitivity. Specificity at D(1) was higher for LFpen (0.90) and for VE at D(3) (0.94). When VE was combined with LFpen the post-test probabilities were the highest (94.0% and 89.2% at D(1) and D(3) thresholds, respectively). High values were observed for the combination of ICDAS and LFpen (92.0% and 80.0%, respectively). LF and LFpen showed the highest values of ICC for interexaminer reproducibility. However, regarding ICDAS, BW and VE, intraexaminer reproducibility was not the same for the two examiners. After primary visual inspection using ICDAS or not, the use of LFpen may aid in the detection of occlusal caries in primary teeth. Bitewing radiographs may be indicated only for approximal caries detection.

Light-emitting diode and laser fluorescence-based devices in detecting occlusal caries

The aim of this study was to assess the performance of two light-emitting diode (LED)- and two laser fluorescence-based devices in detecting occlusal caries in vitro. Ninety-seven permanent molars were assessed twice by two examiners using two LED- (Midwest Caries - MID and VistaProof - VP) and two laser fluorescence-based (DIAGNOdent 2095 - LF and DIAGNOdent pen 2190 - LFpen) devices. After measuring, the teeth were histologically prepared and classified according to lesion extension. At D1 the specificities were 0.76 (LF and LFpen), 0.94 (MID), and 0.70 (VP); the sensitivities were 0.70 (LF), 0.62 (LFpen), 0.31 (MID), and 0.75 (VP). At D(3) threshold the specificities were 0.88 (LF), 0.87 (LFpen), 0.90 (MID), and 0.70 (VP); the sensitivities were 0.63 (LF and LFpen), 0.70 (MID), and 0.96 (VP). Spearman's rank correlations with histology were 0.56 (LF), 0.51 (LFpen), 0.55 (MID), and 0.58 (VP). Inter- and intraexaminer ICC values were high and varied from 0.83 to 0.90. Both LF devices seemed to be useful auxiliary tools to the conventional methods, presenting good reproducibility and better accuracy at D(3) threshold. MID was not able to differentiate sound surfaces from enamel caries and VP still needs improvement on the cut-off limits for its use.

In situ and in vitro comparison of laser fluorescence with visual inspection in detecting occlusal caries lesions

The aim of this study was to compare the in situ and in vitro performances of a laser fluorescence (LF) device (DIAGNOdent 2095) with visual inspection for the detection of occlusal caries in permanent teeth. Sixty-four sites were selected, and visual inspection and LF assessments were carried out, in vitro, three times by two independent examiners, with a 1-week interval between evaluations. Afterwards, the occlusal surfaces were mounted on the palatal portion of removable acrylic orthodontic appliances and placed in six volunteers. Assessments were repeated and validated by histological analysis of the tooth sections under a stereomicroscope. For both examiners, the highest intra-examiner values were observed for the visual inspection when in vitro and in situ evaluations were compared. The inter-examiner reproducibility varied from 0.61 to 0.64, except for the in vitro assessment using LF, which presented a lower value (0.43). The methods showed high specificity at the D(1) threshold (considering enamel and dentin caries as disease). In vitro evaluations showed the highest values of sensitivity for both methods when compared to the in situ evaluations at D(1) and D(2) (considering only dentinal caries as the disease) thresholds. For both methods, the results of sensitivity (at D(1) and D(2)) and accuracy (at D(1)) showed significant differences between in vitro and in situ conditions. However, the sensitivity (at D(1) and D(2)), specificity and accuracy (both at D(1)) of the methods were not significantly different when the same condition was considered. It can be concluded that visual inspection and LF showed better performance in vitro than in situ.

Performance of a conventional sealant and a flowable composite on minimally invasive prepared fissures

Three different fissure preparation procedures were tested and compared to the non-invasive approach using a conventional unfilled sealant and a flowable composite. Eighty permanent molars were selected and divided into 4 groups of 20 teeth each. All the teeth were split into 2 halves, and the exposed fissures were photographed under a microscope (35x) before and after being prepared using the following methods: (I) Er:YAG laser (KEY Laser, KaVo) 600 mJ pulse energy, 6 Hz; (II) diamond bur; (III) Er: YAG laser (KEY Laser, KaVo) 200 mJ pulse energy, 4 Hz; (IV) Control group: Powder jet cleaner (Prophyflex, KaVo, Germany). The pre-and postimages were superimposed in order to evaluate the amount of hard tissue removed. Ten teeth in each group were then acid etched and sealed with an unfilled sealant (Delton opaque, Dentsply), while the remaining 10 teeth were acid etched, primed and bonded (Prime ; Bond NT, Dentsply) and sealed with a flowable composite (X-flow, DeTrey, Dentsply). Material penetration and microleakage were evaluated after thermocycling (5000 cycles) and staining with methylene blue 5%. ANOVA and Mann-Whitney tests were applied for statistical analysis. The laser 600 mJ and bur eliminated the greatest amount of hard tissue. The control teeth presented the least microleakage when sealed with Delton or X-flow. A correlation between material penetration and microleakage could not be statistically confirmed. Mechanical preparation prior to fissure sealing did not enhance the final performance of the sealant.

Detection of approximal caries with a new laser fluorescence device

The laser device DIAGNOdent developed for the detection of occlusal caries has limited value on approximal surfaces. The aim of this study was to develop and to test a new laser fluorescence (LF) device for the detection of approximal caries. Light with a wavelength of 655 nm was transported to the approximal surface using two different sapphire fibre tips. Seventy-five teeth were selected from a pool of extracted permanent human molars, frozen at -20 degrees C until use. Before being measured, they were defrosted, cleaned and calculus was removed with a scaler. The molars were set in blocks simulating the contact area of adults. Bitewing radiographs were obtained using Kodak Insight films. After two independent assessments with the new LF device, the teeth were histologically prepared, and assessed for caries extension. Using the laser, specificity values for D1 threshold (outer half of enamel), D2 threshold (inner half of enamel), D3 threshold (dentine) ranged between 0.81 and 0.93, sensitivity between 0.84 and 0.92 with no difference between the two tips. Bitewing radiography showed an inferior performance compared to LF (p<0.05). Intraex aminer reproducibility was high (kappa>.74). The new LF system might be a useful additional tool in detecting approximal caries. Because of its good reproducibility, it could be used to monitor caries regression or progression on approximal surfaces.

Performance of a new laser fluorescence device for the detection of occlusal caries in vitro

The new device DIAGNOdent pen based on red laser light induced fluorescence was introduced for the detection of approximal and occlusal caries. The aim of this study was to test its performance on occlusal surfaces. The new device comes with two different sapphire fibre tips: a cylindrical tip and a conical tip. The two new sapphire fibre tips were used and compared with the tip currently available with DIAGNOdent (DD). METHODS: The teeth were selected from a pool of extracted permanent human molars, which were stored frozen at -20 degrees C, until use. Prior to being measured the teeth were defrosted and cleaned. One hundred and nineteen teeth were selected and measured with the old tip and with the two new tips of the new device by two independent assessments. The teeth were histologically prepared and assessed for caries extension. RESULTS: Specificity values for D(1), D(2) and D(3) ranged between 0.69 and 0.89, sensitivity between 0.78 and 0.96. There were no statistically significant differences obtained between the two tips of the new and the one tip of the old device (p>0.05). Intra-examiner reliability with kappa values of >0.83 was high. CONCLUSIONS: In this study, the new laser fluorescence device performed on occlusal surfaces as well as the available device.

Shear bond strength of resin cements to human dentin

OBJECTIVES: The objectives of this in vitro study were (1) to assess the bond strength of the universal cement RelyX Unicem to dentin and to compare it with three conventional resin cements, (2) to test the influence of aging on their bonding capacity and (3) to test the influence of the operator on bonding quality by performing the same test in two different centers. METHODS: 160 third molars, divided into 80 for tests at the University of Zurich (Z) and 80 for tests at the University of Berne (B), were assigned to 2 x 8 subgroups of 10 teeth each. The specimens were prepared with the corresponding bonding agents and acrylic rods were luted either with RelyX Unicem (U), RelyX ARC (A), Multilink (M) or Panavia 21 (P). All specimens were stored in water for 24h (W) and half of the specimens were subjected to 1500 cycles of thermocycling (5 degrees C and 55 degrees C) (T). Bond strength was measured by means of a shear test. RESULTS: After water storage RelyX Unicem exhibited lowest bond strength (UWZ: 9.2+/-1.6 MPa, UWB: 9.9+/-1.2 MPa, AWZ: 15.3+/-6.0 MPa, AWB: 12.2+/-4.3 MPa, MWZ: 15.6+/-3.3 MPa, MWB: 12.4 MPa+/-2.4, PWZ: 13.4+/-2.9 MPa, PWB: 14.9+/-2.6 MPa). Thermocycling affected the bonding performance of all four cements. However, bond strength of RelyX Unicem was least influenced by thermocycling (UTZ: 9.4+/-2.9 MPa, UTB: 8.6+/-1.3 MPa, ATZ: 11.4+/-6.3 MPa, ATB: 13.3+/-3.7 MPa, MTZ: 15.4+/-3.1 MPa, MTB: 10.3+/-2.4 MPa, PTZ: 11.1+/-2.8 MPa, PTB: 11.3+/-2.8 MPa). SIGNIFICANCE: Although the bond strength of RelyX Unicem to dentin was lower in comparison to RelyX ARC, Multilink and Panavia 21, its bond strength was less sensitive to variations in handling and aging.

The influence of PVC wrapping on the performance of two laser fluorescence devices on occlusal surfaces in vitro

OBJECTIVE: The aim of this study was to determine the influence of polyvinyl chloride (PVC) wrapping on the performance of two laser fluorescence devices (LF and LFpen) by assessing tooth occlusal surfaces. BACKGROUND DATA: Protection of their tips may influence LF measurements. To date there are no studies evaluating the influence of this protection on the performance of the LFpen on permanent teeth, or comparing it to the original LF device. MATERIALS AND METHODS: One hundred nineteen permanent molars were assessed by two experienced dentists using the LF and the LFpen devices, both with and without PVC wrapping. The teeth were histologically prepared and assessed for caries extension. RESULTS: The LF values with and without PVC wrapping were significantly different. For both LF devices, the sensitivity and accuracy were lower when the PVC wrapping was used. The specificity was statistically significantly higher for the LFpen with PVC. No difference was found between the areas under the ROC curves with and without PVC wrapping. The ICC showed excellent interexaminer agreement. The Bland and Altman method showed a range between the upper and the lower limits of agreement of 63.4 and 57.8 units for the LF device, and 49.4 and 74.2 for the LFpen device, with and without PVC wrapping, respectively. CONCLUSIONS: We found an influence of the PVC wrapping on the performance of the LF and LFpen devices. However, since its influence on detection of occlusal caries lesions is considered for, the use of one PVC layer is suggested to avoid cross-contamination in clinical practice.

In vitro comparison of laser fluorescence performance with visual examination for detection of occlusal caries in permanent and primary molars

The aim of this study was to compare the performance of the DIAGNOdent 2095 with visual examination for occlusal caries detection in permanent and primary molars. The sample comprised 148 permanent human molars and 179 primary human molars. The samples were measured and visually examined three times by two examiners. After measurement, the teeth were histologically prepared and assessed for caries extension. Sensitivity, specificity, accuracy and area under the receiver operating characteristics (ROC) curve were calculated. Intra-class correlation (ICC), unweighted kappa and the Bland and Altman method were used to assess inter- and intra-examiner reproducibility. DIAGNOdent showed higher specificity and lower sensitivity than did visual examination. The ICC values indicated an excellent agreement between the examinations. Kappa values varied from good to excellent for DIAGNOdent but from poor to good for visual examination. In conclusion, the DIAGNOdent may be a useful adjunct to conventional methods for occlusal caries detection.