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EVALUATION OF THE EFFICACY OF CARIES-REVEALING DYES IN DIFFERENTIATING BETWEEN INFECTED AND AFFECTED DENTIN DURING RESTORATIVE TREATMENT

Authors:
  • University of Medicine and Pharmacy Gr T Popa Iasi, Romania

Abstract

The aim of this study is to determine the advantages of using caries-revealing dyes in differentiating between infected and affected dentin during restorative treatment. Material and method: The patients selected for this study presented to the Discipline of Cariology and Restorative Odontotherapy within the faculty of Dental Medicine, UMf "Gr. T. Popa" Iaşi, for a restorative treatment of carious lesions. sable seek dye was applied in order to differentiate the infected dentin from the affected one at the level of 26 molars and premolars that presented cavi-tary occlusal caries. Results: In all cases, the dye remained fixed in the cavity in the dentin, but the color intensity was different. Due to the difference in the intensity of the staining produced by the caries detector, it is possible to differentiate between the infected tissues with a much more intense staining (dark green) and the affected tissue with a less intense staining (light green). Conclusions: The contrast obtained by the caries developer can help to identify carious dentin if tactile discrimination is not available, and can be used as a complementary means of diagnosis.
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Revista Română de Anatomie funcţională şi clinică, macro- şi microscopică şi de Antropologie
Vol. XIX – Nr. 4 – 2020 CLINICAL ANATOMY
EVALUATION OF THE EFFICACY OF CARIES-REVEALING DYES IN
DIFFERENTIATING BETWEEN INFECTED AND AFFECTED DENTIN
DURING RESTORATIVE TREATMENT
Dorelia Lucia Călin




(Abstract): 
         
      
 



  

         

  
Key-words: 
INTRODUCTION

       





ibility (2).
     




 
    

  
     

dentists (3).
By traditiona
      



  
   

      




        
    


   


    

Dorelia Lucia Călin



 

      

        


  

 





      









       

  





      

     
   
       






     



   
      
e areas wi
 

 
     







      

aim    



  
  
    

MATERIAL AND METHOD


     


      
       
       







     


presented below.
      


     

  

tal lesions (fig.2).
      
gray coloration 


Evaluation of the Efficacy of Caries-Revealing Dyes




















  

Fig. 1.
Fig. 2.
Fig. 3. 

Fig. 4. 


Dorelia Lucia Călin
    











     

    





    

      



      


      






    

Fig. 5. 

Fig. 6. 


Fig. 7.

Fig. 8. 


Evaluation of the Efficacy of Caries-Revealing Dyes





      
   


   

RESULTS



     

Fig. 9.  Fig. 10. 

Fig. 11. 

Fig. 12. 

Fig. 13.
inte 
      
      

Dorelia Lucia Călin
Fig. 14. 
Fig. 15. 


Fig. 16. 

Fig. 17. 
is still an infected dentin
Fig. 18. 


Evaluation of the Efficacy of Caries-Revealing Dyes
     
staining and less inten    
   



tion is not available.







DISCUSSIONS






       



       


       


      
dentin (22).


   
     













       
diagnosis an
   

     
 










     

 




      




     
  


       



CONCLUSIONS


   


       

         

 
       




Dorelia Lucia Călin
REFERENCES
  Sturdevant’s art and science of operative dentistry    

       
J Dent.
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    
  
J Dent Res Sci Develop.
 
dye. J Prosthet Dent
 Br
Dent J
 Journal
of Dental Research
 Operative Dentistry

 
The Journal of Adhesive Den-
tistry
 Caries Res


               
J Dent Res
  



Caries Research

J Oral Rehabil


  


detect caries. Oper Dent

J Contemp Dent Pract

British Dental Journal. 
             
Eur J Dent

affected root canal dentin. Kokubyo Gakkai Zasshi

rescence. Acta Medica Bulgarica

vation criteria. Am J Dent
In vitro
J Dent

 
Am J Dentistry.
   in vitro. J
Prosthodont
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Evaluation of the Efficacy of Caries-Revealing Dyes
     
Int J Dentistry Oral Sci,  
        
Oper Dent
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   
J Dent (Tehran),

J Conserv Dent

Int J Dent
Quintessence Int.

SADJ: Journal of the South
African Dental Association=Tydskrif Van die Suid-Afrikaanse Tandheelkundige Vereniging. 
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
Gen Dent
        
Carisolv or conJ Dent
Corresponding author
Călin Dorelia Lucia, Assistant Professor, DMD, PhD
“Grigore T. Popa” University of Medicine and Pharmacy – Iași, Romania
Email: dorelia.lucia@gmail.com
Tel:+40728019779
... In the present assessment, caries detection dye was used to distinguish between infected dentin that must be removed and affected dentin that is preserved as it is capable of remineralization ( Figure 1C), and by this method, a thin dentin bridge thickness is maintained for IPC. Also, caries excavation was done using sharp excavators or large round burs running at low speed with light pressure to minimize any pulp reactions that may result from overheating or vibrations [35]. ...
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The aim of this study was to investigate the efficiency of different diagnostic methods in detection of residual dentinal caries in excavated cavities. Fifty extracted molar with deep dentinal carious lesions were excavated using a slow-speed handpiece. All cavities were assessed by laser fluorescence(LF) device, electronic caries monitor(ECM), and caries detector dye(CDD) by three independent observers blindly. The measurements were repeated after two weeks. Specimens containing dentin slices 150 mum in thickness were prepared for histological analyses. The existence and absence of carious dentin was determined using a lightmicroscope. The average intraobserver accuracy was 1.00 (perfect agreement) for CDD, 0.86 (excellent agreement) for ECM, and 0.50 (good agreement) for LF. The average interobserver accuracy values were 0.92 (excellent agreement), (0.36 marginal agreement) and 0.48 (good agreement), for CDD, ECM, and LF, respectively. The average specificity was 0.60 for CDD, 73% for ECM, and 0.50 for LF. The average sensitivity was 0.55 for CDD, 0.85 for LF, and 0.47 for ECM. The average accuracy values were 0.53, 0.51, and 0.81 for CDD, ECM, and LF, respectively. LF had the greatest sensitivity and accuracy values of any of the methods tested. As a conclusion, LF device is appeared to most reliable method in detection of remain caries in cavity. However, because of its technical sensitivity it may susceptible to variations in measurements. To pay attention to the rule of usage and repeated measurements can minimize such variations in clinical practice. It was concluded that LF is an improvement on the currently available aids for residual caries detection.
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Aim: The purpose of this study is to compare the efficiency of fluorescence-aided caries excavation (FACE) to remove carious dentin primary teeth with that of conventional methods. Methods and materials: After caries excavation was carried out, dentin surfaces were conventionally inspected using visual tactile criteria and 415 cavities which were classified as caries-free, re-inspected with Face-Light and caries detector dye (CDD) methods. Orange-red fluorescing areas classified as carious dentin, as well as stained carious dentin. All the data were recorded according to localization of the caries and determination efficiency of the methods. X(2) test was used to compare the mean values of both Face-Light and dye applications, while Wilcoxon test performed to evaluate the effectiveness for each diagnostic method. Results: A total of 273 patients with 415 Class II (OM/OD) cavities (1.65 ± 0.52 teeth per patient) with carious lesions in molar and premolar teeth, were examined. Out of 415 teeth, in 149 teeth (35.9%) no caries findings had been illustrated. While FACE detected remaining carious or partially removed areas in 237 teeth (57.2%), CDD stained only 29 teeth by itself (P < 0.05). Conclusion: In conclusion, FACE has a higher detectability compared to visual inspection and caries detector dye in diagnosis and removal of carious dentin.
Article
Purpose: The aim of this study was to evaluate the diffusion of 2-Hydroxyethyl methacrylate (HEMA) from resin cement through dentin both affected and unaffected by caries through high-performance liquid chromatography (HPLC) at two time intervals. Materials and Methods: Ten freshly extracted restoration-free, caries-free and ten extracted carious human third molar teeth were used in this study. Standardized box-shaped Class I inlay cavities (6 mm long, 3 mm wide, 2 mm deep) were prepared in all teeth with a high-speed handpiece mounted on a standard cavity machine. In teeth affected by caries, after preparation, the remaining carious lesions were removed, with their removal guided by a proprietary caries detector dye. The remaining dentin thickness (RDT) between the pulpal wall of the cavity and the roof of the pulp chamber was measured at multiple points for each tooth so that groups of 10 teeth each were prepared with RDT 1.2 ± 0.5 mm. Lithium disilicate-based ceramic inlays were manufactured to restore the prepared cavities. A polypropylene chamber was attached to the cementoenamel junction of each tooth to contain 1 ml distilled water. Then, ceramic inlays were cemented with chemically polymerized resin cement (Multilink Automix) according to the manufacturer's instructions. Water elutes were analyzed by HPLC at 4.32 minutes and 24 hours. HEMA diffusion amounts were analyzed using two-way ANOVA and Tukey HSD tests (p < 0.05). Results: HEMA was detected in the pulp chamber elutes of all the teeth. The diffused HEMA amounts were not significantly different between the affected caries and the unaffected groups (p= 0.80) or between time periods (p= 0.44). The carious dentin did not influence the amount of HEMA diffused through the dentin to the pulp space. Conclusions: The highest amount of eluted HEMA concentration detected was not viewed as critical for pulp tissue since the diffused HEMA amounts were below the level of cytotoxicity, according to the literature.
Article
The advent of "Adhesive Dentistry" has simplified the guidelines for cavity preparation enormously. The design and extent of the current preparations are basically defined by the extent and shape of the caries lesion, potentially slightly extended by bevelling the cavity margins in order to meet the modern concept of minimally invasive dentistry. New caries excavation techniques have been introduced, such as the use of plastic and ceramic burs, improved caries-disclosing dyes, enzymatic caries-dissolving agents, caries-selective sono/air abrasion and laser ablation. They all aim to remove or help remove caries-infected tissue as selectively as possible, while being minimally invasive through maximum preservation of caries-affected tissue. Each technique entails a specific caries-removal endpoint and produces residual dentin substrates of different natures and thus different receptiveness for adhesive procedures. This paper reviews the newest developments in caries excavation techniques and their effect on the remaining dentin tissue with regard to its bonding receptiveness.
Article
This in vitro study aimed at evaluating the ability of Laser Fluorescence device (LFpen) in quantifying approximal caries lesions in primary molars. Two examiners assessed 123 approximal surfaces of primary molars using the DIAGNOdent pen (LFpen). Surfaces were determined to be either sound with white-spot lesions or have small cavitations. After sectioning, lesion depth was determined through polarized light microscopy. The intra-/inter-examiner agreement was calculated using intraclass correlation coefficient (ICC) and Bland-Altman analyses. Furthermore, Spearman correlation coefficients (Rs) were calculated between LFpen readings and lesion depth. Correlation between LFpen values and lesion depth was low for both examiners (Rs=0.36 and 0.51), especially when cavitated lesions were excluded from the analysis (Rs=0.22 and 0.40). For all surfaces, ICC revealed intra- and inter-examiner reproducibility values of 0.75 and 0.63, respectively, but when only non-cavitated surfaces were analyzed, these values decreased (0.41 and 0.33, respectively). LFpen readings present low correlation with approximal caries lesion depth and low reproducibility, especially in white-spot lesions. Therefore, the device could not be a suitable method for monitoring non-cavitated approximal caries lesion in primary molars.