Thursday, June 06, 2013

Effect of pit and fissure sealants on caries detection by a fluorescent camera system

Available online 17 May 2013

Abstract

Objective

The aim of this study was to evaluate the effect of sealant placement on the detection of caries by a fluorescent camera (FC), the Spectra caries detector.

Materials and methods

In a laboratory study, FC images and readings were obtained from 31 extracted teeth, before and following application of clear sealants (Shofu Clear or Delton unfilled), or opaque sealants (3M Clinpro or Delton FS). Teeth were then sectioned and examined for enamel or dentine caries. Using each tooth's true caries diagnosis, the sensitivity and specificity of the FC measurements in detecting dentine caries was calculated. In the clinical study, FC readings were obtained from 41 molars in children prior to and following application of clear sealants.

Results

Following application of Shofu or Delton unfilled there were reductions in the mean FC readings of 10% (p = 0.5) and 8.2% (p = 0.009), respectively. Application of two opaque sealants, 3M or Delton FS significantly reduced mean FC readings 16.2% and 20.8% (p < 0.5), respectively. Although the carious lesions could still be observed in FC images from teeth with opaque sealants there was a significant loss of sensitivity in detecting dentinal caries. Clear sealant application caused an insignificant loss of detection sensitivity. Following application of clear sealants to children's molars there was a small (4.01%) but significant (p < 0.01) reduction in FC readings recorded from these teeth.

Conclusions

The FC can detect caries under clear sealants with little loss of sensitivity. Although lesions can be seen through opaque sealants, loss of sensitivity precludes accurate lesion assessment.

Figures and tables from this article:
Full-size image (102 K)
Fig. 1. Photos (a and c) and FC images (b and c) of an extracted maxillary molar with small areas of non-cavitated occlusal caries taken before (a and b) and following (c and d) application of a clear sealant (Shofu ClearCheck). Notice the effect of sealant application on the two areas where the FC indicates dentine caries (readings ≥2).
Full-size image (74 K)
Fig. 2. Photo (a and c) and FC images (b and c) of an extracted mandibular molar with a small area of non-cavitated occlusal caries taken before (a and b) and following (c and d) application of an opaque sealant (3M ESPE Clinpro sealant). Comparisons of the pre and post-sealant photographs show that the lesion is no longer visually detectable. In contrast, the lesion can still be seen on the post-sealant FC image. There was however, a reduction in the FC readings following sealant application.

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