Caries Technology Early caries detection is essential in maintaining oral health; luckily, many products on the market help dentists do so in a particularly easy fashion. Dentaltown s look at some of the top caries detection systems and software helps take the guesswork out of choosing what s best for your practice. by Dentaltown staff 34 JUNE 2016 // dentaltown.com
Company: AdDent Product: Microlux Transilluminator Sterilization: The body of the cordless unit can be wiped down with any disinfectant; sleeves fit the unit and light guide snugly. The light guide can be wiped with disinfectant, cold sterilized, autoclaved or heat sterilized. or calibration required: None. How caries is detected: Transillumination is focused on a particular area; accessory light guides in different sizes help make this easier. The proximal caries attachment can be placed interproximal and detect caries that an X-ray cannot pick up. Will it detect cracks and fractures? Yes. How far subgingival will it work? Using the Proximal or Perio attachment, to 7mm. How well does it detect incipient decay? If so, what percent of mineral loss is required for that? 15 percent. Can you download pictures from the unit? N/A Does it have Wi-Fi, or do you pull a card to transfer pictures? N/A What format (JPG, PDF, etc.) is the export? N/A Is it compatible with the major software companies? N/A Visit addent.com and click Resources to view articles. dentaltown.com \\ JUNE 2016 35
Company: DEXIS Product: CariVu Sterilization: The tip is autoclaved; the handpiece decontaminated with an appropriate intermediate cleaning agent as prescribed by CDC guidelines. or calibration required? No. Company: Air Techniques Product: CamX Spectra Sterilization: Protective hygienic sheaths are used to reduce cross-contamination between patients. If required, the device can be wiped down with chemicals specified in the user manual. or calibration required: None. How caries is detected: Uses fluorescence to detect caries in fissures and smooth surfaces that may go unnoticed in X-ray images. In active mode carious regions appear red, while healthy enamel appears green. After capturing the image within existing imaging software, the extent of the decay will be interpolated and indicated in two ways color gradation and numerals. Will it detect cracks and fractures? Yes, if there are carious bacteria within the cracks and fractures. AirTechniques recommends using its intraoral cameras to evaluate cracks and fractures. How far subgingival will it work? N/A. How well does it detect incipient decay? If so, what percent of mineral loss is required for that? Beginning enamel caries is detected, and caries is detected up to 2mm into the tooth structure. How caries is detected: Near-infrared light illuminates the crown of the tooth by directing it through the buccal and lingual surfaces of the tooth at the same time. This makes enamel appear transparent while porous lesions trap and absorb the light and appear dark. The handpiece s camera displays live video in DEXIS imaging software, which is used to capture still images. Will it detect cracks and fractures? Yes. How far subgingival will it work? N/A. How well does it detect incipient decay? If so, what percent of mineral loss is required for that? CariVu detects incipient caries. Many studies show that radiographs detect a carious lesion when it is in the range of 40 60 percent of demineralized, while it is documented that CariVu can often find caries well before it appears on radiographs. Can you download pictures from the unit? N/A. Images are automatically saved within the software module, which is part of the DEXIS imaging software. Does it have Wi-Fi, or do you pull a card to transfer pictures? See previous answer. What format (JPG, PDF, etc.) is the export? Operator s choice.dex,.jpg,.tif,.dcm. Is it compatible with the major software companies? Yes. http://qos.quintessenz.de/qi_2014_06_s0531.pdf http://www.diagnocam.com/img_cpm/350_diagnocam/ files/diagnocam_lmuabschlussbericht-en.pdf Can you download pictures from the unit? Images are automatically sent to existing TWAIN compatible imaging software. Does it have Wi-Fi, or do you pull a card to transfer pictures? Transfer occurs through direct USB connection. What format (JPG, PDF, etc.) is the export? JPG. Is it compatible with the major software companies? Yes, through either direct integration or TWAIN. Visit airtechniques.com for all articles and information. 36 JUNE 2016 // dentaltown.com
Company: Quantum Dental Technologies Product: The Canary System Sterilization: The handpiece should be wiped down with a disinfectant after each use. The single-use plastic tip adds another level of barrier protection. or calibration required? Periodic maintenance not required, but QDT can assess the functioning and performance of the device by reviewing Canary scan data sent through the Internet. Before the first scan session of the day, the system requires a three-second calibration to confirm the laser is functioning at optimal power. How caries is detected: Photothermal radiometry and luminescence. A low-powered, pulsating laser penetrates below the tooth surface to detect carious lesions as small as 50 microns and as deep as 5mm from the tooth surface. Will it detect cracks and fractures? Yes. The Canary System detects cracks and caries that are not seen with other devices and do require treatment. How far subgingival will it work? Detects changes in the crystal structure of the tooth that can be illuminated by the laser. It cannot detect caries in deep subgingival areas. How well does it detect incipient decay? If so, what percent of mineral loss is required for that? The system can detect incipient or early lesions; it doesn t measure percent of mineral loss but quantifies actual defects, lesions or cracks. Can you download pictures from the unit? Yes, as well as storage on the Canary Cloud. Does it have Wi-Fi, or do you pull a card to transfer pictures? No, but the software can access Wi-Fi via the connecting computer or practice workstation. What format (JPG, PDF, etc.) is the export? All computer-compatible formats. Is it compatible with the major software companies? Are there any it s not compatible with? The Canary System is already bridged to most practice management software. If a bridge isn t available, QDT will work with the PMS company to develop one. thecanarysystem.com/documents/research.pdf thecanarysystem.com/research-patents.php Continued on p. 39 dentaltown.com \\ JUNE 2016 37
Continued from p. 37 clinical lists Company: Carestream Dental Product: Logicon Caries Detector Software No sterilization, calibration or maintenance is needed for software, but it does require license activation from the manufacturer. How caries is detected: Program analyzes the shades of gray in a radiograph to detect density changes that represent demineralization of the tooth material. Will it detect cracks and fractures? How far subgingival will it work? Logicon is approved only for diagnosing proximal caries on adult dentition, not for gingival tissue. How well does it detect incipient decay? If so, what percent of mineral loss is required for that? Approximately 30% through the enamel is needed for the software to generate a decay outline/probability prediction. Downloading pictures: Save diagnosis screen(s) directly onto your computer or portable drive as a TIF file, or as a screen capture on the clipboard to be pasted into the document of your choice. It also gives you the option to attach the file directly to an email. Is it compatible with the major software companies? Are there any it s not compatible with? Logicon software itself works exclusively with Carestream Dental Imaging software (DIS/CSI). However, the TIF files/screen captures from the program are compatible with major software companies. Logicon will not work with other dental imaging programs other than Carestream Dental Imaging software, and it only works with radiographs taken with Carestream Dental s RVG sensors. A clinical study showed that Logicon enabled dentists to find 20 percent more cases of caries into the dentin in permanent teeth than they were able to find visually. Ref: Gakenheimer, David C. The Efficacy of a Computerized Caries Detector in Intraoral Digital Radiography. Journal of the American Dental Association 133 (2002): 883-890 A retrospective clinical study at the University of Louisville revealed that dentists could more than double their detection of subtle, early caries that needed restoration without increasing the number of false positives. (Ref: General Dentistry March/April 2011) Ref: Tracy, Kyle D., Utility and effectiveness of computer-aided diagnosis of dental caries, General Dentistry 59-2 (2011): 136-144 n dentaltown.com \\ JUNE 2016 39