KaVo DIAGNOdent Classic Aug 17, 2012 - LLU- AS KaVo DIAGNOdent Classic Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS Darlene Armstrong, Ed.D.(c)

Laser Fluorescence Unit uses infrared laser fluorescence DIAGNOdent Laser Fluorescence Aug 17, 2012 - LLU- AS Unit uses infrared laser fluorescence First seen in 1998 in Europe FDA approval in 2000 ADA Seal of Acceptance 2005 Developed to detect and quantify hypomineralization dental caries of occlusal and smooth surfaces Uses a diode laser light source with a wavelength of 655 nm and I mW peak power Fiber optic cable transmits the light to a hand held probe with a fiber optic eye in tip Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS Darlene Armstrong, Ed.D.(c)

Measures laser fluorescence within tooth surface Clean, healthy tooth structure exhibits little or no fluorescence This results in low readings Carious tooth structure will exhibit fluorescence, proportionate to the degree of caries This results in high readings Tone louder with higher readings Does not show the extent and severity of lesions for later comparison Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS

Evaluation of Diagnostic Modalities Sensitivity How good the test is at correctly identifying disease Procedure with 100% or 1.00 sensitivity will identify every diseased person while a low sensitivity indicates missed diagnoses High sensitivity tests have very few false-negatives Highly sensitive tests are typically used as screening or ruling out of disease Specificity How good the test is a correctly identifying no disease Procedure that yields a negative result for healthy individuals has a specificity of 100% or 1.00 Highly specific tests produce few false-positives Pretty & Maupomé, 2004 Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS

What Does the Evidence Reveal? Study Sensitivity Specificity Proximal Surfaces (in vitro) Shi & others .75 .84 Occlusal Surfaces (in vivo) Anttonen & others .92 .69 Occlusal Surfaces (in vitro) Costa & others .79 .94 Bader & Shugars, 2004 Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS

DIAGNOdent pen 2190 Hand held unit Introduced in late 2005 Aug 17, 2012 - LLU- AS DIAGNOdent pen 2190 Hand held unit Introduced in late 2005 Research confirms that pen is equivalent to classic unit Kühnisch, Bücher, Henschel,& Hickel, 2007 Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS Darlene Armstrong, Ed.D.(c)

Treatment Sequence www.kavousa.com Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS

www.kavousa.com *** Regardless of course of action taken to treat a specific lesion, preventive therapy May be indicated based on caries risk. Aug 17, 2012- LLU - AS Darlene Armstrong, Ed.D.(c), M.A., RDHAP

How Do You Use the DIAGNOdent? Clinical Tutorial http://www.kavousa.com/Default.aspx?navid=552872&oid=009&lid=Us Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS

Tips for DIAGNOdent Use This device designed for virgin tooth surfaces, primarily occlusal surfaces Sealant and composite material will test positive Always test the DIAGNOdent on a surface before placing in occlusal grooves to ensure calibration (i.e.#8 facial) Clean surface a must-no plaque, debri or stain as it could lead to false positives No extra course green prophy paste as it could lead to false positives Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS

References Bader, J.D., & Shugars, D.A. (2004). A systematic review of the performance of a laser fluorescence device for detecting caries. Journal of the American Dental Association, 135(10), 1413-1426. Chan, D.C. (1993). Current methods and criteria for caries diagnosis in North America. Journal of Dental Education, 57(6), 422-427. Diagnosis and Management of Dental Caries Throughout Life.(2001 March 26-28). NIH Consensus Statement, 18(1), 1-24. Ismail, A.I. (2004). Visual and visuo-tactile detection of dental caries. Journal of Dental Research, 83, 56-66. Kühnisch, J., Bücher, K., Henschel, V., & Hickel, R. (2007). Reproducibility of DIAGNOdent 2095 and DIAGNOdent pen measurements: Results from an in vitro study on occlusal sites. European Journal of Oral Sciences, 115(3), 206-211. Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS

References Loesche, W.J., Svanberg, M.L., Pape, H.R. (1979). Intraoral transmission of Streptococcus mutans by a dental explorer. Journal of Dental Research, 58, 765-770. Nyvad, B. (2004). Diagnosis vs. detection of dental caries. Caries Research, 38,192-198. Pretty, I.A., & Maupomé G. (2004 April). A closer look at diagnosis in clinical dental practice: part 1. Reliability, validity, specificity and sensitivity of diagnostic procedures. Journal of the Canadian Dental Association, 70(4), 251-255. Yassin, O.M. In vitro studies of the effect of a dental explorer on the formation of an artificial carious lesion. ASDC Journal of Dentistry for Children, 62(2), 111- 117. Darlene Armstrong, Ed.D.(c), M.A., RDHAP Aug 17, 2012- LLU - AS