1. Monitoring of Intra-oral Remineralization by Quantitative Light-induced Fluorescence-Digital (QLF-D)
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SI MOOK. KANG1, HONG CHEOL YOON2, ELBERT. de JOSSELIN de JONG3, DAISUKE INABA4, HO KEUN KWON1, and BAEK IL KIM1
1Department of Preventive Dentistry and Public oral Health, Yonsei University, Seoul, South Korea, 2All In One Bio, Seoul, South Korea,  3Research & Development, Inspektor Research Systems bv, Amsterdam, Netherlands, 4Department of Dental Medicine, Iwate Medical University, Morioka, Japan
The results show that fluoride varnish enhances remineralization of enamel for two weeks.
Among the four parameters, the ∆Q has shown the most dramatic change due to decreased area of lesions.
Although fluoride varnish is effective in remineralization, it can not recover all lesion completely.
BACKGROUND
MATERIALS & METHODS
Dental field has historically lacked clinical caries sensitive detection tools that could find an early caries lesion so that we could treat it with therapeutic approaches.
Quantitative light-induced fluorescence (QLF) is one of newly developed detection and assessment tools that use differences in fluorescence between demineralized enamel and sound enamel.
There is a strong evidence that fluorescence loss in enamel correlates with the amount of mineral lost during the demineralization.
Samples : 15 teeth from 5 orthodontic patients (4 female, 1 male) were subjected to monitoring
Fluoride varnish : Fluor Protector (1% difluorsilan; Ivoclar Vivadent, Liechtenstein) A B
Procedure
QLF has many advantages but has some disadvantages that it shows the natural tooth as green color, takes only one tooth at once, and that it is difficult to distinguish dental plaque.
To overcome these limitations, quantitative light-induced fluorescence-digital (QLF-D Biluminatortm, Inspecktor Research Systems BV) was introduced recently.
Fig. 3. QLF-D system
1: Camera body
2: Biluminator™
3: Power box
a: Manual light switch c: USB connector for Biluminator™ and camera
b: Connector for AC/DC adapter d: Connector for Biluminator™
Before F Treatment
Removing orthodontic brackets
QLF-D examination (1)
Fluoride varnish treatment
QLF-D examination (2)
Data analysis
Fig. 1. Extracted tooth image taken
by QLF (A) & QLF-D (B)
Subject 1
Subject 2
Subject 3
Subject 4
Subject 5
After F Treatment
QLF-D is faster and easier to use in clinic than in previous model because it is mounted in DSLR camera. Therefore it can give a broader intra-oral area at once taking and higher resolution.
Moreover, it can show tooth as natural color and stronger red fluorescence of dental plaque because the filter system has been improved.
Although QLF-D has a large potential for detecting small changes in incipient caries lesion without destruction or hazard, there has not been enough clinical trials to support the evidence. △F
-14.0
[%]
△Fmax
- 33 △Q
-30361
[%,px]
Area
2190
[px]
Fig. 5. Intra-oral images of five orthodontic patients before and after fluoride varnish
We need to find a threshold of remineralization by fluoride for proper treatment in clinic. A B
Fig. 4. Analysis program
RESULTS & DISCUSSIONS
CONCLUSION
Table 1. The change of QLF-D parameters before and after fluoride varnish treatment
QLF-D can be used in clinic as a detection and assessment tool that is sensitive enough to explore a infinitesimal mineral changes in enamel.
White spot C
Parameter
Before F varnish treatment
After F varnish treatment
Difference (%) P*
Mean
S.D.
Parameter
Before F varnish treatment
After F varnish treatment
Mean
S.D. t P*
∆F[%]
-16.60
3.74
-14.67
4.13
11.60
0.004
∆Fmax[%]
-46.07
8.10
-39.60
10.91
14.00
0.001
Area[px]
988.20
908.30
43.40
0.006
∆Q[%·px]
49.10
REFERENCES
Fig. 2. QLF-D Biluminatortm device (A) and white spot image by white (B) and blue (C) light
Berg, J. H. The marketplace for new caries management products: dental caries detection and caries management by risk assessment. BMC Oral Health. 2006; 6(Suppl 1): S6.
Feng Y., Yin W., Hu D.Y., Zhang Y., I.ain A.P. Roger P. E. Detection and prevention of early caries after fluoride dentifrice application using quantitative light-induced fluorescence in vivo. West China Journal of Stomatology 2008;26(6):
Meller C., Heyduck C., Tranæus S., Splieth C. A New in vivo Method for Measuring Caries Activity Using Quantitative Light-Induced Fluorescence. Caries Research 2006;40:90–96.
Hazelrigg C. O, Dean J. A, Fontana M. Fluoride varnish concentration gradient and its effect on enamel demineralization. Pediatr Dentistry. 2003;25(2):
de Josselin de Jong E, Sundström F, Westerling H, Tranaeus S, ten Bosch J. J, Angmar-Månsson B. A new method for in vivo quantification of changes with laser fluorescence. Caries Research. 1995;29(1):2-7.
PURPOSE
The aim of this study was to evaluate the capability of QLF-D to monitor changes in early caries lesions two weeks after the fluoride varnish treatment in vivo.
S.D. means standards deviation
* Statistical differences of the data were evaluated by paired t-test