Minimally invasive removal of tooth-colored restorations: evaluation of a novel handpiece using the fluorescence-aided identification technique (FIT)

  • Christian KleinEmail author
  • Arian Babai
  • Christiane von Ohle
  • Marco Herz
  • Diana Wolff
  • Christian Meller
Original Article



This study investigated the ability of the fluorescence-aided identification technique (FIT) facilitated by a novel handpiece to simplify the removal of tooth-colored composite restorations with water-cooled rotating instruments.

Materials and methods

Five undergraduate students and five dentists (6–14 years of professional experience) were asked to remove dental restorations in vitro using both the conventional technique (CT) and the fluorescence-aided identification technique. The FIT method was performed on teeth restored in addition to the fluorescent composite resin with the non-fluorescent (FIT1) and fluorescent (FIT2) bonding agent. CEREC scans were superimposed and three-dimensionally analyzed with the software OraCheck 2.13 with respect to the cavity surface area still covered with composite resin and the volume of the needlessly removed sound hard tissue. Additionally, the removal procedure was timed.


The FIT2 group showed the most promising results: the smallest cavity surface area covered by composite resin independent of the professional expertise, and for the dentist group, the smallest amount of removed sound hard tissue and the fastest removal.


Using the fiber optic of the handpiece for fluorescence excitation has been proven to be effective for performing the FIT, and therefore, to improve the removal of tooth-colored restorations.

Clinical relevance

This study is basic research to encourage the integration of fluorescence inducing light sources in dental treatment units by the manufacturers as a prerequisite for a simplified daily use of the FIT.


Composite restoration Removal Fluorescence-aided identification technique Intraoral scanner 



We wish to express our sincere gratitude to the dental technician and hobby photographer, Klaus Engel (Dental laboratory Dentalteam Bast & Marquart GmbH), for his assistance in taking some of the pictures and video clips presented in this work.

Funding information

The study was performed and funded by the Department of Conservative Dentistry, Periodontology and Endodontology, University Hospital Tübingen.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest. C. Meller declares being the intellectual author of the idea that led to the development of the fluorescence-realizing experimental bonding agent used in this study. No royalties, research grant, or commercial association with the VOCO GmbH or other parties were involved

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.


  1. 1.
    Hunter AR, Treasure ET, Hunter AJ (1995) Increases in cavity volume associated with the removal of class 2 amalgam and composite restorations. Oper Dent 20(1):2–6PubMedGoogle Scholar
  2. 2.
    Krejci I, Lieber CM, Lutz F (1995) Time required to remove totally bonded tooth-colored posterior restorations and related tooth substance loss. Dental materials : official publication of the Academy of Dental Materials 11(1):34–40. CrossRefGoogle Scholar
  3. 3.
    Szep S, Baum C, Alamouti C, Schmidt D, Gerhardt T, Heidemann D (2002) Removal of amalgam, glass-ionomer cement and compomer restorations: changes in cavity dimensions and duration of the procedure. Oper Dent 27(6):613–620PubMedGoogle Scholar
  4. 4.
    Dörter C, Yildiz E, Erdemir U (2003) Effect of operators’ skills on increase in cavity volume of restorations. Quintessence international (Berlin, Germany : 1985) 34(1):27–30Google Scholar
  5. 5.
    Hood JA (1991) Biomechanics of the intact, prepared and restored tooth: some clinical implications. Int Dent J 41(1):25–32PubMedGoogle Scholar
  6. 6.
    da Costa TR, Serrano AM, Atman AP, Loguercio AD, Reis A (2012) Durability of composite repair using different surface treatments. J Dent 40(6):513–521. CrossRefPubMedGoogle Scholar
  7. 7.
    Gordan VV, Mondragon E, Shen C (2002) Replacement of resin-based composite: evaluation of cavity design, cavity depth, and shade matching. Quintessence international (Berlin, Germany : 1985) 33(4):273–278Google Scholar
  8. 8.
    Clark DH, Ruddick RF (1985) Post mortem detection of tooth coloured dental restorations by ultra violet radiation. Acta Med Leg Soc 35(1):278–284Google Scholar
  9. 9.
    Carson DO, Orihara Y, Sorbie JL, Pounder DJ (1997) Detection of white restorative dental materials using an alternative light source. Forensic Sci Int 88(2):163–168CrossRefGoogle Scholar
  10. 10.
    Pretty IA, Smith PW, Edgar WM, Higham SM (2002) The use of quantitative light-induced fluorescence (QLF) to identify composite restorations in forensic examinations. J Forensic Sci 47(4):831–836CrossRefGoogle Scholar
  11. 11.
    Tani K, Watari F, Uo M, Morita M (2003) Discrimination between composite resin and teeth using fluorescence properties. Dent Mater J 22(4):569–580CrossRefGoogle Scholar
  12. 12.
    Lim YK, Lee YK (2007) Fluorescent emission of varied shades of resin composites. Dental materials : official publication of the Academy of Dental Materials 23(10):1262–1268. CrossRefGoogle Scholar
  13. 13.
    Hermanson AS, Bush MA, Miller RG, Bush PJ (2008) Ultraviolet illumination as an adjunctive aid in dental inspection. J Forensic Sci 53(2):408–411. CrossRefPubMedGoogle Scholar
  14. 14.
    Bush MA, Hermanson AS, Yetto RJ, Wieczkowski G Jr (2010) The use of ultraviolet LED illumination for composite resin removal: an in vitro study. Gen Dent 58(5):e214–e218PubMedGoogle Scholar
  15. 15.
    Meller C, Klein C (2012) Fluorescence properties of commercial composite resin restorative materials in dentistry. Dent Mater J 31(6):916–923CrossRefGoogle Scholar
  16. 16.
    Meller C, Klein C (2015) Fluorescence of composite resins: a comparison among properties of commercial shades. Dent Mater J 34(6):754–765. CrossRefPubMedGoogle Scholar
  17. 17.
    Meller C, Connert T, Löst C, ElAyouti A (2017) Reliability of a Fluorescence-aided Identification Technique (FIT) for detecting tooth-colored restorations: an ex vivo comparative study. Clin Oral Investig 21(1):347–355. CrossRefPubMedGoogle Scholar
  18. 18.
    Dettwiler C, Meller C, Eggmann F, Saccardin F, Kuhl S, Filippi A, Krastl G, Weiger R, Connert T (2018) Evaluation of a fluorescence-aided identification technique (FIT) for removal of composite bonded trauma splints. Dent Traumatol 34(5):353–359. CrossRefPubMedGoogle Scholar
  19. 19.
    Weiszfeld A (1985) Restaurations posterieures en resine composite photopolymerisable. Mise en forme directe par moulage des faces triturantes. Les Cahiers de prothese 13(49):117–128PubMedGoogle Scholar
  20. 20.
    Hamilton JC (1986) Occlusal matrix for light cured composites US Patent 4571188Google Scholar
  21. 21.
    Ishihara S (1917) Tests for colour blindness. Handaya Hongo Harukich, TokyoGoogle Scholar
  22. 22.
    Mjör IA, Reep RL, Kubilis PS, Mondragon BE (1998) Change in size of replaced amalgam restorations: a methodological study. Oper Dent 23(5):272–277PubMedGoogle Scholar
  23. 23.
    Forgie AH, Pine CM, Pitts NB (2001) Restoration removal with and without the aid of magnification. J Oral Rehabil 28(4):309–313CrossRefGoogle Scholar
  24. 24.
    Bittar DG, Murakami C, Hesse D, Imparato JC, Mendes FM (2011) Efficacy of two methods for restorative materials’ removal in primary teeth. J Contemp Dent Pract 12(5):372–378CrossRefGoogle Scholar
  25. 25.
    Zaruba M, Ender A, Mehl A (2014) New applications for three-dimensional follow-up and quality control using optical impression systems and OraCheck. Int J Comput Dent 17(1):53–64PubMedGoogle Scholar
  26. 26.
    Mehl A, Gloger W, Kunzelmann KH, Hickel R (1997) A new optical 3-D device for the detection of wear. J Dent Res 76(11):1799–1807. CrossRefPubMedGoogle Scholar
  27. 27.
    Hartkamp O, Peters F, Bothung H, Lohbauer U, Reich S (2017) Optical profilometry versus intraoral (handheld) scanning. Int J Comput Dent 20(2):165–176PubMedGoogle Scholar
  28. 28.
    Mehl A, Koch R, Zaruba M, Ender A (2013) 3D monitoring and quality control using intraoral optical camera systems. Int J Comput Dent 16(1):23–36PubMedGoogle Scholar
  29. 29.
    Ryakhovskiy AN, Kostyukova VV (2016) Comparative analysis of 3D data accuracy of single tooth and full dental arch captured by different intraoral and laboratory digital impression systems. Stomatologiia 95(4):65–70. CrossRefPubMedGoogle Scholar
  30. 30.
    Lee JJ, Jeong ID, Park JY, Jeon JH, Kim JH, Kim WC (2017) Accuracy of single-abutment digital cast obtained using intraoral and cast scanners. J Prosthet Dent 117(2):253–259. CrossRefPubMedGoogle Scholar
  31. 31.
    Haddadi Y, Bahrami G, Isidor F (2018) Effect of software version on the accuracy of an intraoral scanning device. Int J Prosthodont 31(4):375–376. CrossRefPubMedGoogle Scholar
  32. 32.
    Eltahlah D, Lynch CD, Chadwick BL, Blum IR, Wilson NHF (2018) An update on the reasons for placement and replacement of direct restorations. J Dent 72:1–7. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Christian Klein
    • 1
    • 2
    Email author
  • Arian Babai
    • 1
  • Christiane von Ohle
    • 1
  • Marco Herz
    • 1
  • Diana Wolff
    • 1
  • Christian Meller
    • 1
  1. 1.Department of Conservative Dentistry, Periodontology and Endodontology, University Centre of Dentistry, Oral Medicine and Maxillofacial SurgeryUniversity Hospital TübingenTübingenGermany
  2. 2.Private practice Meller ZahngesundheitWaiblingenGermany

Personalised recommendations