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Evidence-Based Caries Prevention pp 13–39Cite as

Detection and Diagnosis of Carious Lesions

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Abstract

The early detection and diagnosis of the carious lesion are a primary consideration of the minimal intervention dentistry (MID) concept. Detection is the identification of a demineralized lesion, while diagnosis is an iterative process using further information from the patient to identify the lesion as carious in nature. Traditionally, visual, tactile, and radiographic methods are used to detect carious lesion; however, recently tactile detection, especially using a sharp explorer, is not recommended apart from the delicate detection of enamel surface integrity/roughness. Use of simple devices such as loupes for magnification of the clean surface can improve detection validity. Advances in technology have led to many different devices being released onto the market to assist in the detection and quantification of carious lesions. Fluorescence of the tooth structure using different wavelengths of light can provide information about lesion extent and area and whether dentine is involved, and several commercial systems are available such as DIAGNOdent®, QLF®, and Soprocare/Soprolife®. It is important to follow standardized procedures with all of these detection techniques, as the validity and reproducibility of the results are highly dependent on this. Electrical impedance and photothermal radiometry have been promoted as alternatives to light-based technologies; however, evidence for these devices is still somewhat limited. All of these traditional and new detection methods will be discussed in the context of minimal intervention dentistry and their potential value to the clinician and patient.

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References

  1. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global burden of untreated caries: a systematic review and metaregression. J Dent Res. 2015;94(5):650–8.

    Article  PubMed  Google Scholar 

  2. Gimenez T, Piovesan C, Braga MM, Raggio DP, Deery C, Ricketts DN, et al. Visual inspection for caries detection: a systematic review and meta-analysis. J Dent Res. 2015;94(7):895–904.

    Article  PubMed  Google Scholar 

  3. de Souza AL, Bronkhorst EM, Creugers NHJ, Leal SC, Frencken JE. The Caries Assessment Spectrum and Treatment (CAST) instrument: its reproducibility in clinical studies. Int Dent J. 2014;64(4):187–94.

    Google Scholar 

  4. Ismail AI, Sohn W, Tellez M, Willem JM, Betz J, Lepkowski J. Risk indicators for dental caries using the International Caries Detection and Assessment System (ICDAS). Community Dent Oral Epidemiol. 2008;36(1):55–68.

    PubMed  Google Scholar 

  5. Kühnisch J, Dietz W, Stosser L, Hickel R, Heinrich-Weltzien R. Effects of dental probing on occlusal surfaces – a scanning electron microscopy evaluation. Caries Res. 2007;41(1):43–8.

    Article  PubMed  Google Scholar 

  6. Kuhnisch J, Bucher K, Henschel V, Albrecht A, Garcia-Godoy F, Mansmann U, et al. Diagnostic performance of the universal visual scoring system (UniViSS) on occlusal surfaces. Clin Oral Investig. 2011;15(2):215–23.

    Article  PubMed  Google Scholar 

  7. Lussi A. Comparison of different methods for the diagnosis of fissure caries without cavitation. Caries Res. 1993;27(5):409–16.

    Article  PubMed  Google Scholar 

  8. Lussi A, Francescut P. Performance of conventional and new methods for the detection of occlusal caries in deciduous teeth. Caries Res. 2003;37(1):2–7.

    Article  PubMed  Google Scholar 

  9. Gordan V, III JR, Carvalho R, Snyder J, Jr JS, Anderson M, et al. Methods used by Dental Practice-based Research Network (DPBRN) dentists to diagnose dental caries. Oper Dent. 2011;36(1):2–11.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bücher K, Galler M, Seitz M, Hickel R, Kunzelmann K-H, Kühnisch J. Occlusal caries extension in relation to visual and radiographic diagnostic criteria: results from a microcomputed tomography study. Oper Dent. 2015;40(3):255–62.

    Article  PubMed  Google Scholar 

  11. Diniz M, Rodrigues J, Neuhaus K, Cordeiro RL, Lussi A. Influence of examiner’s clinical experience on the reproducibility and accuracy of radiographic examination in detecting occlusal caries. Clin Oral Investig. 2010;14(5):515–23.

    Article  PubMed  Google Scholar 

  12. Hall A, Girkin JM. A review of potential new diagnostic modalities for caries lesions. J Dent Res. 2004;83 Spec No C:C89–94.

    Google Scholar 

  13. Slimani A, Panayotov I, Levallois B, Cloitre T, Gergely C, Bec N, et al., editors. Porphyrin involvement in redshift fluorescence in dentin decay. International Society for Optics and Photonics; Proc. SPIE 9129, Biophotonics: Photonic Solutions for Better Health Care IV, 91291C, 2014; doi:10.1117/12.2051741.

  14. Buchalla W, Lennon ÁM, Attin T. Comparative fluorescence spectroscopy of root caries lesions. Eur J Oral Sci. 2004;112(6):490–6.

    Article  PubMed  Google Scholar 

  15. Kleter GA. Discoloration of dental carious lesions (a review). Arch Oral Biol. 1998;43(8):629–32.

    Article  PubMed  Google Scholar 

  16. Sell DR, Monnier VM. Isolation, purification and partial characterization of novel fluorophores from aging human insoluble collagen-rich tissue. Connect Tissue Res. 1989;19(1):77–92.

    Article  PubMed  Google Scholar 

  17. Sell DR, Nagaraj RH, Grandhee SK, Odetti P, Lapolla A, Fogarty J, et al. Pentosidine: a molecular marker for the cumulative damage to proteins in diabetes, aging, and uremia. Diabetes Metab Rev. 1991;7(4):239–51.

    Article  PubMed  Google Scholar 

  18. Buchalla W, Lennon AM, Attin T. Fluorescence spectroscopy of dental calculus. J Periodontal Res. 2004;39(5):327–32.

    Article  PubMed  Google Scholar 

  19. Mitropoulos CM. The use of fibre-optic transillumination in the diagnosis of posterior approximal caries in clinical trials. Caries Res. 1985;19(4):379–84.

    Article  PubMed  Google Scholar 

  20. Peers A, Hill EJ, Mitropoulos CM, Holloway PJ. Validity and reproducibility of clinical examination, fibre-optic transillumination, and bite-wing radiology for the diagnosis of small approximal carious lesions: an in vitro study. Caries Res. 1993;27(4):307–11.

    Article  PubMed  Google Scholar 

  21. Guerrieri A, Gaucher C, Bonte E, Lasfargues JJ. Minimal intervention dentistry: part 4. Detection and diagnosis of initial caries lesions. Br Dent J. 2012;213(11):551–7.

    Article  PubMed  Google Scholar 

  22. Marinova-Takorova M, Anastasova R, Panov VE. Comparative evaluation of the effectiveness of five methods for early diagnosis of occlusal carious lesions – in vitro study. J IMAB. 2014;20(3):533–6.

    Google Scholar 

  23. Kühnisch J, Heinrich-Weltzien R, Tabatabaie M, Stösser L, Huysmans MCDNJM. An in vitro comparison between two methods of electrical resistance measurement for occlusal caries detection. Caries Res. 2006;40(2):104–11.

    Article  PubMed  Google Scholar 

  24. Bin-Shuwaish M, Yaman P, Dennison J, Neiva G. The correlation of DIFOTI to clinical and radiographic images in Class II carious lesions. J Am Dent Assoc. 2008;139(10):1374–81.

    Article  PubMed  Google Scholar 

  25. Söchtig F, Hickel R, Kühnisch J. Caries detection and diagnostics with near-infrared light transillumination: Clinical experiences. Quintessence Int. 2014;45(6):513–38.

    Google Scholar 

  26. Lussi A, Imwinkelried S, Pitts NB, Longbottom C, Reich E. Performance and reproducibility of a laser fluorescence system for detection of occlusal caries in vitro. Caries Res. 1999;33(4):261–6.

    Article  PubMed  Google Scholar 

  27. Tassery H, Levallois B, Terrer E, Manton DJ, Otsuki M, Koubi S, et al. Use of new minimum intervention dentistry technologies in caries management. Aust Dent J. 2013;58(s1):40–59.

    Article  PubMed  Google Scholar 

  28. Bader JD, Shugars DA. A systematic review of the performance of a laser fluorescence device for detecting caries. J Am Dent Assoc. 2004;135(10):1413–26.

    Article  PubMed  Google Scholar 

  29. Ricketts DNJ. The eyes have it. Evid Based Dent. 2005;6(3):64–5.

    Article  PubMed  Google Scholar 

  30. Bader JD, Shugars DA. The evidence supporting alternative management strategies for early occlusal caries and suspected occlusal dentinal caries. J Evid Based Dent Pract. 2006;6(1):91–100.

    Article  PubMed  Google Scholar 

  31. Huth KC, Neuhaus KW, Gygax M, Bücher K, Crispin A, Paschos E, et al. Clinical performance of a new laser fluorescence device for detection of occlusal caries lesions in permanent molars. J Dent. 2008;36(12):1033–40.

    Article  PubMed  Google Scholar 

  32. Huth KC, Lussi A, Gygax M, Thum M, Crispin A, Paschos E, et al. In vivo performance of a laser fluorescence device for the approximal detection of caries in permanent molars. J Dent. 2010;38(12):1019–26.

    Article  PubMed  Google Scholar 

  33. Gimenez T, Braga MM, Raggio DP, Deery C, Ricketts DN, Mendes FM. Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of heterogeneity. PLoS One. 2013;8(4), e60421.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Emami Z, al-Khateeb S, de Josselin de Jong E, Sundström F, Trollsås K, Angmar-Månsson B. Mineral loss in incipient caries lesions quantified with laser fluorescence and longitudinal microradiography. A methodologic study. Acta Odontol Scand. 1996;54(1):8–13.

    Article  PubMed  Google Scholar 

  35. van der Veen MH, de Josselin de Jong E. Application of quantitative light-induced fluorescence for assessing early caries lesions. Monogr Oral Sci. 2000;17:144–62.

    Article  PubMed  Google Scholar 

  36. Boersma JG, Van der Veen MH, Lagerweij MD, Bokhout B, Prahl-Andersen B. Caries prevalence measured with QLF after treatment with fixed orthodontic appliances: influencing factors. Caries Res. 2004;39(1):41–7.

    Article  Google Scholar 

  37. Abrams SH, Sivagurunathan K, Jeon RJ, Silvertown JD, Hellen A, Mandelis A, et al. Multi-center study evaluating safety and effectiveness of the Canary System. Caries Res. 2011;45:174–242.

    Article  Google Scholar 

  38. Jeon RJ, Hellen A, Matvienko A, Mandelis A, Abrams SH, Amaechi BT. In vitro detection and quantification of enamel and root caries using infrared photothermal radiometry and modulated luminescence. J Biomed Opt. 2008;13(3):034025.

    Article  PubMed  Google Scholar 

  39. Jeon RJ, Matvienko A, Mandelis A, Abrams SH, Amaechi BT, Kulkarni G. Interproximal dental caries detection using Photothermal Radiometry (PTR) and Modulated Luminescence (LUM). Eur Phys J Spec Top. 2008;153(1):467–9.

    Article  Google Scholar 

  40. Jeon RJ, Mandelis A, Sanchez V, Abrams SH. Nonintrusive, noncontacting frequency-domain photothermal radiometry and luminescence depth profilometry of carious and artificial subsurface lesions in human teeth. J Biomed Opt. 2004;9(4):804–19.

    Article  PubMed  Google Scholar 

  41. Hellen A, Mandelis A, Finer Y, Amaechi BT. Quantitative remineralization evolution kinetics of artificially demineralized human enamel using photothermal radiometry and modulated luminescence. J Biophotonics. 2011;4(11–12):788–804.

    Article  PubMed  Google Scholar 

  42. Hellen A, Mandelis A, Finer Y, Amaechi BT. Quantitative evaluation of the kinetics of human enamel simulated caries using photothermal radiometry and modulated luminescence. J Biomed Opt. 2011;16(7):071406.

    Article  PubMed  Google Scholar 

  43. Hellen A, Matvienko A, Mandelis A, Finer Y, Amaechi BT. Optothermophysical properties of demineralized human dental enamel determined using photothermally generated diffuse photon density and thermal-wave fields. Appl Opt. 2010;49(36):6938–51.

    Article  PubMed  Google Scholar 

  44. Matvienko A, Mandelis A, Abrams S. Robust multiparameter method of evaluating the optical and thermal properties of a layered tissue structure using photothermal radiometry. Appl Opt. 2009;48(17):3192–203.

    Article  PubMed  Google Scholar 

  45. Terrer E, Raskin A, Koubi S, Dionne A, Weisrock G, Sarraquigne C, et al. A New concept in restorative dentistry: LIFEDT—light-induced fluorescence evaluator for diagnosis and treatment: part 2 – treatment of dentinal caries. J Contemp Dent Pract. 2010;11(1):1–12.

    Google Scholar 

  46. Levallois B, Terrer E, Panayotov Y, Salehi H, Tassery H, Tramini P, et al. Molecular structural analysis of carious lesions using micro-Raman spectroscopy. Eur J Oral Sci. 2012;120(5):444–51.

    Article  PubMed  Google Scholar 

  47. Panayotov I, Terrer E, Salehi H, Tassery H, Yachouh J, Cuisinier FJG, et al. In vitro investigation of fluorescence of carious dentin observed with a Soprolife® camera. Clin Oral Investig. 2012;17(3):757–63.

    Article  PubMed  Google Scholar 

  48. Salehi H, Terrer E, Panayotov I, Levallois B, Jacquot B, Tassery H, et al. Functional mapping of human sound and carious enamel and dentin with Raman spectroscopy. J Biophotonics. 2012.

    Google Scholar 

  49. Rechmann P, Rechmann BMT, Featherstone JDB. Caries detection using light-based diagnostic tools. Compend Contin Educ Dent. 2012;33(8):582–4, 6, 8–93; quiz 94, 96.

    PubMed  Google Scholar 

  50. Gomez J, Tellez M, Pretty IA, Ellwood RP, Ismail AI. Non-cavitated carious lesions detection methods: a systematic review. Community Dent Oral Epidemiol. 2013;41(1):54–66.

    Article  PubMed  Google Scholar 

  51. Gomez J, Zakian C, Salsone S, Pinto SCS, Taylor A, Pretty IA, et al. In vitro performance of different methods in detecting occlusal caries lesions. J Dent. 2013;41(2):180–6.

    Article  PubMed  Google Scholar 

  52. Sitbon Y, Attathom T, St-Georges AJ. Minimal intervention dentistry II: part 1. Contribution of the operating microscope to dentistry. Br Dent J. 2014;216(3):125–30.

    Article  PubMed  Google Scholar 

  53. Erten H, Üçtasli MB, Akarslan ZZ, Uzun Ö, Semiz M. Restorative treatment decision making with unaided visual examination, intraoral camera and operating microscope. Oper Dent. 2006;31(1):55–9.

    Article  PubMed  Google Scholar 

  54. Perrin P, Ramseyer ST, Eichenberger M, Lussi A. Visual acuity of dentists in their respective clinical conditions. Clin Oral Investig. 2014;18(9):2055–8.

    Article  PubMed  Google Scholar 

  55. Rechmann P, Charland D, Rechmann BMT, Featherstone JDB. Performance of laser fluorescence devices and visual examination for the detection of occlusal caries in permanent molars. J Biomed Opt. 2012;17(3):036006.

    Article  PubMed  Google Scholar 

  56. Zeitouny M, Feghali M, Nasr A, Abou-Samra P, Saleh N, Bourgeois D, et al. SOPROLIFE system: an accurate diagnostic enhancer. Scientific World J. 2014;2014:Article ID 924741.

    Google Scholar 

  57. Jablonski-Momeni A, Schipper HM, Rosen SM, Heinzel-Gutenbrunner M, Roggendorf MJ, Stoll R, et al. Performance of a fluorescence camera for detection of occlusal caries in vitro. Odontology. 2011;99(1):55–61.

    Article  PubMed  Google Scholar 

  58. Seremidi K, Lagouvardos P, Kavvadia K. Comparative in vitro validation of VistaProof and DIAGNOdent pen for occlusal caries detection in permanent teeth. Oper Dent. 2012;37(3):234–45.

    Article  PubMed  Google Scholar 

  59. Souza JF, Boldieri T, Diniz MB, Rodrigues JA, Lussi A, Cordeiro RCL. Traditional and novel methods for occlusal caries detection: performance on primary teeth. Lasers Med Sci. 2013;28(1):287–95.

    Article  PubMed  Google Scholar 

  60. Rodrigues JA, Hug I, Diniz MB, Cordeiro RCL, Lussi A. The influence of zero-value subtraction on the performance of two laser fluorescence devices for detecting occlusal caries in vitro. J Am Dent Assoc. 2008;139(8):1105–12.

    Article  Google Scholar 

  61. Rodrigues JA, Hug I, Diniz MB, Lussi A. Performance of fluorescence methods, radiographic examination and ICDAS II on occlusal surfaces in vitro. Caries Res. 2008;42(4):297–304.

    Article  PubMed  Google Scholar 

  62. Diniz MB, Boldieri T, Rodrigues JA, Santos-Pinto L, Lussi A, Cordeiro RCL. The performance of conventional and fluorescence-based methods for occlusal caries detection: an in vivo study with histologic validation. J Am Dent Assoc. 2012;143(4):339–50.

    Article  PubMed  Google Scholar 

  63. Diniz MB, Sciasci P, Rodrigues JA, Lussi A, Cordeiro RCL. Influence of different professional prophylactic methods on fluorescence measurements for detection of occlusal caries. Caries Res. 2011;45(3):264–8.

    Article  PubMed  Google Scholar 

  64. Fried D, Featherstone JDB, Darling CL, Jones RS, Ngaotheppitak P, Bühler CM. Early caries imaging and monitoring with near-infrared light. Dent Clin North Am. 2005;49(4):771–93. vi.

    Article  PubMed  Google Scholar 

  65. Ngaotheppitak P, Darling CL, Fried D, Bush J, Bell S, editors. PS-OCT of occlusal and interproximal caries lesions viewed from occlusal surfaces. roc. SPIE 6137, Lasers in Dentistry XII, 61370L, 2006; doi:10.1117/12.661795.

  66. Fried D, Staninec M, Darling CL, Chan KH, Pelzner RB. Clinical monitoring of early caries lesions using cross polarization optical coherence tomography. Proc Soc Photo Opt Instrum Eng. 2013;8566.

    Google Scholar 

  67. Hosoya Y, Matsuzaka K, Inoue T, et al. Influence of tooth-polishing pastes and sealants on DIAGNOdent values. Quintessence Int. 2004;35:605–11.

    Google Scholar 

  68. Jones RS, Darling CL, Featherstone JDB, Fried D. Imaging artificial caries on the occlusal surfaces with polarization-sensitive optical coherence tomography. Caries Res. 2006;40(2):81–9.

    Article  PubMed  Google Scholar 

  69. Manton DJ. Diagnosis of the early carious lesion. Aust Dent J. 2013;58:35–9.

    Article  PubMed  Google Scholar 

  70. Featherstone JD, Domejean-Orliaguet S, Jenson L, Wolff M, Young DA. Caries risk assessment in practice for age 6 through adult. J Calif Dent Assoc. 2007;35(10):703.

    PubMed  Google Scholar 

  71. Featherstone JDB. The science and practice of caries prevention. J Am Dent Assoc. 2000;131(7):887–900.

    Article  PubMed  Google Scholar 

  72. Fejerskov O. Changing paradigms in concepts on dental caries: consequences for oral health care. Caries Res. 2004;38(3):182–91.

    Article  PubMed  Google Scholar 

  73. Pitts NB, Ismail AI, Martignon S, Ekstrand K, Douglas GVA, Longbottom C. ICCMS™ Guide for practitioners and educators. In: Management GCfC, editor. 2014.

    Google Scholar 

  74. Koubi G, Colon P, Franquin J-C, Hartmann A, Richard G, Faure M-O, et al. Clinical evaluation of the performance and safety of a new dentine substitute, Biodentine, in the restoration of posterior teeth – a prospective study. Clin Oral Investig. 2013;17(1):243–9.

    Article  PubMed  Google Scholar 

  75. Banerjee A, Thompson ID, Watson TF. Minimally invasive caries removal using bio-active glass air-abrasion. J Dent. 2011;39(1):2–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Preventive and Restorative Department, Marseille Dental School, Aix-Marseille University, Marseille, France

    Hervé Tassery MDSc, PhD (Professor)

  2. Laboratory EA 4203, Montpellier University, Montpellier, France

    Hervé Tassery MDSc, PhD (Professor)

  3. Elsdon Storey Chair of Child Dental Health, Growth and Development Section, Melbourne Dental School, University of Melbourne, Parkville, VIC, 3010, Australia

    David J. Manton BDSc, MDSc, PhD (Professor)

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  1. Hervé Tassery MDSc, PhD
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  2. David J. Manton BDSc, MDSc, PhD
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Correspondence to David J. Manton BDSc, MDSc, PhD .

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  1. School of Dentistry, Department of Pedodontics, Ege University, İzmir, Turkey

    Ece Eden

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Tassery, H., Manton, D.J. (2016). Detection and Diagnosis of Carious Lesions. In: Eden, E. (eds) Evidence-Based Caries Prevention. Springer, Cham. https://doi.org/10.1007/978-3-319-40034-1_2

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