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An Update on Demineralization/Remineralization

Mark E. Jensen, MS, DDS, PhD; Robert V. Faller, BS

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  • Vorige
  • Advancing Approaches for Clinical Caries Measurement
  • Volgende

The standard methods for caries diagnosis in the past were the combination of the dental "visual/tactile" examination together with conventional film radiography. Slowly, fiber-optic transillumination became a regular clinical adjunct for caries examination in the clinical setting. In the past decade laser fluorescence for pit and fissure caries has become a more commonplace clinical instrument. Fiber-optic transillumination has advanced further with the use of the DIFOTI system. DIFOTI is a trademarked name which has been taken from "Digital Imaging Fiber-Optic Trans-Illumination". This system and has been available for clinical use for a number of years. Other promising caries detection methods include electrical resistance and Quantitative Laser Fluorescence or QLF. Conventional radiography is slowly giving way to various forms of digital radiography, and some advances in quantitative digital radiography may not be far off. The NIH caries management symposium cited earlier15 addressed various methods of early detection and caries measurement, but the evidence for implementing most of these fell short of what would be convincing. The concept, however, is key to making early clinical assessments of lesions that can be stopped before they are irreversible and need restoration. It is even more exciting to consider the concept of being able to detect the caries lesions in their very early stages and have quantitative measurements of their condition. The object is then to apply "remineralization" therapy to reverse the lesions through products such as fluoridated toothpastes which have documented support for their clinical effectiveness, while using quantitative early detection methods to assess the progress of our therapy. Specific recommendations for patients, or even specific lesions, could be made and monitored for effectiveness long before intervention with a restoration would be necessary.

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