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An Update on Demineralization/Remineralization

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

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This caries detection system takes advantage of tooth fluorescence to record images that can be analyzed to obtain data on: lesion Area (Area in mm2), lesion depth expressed in percentile fluorescence loss (DF in %), and lesion volume (DQ in mm2%) and bacterial activity in terms of percentile increase of red fluorescence (DR).

The Inspektor™ Pro QLF camera system:

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This device uses blue light to illuminate the tooth. This causes the teeth to fluoresce in green (so-called auto-fluorescence). The resulting QLF images show a higher contrast between sound and demineralized tooth tissue as seen in the figures of the extracted premolar.

Besides the green auto-fluorescence, the blue light can also generate red fluorescence that can be seen in the picture below. This red fluorescence is believed to be caused by porphyrins that are the result of the metabolic process of specific bacterial strains. The intensity of the red fluorescence, therefore, seems to be related to the activity of those bacteria.

Clinical QLF showing green auto-fluorescence on the buccal surfaces and red fluorescence at the proximal areas.

Clinical QLF showing green auto-fluorescence on the buccal surfaces and red fluorescence at the proximal areas.

A powerful feature of QLF is the ability to follow teeth-surfaces in time (longitudinal monitoring). The software supports automatic video repositioning that supports the acquisition of comparable QLF images of the same surfaces in time.

 

The software can also analyze recorded images and, thus, provide an objective assessment of areas of concern over time.

 

The photos shown below are research images showing remineralization of a white-spot lesion over a 9 month time period.

Remineralization of a white spot after debracketing:

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(Images and data courtesy of S. Al-Khateeb, Karolinska Institutet, Stockholm, Sweden)

Another typical QLF result as presented in the QLF software is the occlusal surface of the second upper premolar at different time points with 3 months intervals.  The QLF system shows here a slow progression of a caries lesion in a stage where clinical intervention (drilling) is not necessary.

QLF Result

A white spot lesion as seen with QLF. By clicking on one of the links below, you can follow the remineralization process over a period of 100 days. Note the reduction in size of the lesion which represents remineralization.

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