Laser fluorescence measurements compared to electrical resistance of residual dentine in excavated cavities in vivo

Abstract

It has been suggested that laser fluorescence close to the dental pulp shows higher values than more distant measurements. The aim of this study was to assess fluorescence on the cavity floor and to correlate these measurements with electrical resistance as a measure of residual dentine thickness. Thirty carious lesions were excavated with a bur. The endpoint of caries removal was determined by visual, tactile and auditory means. Fluorescence was measured with the Diagnodent device and with the fluorescence feedback system of a therapeutic Er:YAG laser. Electrical resistance of the residual dentine (Prepometer units, PU) was measured with a proprietary device. Significant differences were observed between the fluorescence systems (p < 0.05). For Diagnodent, a decrease of electrical resistance of the residual dentine resulted in an increase of the fluorescence values of 2.99 units/PU (95% CI = 2.00-3.97) and an increase of 0.30 units/PU (95% CI = 0.19-0.40) for the fluorescence feedback system. For zero electrical resistance, a predicted maximum value of 51.5 units (95% CI = 41.3-61.7) was calculated for the Diagnodent and 5.1 units (95% CI = 4.1-6.2) for the feedback system. The study indicates that using the suggested detection cut-off with the Diagnodent device may be not suited to assess the endpoint of caries removal close to the dental pulp. Employing the Key Laser III, values up to 6 units might be caused solely by close proximity to the pulp, which should be considered when caries removal by laser is controlled by laser fluorescence feedback.