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. 2018 Nov:78:76-82.
doi: 10.1016/j.jdent.2018.08.009. Epub 2018 Aug 19.

Objective and quantitative assessment of caries lesion activity

Masatoshi Ando  1 , Margherita Fontana  2 , George J Eckert  3 , Rodrigo A Arthur  4 , Hui Zhang  5 , Domenick T Zero  6
Affiliations

Objective and quantitative assessment of caries lesion activity

Masatoshi Ando et al. J Dent. 2018 Nov.

Abstract

Objectives: Evaluate the ability of objectively measured specular reflection, roughness, and fluorescence change during dehydration to assess caries lesion activity.

Methods: One hundred ninety-five ground/polished 3 × 3 × 2 mm sound human enamel specimens were divided into three groups and demineralized using a multispecies microbial caries model for 3, 6, or 9 days; and then remineralized with 1100 ppm-F as NaF solution for 10 days using a pH-cyclic model. Reflection (amplitude: %), roughness (Ra: μm), fluorescence change during dehydration (ΔQ: %×mm2), and microfocus computed tomography [μ-CT: lesion volume (μm3)] were measured for sound, demineralized and remineralized enamel. The surface was hydrated and fluorescence images were acquired at 1 s intervals for 10 s (ΔQ10). During image acquisition, surface was dehydrated with continuous compressed air. Changes-in-ΔQ per second (ΔQD: %×mm2/sec) at 5 (ΔQD5) and 10 s (ΔQD10) were obtained.

Results: Reflection decreased from sound to demineralized groups (p < 0.0001); remineralized groups were higher than demineralized groups (p < 0.001), but not different from sound (p > 0.32). Roughness increased from sound to demineralized groups (p < 0.0001) and remineralized groups were also higher than sound (p < 0.0001). ΔQ10, ΔQD5 and ΔQD10 increased from sound to demineralized groups (p < 0.0001), and remineralized groups decreased compared to demineralized groups (p < 0.05), but was higher than sound (p < 0.0001). The correlations of μ-CT with reflection, roughness, and ΔQ10 were -0.63, 0.71, and 0.82, respectively (p < 0.0001).

Conclusions: Reflection, roughness and ΔQ could distinguish between sound and demineralized enamel. Reflection and ΔQ were able to distinguish between demineralized and remineralized enamel.

Clinical significance: Determination of caries activity, whether a lesion is active or inactive, is an essential and critical component of caries diagnosis. However, especially for enamel lesions, it is difficult to estimate without longitudinal follow-up. Reflection, roughness and fluorescence change during dehydration have the potential to measure caries lesion activity at a-single-appointment.

Keywords: Caries lesion activity; Demineralization; Fluorescence imaging; Reflection; Remineralization; Roughness.

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Conflict of interest statement

Declaration of Interest

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Schematic diagram of surface dehydration hypothesis of this study at the lesion body level.
Figure 2.
Figure 2.
Average and standard error of ΔQD (%×mm2/sec) at 5 and 10 seconds of dehydration. Significant differences among the groups and treatment periods (p<0.05) are represented by different superscript letters for 5 seconds of dehydration and different superscript numbers for 10 seconds of dehydration.
Figure 3.
Figure 3.
2D Cross section of μ-CT image from Demin 9d group. (A) Demineralized surface layer. (B) Remineralized surface layer.
See this image and copyright information in PMC

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