Diagnosis and Assessment of Dental Caries Using Novel Bioactive Caries Detecting Dye Solution

Abstract

Background: The goal of materials should be early caries detection, removal of carious lesions, and reduction of dentin hypersensitivity. Thus, the study aims to determine the efficacy of a bioactive caries detecting dye (BCD) for the diagnosing and mechanical removal of occlusal and proximal dental caries.

Methods: Patients with occlusal (A1, A2) and proximal carious lesions (B1, B2) were treated with the rotary technique and BCD solution on 120 teeth (n = 60 for each). Group 1: Excavation was performed using diamond points. Group 2: 0.5 mL of BCD solution was scrubbed for 20 sec and excavation was performed with a sharp spoon excavator. Post-excavation cavity volume analysis was performed using a 3D scanner. The time required, VAS for pain, VAS for facial expression, and sound eye motor scoring were scored during excavation. Post-restoration evaluation was performed at 3, 6, and 12 months (FDI criteria).

Results: The chi-square test revealed that the A1 (197.90 30.97 s) and B1 (273.06 69.95 s) had significantly less mean procedural time than the A2 (292.13 44.87 s) and B2 (411.86 88.34 s). BCD (A2, B2) group showed good patient acceptance, less pain during caries excavation VAS (p = 0.001, FACE (p = 0.001), and SEM (p < 0.001) analysis than the rotary group. There was a statistically insignificant difference between groups immediately (p = 0.235), (p = 0.475) and after 24 h (p = 0.561), (p = 0.688). Color score, hardness of excavated surface, and caries removal score for occlusal and proximal groups showed insignificant differences between the groups. BCD group showed significantly less mean caries excavated volume for the occlusal group (p = 0.003) as compared to the proximal group (p = 0.417) evaluated by 3D scanner. Evaluation of restoration after 3-, 6-, and 12 months intervals (Occlusal caries group (p = 0.247), (p = 0.330), and (0.489) and Proximal caries group (p = 0.299), (p = 0.594), and (0.494)) was acceptable for both the groups.

Conclusion: BCD helps in identification of dental caries clinically, radiographically, and in effective removal of denatured teeth with less pain or sensitivity.

Keywords: 3D scanner; bioactive caries detecting dye solution; caries excavation; chemomechanical caries removal; dental caries; dentin hypersensitivity; diagnostic imaging; minimal intervention dentistry; pain perception.

Figure 1

Flow chart of clinical study (CONSORT) for BCD.

Figure 2

The steps of volume determination by 3D scanner: (A): silicon impression; (B): working cast; (C): volume determination illustration (mm²) using exocad software.

Figure 3

Clinical steps for the occlusal caries group (Control group): (A,B,I): preoperative clinical photo and radiograph (red circle); (C): caries excavation with diamond point; (D): finishing of cavo-surface margins using Arkansas stone; (E): final prepared cavity; (F,J): cavity restored with RMGIC material and immediate post-restoration radiograph (red circle); (G,K): post-restoration clinical photo and radiograph (red circle) after 3 months; (H,L): post-restoration clinical photo and radiograph (red circle) after 6 and 12 months.

Figure 4

Clinical steps for occlusal caries group (BCD group): (A,K): preoperative clinical photo and radiograph (red circle); (B,C,L): application clinically and extension of radiopaque BCD on radiograph (red circle); (D): caries excavation with spoon excavator and caries debris during excavation; (E): Finishing of cavo-surface margins using Arkansas stone; (F,M): final prepared cavity and post-caries excavation radiograph (red circle); (G): cavity restored with RMGIC material: (H,N): post-restoration clinical photo and radiograph (red circle) after 3 months; (I,O): post-restoration clinical photo and radiograph (red circle) after 6 months; (J,P): post-restoration clinical photo and radiograph (red circle) after 12 months.

Figure 5

Clinical steps for the proximal caries group (BCD group): (A,J): preoperative clinical photo and radiograph (red circle); (B,C): application of BCD solution; (K): extension of radiopaque BCD solution seen on radiograph (red circle); (D,E): caries excavation with spoon excavator and finishing with Arkansas stone; (F,L): post-caries excavation clinically and radiographically (red circle); (G,M): cavity restored with composite material and immediate post-restoration radiograph (red circle); (H,N): post-restoration clinical photo and radiograph (red circle) after 3 months; (I,O): post-restoration clinical photo and radiograph (red circle) after 6 and 12 months.