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Diagnosis of dental caries 2017
Yasser	Ali	Al	Mortada	Al	Wasifi
BDS,	MSc,	PhD,	DDS.	
Assistant	Professor	of	Esthetic	Restorative	Dentistry
Taibah	University	(KSA)
Ain Shams	University	(EGYPT)
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
a) Visual-Tactile Examination
b) Conventional radiography
a) Digital	Radiography
b) Enhanced	Visual	Techniques
c) Fluorescent	Technique
d) Electric-Based	Detection	Systems
e) Ultrasound	Techniques
f) Chemical	Dyes
1. Stepwise Excavation
2. Air Abrasion
3. Laser
4. Ozone
5. Chemo-Mechanical Caries Removal
6. Photo-Activated Disinfection
7. Polymer Bur
8. Micro-Preparation Bur
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
LIKE ! " DISLIKE
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
False positive = Questionable lesion
False negative = Lesion redetected
Sensitivity	=	
True	Positives
True	Positives	+	False	Negatives
False positive = Questionable lesion
False negative = Lesion redetected
Specificity	=	
True	Negatives
True	Negatives	+	False	Postives
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Score Surface	Status Score Surface	Status
0 Not	sealed	or	restored 5 Stainless	Steel Crowns
1 Sealant,	partial 6 Porcelain	or	gold	or	PFM	crown	or	veneer
2 Sealant,	Full 7 Lost	or	broken	restoration
3 Tooth	Colored	Restoration 8 Temporary	restoration	
4 Amalgam	Restoration
9 Used	for	missed	teeth	due	to	one	
of	the	following	conditions:
97
98
99
Tooth	extracted	because	of	caries
Tooth	extracted	for	reasons	other	than	caries
Unerupted
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Score Surface	Status Score Surface	Status
E Excluded	root	surfaces	(no	gingival	
recession)
3 Cavitated (greater	than	0.5mm	in	depth)	
carious	root	surface— soft	or	leathery
0 Sound	(no	caries	or	restoration) 4 Cavitated (greater	than	0.5mm	in	depth)	
carious	root	surface—hard	and	glossy
1 Non-cavitated carious	root	surface— soft	
or	leathery
6 Extensive	cavity:	an	extensive	cavity	
involves	at	least	half	of	a	tooth	surface	
and	possibly	reaching	the	pulp.	
2 Non-cavitated carious	root	surface— hard	
and	glossy
7 Filled	root	with	no	caries
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
2 New Developments in Caries Removal and Restoration
rasion
minimal
ion and
surface
r abra-
is light
powder
d vari-
Fig. 2.5 The air abra-
sion handpiece is light
and the flow of powder
has a controlled vari-
able outflow
but they have the disadvantage that they can easily cause iatrogenic dam-
age by removing exposed cementum and root dentin in teeth affected by
gingival recession and periodontal disease. Atkinson et al. (1984) found that
their air-powder abrasive system removed a mean depth of 637µm of root
structure in 30s of exposure time. Further research aimed at identifying less
abrasive powders is ongoing (Petersilka et al. 2003), because softer particles
might be more effective in removing carious dentin more selectively. Lau-
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Administration approved the erbium:YAG laser for caries removal in the USA.
The Fidelis erbium:YAG laser (Fotona, Ljubljana, Slovenia) is one example of
the commercially available lasers for dental use, but it is a rather large device
(Fig. 2.1), with settings for varying the cutting speed (Fig. 2.2).
Erbium:YAG laser treatment of teeth produces no smear layer, so the adap-
tation of filling materials to the enamel and dentin surfaces should be optimal.
Fig. 2.1 The erbium-YAG laser is commer-
cially available, but many perceive it as
costly and offering few advantages over
conventional methods of cavity prepara-
tion. The machine is large and occupies
considerable space in the dental office
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Carisolv®
gel multimix
25% faster compared with previous gel
The removal of caries with the new gel takes an average of 5.2 min-
utes, less than 30 per cent of the total treatment time. This develop-
ment of Carisolv®
makes it possible to remove caries as fast as with
the drill but with all the advantages a minimally-invasive method
Minimally-invasive, precise and reliable caries removal
Carisolv®
– minimally-invasive method for
caries removal
Minimally-invasive dentistry comprises biologically-
oriented procedures. The teeth are treated with preci-
sion and caution in order to last as long as possible,
avoid post-operative complications and fulfil the de-
mands of present-day patients.
Using the gel-based caries removal method Carisolv®
brings you as close to minimally-invasive procedures
as possible. The method involves the use of a gel that
selectively reacts with denatured collagen, thereby mak-
ing the carious dentine softer. Specially-designed
instruments – hand and power-operated – are used to
remove the softened material. Drill, air abrasion or
similar techniques are used if access to the cavity is
required.
Carisolv®
• Well documented
• Minimally-invasive, selective and precise
• Minimises the need for the drill and anaesthetics
and enhances patient comfort
• Makes it possible to avoid drilling close to the
pulp
• Carisolv®
instruments with sharp yet blunt cutting
angles help to protect healthy tissue
Carisolv®
– the clinical procedure
1. The gel does not affect healthy dentine or soft
mands of present-day patients.
Using the gel-based caries removal method Carisolv®
brings you as close to minimally-invasive procedures
as possible. The method involves the use of a gel that
selectively reacts with denatured collagen, thereby mak-
ing the carious dentine softer. Specially-designed
instruments – hand and power-operated – are used to
remove the softened material. Drill, air abrasion or
similar techniques are used if access to the cavity is
required.
Carisolv®
• Well documented
• Minimally-invasive, selective and precise
• Minimises the need for the drill and anaesthetics
and enhances patient comfort
• Makes it possible to avoid drilling close to the
pulp
• Carisolv®
instruments with sharp yet blunt cutting
angles help to protect healthy tissue
Carisolv®
– the clinical procedure
1. The gel does not affect healthy dentine or soft
tissue. Nor does it affect enamel. Consequently
Carisolv™
should be used in combination with the
drill or alternative techniques.
2. Drilling could preferably be used whenever the
cavity needs to be opened up, for adjustment of
cavity periphery or whenever there are large
amounts of caries and when the risk to affect
healthy tissue is minimal.
3. Cover the cavity with gel and wait for 30 seconds
until the carious dentine has been softened.
4. Softened caries can then be scraped away using
the PowerDrive™
and/or the Carisolv®
hand
instruments.
5. Repeat steps three and four without waiting 30
seconds, until the cavity is free from caries.
6. Inspect and fill as usual.
syringe should be sufficient for approximately 10 treat-
ments. Only the amount of gel that is needed for each
individual treatment is extruded.
An opened package can be kept at room temperature
during working hours. At all other times, it should be
kept in a refrigerator. An opened package can be kept
up to one month, for subsequent use.
The gel comprises uncoloured fluid of high viscosity,
which contains three different amino acids, and a trans-
parent fluid consisting of a low concentration of so-
dium hypochlorite. When the fluids are mixed, their
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017
Diagnosis of dental caries 2017

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Diagnosis of dental caries 2017

  • 6. a) Visual-Tactile Examination b) Conventional radiography a) Digital Radiography b) Enhanced Visual Techniques c) Fluorescent Technique d) Electric-Based Detection Systems e) Ultrasound Techniques f) Chemical Dyes
  • 7. 1. Stepwise Excavation 2. Air Abrasion 3. Laser 4. Ozone 5. Chemo-Mechanical Caries Removal 6. Photo-Activated Disinfection 7. Polymer Bur 8. Micro-Preparation Bur
  • 14. LIKE ! " DISLIKE
  • 20. False positive = Questionable lesion False negative = Lesion redetected Sensitivity = True Positives True Positives + False Negatives
  • 21. False positive = Questionable lesion False negative = Lesion redetected Specificity = True Negatives True Negatives + False Postives
  • 77. Score Surface Status Score Surface Status 0 Not sealed or restored 5 Stainless Steel Crowns 1 Sealant, partial 6 Porcelain or gold or PFM crown or veneer 2 Sealant, Full 7 Lost or broken restoration 3 Tooth Colored Restoration 8 Temporary restoration 4 Amalgam Restoration 9 Used for missed teeth due to one of the following conditions: 97 98 99 Tooth extracted because of caries Tooth extracted for reasons other than caries Unerupted
  • 80. Score Surface Status Score Surface Status E Excluded root surfaces (no gingival recession) 3 Cavitated (greater than 0.5mm in depth) carious root surface— soft or leathery 0 Sound (no caries or restoration) 4 Cavitated (greater than 0.5mm in depth) carious root surface—hard and glossy 1 Non-cavitated carious root surface— soft or leathery 6 Extensive cavity: an extensive cavity involves at least half of a tooth surface and possibly reaching the pulp. 2 Non-cavitated carious root surface— hard and glossy 7 Filled root with no caries
  • 114. A) DIGITAL RADIOGRAPHY B) ENHANCED VISUAL TECHNIQUES C) FLUORESCENT TECHNIQUE D) ELECTRIC-BASED DETECTION SYSTEMS E) ULTRASOUND TECHNIQUES F) CHEMICAL DYES
  • 129. A) DIGITAL RADIOGRAPHY B) ENHANCED VISUAL TECHNIQUES C) FLUORESCENT TECHNIQUE D) ELECTRIC-BASED DETECTION SYSTEMS E) ULTRASOUND TECHNIQUES F) CHEMICAL DYES
  • 143. A) DIGITAL RADIOGRAPHY B) ENHANCED VISUAL TECHNIQUES C) FLUORESCENT TECHNIQUE D) ELECTRIC-BASED DETECTION SYSTEMS E) ULTRASOUND TECHNIQUES F) CHEMICAL DYES
  • 165. A) DIGITAL RADIOGRAPHY B) ENHANCED VISUAL TECHNIQUES C) FLUORESCENT TECHNIQUE D) ELECTRIC-BASED DETECTION SYSTEMS E) ULTRASOUND TECHNIQUES F) CHEMICAL DYES
  • 178. A) DIGITAL RADIOGRAPHY B) ENHANCED VISUAL TECHNIQUES C) FLUORESCENT TECHNIQUE D) ELECTRIC-BASED DETECTION SYSTEMS E) ULTRASOUND TECHNIQUES F) CHEMICAL DYES
  • 182. A) DIGITAL RADIOGRAPHY B) ENHANCED VISUAL TECHNIQUES C) FLUORESCENT TECHNIQUE D) ELECTRIC-BASED DETECTION SYSTEMS E) ULTRASOUND TECHNIQUES F) CHEMICAL DYES
  • 209. 2 New Developments in Caries Removal and Restoration rasion minimal ion and surface r abra- is light powder d vari- Fig. 2.5 The air abra- sion handpiece is light and the flow of powder has a controlled vari- able outflow but they have the disadvantage that they can easily cause iatrogenic dam- age by removing exposed cementum and root dentin in teeth affected by gingival recession and periodontal disease. Atkinson et al. (1984) found that their air-powder abrasive system removed a mean depth of 637µm of root structure in 30s of exposure time. Further research aimed at identifying less abrasive powders is ongoing (Petersilka et al. 2003), because softer particles might be more effective in removing carious dentin more selectively. Lau-
  • 214. Administration approved the erbium:YAG laser for caries removal in the USA. The Fidelis erbium:YAG laser (Fotona, Ljubljana, Slovenia) is one example of the commercially available lasers for dental use, but it is a rather large device (Fig. 2.1), with settings for varying the cutting speed (Fig. 2.2). Erbium:YAG laser treatment of teeth produces no smear layer, so the adap- tation of filling materials to the enamel and dentin surfaces should be optimal. Fig. 2.1 The erbium-YAG laser is commer- cially available, but many perceive it as costly and offering few advantages over conventional methods of cavity prepara- tion. The machine is large and occupies considerable space in the dental office
  • 224. Carisolv® gel multimix 25% faster compared with previous gel The removal of caries with the new gel takes an average of 5.2 min- utes, less than 30 per cent of the total treatment time. This develop- ment of Carisolv® makes it possible to remove caries as fast as with the drill but with all the advantages a minimally-invasive method Minimally-invasive, precise and reliable caries removal
  • 225. Carisolv® – minimally-invasive method for caries removal Minimally-invasive dentistry comprises biologically- oriented procedures. The teeth are treated with preci- sion and caution in order to last as long as possible, avoid post-operative complications and fulfil the de- mands of present-day patients. Using the gel-based caries removal method Carisolv® brings you as close to minimally-invasive procedures as possible. The method involves the use of a gel that selectively reacts with denatured collagen, thereby mak- ing the carious dentine softer. Specially-designed instruments – hand and power-operated – are used to remove the softened material. Drill, air abrasion or similar techniques are used if access to the cavity is required. Carisolv® • Well documented • Minimally-invasive, selective and precise • Minimises the need for the drill and anaesthetics and enhances patient comfort • Makes it possible to avoid drilling close to the pulp • Carisolv® instruments with sharp yet blunt cutting angles help to protect healthy tissue Carisolv® – the clinical procedure 1. The gel does not affect healthy dentine or soft
  • 226. mands of present-day patients. Using the gel-based caries removal method Carisolv® brings you as close to minimally-invasive procedures as possible. The method involves the use of a gel that selectively reacts with denatured collagen, thereby mak- ing the carious dentine softer. Specially-designed instruments – hand and power-operated – are used to remove the softened material. Drill, air abrasion or similar techniques are used if access to the cavity is required. Carisolv® • Well documented • Minimally-invasive, selective and precise • Minimises the need for the drill and anaesthetics and enhances patient comfort • Makes it possible to avoid drilling close to the pulp • Carisolv® instruments with sharp yet blunt cutting angles help to protect healthy tissue Carisolv® – the clinical procedure 1. The gel does not affect healthy dentine or soft tissue. Nor does it affect enamel. Consequently Carisolv™ should be used in combination with the drill or alternative techniques. 2. Drilling could preferably be used whenever the cavity needs to be opened up, for adjustment of cavity periphery or whenever there are large amounts of caries and when the risk to affect healthy tissue is minimal. 3. Cover the cavity with gel and wait for 30 seconds until the carious dentine has been softened. 4. Softened caries can then be scraped away using the PowerDrive™ and/or the Carisolv® hand instruments. 5. Repeat steps three and four without waiting 30 seconds, until the cavity is free from caries. 6. Inspect and fill as usual. syringe should be sufficient for approximately 10 treat- ments. Only the amount of gel that is needed for each individual treatment is extruded. An opened package can be kept at room temperature during working hours. At all other times, it should be kept in a refrigerator. An opened package can be kept up to one month, for subsequent use. The gel comprises uncoloured fluid of high viscosity, which contains three different amino acids, and a trans- parent fluid consisting of a low concentration of so- dium hypochlorite. When the fluids are mixed, their