SENSITIVITY: Ability of a caries detection
method to correctly identify true positives (presence of caries).
Numerous new technologies have been developed recently to identify
demineralization; the earliest sign of dental caries, but several other
improvements to existing technologies have also occurred.
Radiographs played an early role in identifying carious lesions, but
as the speed of the film increased, and the radiation dosage decreased, the
contrast in density of tissue became more difficult to interpret. This was also
compounded, perhaps, by the expanded use of fluoride making enamel more
resistant to demineralization, and, suddenly, the issue of hidden-decay became
a daily reality for practitioners.
Improvements in digital radiography and sensors, coupled with the
development of software tools to manipulate images, have certainly overcome
many of these issues. However, digital radiography alone is not enough.
Magnification and accessory illumination, or loupes and headlights, have
definitely enhanced the visual examination and the dentist’s ability to be more
accurate in identifying caries activity.
Combined, these improvements have dramatically improved the old “pick
and stick” technology of the past. Sensitivity and specificity in caries
detection can be enhanced even further yet with several new emerging
technologies. This results in more accurate diagnosis and overall treatment
planning and outcomes.
Carious dentin areas exhibit
a red fluorescence on using
the Caries Detection System, which is differentiated from the green fluorescence of
non-carious areas. The red fluorescence is emitted by porphyrin compounds,
which are generated by bacteria...
The emerging biofilm
science is changing how the dental profession looks at dental caries as a
disease model. By early and accurate identification of dental caries, medical
model therapies and minimally invasive surgical procedures provide patients
with the best predictable treatment outcomes possible today....
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