International Journal of Dentistry Research 2024; 9(1): 28-32 ;   DOI:10.31254/dentistry.2024.9108

Case Report

Shedding light on hidden caries detection with fluorescence enhanced dental loupes and radiographic examination: A case report

Gal Hiltch¹ , Liviu Steier² , José Antonio Poli de Figueiredo³

Gal Hiltch,Liviu Steier,José Antonio Poli de Figueiredo

1. Post-Graduate Program in Dentistry, Federal University of Rio Grande do Sul—UFRGS, Porto Alegre, Brazil
2. Specialist in Prosthodontics, Specialist in Endodontics; Associate Professor, Department of Preventive and Restorative Sciences, Dental School, University of Pennsylvania- UPENN, Pennsylvania, USA
3. Vice-Provost (Research)- Federal University of Rio Grande do Sul, Department of Science and Morphology, Porto Alegre, Brazil

*Author to whom correspondence should be addressed.

Received: 25th January, 2024 / Accepted: 23rd March, 2024 / Published : 30th April, 2024

Abstract

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This study evaluated the effectiveness of newly introduced fluorescence-enhanced dental loupes ("Reveal") in facilitating the discovery of hidden and early carious lesions. Additionally, it compared fluorescence-based caries detection methods with traditional radiographic techniques. Traditionally, visual-tactile inspection and radiographs are used for caries detection. However, these methods have limitations, including operator subjectivity and exposure to ionizing radiation. Fluorescence-based devices aim to mitigate some of these limitations. Utilizing purple/blue light, physical and biological interactions occur between the light and tissues, allowing for early detection of enamel demineralization (through scattering) and the byproducts of bacterial activity (via red fluorescence). The report describes the examination of three patients with varying lesion types using the "Reveal" loupes, under dual white-light/fluorescence-light conditions. Photographic documentation was performed with a Nikon camera using a "Reveal" coated lens. Lesions were classified according to the ICDAS system, and treatments were tailored based on the lesion type and severity. The findings of the case report showed that fluorescence-light examination with the new device may enhance the detection of early occlusal and smooth surface caries. Notable red fluorescence from active caries lesions was evident, as well as identification of sub-surface dentinal lesions. The dual white-light/fluorescence-light approach was perceived as helpful in treatment guidance, and achieving treatment goal. While fluorescence techniques excelled in identifying surface and near-surface lesions, the traditional radiographic methods are still considered the gold standard in deep lesion detection and monitoring. In conclusion, the clinical use of fluorescence-enhanced dental loupes may increase caries detection sensitivity without compromising the high specificity of the traditional visual-tactile method. Adequately combining fluorescence-based detection methods with radiographic techniques can provide a comprehensive evaluation of dental health, suggesting a promising direction for enhanced clinical decision-making across various dental disciplines. Further research is needed to establish the definitive effectiveness of these devices. 

Keywords

Dental loupes, Carious lesions, Radiographic technique, Clinical dentistry

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