8/22/2016

Thetopadvancesincariesdetection|DentalProductsReport

Asthetechnologyevangelist,Isometimeslosemyselfinreadingaboutandresearchingdifferentaspectsoftechnology.Onoccasion,Icangodownthetechnologyrabbitholeand
disappearforhoursatatime."/>Asthetechnologyevangelist,Isometimeslosemyselfinreadingaboutandresearchingdifferentaspectsoftechnology.Onoccasion,Icangodownthe
technologyrabbitholeanddisappearforhoursatatime."/>

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The top advances in caries detection

While stealth can be great for many things, it's not something you
want in dentistry.
July01,2015

Innovator Proles 2016

Composite
Digital Imaging
Software

ByDr.JohnFlucke

Asthetechnologyevangelist,Isometimeslosemyselfin
readingaboutandresearchingdifferentaspectsof
technology.Onoccasion,Icangodownthetechnology
rabbitholeanddisappearforhoursatatime.
Oneofthesubjectsthathasfascinatedmeovertheyearsisstealth.WhileIgetthe
concept,itstillamazesmethatanobjectaslargeastheB2Spiritstealthbomber(172feet
wideby69feetlong)canbevirtuallyinvisibletoradar.
Obviously,insomecases,stealthisareallygoodthing.However,inhealthcare,itcanbea
seriouschallenge.Noonelikessurprisesindentistrynotpatients,notdoctorsandnot
staff.Also,asaprofessionthatpridesitselfonbeingconservative,wouldntitbegreatto
notonlyseedecaybeforeitsurprisesyoubutalsodetectitatitsearliestandsmallest
stages?

MorefromDr.Flucke:Howdigitaldentistryworks
Weareenteringaphaseinourprofessionwherethesharpexplorerdiagnosisasthe
primarymeansforcariesdiagnosiswilltakeabackseattoothermodalities.Whilethe
explorercanstilldetectcariouslesions,thoselesionsarelargerthanonesthatcanbe
detectedbyothermodalities.Thismeansconservativeexaminationanddiagnosiscanbe
morereliablyperformedthroughtheuseofotherdiagnosticmeansanddevices.
Tome,thisisafascinatingsubjectbecauseIfeelcariesdiagnosishasbecomemorelikea
mosaic.BythatImeanIacquirediagnosticinfofromseveraldifferentmodalities,whichare
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Thetopadvancesincariesdetection|DentalProductsReport

likethemosaictiles,andthenwhenIstepbackandviewallofthetiles,Icanseethe
picturetheindividualtilescreate.

Stratasys: A next-level lab solution

MorefromDr.Flucke:CAD/CAM:Havingitall,yourway

Webinar: Learn the real value of 3D ...

Firstandforemost,Iwanttomakeitclearthatmydiagnosticprocessisdatadriven.The
moreinformationIcanget,thebetterIfeelaboutmydecisions.Now,wevealwaysbeen
datadrivenindiagnosisitsjustthatwemaynothavereallybeenawareofit.Anytimewe
lookatabitewing,draganexploreracrosstheocclusalsurfaceorlookatabiggapinthe
marginofanoldamalgamontheocclusaloftoothNo.30,wearegatheringdata.

Bench Mastery: Improved ceramic ...

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SowhenIsitdownwithapatienttodoanexam,Imusingseveraldifferentmodalitiesto
gatherdata.WhileIdontdependontheexplorernearlyasmuchasIusedto,itisstill
usedonoccasion.Imalsodoingmyexamsutilizingmagnification.

Continuetopagetwoformore...

MyOrascopticEyeZoomsurgicaltelescopesprovideupto5.0xmagnification.Pairingthat
levelofmagnificationwithabrightglassesmountedLEDheadlightmakesitmucheasier
toseethebreakdownoftheenamel.Itsalsonotuncommonformetonoticeanareaof
decalcificationunderamarginalridgethatisindicativeofaninterproximallesion.
SometimestheseinterproximalareashavebeennoticedonabitewingandIcanconfirm
duringtheintraoralexam,andsometimestheareasarediscoveredbytheintraoralexam
alone.

Relatedreading:MakechangingmagnificationeasywithEyeZoom[VIDEO]
Italsohelpstohaveanintraoralcameraavailable,aswell.While5.0xiscertainlynice,
intraoralcamerascanenlargemuchmorethanthat.Magnificationof28xto32xisnot
uncommon,andbeingabletoseeimagesonamonitorfromdifferentanglescanalso
makeatremendousdifference.Theothergreatfeatureofintraoralphotosisthattheycan
besavedandreviewedatthenextperiodicexamination.Thisprovidesevenmoredataon
areasthatmighthavebeendeterminednottoneedrestorativeatpreviousappointments.
Allowingforacompareandcontrasttopreviouspointsintimeisatremendousadvantage.
However,thereareevenmorewaystoevaluateyourpatientsconditionandgenerate
moredata.Onceagain,Idliketoemphasizethesedevicesarejustmorewaysof
gatheringdata.Itisuptothedoctortoevaluatethatdataanddeterminewhatcourseof
action(ifany)isnecessary.Letstakealookatsomeofthemnow.
Logiconsoftware
IfyouuseCarestreamforyourdigitalradiography,youshouldcheckoutLogicon.Itisan
optionalcomponentoftheCarestreamsoftware.Thissoftwareperformsananalysisof
bitewingsandhelpslocateinterproximallesions.Itusesadatabaseofconfirmedareasof
interproximalcariesandcomparesthemtotheradiographsjusttakentoseeiflesions
exist.

MoreonLogiconsoftware:CarestreamDentalannouncesreleaseofLogiconCaries
Detector5.1
ACTEONSoproLIFE
TherearetwodifferentdevicesfromACTEONthatcanhelpgeneratemoredata.Thefirst
istheSoproLIFE(lightinducedfluorescenceevaluator).Thisdevicefunctionsastwo
devicesinone.IthasaseriesofwhiteLEDsthatletitperformthefunctionsofanintraoral
camera,anditalsocanbeswitchedovertovioletLEDsthatprovidevisualcaries
detection.
Underthevioletlight,cariesglows(fluoresces)andthiscanbeseenintheimagestaken
bythedevice.Theglowingareasareoftensmallerthanwhatcanbedetectedbyasharp
explorer,makingthis(andallthevisualdevicesdiscussedhere)moreaccurateandmore
conservativethananexplorer.Thedeviceisrecognizedbydentalsoftwareasanintraoral
camera.Thatmeansyoucanstoretheimagesandassociatethemwithteeth,allowingyou
tokeepavisualhistoryofchangesovertime.

Relatedreading:Productsinpractice:SoproLIFEinmypractice
ACTEONSoproCARE
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ThesecondACTEONdeviceistheSoproCARE.Thisfunctionsasathreeinonedevice.
Likeitslittlebrother,itfunctionsasatrueintraoralcameraandfluorescentcariesdetector.
However,italsofunctionsasadetectorofpotentialperioproblemsbyalsohavingaperio
mode.TheperiomodeusesadifferentsetofLEDsthatallowfortheidentificationand
illuminationofgingivalinflammation,plaqueandcalculus.Whenpairedwithamonitorfor
patientviewing,thismeanshygienistscansharewithpatientsareasofperiodontalconcern
withpicturesthatshowpatientsinflammationintheirownmouths.Combinedwiththe
regularintraoralcameraandcariesdetectionmodes,thisdevicecandoitall.Italso
interfaceswithyourdentalsoftwaretostoretheimages.

AbehindthesceneslookatACTEONNorthAmerica'sSoproCARE
Continuetopagethreeformore...
DEXISCariVu
TheCariVuisaveryinterestingdevice.Ratherthanusingfluorescence,theCariVu
functionsasatransilluminator.Itshinesaninvisible(tothenakedeye)nearinfraredlight
intothetoothfrombuccalandlingualsimultaneously.Whilethesetwolightsourcesprovide
transillumination,thereisacamerabuiltintothehandpiecethatallowsviewingandcapture
fromtheocclusalsurface.Theresultisaverybrightlyilluminatedtoothwithacrispblack
andwhiteimagefromtheocclusal.
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Theresultisthatcaries,bothontheocclusalandinterproximalsurfaces,canbeseenand
captured.Also,ifthedeviceistippedtothebuccalorlingualitcanprovideimagesofthose
surfacesaswell.Whileitisnotareplacementforthebitewing,CariVucandefinitelyhelp
findinterproximallesionsradiographsmightmissaswellasconfirmareasthatmightbe
questionableonabitewing.Theinfraredenergyprovidesilluminationthatisrightinthe
Goldilockszone(nottoobrightandnottoodim)sothatthetoothisperfectly
transilluminated.
ThedeviceconnectsonlythroughtheDEXISImagingSoftware,butthatallowstheCariVu
imagestobestoredandcomparedsidebysidewithDEXISbitewings,whichisareally
nicefeature.Thesystemiscompactandeasytouse.

Dr.FluckeexplainshowandwhyDEXISCariVuchangedhispracticeforthebetter
AirTechniquesSpectra
TheSpectraisanotherfluorescencedevice.Thisoneonlyperformsonefunction,whichis
cariesdetection.However,italsoaddsanicefeature.AftertheSpectraimageissavedor
frozenonthecomputerscreen,asoftwarealgorithmisappliedtotheimage.Thistakes
lessthanasecond,andthenanimageisoverlaidonthepictureofthetooth.Thisoverlay
hastheappearanceofdopplerweatherradar.Thismeansitisacombinationofblue,red,
orangeandyellow,witheachcolorcorrespondingtodeeperpenetrationofthecaries
causingbacteria.Thecolorsareagreatcommunicationtoolforpatients,andtheyalso
provideagreatsourceofinformationforthepractitioner,asitiseasytoseethesizeofthe
lesioninallthreedimensions.Thismakesrestorationmorepredictableandhelpsthe
doctordecidewhetheranestheticisneededornot.Liketheotherdevices,theimagescan
bestoredinyourpracticemanagementsoftwareandmonitoredifneedbe.
Puttingitalltogether
Byusingacombinationofthesuggestionsanddevicesinthisarticle,adoctorcancreate
quiteafewdatapoints.However,thereisonemoredatapointIhaventcoveredyetthat
extendstopatienthistoryaswell.Thelongerpatientsareinmypractice,thebetterIgetto
knowthem,theirhabits,homecare,etc.ThishelpsmedetermineifIrestore,remineralize,
monitororsomethingelse!
BycombiningalltheinfoIcan,amorecompletepicturecanbeobtainedthathelpsme
makebetterclinicaldecisions.Intheend,thequestionIneedtoansweriswhatisinthe
bestinterestsofthepatient?ThatanswerlieswithinasmanydatapointsasIcangather.

MorefromDr.Flucke:Achangewhosetimehasclearlycome
Abouttheauthor

JohnFlucke,DDS,isthetechnologyeditorforDentalProductsReportanddentistrys
technologyevangelist.HepracticesinLeesSummit,Mo.,andhasfollowedhispassions
forbothdentistryandtechnologytobecomearespectedspeakerandclinicaltesterofthe
latestindentaltechnologywithafocusonthingsthatprovidebettercareandbetter
experiencesforpatients.Heblogsabouttechnologyandlifeatblog.denticle.com.
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August2015

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Dr.JohnFlucke

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Dr. John Flucke

Dr.JohnFluckeisinprivatepracticeinLeesSummit,Mo.He
alsoservesastechnologyeditorforDentalProductsReport

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