Prof. Dr. Dilek Tağtekin

Clinical Imaging Systems in the Management of Caries and Dental Plaque

Imaging techniques in today’s dentistry are usually used as tools to assist diagnosis. These tools allow dentists to see areas that cannot be seen with naked eye, share the images taken with other dentists and patients when needed and create a database while they can be used in many other areas. As imaging enables patients see their intraoral problems, it also has positive impact on patient-dentist relations. With the use of imaging devices, patient compliance and treatment success can be increased visibly. Moreover, they also help motivate patients about oral hygiene before and after treatment. The duty of intraoral cameras that are not so common and used only for imaging has been assumed by intraoral scanning devices recently. Patients’ current state and work flow can be recorded at both diagnosis and treatment planning as well as treatment stages. Imaging of early lesions is very important in preventive dentistry. Caries can be usually detected with bite-wing radiography or visual examination. In addition, studies show that radiography has lower sensitivity in detection of initial lesions that do not have cavitation. Therefore, there is a need to develop advanced methods in non-cavitated caries detection. To that end, several methods have been developed and lesions can be imaged with the help of fluorescence, transillumination, digital radiography, digital photography, mobile dental photography. To increase patient motivation and detect plaque, plaque staining and intraoral imaging methods are used. QLF-D works with fluorescence principle was first develop for the diagnosis of initial caries lesions but in time it has been used for comprehensive plaque procedures. FluoreCam with the same working principle as QLF is primarily used to detect changes in enamel tissue, initial caries lesions and remineralization while it can also be used as an auxiliary method for dental plaque imaging. Moreover, diagnostic modes were added to certain light devices to detect caries lesions, white lesions, hypomineralization, approximal caries, fractures and cracks and dental plaques. Intraoral scanners that have been used in clinical practice in recent years can also be used as a tool for surgery and diagnosis of plaques and caries. Digital intraoral scanning plays an important role in diagnosis and recording and following up patient data as it allows three dimensional imaging of teeth. With intraoral scanners containing near infrared rays, early caries lesions can be scanned simultaenously during scanning process. Location and depth of caries lesions can be determined and visualized three dimensionally, which will facilitate diagnosis, treatment and follow-up for dentists and increase patient motivation substantially. With increased use of intraoral scanners in clinical practice, it is suggested they will be used for that purpose more commonly.