The Journal of Clinical Dentistry has published its first issue for 2012. The lead article: “In Vitro Evaluation of the Spectra Early Caries Detection System.” The authors (Maria Graye, Kenneth Markowitz, Maxine Strickland, Gerald Guzy, Mary Burke, and Milton Houpi) comprise a private practice pedodontist and five faculty members from the University of Medicine and Dentistry of New Jersey.

The evaluation finds that Spectra is a useful adjunct for detecting, assessing, and monitoring enamel demineralization and caries progression. Kathy Kincade, Editor in Chief at Dr. Biscuspid, has provided a timely review, summarized herein.

Using 41 extracted molars, the research compared Spectra and radiographic caries expression on occlusal surfaces. Caries progression was classified using the International Caries Detection and Assessment System (ICDAS).

Air Techniques Spectra caries detection aid

Radiography found that 9 of the 41 occlusal surfaces showed signs of decay. Spectra replicated these results. Moreover, high ICDAS scores were associated with higher Spectra readings. Spectra readings thus add significant information to relatively low sensitivity/high specificity radiographic results. Using Spectra along with radiography, the clinician may identify smaller lesion progressions. Spectra also detected in detected dentin caries better than radiography alone.

In sum, “When used in conjunction with visual and radiographic examination, the Spectra is an effective means of analyzing the occlusal surface of molars and is well-suited to detecting early stages of the caries process. The Spectra can detect areas of enamel demineralization and dentin decay, as well as create a continuous scale that represents the full extent of the caries process.”

We reiterate that Spectra provides simple, dependable, early caries detection and supports a minimally invasive treatment approach. The color imagery makes caries progression more clear and allows for more focused treatment options. Spectra is safe, user-friendly and patient-friendly.

Dental Tech Today features products and protocols that can help practitioners achieve better patient care, clinical efficiencies, and significant returns on investment. Dental lasers are among the products, but the concept reaches to include many technologies for disease-focused, minimally-invasive dental diagnosis and treatment.  

Since their introduction during the early 1990s, dental lasers have followed a number of standard trends in technology development. Let’s look at size reduction with focus on the emerging pen lasers. The pens are a significant new product in laser dentistry, but one pays a price for small size. 

The first dental lasers were based on crystal or gas laser generators. By nature, these were—and remain—large and complex machines. Then and now, a crystal or gas dental laser is, essentially, its own cart. Later in the 1990s, the diode or “chip” lasers brought size and weight down immensely. In their initial configurations, “desktop” diodes weighed in at 5-15lbs and had footprints of a square foot or a bit less.

Within the last decade, truly portable diodes have come around. Portables weigh 3-5lbs and have with footprints of a quarter square foot or so. With advances in diode technology and cooling systems, the portables can produce the power seen in all but the largest desktops. Most portables range 5 to 12 watts.

Current size reduction brings the self-contained pen laser. While much larger than any writing instrument, pen lasers may way just 100g, comparable with an electric handpiece. Most of a pen’s bulk comes in the power system, a rechargeable lithium ion battery that fits inside the proximal housing.

Pen lasers offer the ultimate in portability and prices well below the portables. Pen lasers, nevertheless, come with a significant compromise in laser ability regarding clinical use—limited power.

A pen laser has two inherent power limitations. First, the diode (laser generator) itself is limited in power. In desktop and portable configurations, there is room to “stack” diode chips, much like battery cells in series. Pen lasers don’t have room to stack chips. Second, small battery size limits the power that can be delivered to the generator. Moreover, a battery loses lasing power as it loses charge.

Current pens are limited to 3W peak power and have relatively short (often unpublished) emission duration times. While, at first glance, 3W peak may not seem unreasonable, real limitations are there. The trend in diode laser applications is to pulse the beam with an emission phase (T_on) brief in relation to the rest phase (T_off). With short emission phases, pulse average power is less than half of peak power. With 3W peak power, the pulsed pen laser beam cannot effectively treat the range of intraoral tissue conditions.

In sum, with the pen laser concept, the small diode delivery system outstrips the limits of battery power. Meanwhile, new clinical applications call for more peak power delivered in shorter pulses. Pen lasers cannot deliver the peak power for the new standards.

Pen lasers may look and feel good—and the price may feel good too. Nevertheless, pen lasers do not provide the range of clinical applications that give value to desktop and portable diodes. 

Today’s dentists face three common yet difficult diseases:

– Dental Caries …. Endemic disease which, with modern hygiene, becomes hard to detect and treat.

– Perio Disease … Affects 80% of North American adults; causally linked with other inflammatory diseases.

– Oral Cancer …… North America’s sixth leading cancer—the only cancer with undiminished mortality rates.

With Dr. Swick as our thought leader, five manufacturers are offering complementary technologies toward diagnosing and treating these diseases. We call it Dental Tech Today. We believe that when linked within the clinical approach, Dental Tech Today products and protocols can help practitioners achieve better patient care, clinical efficiencies, and significant returns on investment.

Dental Tech Today sponsors Dr. Swick  at regional dental meeting symposiums. Each presentation combines a science-based lecture overview with hands-on demos and coordinated trade show presentation. Dr. Swick delivers information in which dental practitioners can trust. Check for our presence at your next regional meeting.

CrystalMark Air Abrasion Caries Restoration

CrystalMark CrystalAir

“With today’s widespread use of fluoride, the presentation of occlusal pit and fissure caries has changed. Caries may often begin in fissure walls or in the dentine without any enamel decalcification. This type is extremely difficult to diagnose with an explorer. Air abrasion is a great solution for these kinds of caries, especially on occlusal surfaces” (Dr. Swick).

CrystalAir air abrasion system is available with helium delivery, which abrades twice as effectively as air delivery. Independent adjustment of delivery pressure and powder flow allows for more visibility, control and patient comfort with less powder usage. Very low air pressures generate no patient sensitivity. Treat the range of cavity design categories. Remove composite and sealants (CrystalMark).

Helios Tissue Optimized Diode Lasers

Helios Wiser

“Diode laser light is therapeutic at the cellular and molecular levels, and so plays into emerging periodontal protocols, especially in controlling biofilm infection. Moreover, pulsed diode emissions are able to stimulate re-growth in deep vertical bony defects. Diode laser success in periodontics lies in modulating the emission in relation to specific diseased tissue biotype. With tissue optimized emission, treatment is effective while thermal damage is limited” (Dr. Swick).

The Wiser utilizes Dr. Swick’s biotype-specific pulse parameters. With Tissue-Optimized Pulsing the practitioner can use basic biological expertise to dial-in the proper treatment. Using the Wiser as a foundation for nesting treatments, general practitioners can build diverse, evidence-based programs for managing soft tissue health (Helios Laser).

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Seiler Intraoral Microscopes and Loupes

Seiler Evolution xR6

“Microscopes give doctors the ability to see into canals, view margins, and diagnose fractures and decay that they would not be able to with the naked eye or loupes. Microscopes also offer direct illumination, the ability to add video and camera options for imaging, and great marketing opportunities. Combining a microscope with a laser lets the doctor see exact detailing with tooth and gums” (Dr. Swick).

The Evolution xR6 offers a new 6 step magnification turret and movement specifically engineered for the dental professional. Will enhance the doctor’s work from the initial exam to the final surgical procedure. The Evolution xR6 is great for any dental professional ranging from the general dentist to the endodontist in the office (Seiler).

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Spectra Caries Detection

Spectra Caries Detection Aid

“During the last thirty years, major changes have occurred in the pattern of dental caries disease The clinician needs to be able to monitor the outcome of noninvasive measures and in cases where there is evidence of lesion progression, make a timely decision to intervene, using minimally invasive techniques and restoring damaged tooth structure without weakening the tooth” (Dr. Swick).

Simple, dependable, early caries detection.
Supports a minimally invasive treatment approach.
Treatment options made more clear with color images.
An ideal complement to X-rays during patient exams.
Safe, user-friendly and patient-friendly.
Excellent for both early detection and excavation.
Capture, store, compare and retain your images (Spectra).

VELscope Oral Cancer Detection

VELscope VX

“Oral Cancer is the Forgotten Disease. In North America, oral cancer sees twice as many deaths per year as does cervical cancer. How many potentially malignant lesions have you discovered? How many have you not noticed? We should be identifying oral abnormalities at the earliest stages. Direct Optical Fluorescence Visualization is an effective method for assessing oral mucosal abnormalities” (Dr. Swick).

The VELscope Vx’s blue-spectrum light causes the soft tissues of the mouth to naturally fluoresce. Healthy tissues fluoresce in distinctive patterns — patterns that are visibly disrupted by trauma or disease. With Direct Optical Fluorescence Visualization, a wide variety of oral abnormalities can be discovered — often before they’re visible to the unassisted eye (VELscope).