F. DIAGNOdent readings vs. recommended treatment chart by manufacturer
| KaVo DIAGNOdent | |||||
| Correlation of DIAGNOdent Values to Possible Course of Action | |||||
| Possible Course of Action* | |||||
| DIAGNOdent Values | No Action | Preventive Therapy | Record & Monitor | Sealant | Preparation |
| 0 to 5 | x | ||||
| 5 to 10 | x | x | |||
| 10 to 15 | x | x | x | x | |
| 15 to 20 | x | x | x | ||
| 20 to 25 | x*** | x | x | x** | |
| 25 to 30 | x*** | x | x | x** | |
| 30+ | x*** | x | |||
* Taken from Lussi; See "Research Supporting DIAGNOdent
Scale Readings," (page 6 of Manufacturers instructions)
** In unusual cases of virulent disease, preparation may be a course of action
when a value between 20 - 30 is recorded.
*** Regardless of course of action taken to treat a specific lesion, preventive
therapy may be indicated based upon caries risk.
Discussion: CRA's work indicates that the DIAGNOdent course of action scale appears to be overly conservative in its recommendation to withhold excavation until a DIAGNOdent reading > 20 is observed. This recommendation is not to excavate until > 20, yet 39% of the time carious lesions 2mm deep were found for readings 8 - 18, & 22% of the time lesions 3mm deep were found for readings 8 - 18. These same lesion depths were found 35% of the time & 23% of the time at readings of > 20.
CRA data agree with serveral reports published
by Lussi, et al:
1. (Lussi, A, et al.: "Performance of a Laser Fluorescence System for
Detection of Occlusal Caries", 45th ORCA Congress, 1998, Abst.#87, p.297)
2. (Lussi, A., et al.: "Performance and Reproducibility of a Laser Fluorescence
System for Detection of Occlusal Caries in vitro." Caries Research, 1999; 33:261-266)
3. (Lussi, A., et al.: "Reproducibility of a Laser Fluorescence System
for Detection of Occlusal Caries." 45th ORCA Congress, 1998, Abst. #88, p. 297)
4. (Lussi, et al.: "Clinical Performance of the Laser Fluorescence System
DIAGNOdent for Detection of Occlusal Caries." 46th ORCA Congress, 1999, Abst.
#55, p. 299)
5. (Lussi, A., and Hibst, R.: "Methods for Occlusal Caries Detection
Used in Daily Practice," Indiana Conference 1999)
6. (Lussi, A.: "Clinical Performance of the Laser Fluorescence System
DIAGNOdent for Detection of Occlusal Caries" (in German), Acta Med Dent Helv
5: 15-19 2/2000)
Other significant published research on the evaluation
of the DIAGNOdent:
1. (Shi X-Q, Welander U, Angmar-Mansson B: "Occlusal caries detection
with KaVo DIAGNOdent and radiography: An in vitro comparison." Caries Res 34:151-158,2000
2. (Gerry Ross: "Caries Diagnosis With The DIAGNOdent Laser: A User's
Product Evaluation." Ont. Dent, Vol 76 NO2, March 1999, pp 21 - 24
G. Conclusions
CRA data showed the DIAGNOdent to be helpful in confirming carious lesions in cases where radiographs were not helpful & for patients who refused radiographs. DIAGNOdent readings are a useful adjunct to conventional methods for caries determination. Experience is required to develop a reliable technique. Overall, these data indicate the DIAGNOdent is a promising new technology for assessment of carious lesions.