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INDEX
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Traditional caries diagnostic model
Current caries model
Caries detection dye (CDD)
How to use the DIAGNOdent
Interpreting the results
False positives
Hypomineralized (hypocalcific) enamel
Hidden caries
Variable readings
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Fissure sealants
Website: www.advancedental-ltd.com
Traditional
Fissure Caries
and Diagnostic
Model
Traditional
Diagnostic
Model
Low sensitivity
High specificity
Low Sensitivity
Conventional diagnosis can miss
significant amounts of decay
High Specificity
Conventional diagnosis does not produce
a lot of false positive diagnoses
Traditional fissure caries model
Probe does
not stick
“No caries”
Traditional fissure caries model
Enamel
decalcification
Probe will now
stick
Traditional fissure caries model
Continuing
decalcification
finally leads to
cavitation of
the enamel
Traditional fissure caries model
Continuing
decalcification
finally leads to
cavitation of
the enamel
Traditional fissure caries model
Continuing
acid attack
leads to dentin
caries and
further
cavitation
Traditional fissure caries model
Traditional fissure caries model
Penning C, van Amerongen JP, Seef RE
& ten Cate JM.
Validity of probing, for fissure caries
diagnosis.
Caries Res 26(6):445-9, 1993
“ Probing found unreliable
in finding fissure caries”
Black, G.V. Operative Dentistry. Vol. I
Henry Kimpton, London. 7th Ed, p32, 1924
“ A sharp explorer should be
used with some pressure and
if a very slight pull is
required to remove it, the pit
should be marked for
restoration even if there are
no signs of decay.”
ROCK WP, KIDD EAM.
Br Dent J. 164(8): 243-47, 1988.
“… decay is difficult to detect in
radiographs unless larger than
2mm to 3mm deep into dentin,
or 1/3 the bucco-lingual
distance.”
Not diagnosed by mirror,
probe and Xray examination
1mm deep “cavity”
2mm deep “cavity”
3mm deep “cavity”
4mm deep, total decalcification.
Cavity was widened to 1/3
occlusal width to show on Xray
4mm
1/3
occlusal
width
Contact point caries is much
easier to detect radiographically
Digitally created
Chan DCN. Current methods and criteria
for finding decay in North America.
J Dent Ed 57(6):422-425, 1993
Caries is regularly found
beneath a seemingly intact
enamel surface
Frequently the diagnosis of
occlusal caries is less than
straightforward
AL-SEHAIBANY, WHITE & RAINEY
J Clin Pediatr Dent 20(4):293-298 1996
The reliability of carious lesion
diagnosis by sharp explorer compared
to diagnosis of carious lesion by
histological cross section was 25%.
______________________________
A seemingly intact occlusal enamel surface
may conceal an extensive lesion of the
dentin
The traditional fissure
caries diagnostic
model is very crude
LOW SENSITIVITY
Current caries
model
Modern fissure caries model
Organic plug
Modern fissure caries model
Organic plug
Decalcified or
hypocalcific
enamel
Acid percolation
through porous,
hypocalcific
enamel can lead to
failure of the
organic plug
Modern fissure caries model
Enamel may be
developmentally
hypomineralized,
and consequently
porous through its
full thickness
ACID
Consequently,
dentin can be
exposed to acid
without cavitation
of the enamel
leading to
developmental
dentin caries
Modern fissure caries model
OR
by the time the
tooth has
emerged from
under the
operculum, the
fissure enamel
can already be
carious
ACID
Modern fissure caries model
These areas may
not be
decalcified, and a
probe won’t stick
Modern fissure caries model
Once the organic
plug fails,
bacteria have
access to the
depths of the
fissure
Decalcification
Fissure walls are
in close
apposition
A probe will be
unable to detect
caries here
Modern fissure caries model
Presentation is
inverted
compared to the
traditional
model
Continuing
decalcification
+dentin caries
Modern fissure caries model
Defects in the
fissure walls can
lead to dentin
caries with
NO enamel
decalcification
Can’t
diagnose
this with a
probe or
Caries
Detection
Dye (CDD)
Modern Fissure Caries
Anatomy Model
(Summary of realistic ‘coke bottle ‘ shape)
Organic plug
(This area may
not be
decalcified
thus a probe
won’t stick)
Enamel defects
in fissure wall
Decalcified or
hypocalcific
enamel (caries in
this zone is
undetectable by
probe)
De-mineralizing
dentin
The DIAGNOdent can diagnose
this zone in the fissure
Fissure Caries
 The
DIAGNOdent can “read” 2mm
into the tooth
 As long as the fissure is cleaned of
debris, readings will detect changes in
the underlying enamel and dentin
 The use of caries detection dye (CDD)
to stain porous, carious enamel will
help identify carious tooth structure
that needs removing
How Does Caries Detection
Dye Work
Fusayama T. A Simple Pain –Free Adhesive
Restorative System.1:18 1993
“The mechanism of differential staining
does not involve selective chemical
bonding of the dye in usual staining,
but the selective penetration of the
solvent”
How Does Caries Detection
Dye Work
Fusayama T. A Simple Pain –Free Adhesive
Restorative System.1:18 1993
It is simply filling the voids in enamel and
dentin that are created by acid attack, or
filling voids present in hypomineralized
enamel
Slow onset caries
Caries Detection Dye
SEM Haikel et al.1983
Enamel prisms remain, but with some mineral loss P
Loss of interprismatic enamel creates a “micro-pore” effect S
AL-SEHAIBANY F, WHITE G & RAINEY J.T.
J Clin Pediatr Dent 20(4):293-298, 1996
CDD is a reliable diagnostic tool for occlusal
carious lesions. Ratio of occlusal grooves
stained by dye, to underlying carious
lesions, is 1:1 by histological x-section in
extracted teeth
75% of occlusal carious lesions missed
by probing were found using CDD
Carious fissure walls in very
close apposition
Carious fissure walls in very
close apposition
Fissure appears
totally sound
Carious fissure walls in very
close apposition
Fissure appears
totally sound
Carious (decalcified)
enamel in the depths
of the fissure
Stained with Caries
Detection Dye
Carious fissure walls in very
close apposition
CDD
Occlusal fissure caries
Stained with CDD
This tooth was
partially erupted
under an
operculum for
18 months.
CDD has stained
the carious
enamel.
Carious enamel and
dentin stained
Note diffusion
of the dye into
demineralized
occlusal
enamel, as
well as into
the fissure
Fissure Caries
DIAGNOdent
Demineralized,
opaque carious
enamel in the
opening of the
fissures
45
Stained pits
38
Fissure Caries
DIAGNOdent
Stained with
Caries Detection
Dye
45
38
Fissure Caries
DIAGNOdent
What the
DIAGNOdent
detected
45
None of this was
detected using a
probe and X-rays
38
KaVo DIAGNOdent laser
KaVo DIAGNOdent laser
 655
nm diode laser
 Reads
2mm into the tooth
 Detects
“fluorescence” in ANYTHING
you aim it at
High sensitivity
Low specificity
It responds to…
 High
natural fluorescence of the tooth
 Plaque
and organic plug
 Composite
and stained margins
 Calculus
 Food

(particularly greens)
Hypocalcific enamel, carious enamel / dentin
DIAGNOdent Laser
A probe would not
stick in these fissures
Sectioned
tooth
However, the decay
could be found with a
diagnostic laser
DIAGNOdent Sleeve
Denticator 600 – 800 HL 1000 High Long Sleeve
You can use a sleeve so that you don’t need
to autoclave the tips all the time
Simply calibrate the unit through the sleeve
Scanning the Fissures
Do not apply pressure. It is not a probe!!
Scanning the Fissures
Rotate the tip to “read” the fissure walls
Techniques
There are two main techniques
Thorough sodium bicarbonate prophy
before scanning. If debris is missed,
false positives can still occur.
These areas then require further
cleaning with the PROPHYflex to
ensure an accurate second reading.
PROPHYflex (KaVo)
Sodium Bicarbonate for cleaning fissures
Techniques
Scan the mouth and note areas with positive
readings >15
Many will have no debris or organic plug, and the
reading will be reliable
If there is a plug or debris with a high reading,
selectively clean these fissures and re-scan
Negative readings <10 are almost always reliable
A more time-efficient technique
PROPHYflex (KaVo)
Sodium Bicarbonate for cleaning fissures
DO NOT use the RONDOflex
(air abrasion) to clean fissures
prior to using the
DIAGNOdent
Air abrasion with Aluminum
Oxide cuts tooth structure
Unnecessary removal of
sound enamel is NOT
indicated for diagnostic
purposes
PROPHYflex (KaVo)
- to ensure trouble-free use
Use a second powder container
After use, remove the powder
container and replace it with the
empty one
Operate the unit for 10 secs to flush
out the internal lines and tip, then
run for 10 secs with water turned off
before autoclaving
Interpreting the Results
A sound knowledge is required of
 Fissure
anatomy and developmental defects
 The caries process
 Enamel morphology in relation to
 Developmental
 Carious
 Sources
hypocalcific enamel
enamel
of false positives
Interpreting the Results
 When
scanning carious enamel, the
DIAGNOdent reacts to intensity of
demineralization rather than the depth
of the lesion
 An
understanding of the way caries
develops in enamel allows for a better
interpretation of the information
provided by the DIAGNOdent
Interpreting the Results
 Slow
onset caries leads to loss of
interprismatic enamel that becomes microporous through to the dentin
 This
allows acid to dissolve mineral content
from the dentin without any macroscopic
cavitation of the overlying enamel
 This
is the most common type of damage
that occurs in the walls of fissures
Early Carious Enamel
Enamel is micro-porous
but macroscopically
sound
SEMS
Thylstrup and Fejerskov 1981
Carious Enamel
SEMS
Haikel et al.1983
Rapid onset
Slow onset
Intraprismatic enamel is
lost. Chalky and prone
to cavitation.
Interprismatic enamel is
lost. Enamel is porous
without cavitation.
Slow Onset Carious Enamel
Acid infiltration
SEMS Haikel et al.1983
Enamel prisms remain, but with some mineral loss P
Loss of interprismatic enamel creates a “micropore” effect S
Smooth surface dentin caries
Microporous enamel
Cusp implosion due
to non-cavitated
lingual
decalcification in a
15yr. old
Smooth surface dentin caries
Acid infiltration
through porous, but
macroscopically
sound lingual enamel
lead to
demineralization of
the underlying dentin
Rapid onset caries
13 yr old patient. Rapid onset
contact point caries.
Rapid onset caries
Rapid mineral loss of intraprismatic
enamel and associated cavitation
Rapid onset caries
Caries Detection Dye accurately
stains demineralized carious enamel
Rapid onset caries
Compare
Enamelthis
cavitation
to… has
occurred
before any
mineral loss in
the dentin
Rapid onset caries
Slow onset caries
This
… is
slow
alsoonset,
the usual
non-cavitated
presentation
contact
of caries
in the depths
point
of caries
a fissure complex
Interpreting the Results
 The
DIAGNOdent reacts equally to
either form of enamel damage and
cannot differentiate between slow
onset and rapid onset caries
 Treatment decisions are related to an
understanding of the caries process and
the recognition of the type of enamel
damage present
Interpreting the Results
DIAGNOdent readings of smooth surface caries
Enamel
cavitation
beginning
Interpreting the Results
DIAGNOdent readings of smooth surface caries
65
99
48
36
20
Interpreting the Results
 The
readings are related to the degree and
intensity of demineralization, rather than the
depth of the lesion
 As
the enamel becomes more porous, from
right to left, the reading increases
 Dentin
damage is more intense under the
more porous enamel, and is worst where
cavitation of the enamel has commenced
Interpreting the Results
Dentin caries was
at its deepest
where the
DIAGNOdent
readings were the
highest
Interpreting the Results
 Therefore,
there is a correlation between
the dentin caries and the DIAGNOdent
reading, but this is related to the
intensity of the damage to the overlying
enamel, rather than the DIAGNOdent
giving a numerical reading that is
indicative of depth of the lesion
Relating DIAGNOdent readings of
smooth surface caries to fissure caries
By understanding that the
DIAGNOdent indicates intensity of
demineralization rather than depth,
fissure caries presents the potential to
generate misleading responses
DIAGNOdent readings
Carious or hypocalcific
enamel
Severe, but superficial
demineralization in this zone
will give a high reading, even
though there is not significant
caries present in the depths of
the fissure
DIAGNOdent readings
Fissure walls in this zone
are sound
Caries developing in the
depths of the fissure will give
a lower reading than the
previous case, even though
the enamel damage may be
more severe, because the laser
is now scanning through a
layer of sound enamel
DIAGNOdent readings
Caries in this site will also
give a lower reading,
compared to a similar lesion
on a smooth surface, due to
the filtering effect of the
overlying sound enamel
DIAGNOdent readings
As the lesion progresses, the
demineralization in the
enamel fissure walls
becomes more severe
This gives a higher reading,
but this is still not totally
predictive of the depth of the
dentin caries
DIAGNOdent readings
Dentin caries developing
under enamel defects in the
depths of the fissure will
give lower readings because
of the thickness of the
overlying sound enamel
This is a form of “hidden
caries”
Step down technique
If a reading is obtained that
causes concern, yet there is
no visible evidence to
support the reading,
minimally invasive
techniques are essential
when investigating the
fissure
Step down technique
Carefully open the fissure
entrance with Air-abrasion
Step down technique
Re scan the fissure. If the
reading drops, the enamel
damage was present in the
fissure opening. If the
reading remains constant, or
increases, there is caries
deeper in the fissure
complex.
Sudden increase in
reading while rotating
the tip in a fissure
If there is fissure caries
developing in one wall of a
fissure, the initial angulation
of the beam may completely
miss the lesion. As an
example, the reading at this
point the reading may only
be 5-10
Sudden increase in
reading while rotating
the tip in a fissure
As the beam approaches the
carious wall, the reading
will begin to increase
Sudden increase in
reading while rotating
the tip in a fissure
Once the beam is directed at
the lesion, there will be a
rapid increase in the
reading. The reading could
now be 30-40, yet there is
no external evidence of a
lesion.
Sudden increase in
reading while rotating
the tip in a fissure
Many of these lesions are
very localized and subtle
and if the fissure is not
entered with minimally
invasive techniques like Airabrasion, they will not be
observed and the reading
from the DIAGNOdent is
consequently discredited.
Sudden increase in
reading while rotating
the tip in a fissure
Readings that oscillate with
simple rotation of the tip are
generally very reliable. If
there was something present
in the fissure entrance to
cause a false positive, the
reading would remain
constantly high, rather than
oscillate with the rotation of
the tip
False Positives
Organic plug
 Composites
 Stained composite margins
 Calculus
 Impacted food in the fissures
 Some prophy pastes
 Remineralized carious enamel
 Naturally fluorescent enamel

False Positives
Some prophy pastes
 If
you are not using sodium bicarbonate
prophylaxis (PROPHYflex), check if your
prophy paste causes a high reading by placing
the DIAGNOdent tip into the prophy paste
you are using
 Impacted paste in the fissures will give a high
reading, particularly with green coloured
pastes
False Positives
Some polishing pastes
 If
you are not using sodium bicarbonate
prophylaxis (PROPHYflex), check if your
prophypaste casues a high reading by placing
the DIAGNOdent tip into the prophypaste you
are using
 Impacted paste in the fissures will give a high
reading, particularly with green coloured
pastes
False Positives
Naturally fluorescent enamel
 Calibrate
by placing the tip on a
smooth surface and hold the ring
switch for two beeps to auto-calibrate
for the fluorescence
Latest model is one beep
Initial DIAGNOdent
readings
34
58
20
False Positives

After deducting the natural
fluorescence reading of 10, the display
indicated the following
Natural fluorescence reading 10
34
58
20
24
48
10
False Positives

What was in there?
24
48
10
No caries in the mesial fissures
What about this fissure?
Images courtesy R Ehrlich
Heavily stained fissure
Is it carious or not?
What about this fissure?
Images courtesy R Ehrlich
The fissure was stained, but
there was no active caries
present
(Dormant caries)
Laser Diagnosis
Images courtesy R Ehrlich
Diagnodent 6
Cautious, minimally
invasive techniques are
essential when there is
doubt

Found in newly erupted teeth

Higher level of pores

Highly substituted enamel
DIAGNOdent 99
Caries potential is
related to the site
Smooth surface
Low risk

Caries potential is related to
the site

Plaque retention (acid) will
mean caries WILL develop
under this hypocalcific
enamel
DIAGNOdent 99
Fissures
High risk
This is an extreme
example. Most often, the
presentation of
developmental hypocalcific
enamel is much more subtle

The caries establishes in
the dentin via the porous,
developmentally defective
enamel

Fissures
High risk
Defects existed that led
directly to the dentin

Conclusion
Developmental hypocalcific
enamel is of significance if it
is detected in the pit and
fissure system
High risk
Defects existed that led
directly to the dentin

The DIAGNOdent will alert
you
Use CDD to confirm it
CDD will stain porous
hypocalcific enamel that is
becoming carious
High risk
Hypocalcific enamel and
carious fissure enamel
DIAGNOdent 45
15 yr old. High caries risk
The fluorotic or
hypocalcific
enamel on the
cusps has
remineralized. It
is hard and shiny.
DIAGNOdent 65
Hypocalcific enamel and
carious fissure enamel
HOWEVER
15 yr old. High caries risk
In the fissure, the
enamel has been
continually exposed to
plaque acid. It has the
dull chalky appearance
associated with active
caries.
Hypocalcific enamel and
carious fissure enamel
Fissure caries
alongside
developmentally
defective enamel
A SITE SPECIFIC
PROBLEM
15 yr old. High caries risk
Hypocalcific enamel and
carious fissure enamel
The porous, actively
carious fissure enamel
absorbs CDD
The remineralized
hypocalcific enamel
does not
15 yr old. High caries risk
A SITE SPECIFIC
PROBLEM
Hypocalcific enamel and
carious fissure enamel
Do not treat
Treat
15 yr old. High caries risk
Arrested caries/remineralization
DIAGNOdent
55
35 yr old
Eruption phase, smooth surface caries has
remineralized. It is hard and shiny and does not absorb
CDD.
Arrested caries/remineralization
concepts
Diagnodent 55
35 yr old
Eruption phase, smooth surface caries has
remineralized. It is hard and shiny and does not absorb
CDD.
Fissure Caries
An understanding of the fissure caries
process is essential to be able to
interpret the information provided by
the DIAGNOdent.
Hidden Caries or
Hypo-calcification
Organic plug
(This area may
not be
decalcified
thus a probe
won’t stick)
Enamel defects
in fissure wall
Decalcified or
hypocalcific
enamel (caries in
this zone is
undetectable by
probe)
De-mineralizing
dentin
Hidden Fissure Caries
 The
DIAGNOdent can detect these
lesions up to 2mm into the tooth
 Low
readings may occur if the caries is
developing at the bottom of an
otherwise sound fissure
 Readings
in the following tooth
increased as the fissure was opened up
Hidden Fissure Caries
DIAGNOdent
Step down
technique
No visible
demineralization
40
Hidden Fissure Caries
DIAGNOdent
48
Fissure minimally
investigated with
Air-abrasion and
re-stained with
Caries Detection
Dye
Hidden Fissure Caries
DIAGNOdent
48
Reading has
increased.
The caries
developing in the
depths of the fissure
has not been reached.
The enamel in the
fissure entrance was
non carious.
Hidden Fissure Caries
Fissure opened
and re-stained
with CDD
Significant lateral
spread of dentin
caries was
encountered
Hidden Fissure Caries
DIAGNOdent 24
Stained with Caries Detection Dye.
NO CDD stain.
Conservatively investigated and
rechecked with the DIAGNOdent
DIAGNOdent 38
The DIAGNOdent tip is now 1mm closer to
the dentin, and is reading the caries better
and it
Conclusion
If
the fissure is clean and
unstained, and CDD is not
staining carious enamel then….
the DIAGNOdent is probably
reading deeper, “hidden” caries
Conclusion
To use the DIAGNOdent in this stepdown technique requires the use of a
minimally invasive technology
-the best of which is Air-abrasion, due
to its ability to selectively dissect out
damaged tooth structure
Non-probeable stained fissure
DIAGNOdent 20
Photo courtesy A Brostek
NO Caries!
Photo courtesy A Brostek
Cautious investigation
with Air Abrasion
meant a fissure sealant
could be placed without
undue “cutting” of the
tooth.
What if a high speed
fissure bur had been
used instead?
The result was a fissure sealant
Photo courtesy A Brostek
Stained Pits and Fissures
Non-probeable pits and
fissures (32yr old)
6
21
WHAT HAPPENED
HERE!!!
6
21
The early enamel caries has
remineralized. Hence the
low reading of 6.
However, there was a defect
at the bottom of the fissure
that allowed dentin caries to
progress. It was more than
2mm inside the tooth and
the DIAGNOdent could not
“see” it.
Stained enamel does not always give
positive DIAGNOdent readings
The dilemma of stained
fissures.
The mesial pit had enamel
fissure caries and dentin
caries not on X-rays.
From the history of the distal
pit, it was only going to be
time before the mesial grew.
Cautious, minimally invasive
techniques like the step-down
technique are required at
marginal DIAGNOdent readings
Under 30 because…
..you might be scanning very
shallow, intensely demineralized
enamel, or it might be deep
caries developing under 2mm of
sound enamel
Laser fluorescence basically
responds to the intensity of the
damage to the enamel rather than the
depth of damage. There is a basic
correlation to intensity of
demineralization and depth, but it is
not consistent in the caries process.
Most reliably
confirms the
absence of disease
It is NOT a traffic light for when to
treat a tooth!
Accurate caries diagnosis
requires….
Consistent use of magnification with
illumination
An understanding of the caries process
and the variability of fissure anatomy
Elimination of debris
Quality radiography
Laser caries diagnosis
CDD to guide caries removal
Accurate caries diagnosis
requires….
...the
consistent use of ALL
the modern diagnostic
modalities because caries
can have varied
presentations in
a mouth
Caries initiation factors
2 factors are considered important
for plaque accumulation and caries
initiation on occlusal surfaces
-The stage of eruption / functional status
-Tooth specific anatomy
Caries initiation factors
Studies have shown that due to the chemical
immaturity of the newly erupted enamel
-almost all molar occlusal caries is initiated
in the long eruption period (12-18 months)
-premolars are the opposite, with a short
eruption period and consequent low
incidence of occlusal caries
Caries initiation factors
Per Axelsson DDS PhD. Diagnosis and Risk Prediction of
Dental Caries, Vol 2; Ch 5: Development and diagnosis of
carious lesions: p182. Quint Pub, 2000.
Cavalho et al (1989) showed that most
occlusal lesions in molars are initiated
during eruption…
(12-18 months)
Caries initiation factors
Kotsanis N, Darling A. Influence of post-eruptive age of enamel on
it's susceptibility to artificial caries.Caries Res. 25:241-250 1991.
…in addition, susceptibility to caries is strongly
correlated to the post-eruptive age of the
enamel
The enamel is most susceptible to dental caries
during and just after eruption, until secondary
maturation is completed, after some years
exposure to the oral environment
Slow eruption phase
This is
when most
fissure
caries
becomes
established
Slow eruption phase
Combine this
with some
developmental
fissure
morphology
defects
Instant
caries
Caries initiation factors
Morphology and slow eruption phase
DIAGNOdent
48
36
What
if the defects
Enamel
defects are in Deep fissures retain
the depths of a fissure?
plaque and food
Caries initiation factors
Morphology and slow eruption phase
DIAGNOdent
48
36
Sealing these teeth without diagnosis would
lead to failure of the sealant
Fissure Sealants
 Most
often, sealants have been placed
without a detailed caries diagnosis
 Consequently, inadvertent attempts are
made to resin bond to hypocalcific
enamel or carious enamel
 This leads to debonding and staining at
the margins which the DIAGNOdent
will react to
Fissure Sealants
 Opaque
sealants cannot be scanned
through
 Transparent sealants may allow
leakage and caries to be detected
 Test
the resin response by scanning an
obviously sound area of resin
 If
there is no response from the resin, it
is safe to “scan” through the resin
12 Yr Old Fissure Sealant
DIAGNOdent 65
Sealant removed, stained
with CDD and opened
Suspect clear fissure
sealant in a 14yr old
DIAGNOdent 55
Fissure sealant removed and
stained with CDD
Was not on the X-rays!
Sealant placed on undiagnosed
caries
Caries Detection Dye
can be used to check
for leakage. Here it
is penetrating
through the porous,
carious enamel
underneath the
partially retained
sealant
Sealant placed on undiagnosed
caries
Microleakage indicated by CDD
diffusing under the sealant
Sealant placed on undiagnosed
caries
Microleakage indicated by CDD
diffusing under the sealant
5 year old opaque sealant stained
with Caries Detection Dye
A very seriously failed fissure
sealant!!
Reliability
 The
DIAGNOdent is not reliable in
detecting leaking sealants, however, it will
give you some assistance when assessing
the seal on clear sealants.
 Be careful that you are not reading a high
fluorescence resin or organic plug not
removed from the fissures prior to
palcement of the original sealant.
Diagnose prior to any treatment
 All
fissures should be scanned with the
DIAGNOdent before placing fissure
sealants
 This will alert you to the presence of
damaged enamel that could prevent
successful resin bonding, which can lead to
failure of the sealant
 Removal of diagnosed carious or
hypocalcific enamel with Air-abrasion will
improve the success rate of sealants
KaVo DIAGNOdent
DO YOU NEED A
DIAGNOdent ?
Micro-Dentistry requires a
conscious effort to adopt
diagnostic, re-mineralization,
preparation and restorative
techniques that allow for
conservation of sound tooth
structure
Air-abrasion is the
preparation technique of
choice once a decision has
been made to instigate
invasive treatment. It allows
the selective removal of
defective tooth structure.
KaVo RONDOflex
A simple Air-abrasion unit that
connects directly to a multiflex
coupling
For more information on Microdentistry techniques
go to the website link below.
There are further CDRoms available covering
Patient Microdentistry Education
Micro restorative techniques
Glass Ionomer-Composite Co-cure technique
E-mail: [email protected]
Website: www.advancedental-ltd.com
Postal: G W Milicich,
72 Braid Rd, Hamilton 2001, New Zealand