Name: detection and removal of tooth-colored composite resin using the fluorescence-aided identification technique
Uploaded: 2022-07-27T12:40:00
Description: Watch this Scientific Journal Video about Detection and Removal of Tooth-Colored Composite Resin Using the Fluorescence-Aided Identification Technique at JoVE.com

This study was supported by a research grant from the Swiss Dental Association (SSO Research Grant 292-16).

The teeth used in this study were part of a project approved by the local Ethics Committee (EKNZ UBE-15/111). The participants provided written informed consent, and all data were de-identified to protect patient confidentiality.
1. Detection of tooth colored composite resin material using FIT
<ol>
	<li>Darken the room (natural and artificial light).</li>
	<li>Wear clear or yellow-tinted safety glasses with UV protection.</li>
	<li>Use a fluorescence-inducing light source to...

<ol>
	<li>Meller, C., Connert, T., L&#246;st, C., ElAyouti, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+of+a+Fluorescence-aided+Identification+Technique+(FIT)+for+detecting+tooth-colored+restorations:+an+ex+vivo+comparative+study.">Reliability of a Fluorescence-aided Identification Technique (FIT) for detecting tooth-colored restorations: an ex vivo comparative study.</a> Clinical Oral Investigations. 21 (1), 347-355 (2017).</li><li>Kiran, R., Chapman, J., Tennant, M., Forrest, A., Walsh, L. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluorescence-aided+selective+removal+of+resin-based+composite+restorative+materials:+An+in+vitro+comparative+study.">Fluorescence-aided selective removal of resin-based composite restorative materials: An in vitro comparative study.</a> Journal of Esthetic and Restorative Dentistry. 32 (3), 310-316 (2020).</li><li>Meller, C., Klein, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluorescence+properties+of+commercial+composite+resin+restorative+materials+in+dentistry.">Fluorescence properties of commercial composite resin restorative materials in dentistry.</a> Dental Materials Journal. 31 (6), 916-923 (2012).</li><li>Uo, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rare+earth+oxide-containing+fluorescent+glass+filler+for+composite+resin.">Rare earth oxide-containing fluorescent glass filler for composite resin.</a> Dental Materials Journal. 24 (1), 49-52 (2005).</li><li>Fondriest, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Shade+matching+in+restorative+dentistry:+the+science+and+strategies.">Shade matching in restorative dentistry: the science and strategies.</a> International Journal of Periodontics and Restorative Dentistry. 23, 467-479 (2003).</li><li>Takahashi, M. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluorescence+intensity+of+resin+composites+and+dental+tissues+before+and+after+accelerated+aging:+a+comparative+study.">Fluorescence intensity of resin composites and dental tissues before and after accelerated aging: a comparative study.</a> Operative Dentistry. 33 (2), 189-195 (2008).</li><li>Klein, C., Wolff, D., Ohle, C. V., Meller, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+fluorescence+of+resin-based+composites:+An+analysis+after+ten+years+of+aging.">The fluorescence of resin-based composites: An analysis after ten years of aging.</a> Dental Materials Journal. 40 (1), 94-100 (2020).</li><li>Lee, Y. K., Lu, H., Powers, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Changes+in+opalescence+and+fluorescence+properties+of+resin+composites+after+accelerated+aging.">Changes in opalescence and fluorescence properties of resin composites after accelerated aging.</a> Dental Materials. 22 (7), 653-660 (2006).</li><li>Lee, Y. K., Lu, H., Powers, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optical+properties+of+four+esthetic+restorative+materials+after+accelerated+aging.">Optical properties of four esthetic restorative materials after accelerated aging.</a> American Journal of Dentistry. 19 (3), 155-158 (2006).</li><li>Dietschi, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Free-hand+composite+resin+restorations:+a+key+to+anterior+aesthetics.">Free-hand composite resin restorations: a key to anterior aesthetics.</a> Practical Periodontics and Aesthetic Dentistry. 7 (7), 15-25 (1995).</li><li>Bush, M. A., Hermanson, A. S., Yetto, R. J., Wieczkowski, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+ultraviolet+LED+illumination+for+composite+resin+removal:+an+in+vitro+study.">The use of ultraviolet LED illumination for composite resin removal: an in vitro study.</a> General Dentistry. 58 (5), 214-218 (2010).</li><li>Baelum, V., Fejerskov, O., Fejerskov, O., Nyvad, B., Kidd, E. A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+big+is+the+problem?+Epidemiological+features+of+dental+caries.">How big is the problem? Epidemiological features of dental caries.</a> Dental Caries-the Disease and its Clinical Management. 3rd edn. , 25 (2015).</li><li>Lynch, C. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Guidance+on+posterior+resin+composites:+Academy+of+Operative+Dentistry+-+European+Section.">Guidance on posterior resin composites: Academy of Operative Dentistry - European Section.</a> Journal of Denistry. 42 (4), 377-383 (2014).</li><li>Demarco, F. F., Corr&#234;a, M. B., Cenci, M. S., Moraes, R. R., Opdam, N. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Longevity+of+posterior+composite+restorations:+not+only+a+matter+of+materials.">Longevity of posterior composite restorations: not only a matter of materials.</a> Dental Materials Journal. 28 (1), 87-101 (2012).</li><li>Eltahlah, D., Lynch, C. D., Chadwick, B. L., Blum, I. R., Wilson, N. H. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+update+on+the+reasons+for+placement+and+replacement+of+direct+restorations.">An update on the reasons for placement and replacement of direct restorations.</a> Journal of Dentistry. 72, 1-7 (2018).</li><li>Bonstein, T., Garlapo, D., Donarummo, J., Bush, P. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+varied+repair+protocols+applied+to+aged+composite+resin.">Evaluation of varied repair protocols applied to aged composite resin.</a> Journal of Adhesive Dentistry. 7 (1), 41-49 (2005).</li><li>Crumpler, D. C., Bayne, S. C., Sockwell, S., Brunson, D., Roberson, T. 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An in vivo study in man.</a> Journal of Clinical Periodontology. 17 (3), 138-144 (1990).</li><li>Diangelis, A. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=International+Association+of+Dental+Traumatology+guidelines+for+the+management+of+traumatic+dental+injuries:+1.+Fractures+and+luxations+of+permanent+teeth.">International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth.</a> Dental Traumatology. 28 (1), 2-12 (2012).</li><li>Tani, K., Watari, F., Uo, M., Morita, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Discrimination+between+composite+resin+and+teeth+using+fluorescence+properties.">Discrimination between composite resin and teeth using fluorescence properties.</a> Dental Materials Journal. 22 (4), 569-580 (2003).</li><li>Carson, D. O., Orihara, Y., Sorbie, J. L., Pounder, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Detection+of+white+restorative+dental+materials+using+an+alternative+light+source.">Detection of white restorative dental materials using an alternative light source.</a> Forensic Science International. 88 (2), 163-168 (1997).</li><li>Kiran, R., Chapman, J., Tennant, M., Forrest, A., Walsh, L. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluorescence-aided+selective+removal+of+resin-based+composite+restorative+materials:+An+in+vitro+comparative+study.">Fluorescence-aided selective removal of resin-based composite restorative materials: An in vitro comparative study.</a> Journal of Esthetic and Restorative Dentistry. 32 (3), 310-316 (2020).</li><li>Dettwiler, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluorescence-aided+composite+removal+in+directly+restored+permanent+posterior+teeth.">Fluorescence-aided composite removal in directly restored permanent posterior teeth.</a> Operative Dentistry. 45 (1), 62-70 (2020).</li><li>Dettwiler, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+a+Fluorescence-aided+Identification+Technique+(FIT)+for+removal+of+composite+bonded+trauma+splints.">Evaluation of a Fluorescence-aided Identification Technique (FIT) for removal of composite bonded trauma splints.</a> Dental Traumatology. 34 (5), 353-359 (2018).</li><li>Schott, T. 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A., Almeida, L. F., Martins, L. P., Martins, R. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessing+adhesive+remnant+removal+and+enamel+damage+with+ultraviolet+light:+An+in-vitro+study.">Assessing adhesive remnant removal and enamel damage with ultraviolet light: An in-vitro study.</a> American Journal of Orthodontics and Dentofacial Orthopedics. 151 (2), 292-296 (2017).</li><li>Klein, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Minimally+invasive+removal+of+tooth-colored+restorations:+evaluation+of+a+novel+handpiece+using+the+fluorescence-aided+identification+technique+(FIT).">Minimally invasive removal of tooth-colored restorations: evaluation of a novel handpiece using the fluorescence-aided identification technique (FIT).</a> Clinical Oral Investigations. 28 (8), 2735-2743 (2019).</li><li>Leontiev, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accuracy+of+the+fluorescence-aided+identification+technique+(FIT)+for+detecting+tooth-colored+restorations+utilizing+different+fluorescence-inducing+devices:+an+ex+vivo+comparative+study.">Accuracy of the fluorescence-aided identification technique (FIT) for detecting tooth-colored restorations utilizing different fluorescence-inducing devices: an ex vivo comparative study.</a> Clinical Oral Investigations. 25 (9), 5189-5196 (2021).</li><li>Eichenberger, M., Perrin, P., Neuhaus, K. 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The conventional illumination (for example by a dental unit lamp) is an unsatisfactory diagnostic tool for the identification of composite resin restorations. For superior diagnostics with conventional illumination, a magnification aid, drying, or even effortful cleaning of the teeth is necessary. Even under ideal circumstances, conventional illumination seems to be insufficient. A study showed that conventional illumination may lead to misdetection of composite resin restorations and sound tooth substance<sup class="xre...

The application of FIT facilitates the distinction of composite resin materials from sound tooth substance compared to conventional illumination, for example, by a dental unit lamp1,2. Fluorescence occurs when a material emits the light at a higher wavelength than it has been absorbed. As a result of this illumination, the material appears brighter than the tooth3. The maximum fluorescence of composite resin materials occurs when illuminated by a wavelength of 398 &#177; 5 nanometers3. Fluorescence in composite resin materials appears due to rare earth oxides added to the glass fillers, some of the main components of composite resins4,5. The addition of these fluorescent substances intends to adapt the optical properties of composite resins to the tooth structure to improve the esthetic properties of composite resins4,5. FIT is applicable on many composite resin materials as they show these fluorescence properties3. However, fluorescence decreases with the ageing of the composite resin materials6,7,8,9.
The distinguishment of composite resin materials from tooth structure with conventional illumination is a challenge since modern composite resin materials match the optical properties of tooth substance almost perfectly10,11. The misdiagnosis of composite resin results in inaccurate dental charts, false caries risk assessment, and inappropriate treatment planning11. Moreover, epidemiological data is falsified12.
Composite resin is the material of choice for direct restorations due to its straightforward handling, esthetic properties, and clinical performance13. Nevertheless, many composite restorations must be renewed due to secondary caries, fractures, or other reasons14,15. However, the removal of residual composite resin materials can be demanding under conventional light conditions. Even with the application of a magnification aid and the use of tactile probes or extensive drying of the teeth, composite residues are sometimes difficult to distinguish from sound tooth structure. Leftovers of composite remnants during the removal of the adhesive restoration lower the quality of further restorations and have an esthetic impairment due to possible discoloration of the margins1,16,17,18,19,20,21,22. On the contrary, an overpreparation due to misdiagnosis of composite resin versus tooth structure may result in unnecessary substance loss1,2.
In dental traumatology, fixation of the injured teeth using trauma splints is frequent and mandatory in many cases23. The trauma splints are usually fixed on the teeth using a flowable composite resin material. Incomplete removal of the composite resin material in this scenario may lead to the impairments described above. Since dental trauma occurs mostly in front teeth, an impairment of the esthetics and sufficient adhesion of further reconstructions are crucial. Therefore, the aim of the article is to demonstrate the application of the FIT method as an efficient and straightforward approach for detecting and removing composite resin materials.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Bonding Resin Remover, H22ALGK 016</td>
			<td>Komet Dental, Lemgo, Germany</td>
			<td></td>
			<td>Any other material/equpiment with the same function/purpose might be used.</td>
		</tr>
		<tr>
			<td>Cerec Omicam, Connect SW 5.1.3</td>
			<td>Dentsply Sirona, York, PA, USA</td>
			<td></td>
			<td>Any other material/equpiment with the same function/purpose might be used.</td>
		</tr>
		<tr>
			<td>Diamant bur</td>
			<td>Intensiv SA, Montagnola, Switzerland</td>
			<td></td>
			<td>Any other material/equpiment with the same function/purpose might be used.</td>
		</tr>
		<tr>
			<td>Mandrell</td>
			<td>3M, Saint Paul, MN, USA</td>
			<td></td>
			<td>Any other material/equpiment with the same function/purpose might be used.</td>
		</tr>
		<tr>
			<td>MASTERmatic</td>
			<td>KaVo Dental GmbH, Biberach, Germany</td>
			<td></td>
			<td>Any other material/equpiment with the same function/purpose might be used.</td>
		</tr>
		<tr>
			<td>Occlubrush</td>
			<td>Kerr, Orange, CA, USA</td>
			<td></td>
			<td>brush polishing system</td>
		</tr>
		<tr>
			<td>OraCheck Software, Version 5.0.0</td>
			<td>Cyfex AG, Zurich, Switzerland</td>
			<td></td>
			<td>Any other material/equpiment with the same function/purpose might be used.</td>
		</tr>
		<tr>
			<td>SIROInspect</td>
			<td>Dentsply Sirona, York, PA, USA</td>
			<td></td>
			<td>Any other material/equpiment with the same function/purpose might be used.</td>
		</tr>
		<tr>
			<td>Sof-Lex</td>
			<td>3M, Saint Paul, MN, USA</td>
			<td></td>
			<td>Contouring/polishing discs; any other material/equpiment with the same function/purpose might be used.</td>
		</tr>
	</tbody>
</table>

detection and removal of tooth-colored composite resin using the fluorescence-aided identification technique

The detection and removal of tooth-colored filling materials is a major challenge for every dentist. The Fluorescence-aided Identification Technique (FIT) is a noninvasive tool to facilitate the distinction of composite resin material from sound tooth substance. Compared to conventional illumination, FIT is a very accurate, reliable, and fast diagnostic method. When composite resin is illuminated with a wavelength of approximately 398 &plusmn; 5 nm, certain fluorescent components make the composite resin appear brighter than the tooth structure. Any fluorescence-inducing light source with the appropriate wavelength can be used for this method. Optimally, this technique is used without additional natural or artificial lighting. The application of FIT can be used for diagnostic purposes, for example, dental charts, and additionally for the complete and minimally invasive removal of composite resin restorations, bracket debonding, and trauma splint removal. The assessment of volumetric changes after composite removal can be provided by overlapping pre- and postoperative scans and subsequent calculation using suitable software.

Usage of the FIT method makes most composite resin materials appear brighter than sound tooth structure (Figure 2 and Figure 5). Therefore, FIT is applicable not only in the detection of composite resin material, but it also facilitates the removal of composite resin materials in general, and explicitly in posterior teeth, during orthodontic bracket debonding and in trauma splint removal1,2,<s...

Watch this Scientific Journal Video about Detection and Removal of Tooth-Colored Composite Resin Using the Fluorescence-Aided Identification Technique at JoVE.com

Detection and Removal of Tooth-Colored Composite Resin Using the Fluorescence-Aided Identification Technique

The Fluorescence-aided Identification Technique is a practicable, fast, and reliable approach for the differentiation of composite resin restorations from tooth substance, and facilitates the minimally invasive and complete removal of composite resin restorations and composite bonded trauma splints.

The detection and removal of tooth-colored filling materials is a major challenge for every dentist. The Fluorescence-aided Identification Technique (FIT) ...

The detection and removal of tooth-colored filling material is a challenge. The fluorescence-aided identification technique, FIT, is a diagnostic tool that facilitates the differentiation of composite resin from tooth substance. FIT enables the minimal invasive removal of composite resin restorations and composite-bonded trauma splints.It's a straightforward, fast, and reliable diagnostic approach. To begin, wear clear or yellow-tinted safety glasses with UV protection, then darken the room. Use a fluorescence-inducing light source to illuminate the tooth substance and tooth-colored composite resin restoration.For a pre-operative scan, start the intraoral scanning device and open the appropriate software For experimental evaluation purposes. Press Add New Patient to register the patient. Fill in the gaps such as last name, first name, date of birth, and patient ID, then press Add Case.Choose Jaw Scan and Impressions under the section Indications, then press Next. Darken the room and dry the field of operation to ease the scanning procedure. Start the intraoral scanner and perform a digital surface scan of the field of operation.To visualize the composite resin material, illuminate the tooth substance and tooth-colored composite resin restoration. Remove the composite resin material using a high-speed contra angle handpiece with diamond burs, a bonding resin remover, and polishing devices. Next, perform the post-operative scan for experimental volumetric assessment as per the steps demonstrated earlier for the pre-operative scan.For experimental volumetric assessment, select the patient and case, then open case and press Model. Then press Export to export the pre and post-operative scans as surface tessellation language in the highest resolution. Then open suitable software and press Recombine.Upload the pre and post-operative scans to the software by pressing Import. Next press Analysis to visualize the volumetric changes from pre to post-operative scans. Select the tooth sites where volumetric changes presumably occurred by choosing Region under the section Tools.Analyze the volumetric changes using the linear and volumetric measurement software tools Distances and Volume Analysis respectively. Press Distances under the section Tools for linear quantification of tooth substance loss and composite resin remnants in color. Use the color bar on the left to quantify linear volumetric changes.Additionally, locate the cursor on the relevant tooth sites and observe the exact cursor distance in the box on the left. The representative tooth model with several composite resin restorations and trauma splint fixed with composite resin is shown here. The usage of the fluorescence-aided identification technique made most composite resin materials brighter than sound tooth structures.A tooth model after trauma splint removal under conventional illumination and using the fluorescence-aided identification technique is shown here. A volumetric assessment showed quantification of the composite remnants and tooth substance loss. The discrepancy of the pre and post-operative scan revealed composite remnants and substance loss in teeth 13, 12, and 11.In contrast, teeth 21, 22, and 23 did not show any surface changes after trauma splint removal. Moreover, the composite remnants were undetected under conventional light illumination and became visible using the fluorescence-aided identification technique. Any fluorescence-inducing light source is applicable for the FIT method.Darken the room to avoid interference with other light sources. FIT is applicable not only for the detection and removal of composite resin restorations and trauma splints. It can also be applied in bracket debonding and dental forensics.

Research

JoVE Journal

Medicine

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