Overview

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Overview

• Principles of QLF
• The Equipment
• The Results
• Clinical Uses
• Questions and Demonstration

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Why a New Diagnostic Method?

• Prevent cavitation
• Spotting trouble early
• early lesions (white spots)
• bacterial activity
• Follow trouble through time
• Objective support for the prevention process
• Enhance the quality of oral care
• Improve the quality of restorations and sealants
• Improve, encourage and focus the quality of oral
  hygiene

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Early Lesion Detection

• Scattering properties of tooth tissue allow
  contrast enhancement

E
D
White Spot
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Red Fluorescence Detection
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D
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Pre-invasive Lesion Detection
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QLF Contrast Enhancement
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Examples of Bacterial Activity
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The System and The Software
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Dentistry QLF-Scan, QLF-Pro
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Longitudinal Monitoring
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Caries Mapping
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Red Fluorescence Quantification
clean
RCutoff 20
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Danger Zones Bacterial Activity
Sealants
Restorations
Hidden Caries
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Use During Restorative Procedures

• Diagnose presence of secondary caries
• Check removal of bacterially affected tooth
  substance

All pictures courtesy of Dr. R. Heinrich-Weltzien
and Dr. J. Künisch, Friedrich-Schiller
University of Jena, Erfurt, Germany
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Red Fluorescence Caries Excavation
RCutoff 20
P. Sas 2003
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Red Fluorescence Sealants
Sound Sealant
Leaking Sealant
R. Heinrich et al. 2001
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Conclusions

• Agreement with visual inspection (Radike)
• better sensitivity
• very good specificity
• Quick patient assessment
• Amount of initial lesions detected with
  QLF-Vision indicates caries risk
• Longitudinal monitoring of lesions
• follow de- and remineralization in time
• QLF-Vision is a reliable method for early lesion
  monitoring

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• QLF
• makes the
• invisible
• visible

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Clinical Validation

• 1994 Øgaard and ten Bosch demonstration of
  lesion tracking by measuring scattering
  properties
• 1995 de Josselin de Jong ea Improvement of QLF
  system
• 1997 Al-Khateeb ea detection of remin with QLF
  in weekly intervals consistent with
  microradiography
• 1998 Al-Khateen ea QLF can be used to evaluate
  pre-invasive treatment
• 1998 Connersville study (IU)
• QLF appropriate for use on occlusal as well as
  buccal-lingual surfaces
• QLF is practical for large-scale clinical studies
  
• QLF detects 4-9 times as many lesions vs. visual
  inspection
• QLF validity for caries detection supported (ten
  Cate ea, 1999)

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Clinical Validation

• 2001 Traneus ea QLF is a sensitive method for
  longitudinal monitoring of incipient lesions on
  smooth surfaces
• Heinrich ea (to be published) QLF was able to
  separate groups of high-caries patients (33) that
  were given prophylaxis with or without the
  application of fluoride varnish, every 8 weeks
  for 6 months.

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Clinical Validation in Progress

• At IUPUI (Dr. George Stookey)
• 2-Year study to validate QLF for the detection of
  primary caries
• 2-Year study to validate QLF for the detection of
  secondary caries
• 18-Month study of QLF to monitor caries in
  orthodontic patients
• 18-Month study of ability of QLF to detect
  differences in caries rates in patients provided
  toothpastes with different concentrations of
  fluoride
• At Inspektor
• Correlation between red fluorescence and specific
  bacterial strains.
• Clinical study on bracket related incipient caries