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Int Poster J Dent Oral Med 14 (2012), No. 1     15. Mar. 2012

Int Poster J Dent Oral Med 2012, Vol 14 No 1, Poster 582

Constriction with Conviction

Dyes for caries detection

Language: English
 

Authors:
Assoc. Prof. Patni Pallav Mahesh,
Devi Ahilya University, Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry and Hospital (SAIMS), Indore, M.P, India
Prof. Chandak Manoj, HOD,
Sharad Pawar Dental College, ,Department of Conservative Dentistry and Endodontics, Sawangi (Meghe) Wardha, M.S, India
Prof. Ghonmode W. N., Principal, HOD,
Maitri College of Dentistry & Research Centre, Department of Conservative Dentistry and Endodontics, Anjora, Durg, C.G, India
Assoc. Prof. Heda Amit,
Jamanlal Goenka Dental College, Department of Conservative Dentistry and Endodontics, Akola, Maharashtra, India
Jain Patni Mona, B.D.S,
Dr. V.K. Jain Hospital, Jaora Compound, Indore, M.P., India

Date/Event/Venue:
25th-27th June 2004
5th All India P.G Students Convention, Conservative Dentistry and Endodontics.
Kanyakumari, India

Poster Award
Silver

Introduction

The main goal of treating dental caries is complete removal of carious tissues with maximum preservation of sound tooth structure and maintenance of pulp vitality [4]. Clinical assessment of dental caries is often based on color and dentin hardness which is considered to be completely subjective with low reproducibility [5, 6]. Application of caries detector dyes to facilitate diagnosis of carious dentin was initially introduced by Fusayama in 1979[7]. Dyes may be beneficial in detecting caries and when not used during cavity preparation, carious tissues may go undiagnosed by the clinician [8, 9].

Fig. 1.1: Molecular structure of Acid Red and Basic Fuschin Fig. 1.2: Unstained
Fig. 1.3: Basic fushin stained Fig. 1.4: Mallory -Azan stained
Fig. 1.5: Unstained Fig. 1.6: Unstained
 
Fig. 1.7: Acid Red stained
 
 

Conclusions

The carious dentin is invaded by bacteria. The infected dentin must be removed, but the dentin that is not infected must be saved. When caries penetrates dentin, softening is always deepest, discoloration is next and bacterial invasion is last. In chronic decay, discoloration is heavy and reaches the comparatively harder and deeper layer, and so does bacterial invasion. In acute decay discoloration is light and does not reach the harder layer. Bacterial invasion remains at the very soft and superficial layer.
In the year 1979, Takao Fusayama suggested 0.5% solution of basic fuschin in propylene glycol can be used as a dye for caries detection but later was found to be carcinogenic. After researches 1% acid red was found to be a suitable dye (Figure 1).
The natural carious dentin of human teeth consists of two layers with definite boundary. The collagen fiber is deteriorated in the outer carious dentin but keeps its sound proper histo-chemical character in the inner carious dentin and normal dentin (Figure 2).
1% Acid Red stains the outer carious dentin clearly red but not the inner carious dentin and normal dentin (Figure 3).
Because re-mineralization of dentin occurs on the basis of collagen fibers on the periodic joints on which apatite crystals attach in fringes, it cannot occur in the outer carious dentin in which collagen fibers are broken, losing intermolecular crosslink. But it can occur in the inner carious dentin in which collagen fibers keep their characteristic cross band structure with intermolecular cross links only partly and reversibly shifting to precursors.

Hardness cannot be used as a guide for caries removal, because the hardness of the bacterial front is very inconsistent. In chronic decay complete removal of remarkably discolored dentin can assure complete removal of infected dentin without excessive over reduction. The softened but not infected dentin of acute decay should be saved if it is re-mineralizable.
Dyes are the correct way of determination, discrimination and estimation of caries extent and their use guides us to our path of "Constriction with Conviction". (Figure 4).
 

Fig. 2: Collagen Molecule Fig. 3: 1% Acid Red
Fig. 4.1: Clinical case of proximal decay Fig. 4.2: Application of caries detector
Fig. 4.3: Outer carious dentin stained red Fig. 4.4: Opening the cavity
Fig. 4.5: Outer carious dentin stained red Fig. 4.6: Removing red-stained tissue
Fig. 4.7: Reapplication of caries detector Fig. 4.8: Spray washing of caries detector
Fig. 4.9: Cavity preparation is completed when no more tissue can be stained red Fig. 4.10: Restoration completed

Literature

  1. Fusayama T: Clinical guide for removing caries using a caries-detecting solution. Quintessence International 1988, 19, pp. 397-401.
  2. Fusayama T: Two layers of carious dentin: diagnosis and treatment. Operative Dentistry 1979, 4, pp. 63-70.
  3. Fusayama T, Okuse K, Hosoda H: Relationship between hardness, discoloration, and microbial invasion in carious dentin. Journal of Dental Research 1966, 45, pp. 1033-46.
  4. Roberson M, Heymann O: Sturdevant's art and science of Operative Dentistry. 5th ed. St. Louis:Mosby, 2006, pp. 308-11.
  5. Iwami Y, Shimizu A , Narimatsu M, Kinomoto Y, Ebisu S: The relationship between the color of carious dentin stained with a caries detector dye and bacterial infection. Operative Dentistry 2005, 30(1), pp. 83-9.
  6. Iwami Y, Hayashi N, Yamamoto H, Hayashi M, Takeshige F, Ebisu S: Evaluating the objectivity of caries removal with a caries detector dye using color evaluation and PCR. Journal of Dentistry 2007, 35(9), pp. 749-54.
  7. Ansari G, Beeley JA, Reid JS, Foye RH: Caries detector dyes--an in vitro assessment of some new compounds. Journal of Oral Rehabilitation 1999, 26(6), pp. 453-8.
  8. Boston DW, Liao J: Staining of non-carious human coronal dentin by caries dyes. Operative Dentistry 2004, 29(3), pp. 280-6.
  9. Franco SJ, Kelsey WP: Caries removal with and without a disclosing solution of basic fuchsin. Operative Dentistry 1981, 6(2), pp.46-8.
     

This Poster was submitted by Assoc. Prof. Pallav Mahesh Patni.
 

Correspondence address:
Assoc. Prof. Pallav Mahesh Patni
Devi Ahilya University
Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry and Hospital (SAIMS)
Indore, M.P
India