Detection and Assessment of Dental Caries pp Cite as. Transillumination of teeth has been advocated for caries detection for over years and requires minimal experience to implement in clinical practice. Fibre-optic light sources are readily available and when used appropriately, help to enhance the contrast between sound tooth tissue and caries lesions. Improvements in technology have spawned digital methods of capturing images of transilluminated teeth, permitting longitudinal assessment of lesion status via appraisal by the clinician.

More recently, technologies employing near-infrared wavelengths of light have become commercially available and permit the capture of transillumination images less confounded by extrinsic staining and with increased penetration into the tooth structure. Fibre-optic transillumination of teeth, both traditional and digital, is simple to employ in clinical practice, well tolerated by patients and offers a non-invasive and non-irradiating adjunct to visual detection.

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Hume W. Need for change in dental caries diagnosis. In: Stookey G, editor. Early detection of dental caries: proceedings of the 1st annual Indiana conference.

Indianapolis: Indiana University School of Dentistry; Google Scholar. Pine CM. Fibre-optic transillumination FOTI in caries diagnosis.

Gomez J. Detection and diagnosis of the early caries lesion. BMC Oral Health. CrossRef Google Scholar. Pretty IA.

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Caries detection and diagnosis: novel technologies. J Dent. Comparison of fibre optic transillumination with clinical and radiographic caries diagnosis.Pitel, DMD. Fiber-optic transillumination FOTI is a well-accepted and valuable adjunctive diagnostic tool with a wide range of clinical applications. In dentistry, FOTI has been primarily associated with caries diagnosis and has been corroborated through research studies to be a valid indicator of the histological presence or absence of bacterially infected tooth structure.

In this review, techniques for using FOTI for tooth evaluation are presented along with examples of how FOTI can be effectively used as a supplemental diagnostic aid. In this era of enhanced diagnostic digital technologies, clinicians desiring to provide the most up-to-date digital technology when diagnosing and treating their patients must be careful not to overlook opportunities to use well-proven evidence-based technologies.

foti in dentistry

One such example of an adjunctive diagnostic tool that does not require additional digital support is fiber-optic transillumination FOTI. Applications for fiber-optic transillumination include: its use as an adjunctive diagnostic aid for anterior and posterior interproximal caries and occlusal caries diagnosis; detection of calculus; evaluation of stained margins of composite resins; evaluation of cusp fractures and cracked teeth; as an exploration tool to illuminate endodontic access and root canal orifices within the pulp chamber of teeth during endodontic treatment; as a tool for improved evaluation of soft-tissue lesions; for evaluation of all-ceramic restorations to rule out any fractures before cementation; for clinical evaluation of fracture and craze lines in all-ceramic restorations and natural teeth; and for evaluation of depth of extrinsic staining to determine appropriate treatment recommendations.

Fiber optics optical fiber refers to flexible, thin cylindrical fibers of high-optical-quality glass or plastic. The theory of fiber optics is based on a single optical fiber that consists of glass or plastic material with an outer cladding of a lower index of refraction material.

Since the fiber core has a higher refractive index, light rays are reflected back into the core. Individual fibers are grouped together to form a fiber optic bundle. Dental and medical transillumination refers to light transmission through tissues of the body. In fact, physicians use transillumination for diagnosis of hand tumors and for evaluation of sinuses and breasts. A bright light can illuminate the translucent tooth structure to reveal changes in tooth color, the presence of cracks and fractures, as well as other defects.

Typically, the majority of carious lesions are visually accessible. While caries is decreasing on interproximal surfaces, occlusal pit and fissue caries has shown a continued increase, yet the interproximal surfaces of the tooth are the least accessible to diagnose.

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Accurate diagnosis of smooth-surface proximal enamel and dentin carious lesions is highly challenging to the clinician. Interproximal caries is typically diagnosed using an intraoral clinical assessment, including visualization of superficial enamel discolorations combined with using an explorer to feel for surface roughness and cavitation combined with the use of bitewing radiographs. Radiographs are an important diagnostic tool for the detection of interproximal caries, 12,13 and bitewing radiographs are the most frequently used aid in assessing the potential for caries on the proximal tooth surface.

It is well accepted and proven that ionizing radiation dosages are cumulative in their effects and their risks. Using a narrow beam of bright white light directed across the facial and interproximal surfaces, the dry tooth can be visualized for changes in color, texture, tooth surface appearance, and the presence or absence of shadows within the tooth.

Basic Dental Instruments

FOTI has been corroborated through research studies to be a valid indicator of the histological presence or absence of bacterially infected tooth structure, with a specificity and sensitivity equivalent to or better than radiographs. Specificity measures the proportion of negatives, ie, the percentage of individuals who do not have the condition. From the evidence, the research strongly suggests that proximal caries diagnosis should be based on a combination of evaluations, not a single method, and that combining radiographs, clinical examination, and FOTI together provides the most accurate assessment.

Traditionally, the use of the brightest light has been associated with providing the best diagnostic tool to illuminate the oral cavity and teeth. These smaller light guides provide white light that can be used as an indirect light for FOTI. Past FOTI devices were large boxes with light sources that required fans for cooling and tethered electrical sources.

The technique of moving the light angulation to change the irradiance provides a more accurate portrayal of different tooth conditions.

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FOTI works due to differences in normal enamel and dentin light transmission compared with caries, calculus, restorative materials, and external tooth discolorations. Calculus shows up as a darkened area on the surface of the tooth. Translucent tooth-colored restorative materials can be easily distinguished from normal tooth structure using FOTI. For both maxillary and mandibular anterior teeth, in order to visualize anterior proximal caries the probe should be placed on the labio-cervical region of the tooth, and the surface should be examined from the lingual aspect with a mouth mirror Figure 1.

In some cases, because of the thinness of mandibular incisors, the light guide can be placed on the lingual surface. To visualize posterior proximal caries using a conventional light guide, the probe is placed on the cervical area of the tooth, buccally or lingually. Light passes into the cervical tooth structure and then radiates occlusally. Caries can appear as a dark shadow on the occlusal surface Figure 2.Be sure to call ahead with Dr. Foti to book an appointment. Eye Group.

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What went well Appointment scheduling 3 Appointment wasn't rushed 3 Explained conditions well 3. What could be improved. Reply Flag. Outstanding Dr. What went well No results. What could be improved No results. Johnny Devine in Tom's River — Dec 05, Leave a review How was your experience with Dr.

Overall Patient Satisfaction 3 responses. About Me Biography Dr. Practice Areas Dentistry. Frequently Asked Questions.Updated: Aug 22, FOTI works quite simply. When a healthy tooth is illuminated, the light will transmit uninterrupted across the tooth 1.

A tooth with caries, cracks, lesions or an otherwise unhealthy tooth will interrupt the light beam in various ways 1. Interpreting this information will aid immensely in your day-to-day diagnoses. FOTI can be used alone to diagnose or in conjunction with your current clinical examination practices 3. In fact, many studies have determined that visual inspection and radiographs alone have a poor performance compared to FOTI 4.

If you aid your visual inspection or supplement your radiographs with FOTI, you will much more clearly see the difference between structurally sound teeth and those with fractures, caries or decay While radiographs are sometimes necessary, FOTI has been found in several research studies to be a valid replacement for them for certain diagnoses. One such study in particular noted that FOTI was equivalent to or better than radiographs when diagnosing infected tooth structure 2.

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Additionally, general practice dentists detected more approximal enamel and dentinal lesions when using FOTI compared to other examinations in multiple other studies These same studies concluded that using FOTI for carries performed statistically superior to using radiographs alone 4. Also important to consider is the obligation dentists have to their patients to avoid over exposure to radiation during x-ray.

Keeping radiation exposure low is a must, especially for children and patients who have had radiographs recently 3. FOTI can be used repeatedly with no risk to the patient as a substitute to radiographs to evaluate and diagnose many tooth conditions. Not only have studies found that FOTI can be used as a valid replacement for radiographs, but one study noted how general dentistry practitioners used FOTI as a tool to decide whether to take radiographs 3. A pre-radiograph inspection with FOTI can save you time and money and allow you to accurately diagnose and quickly treat your patients.

Also, if radiographs are necessary, FOTI can be used to obtain more details about concerns found on radiographs 3. Specifically, using a FOTI instrument is.

Illuminating root canal orifices within the pulp chamber. Detecting Fracture and craze lines in ceramic restorations. Diagnosing anterior and posterior interproximal carries. Those who have used and studied the use of FOTI have found specific features of FOTI instruments that have been the most useful and effective diagnostically.

The Titan Transilluminator has been developed with these features in mind to give dentists what they need and want in order to find more success while using FOTI.

foti in dentistry

Another must have feature in FOTI is a high intensity light source to show light scattering within the tooth 4. It will give you just the right amount of light to show scattering within the tooth and is adjustable to three intensity levels. When asked what design features dentists look for most in transillumination instruments, one of the top requests was for a compact and portable design 3. With a magnetically coupled light guide cable, there is no binding and the instrument can easily be manipulated to any angle for accurate tooth diagnoses.

Additionally, the small, portable and rechargeable light engine can easily move from room to room in a multiple room practice. Another request made by dentists was for a transillumination instrument that has a reasonable cost 3. Supplying your practice with several for your daily needs is very inexpensive. FOTI is a must in every dental practice. FOTI as a diagnostic aid is pain free, non-invasive and simple to use with no risk to the patient and has been shown to be more effective than radiographs for many diagnoses.It is based on light transmission through an optic fiber; as the light falls upon the tooth surface, it spreads through the healthy dental tissue.

foti in dentistry

In this context, caried tissue is characterized by an increased organic component, with alteration of the homogeneity of the inorganic component - thereby resulting in a loss of light transmission capacity. FOTI has been used fundamentally for identifying proximal surface caries Cortes et al. The technique is of great help in diagnosing cracked tooth syndrome Fig.

However, it is little used for diagnosing hidden dentin caries, where moreover few studies have assessed its diagnostic performance, precision and reproducibility. FOTI is more specific than sensitive. Table 6 reports the validity of the test in different in vitro studies referred to occlusal caries.

foti in dentistry

In an in vivo study with full sample validation, our group Guerrero, has recorded a sensitivity of 0. These data are in line with those reported by other in vitro studies Ashley et al. As a coadjutant to visual inspection, FOTI can offer an alternative to X-rays in situations where patient irradiation is not possible. It is therefore interesting to compare both methods. In reference to occlusal caries, some authors Wenzel et al.

Once caries has progressed to the dentin, FOTI proved to be significantly inferior to conventional X-rays Guerrero, However, the fact that FOTI is not routinely used by dental professionals, is not recommended as a technique of choice, and is moreover supported by limited research indicates that the inconveniences which we have observed Guerrero, - involving a large proportion of false-negative results - are probably coincident with those of other authors who have studied this technique.

The main advantage of FOTI is its optimum PPV performance, which means that any positive reading is almost certainly indicative of an existing lesion. Digitalization may represent a step forward in transillumination diagnosis. The images can be filed, reproduced and studied by different examiners, and may serve to monitor the lesion. Interpretation of the image is where problems are found, however, since the results are not directly quantified by the technique.

To summarize, FOTI in combination with visual inspection may be useful for determining occlusal caries depth, though further in vivo studies are needed. While in wait of such studies, we consider that transillumination should not be used for diagnosing hidden dentin caries, due to the low sensitivity of the technique and its poorer results compared with X-rays.

Continue reading here: Electronic caries monitorization ECM. Toothache Treatment. Doctor Steve Abel Fitness current. Guilt Free Deserts. Paleo Grubs Cookbook.

The Divorce Survival Guide for Women. Mend the Marriage. The Secret Survey. Recommended Toothache Treatment. Related Category Caries.Background: The detection of carious lesions in the initial stages of development is very important in order to prevent the occurrence of cavitation. Aims and Objectives: The aim of the present study was to compare three methods-visual examination, FOTI, and bitewing radiographic examination-for the detection of noncavitated and cavitated approximal carious lesions.

Materials and Methods: Seventy students mean age 14 years with low caries prevalence were examined by three examiners. The tooth surfaces judged as having caries by at least one examiner or one diagnostic method were scheduled for tooth separation. Conclusion: We conclude that FOTI or radiographic examination, or both, used as adjuncts to clinical examination, could improve the detection of noncavitated and cavitated approximal carious lesions.

Although FOTI should not replace bitewing radiographic examination, it does seem to have additional value for the detection of carious lesions on approximal surfaces of the posterior teeth in school children with low caries prevalence.

This article has been cited by 1 Near infrared transillumination compared with radiography to detect and monitor proximal caries: A clinical retrospective study Marwa Abdelaziz,Ivo Krejci,Thomas Perneger,Albert Feilzer,Lydia Vazquez Journal of Dentistry.

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Reissmann Community Dentistry and Oral Epidemiology. Van Landuyt,A. Innes Advances in Dental Research. The relative diagnostic yields of clinical, FOTI and radiographic examinations for the detection of approximal caries in youngsters.

Indian J Dent Res ; Materials and Methods. Pitts NB. Caries Res ; Fejerskov O.

Fiberoptic transillumination FOTI and digital imaging fiberoptic transillumination DIFOTI

Changing paradigms in concepts on dental caries: Consequences for oral health care. Ismail AI. Clinical diagnosis of precavitated carious lesions. Community Dent Oral Epidemiol ; A systematic review of the performance of methods for identifying carious lesions.Be sure to call ahead with Dr.

Foti Jr to book an appointment. V M Augustine MD. Likelihood of recommending Dr. Foti Jr to family and friends is 5 out of 5. What other Dentistry Practitioners practice nearby? Click here to compare with other Dentistry Practitioners. Where is Dr. Find other locations and directions on Healthgrades. Does Dr. Foti Jr has not yet indicated whether they offer telehealth services. How can I make an appointment with Dr. Find contact information here to make an appointment. Accepted insurance can change.

Please double-check when making an appointment. Show Phone Number. Click to Call. Overview Ratings 1. Compare Dr. Learn more. View More Providers Like This. Foti Jr's Reviews Likelihood to recommend Dr. Foti Jr 5. Leave a review How was your experience with Dr. Foti Jr? Overall Patient Satisfaction 1 responses.

About Me Biography Dr. He graduated from State University Read more. Practice Areas Dentistry.