New fluorescence and reflectance analyses to aid dental material detection in human identification

The human fluorescence discrimination as precondition for the use of fluorescence-aided identification techniques (FIT)

OBJECTIVES

The fluorescence-aided identification technique (FIT) is based on the fluorescence properties of dental materials, specifically the intensity of their fluorescence compared to the autofluorescence of hard dental substances; this creates a perceived contrast between dental material and tooth. However, no studies to date have determined the extent to which the fluorescence intensity of tooth-colored dental materials must differ from that of natural autofluorescence to ensure reliable visual detection. The aim of this study was therefore to determine, for the first time, how pronounced the difference between fluorescence intensity and autofluorescence must be to reliably identify tooth-colored material.

METHODS

Ten dentists assessed six different resin-based composite (RBC) samples of varying fluorescence intensity placed in the cavities of ten extracted teeth under standardized fluorescence-exciting illumination. The outcome variable was fluorescence perceptibility. Their assessments of the outcome variable were compared with measurements of the fluorescence intensities of the RBCs and the surrounding dental hard tissues, which were expressed as a fluorescence intensity ratio. Demographic data of the participants, including age, gender, and professional experience, were also recorded.

RESULTS

No significant differences were found for visual fluorescence perceptibility in relation to the explanatory variables of gender (p = 0.14), age (p = 0.13), and professional experience (p = 0.34). In contrast, the fluorescence intensity ratio was significantly different (p < 0.0001).

SIGNIFICANCE

For both clinicians and manufacturers, fluorescence intensity levels are important when selecting or developing FIT-compatible materials. Our results suggest that the fluorescence intensity levels of dental materials should be no more than 75% and no less than 200% of tooth natural autofluorescence to ensure reliable detection of tooth-colored materials.

Atlas of Dental Near-Infrared Transillumination Images

Technological improvements have introduced significant innovations in dentistry and broadened the array of tools and techniques in dental care. One technological development that has been widely researched over the past 20 years is the use of Near-Infrared Transillumination (NIRT) imaging for the diagnosis of dental caries. This paper aims to introduce a comprehensive collection of NIRT images, intended as a reference tool for routine dental examinations, dental research, pedagogical activities, and forensic odontology. The collection presents pairwise clinical and NIRT images categorized as follows: (a) healthy teeth, (b) carious teeth, (c) restored teeth, (d) enamel defects, and (e) diverse findings. This atlas could be a valuable tool for the dental community as it is designed as an identification guide of NIRT illustrated dental features.

Quantitative and Qualitative Assessment of Fluorescence in Aesthetic Direct Restorations

Currently available direct restoration materials have been developed to have improved optical properties to interact with light in the same manner as the natural tooth. The objective of this study was to investigate the fluorescence of different enamel resin composites. In the present study, nine brands of enamel composites were tested in vitro, some of which are cited by manufacturers as having color adjustment potential. Fluorescence spectra of the composite specimens and the human natural enamel were measured with a fluorescence spectrophotometer immediately after preparation and after 6 months. Qualitative data of the specimens were also collected. Statistical analyses were conducted by Kruskal−Wallis and Mann−Whitney U nonparametric tests (p < 0.05). Almost all tested resin composites presented a significant decrease in the fluorescence values after a period of 6 months. There was no significant decrease in fluorescence in the case of Harmonize™ resin composite samples, which presented the lowest initial fluorescence values. The highest value in the reduction of the initial fluorescence intensity after 6 months (22.95%) was observed for the Charisma® specimens. Composites with a color adjustment did not perform significantly better than other composites in terms of reduction in fluorescence intensity.

Use of auxiliary devices during retreatment of direct resin composite veneers

The removal of direct composite veneers, when the retreatment is necessary, represents a challenge to the clinician, since the healthy dental structure must be preserved. Thus, the aim of this study was to compare the accuracy provided by different auxiliary devices during retreatment of direct composite veneers. Seventy-five bovine teeth were prepared for direct composite veneers, scanned (T1), and restored. Specimens were divided into 5 groups for retreatment: conventional high-speed handpiece without auxiliary device (WD); high-speed handpiece with a white LED (WL); high-speed handpiece with an UV light (UL); electric motor and multiplier 1/5 handpiece (EM); and conventional high-speed handpiece using magnifying loupe (ML). After retreatments, other scanning was performed (T2). Changes on dental wear or composite residues areas, as well as, the average between wear and presence of residues were measured. Data were submitted to Kruskal-Wallis and Dunn’s post-test (p≤ 0.05). There were greater areas of wear for ML, being statistically superior to WD and EM groups. The ML presented smaller residues areas, being statistically lower than the WD and EM groups. Regarding the average between wear and the presence of resin residues, additional wear occurred after re-preparation, regardless of the group. Magnifying loupe promoted greater areas of wear and smaller areas of resin residues than conventional high-speed handpiece and electric motor. Both techniques using light accessories did not differ from other ones.

Fluorescence intensities of composite resins on photo images

Recording fluorescence using flash photography, may help reduce time of capture and apply effectively in clinical practice. To test methods for visualizing composite resins fluorescence by direct digital photography. Sixty-four specimen discs (1.5 × 10 mm) were prepared from 8 different composite resin brands. Their CIELAB color coordinates (L*, a*, b*) and fluorescence were measured using a portable colorimeter and a fluorescence spectrophotometer. The mean of three measurements was recorded and then specimens were photographed by a DSLR camera with two different filters (365 nm and 405 nm) mounted on a commercial macro flash. RGB values of all specimens on the photographs were measured by using Photoshop software and converted to CIELab. Data were then analyzed using Kruskal–Wallis and Dunn’s multiple comparisons tests. Correlation and regression analyses were also used to relate fluorescence and color parameters on the photographs at α = 0.05. Fluorescence and color data indicated significant differences among the materials (p < 0.05). L* a* and b* color coordinates from both photographs were highly correlated to fluorescence intensities found by the reference method (r₃₆₅ − 0.95, r₄₀₅ − 0.94), while regression analysis indicated a strong linear relationship (R²₃₆₅ − 0.88, R²₄₀₅ − 0.89). The study showed that filtered flash photography either by the use of a 365 nm or a 405 nm band pass filter can directly visualize fluorescence of composite resin materials and differences in fluorescence between them.