Surface area and volume determination of subgingival calculus using laser fluorescence

Visible red (655 nm) laser fluorescence (LF) devices are currently used for identifying deposits of subgingival calculus on the root surfaces of teeth during dental examination and treatment; however, it is not known how the fluorescence readings produced by commercially available LF systems correlate to the nature of the deposits. This laboratory study explored the correlation between LF digital readings and the surface area and volume of subgingival calculus deposits on teeth. A collection of 30 extracted human posterior teeth with various levels of subgingival deposits of calculus across 240 sites were used in a clinical simulation, with silicone impression material used to replicate periodontal soft tissues. The teeth were scored by two examiners by using three commercial LF systems (DIAGNOdent, DIAGNOdent Pen and KEY3). The silicone was removed, and the teeth were removed for photography at × 20 magnification under white or ultraviolet light. The surface area, thickness, and volume were calculated, and both linear least squares regression and nonlinear (Spearman's rank method) correlation coefficients were determined. Visible red LF digital readings showed better correlation to calculus volume than to surface area. Overall, the best performance was found for the KEY3 system (Spearman coefficient 0.59), compared to the Classic DIAGNOdent (0.56) and the DIAGNOdent Pen (0.49). These results indicate that while visible red LF systems vary somewhat in performance, their LF readings provide a useful estimation of the volume of subgingival calculus deposits present on teeth.