Relative ability of laser fluorescence techniques to quantitate early mineral loss in vitro

This in vitro investigation was undertaken to explore two different nondestructive methods to detect very early demineralization. These methods were based on the premise that the clinical detection of caries at a very early stage of formation might permit more efficient reversal of the caries process than may occur when lesions are detected at a more advanced stage, such as a so-called 'white spot'. The methods evaluated in this study were quantitative laser fluorescence (QLF) and an experimental dye-enhanced laser fluorescence (DELF) technique. Prepared and polished bovine enamel specimens were demineralized in a conventional lactic acid-Carbopol solution for varying periods of time between 0 and 24 h with an area of sound enamel retained on each specimen. The coded and randomized specimens were then analyzed for the presence and severity of enamel demineralization using QLF after which they were exposed to a selected dye (Pyrromethene 556) and similarly examined using DELF. The specimens were then sectioned and examined by conventional transverse microradiography and by confocal laser-scanning microscopy. Results were analyzed statistically with sensitivity and specificity determined using sound enamel as the reference. The results indicated that QLF could detect demineralization which occurred as a result of 8 h exposure to the decalcification solution and was able to quantify changes in lesion severity associated with longer demineralization. While DELF was capable of detecting enamel demineralization after only 2 h exposure to the decalcification solution, it was unable to quantify increasing amounts of demineralization associated with longer periods of exposure to the decalcification solution. In summary, while DELF was able to detect very early demineralization, only QLF was capable of detecting and quantifying changes in the extent of the decalcification occurring with demineralization periods up to 24 h.