Visual method with temporary elective tooth separation and impression of the approximal lesion

29-03-2010
Visual method with temporary elective tooth separation and impression of the approximal lesion
Temporary elective tooth separation, complemented by a localized impression of the opened interproximal space, allows a more sensitive diagnosis of cavitation than does the purely visual separation method. This also has the advantage of providing a replica as a reference for visual monitoring of changes in size or even measurement of serial impressions (Neilson and Pitts, 1993; Seddon, 1989). 
 
This method is currently gaining international acceptance, and a recently demonstrated association between cavitation status and carious activity may be an important step forward in aiding appropriate decision making (Bjarnason, 1996; Danielsen et al, 1996; Lunder and von der Fehr, 1996).
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Articles for theme “caries”:
29-03-2010
Visual method with temporary elective tooth separationThe once popular technique of temporary elective tooth separation as an aid to diagnosis of caries in approximal smooth surfaces is now regaining popularity, albeit with more humane and less traumatic methods that seem acceptable to most patients and dentists. This method permits a more definite assessment of whether radiographically detectable approximal enamel (D1, D2) and dentin lesions (D3) are cavitated (Pitts and Longbottom, 1987; Pitts and Rimmer, 1992; Rimmer and Pitts, 1990).
29-03-2010
Visual method used in European epidemiologic surveysProbing has been criticized for several reasons: It may allow transmission of  cariogenic bacteria from infected sites, it can irreversibly traumatize potentially remineralizable noncavitated lesions of enamel and dentin, and it may provide no more accuracy in diagnosis than visual inspection alone, particularly in the fissures and on the posterior approximal surfaces. Accordingly, a so-called European system of examination for surveys, based primarily on detailed visual examination, has been adopted by many epidemiologists.
29-03-2010
Clinical visual-tactile methodThis method is based on a combination of light, mirror, and gentle probing and is used in most epidemiologic surveys in the United States. Caries is diagnosed if the tooth meets the American Dental Association criteria of softened enamel that catches an explorer and resists its removal (the so-called sticky fissure) or allows the explorer to penetrate proximal surfaces under moderate-to-firm probing pressure. Lighting is usually adequate, but the teeth are neither cleaned nor dried.
29-03-2010
Visual method used in general practiceThe visual method, a combination of light, mirror, and the probe for detailed examination of every tooth surface, is by far the most commonly applied method in general practice worldwide. Although sensitivity is low and specificity is high, it may be possible to detect:1. Noncavitated enamel lesions (D1) on the free smooth surfaces (buccal and lingual), most anterior approximal surfaces, and the opening of some fissures 2. Clinically detected “cavities” limited to the enamel (D1, D2)3.
29-03-2010
Diagnosis and Registration of Carious LesionsIntroductionThe coronal carious lesion starts as a clinically undetectable subsurfacedemineralization. With further progression, it will eventually become clinicallydetectable, and can then be classified according to type, localization, size, depth, andshape (see Table 15).Apart from for the occult fissure lesion penetrating deeply into the dentin, dilemmasin clinical detection and registration arise not with the advanced lesion, but primarilywith the early lesion (confined to the outer enamel), the noncavitated lesion of dentin,recurrent caries (around the margins of restorations), and subgingival root caries.