What you talkin’ ’bout Willis?!

Fluorescence mainly an adjunct for occlusal caries detection By Kathy Kincade, Editor in Chief DrBicuspid – April 2, 2012 — While fluorescence-based caries detection devices have been shown to offer clinical decision-making support, visual inspection should continue to be the primary detection method for occlusal caries, according to a new study in the Journal of the American Dental Association.  Visual examination and radiographic imaging are the two most common methods of caries detection, but both exhibit high specificity and low sensitivity for occlusal caries, noted the study authors, a team of university researchers from Brazil and Switzerland (JADA, April 2012, Vol. 143:4, pp. 339-350). These challenges have prompted the development of additional tools and methods to improve caries detection and quantify early lesions, including laser-fluorescence-based devices like the Diagnodent (KaVo) and VistaProof (Durr Dental; sold in the U.S. by Air Techniques as Spectra). But there has been ongoing discussion and debate over the effectiveness of these devices compared to visual examination using the International Caries Detection and Assessment System (ICDAS) and radiography. Read article

Study questions TBlue accuracy in detecting oral dysplasia By Donna Domino, Features Editor DrBicuspid – March 30, 2012 — Toluidine blue (TBlue) is a useful adjunct to visual examination in the detection of oral cancer, but its sensitivity is low when used to detect oral epithelial dysplasia, according to a new study by a team of British researchers (Oral Diseases, March 21, 2012).  However, TBlue can be useful for specialists in spotting potentially malignant disorders and reducing unnecessary biopsies. Potentially malignant disorders of the oral cavity (OPMDs), such as oral leukoplakia and erythroplakia, often precede the development of oral squamous cell carcinomas, the study authors noted. But their benign clinical appearance can make them difficult to diagnose. As a result, several adjunctive diagnostic clinical tools have been developed to aid in the visualization and detection of OPMDs. One of the most widely studied has been the TBlue test. TBlue is a dye that stains nucleic acids and abnormal tissues and binds preferentially to tissues undergoing rapid cell division. It is marketed by Zila Pharmaceuticals in the form of a swab sold in conjunction with the ViziLite system. Read article