Comparison of Rotary and Ultrasonic Caries Removal Determined by Two Fluorescent Caries Detection Devices

Abstract

Purpose: In this study, caries removal using an ultrasonic vibrating instrument with a curved shank was compared with conventional bur excavation with regard to the endpoint of dentin removal. In addition to the Micro Vickers Hardness (MVH), fluorescent caries detection devices using a laser (DIAGNOdent) or an LED (Vistacam P) were used for the comparison. Methods: Twenty extracted human teeth with dentin caries were longitudinally sectioned through the center of the caries. Micro Vickers Hardness (MVH) was measured every 200 μm from the pulp chamber to the caries region. In one group, carious dentin was removed using an ultrasonic apparatus by a dentist with 15 years of clinical experience. In the other group, carious dentin was removed using a low-speed dental cutting bur together with a caries detector (Caries Check). Subsequently, the hardness of the dentin cavity wall was confirmed, and fluorescence from the cavity wall was measured as D-values and Vistacam P values using the DIAGNOdent and Vistacam P. Results: Between the two groups, there were no significant differences in Vistacam P values (p>0.05), while the vibrating diamond tip group exhibited a significantly higher MVH and lower D-value than the control group (p<0.05). Conclusions: The use of a low-speed bur together with Caries Check is recommended in order to avoid excessive excavation of carious dentin, since the MVH and D-values suggest that the ultrasonic vibrating instrument removed a greater amount of carious dentin. Vistacam P could not detect the difference between the two caries removal methods.