ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Efficacy Of Caries Detector Dye To Diagnosis Caries For Removal Of Dentinal Caries
Clinical Question Will using a caries detector dye help in the diagnosis of dentinal caries and help in the determination to remove more dentin to remove caries?
Clinical Bottom Line Caries detector dye does not reliably aid in the diagnosis of caries, especially for removal of dentin to remove caries. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17689167Yukiteru/200741 cases of dentin caries in 32 extracted human molarsIn Vitro trial
Key results41 cases of dentin caries were stained with caries detecting dye, divided into 3 groups and caries removed until a light pink color was left as per manufacturer recommendation by 3 operators. The corrected L*, a* and b* values (CIE 1976 L*a*b* color system) of dentin surfaces were calculated from the sticker color changes. Detection of bacterial DNA in the dentin after caries removal was done by PCR. There were significant differences in intra-operator corrected values for L*, a* and b* (p<0.05 and “the intra-class correlation coefficient of the corrected L*, a* and b* values was 0.34, 0.30 and 0.49, respectively.”) Seventeen of the 41 specimens had bacterial DNA present after caries removal.
Evidence Search PubMed: “Caries detector dye”
Comments on
The Evidence
This was done on extracted teeth not in vivo, no blinding was done and randomization is unknown.
Applicability Dental operators need to decide if more dentin should be removed to remove all caries in deep carious lesions. Caries detector dye is indicated as a way to diagnosis remaining caries and to help in this decision. But there can be an effect on complete caries removal if there is a difference in how operators see the light pink recommended by the manufacturer to indicate caries removal. This study showed that after manufacturer recommended light pink was achieved for caries removal there were still bacteria left in the dentin. Therefore the use of caries detector dye is of very limited value to diagnose remaining dentinal caries.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (Endodontics) (General Dentistry) (Pediatric Dentistry) (Periodontics) (Prosthodontics) (Restorative Dentistry) (Basic Science)
Keywords Caries detector dye, color, and Polymerase chain reaction
ID# 267
Date of submission: 11/11/2009spacer
E-mail cushen@livemail.uthscsa.edu
Author Sarra Cushen, DDS
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Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Wendell De la Cruz (San Antonio, Texas) on 04/02/2012
A PubMed search on this topic was conducted in April 2012 and a more recent publication was found: PubMed ID 18938022. This study involving 62 permanent teeth in vivo provides evidence that contradicts the conclusion of this CAT. New advances in caries detector dyes have created a better distinction between carious dentin and porous uninfected dentin.
by Ivy Peltz (New York, NY) on 03/26/2012
Nicely done, Sarra! You continue to represent NYUCD beautifully! Thank you for that!
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