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ePaper created 2015-03-12, 18:17:50 | version 1.33.01
interview 05IDS 2015 – 13. März 13 March This interview with dental hygienist Sylvia Fresmann looks at a recent case study on DIAGNOcam published in Quintessence,and how this new technology is expanding clinician options for digital diagnosis So often in dentistry it feels like the reason we do things a certain way is because — on some level — they’ve always been done that way. A certain type of clinical inertia becomes accep- table in the name of predictability. In the case of caries detection, there is clinical inspection and radiographic bitewings. What do you see as the primary limita- tions of each? • Clinical inspection: The clinical exami- nation often fails to underestimate the extentoftoothdecay.Manydentistsalso use a pointed probe for the examination to palpate the surface—but in this case, there is a high risk of penetrating the surface of the tooth, creating a defect • Radiographic bitewings: Obtaining sat- isfactory bitewings in children is dif- ficult and often impossible. Overlap- ping effects, brackets, arches and other orthodontics make the diagnosis more difficult. The repeatability of X-rays is limited because of the associated ion- izing radiation. That is why alternative methods without using dental X-rays are preferable. In the DIAGNOcam case study that appea- red in Quintessence, 121 of the 127 lesions were classified identically by traditional bitewings and near-infrared light—com- parison of results showed 95.3 per cent agreement. Does that level of accuracy with DIAGNOcam surprise you? I’mnotsurprisedbytheprecisionofthe DIAGNOcam.Theimagesareverydetailed andthatlevelofaccuracymatcheswithmy experiences in our daily clinical practice. There have been a variety of caries detection alternatives released over the last five to ten years. Limitations to use are often centered on an inability to incorporate data into a strategy that goes beyond a “let’s watch it” or “wait and see” approach. One especially insightful addition to the Quintessence article is the classification system clinicians were able to create using the visuals captured by DIAGNOcam. Does that level of spe- cificity help enable you as a hygienist to better address carious lesions with patients? Yes, of course. As a dental hygienist I often advise and visualize. The DIAGNO- cam helps me to show that there is a cari- ous lesion, even though the patient has no pain. Early detection helps to avoid large defects. Each dental hygienist should integrate a DIAGNOcam into her daily workflow — this is pure prevention! What do you feel sets this method of caries detection apart from other dia- gnostic alternatives currently on the market? For me, DIAGNOcam is the best and most reliable method to detect caries lesions early and provide dental hygien- ists with the opportunity to treat them preventively. In our dental office, the DIGANOcam images are recorded in our computer system so our dentists are able to look at the diagnostics from any and every workstation in the practice. This makes cooperation easier and assures more complete documentation. 5 Sylvia Fresmann 5 Vergleich der Röntgenaufnahmen (oben) mit der DIAGNOcam-Aufnahme (unten). 5 Comparison of X-ray, top, to DIAGNOcam image, bottom. 5 Die aufgeführte DIAGNOcam-Studie ist in der Quintes- sence Juni-Ausgabe 2014, Vol. 45, No. 6 erschienen 5 The DIAGNOcam study being discussed appeared in Quintessence, June 2014, Vol. 45, No. 6.