This study compared two methods of cleaning stained pits and grooves (fissures) on the chewing surfaces of back teeth before measuring them with a laser fluorescence device (DIAGNOdent), which is used to help detect early tooth decay. In the same patients, one side of the mouth was treated with mechanical polishing using a prophylaxis paste, while the other side was treated with a 35% hydrogen peroxide gel. The study measured whether either cleaning method changed the device's readings, and if so, by how much. The results showed that the readings increased after both procedures, but the increase was larger after polishing than after hydrogen peroxide application. These findings may help clinicians better interpret DIAGNOdent readings after cleaning stained teeth.
In this randomized, single-blind, split-mouth clinical study, 126 posterior teeth from 24 adult participants with clinically visible occlusal fissure staining were evaluated. For each participant, opposing jaws were randomly assigned to receive either mechanical polishing with a fluoride-free prophylaxis paste (30 seconds) or a 35% hydrogen peroxide gel (15 minutes). DIAGNOdent Pen laser fluorescence measurements were recorded at three time points: baseline, after air-water spray cleaning and drying, and after the assigned surface procedure. Digital bite-wing radiographs were obtained as a non-invasive clinical reference. Within-group comparisons were analyzed using the Wilcoxon signed-rank test, and between-protocol comparisons were analyzed using a linear mixed-effects model with patient as a random effect and surface procedure as a fixed effect.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
25
Application of a fluoride-free prophylaxis paste (Cleanic, Kerr, Salerno, Italy) to the occlusal fissure area using a polishing brush attached to a micromotor operating at 10,000 rpm, for 30 seconds with light pressure using circular movements, followed by water spray rinse and air drying.
Application of an in-office bleaching agent containing 35% hydrogen peroxide (Whiteness HP, FGM Dental, Brazil), prepared per manufacturer's instructions (3 drops peroxide, 1 drop thickener), covering the stained fissure areas for 15 minutes, followed by aspiration, water rinse, and air drying.
İstanbul Kent University
Istanbul, Turkey (Türkiye)
Change in DIAGNOdent Score
Change in DIAGNOdent Pen laser fluorescence score, calculated as the post-surface-procedure value minus the baseline value, measured at the deepest point of the occlusal fissure. The DIAGNOdent Pen (KaVo, Biberach, Germany) scale ranges from 0 to 99, with higher scores indicating greater fluorescence and a higher likelihood of caries-related or stain-related tissue changes.
Time frame: Measured at baseline and immediately after the assigned surface procedure (within a single clinical session)
DIAGNOdent Score Change After Air-Water Spray Cleaning
Change in DIAGNOdent score from baseline to after air-water spray cleaning and drying, prior to the assigned surface procedure.
Time frame: Baseline and immediately after air-water spray cleaning (single clinical session, same-day)
Between-Group Comparison of DIAGNOdent Score Change
Comparison of the post-procedure minus baseline DIAGNOdent score change between the mechanical polishing group and the 35% hydrogen peroxide group, analyzed using a linear mixed-effects model.
Time frame: Baseline and immediately post-procedure (single clinical session, same-day)
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