Detection and Removal of Tooth-Colored Composite Resin Using the Fluorescence-Aided Identification Technique

The detection and removal of tooth-colored filling material is a challenge. The fluorescence-aided identification technique, FIT, is a diagnostic tool that facilitates the differentiation of composite resin from tooth substance. FIT enables the minimal invasive removal of composite resin restorations and composite-bonded trauma splints.

It's a straightforward, fast, and reliable diagnostic approach. To begin, wear clear or yellow-tinted safety glasses with UV protection, then darken the room. Use a fluorescence-inducing light source to illuminate the tooth substance and tooth-colored composite resin restoration.

For a pre-operative scan, start the intraoral scanning device and open the appropriate software For experimental evaluation purposes. Press Add New Patient to register the patient. Fill in the gaps such as last name, first name, date of birth, and patient ID, then press Add Case.

Choose Jaw Scan and Impressions under the section Indications, then press Next. Darken the room and dry the field of operation to ease the scanning procedure. Start the intraoral scanner and perform a digital surface scan of the field of operation.

To visualize the composite resin material, illuminate the tooth substance and tooth-colored composite resin restoration. Remove the composite resin material using a high-speed contra angle handpiece with diamond burs, a bonding resin remover, and polishing devices. Next, perform the post-operative scan for experimental volumetric assessment as per the steps demonstrated earlier for the pre-operative scan.

For experimental volumetric assessment, select the patient and case, then open case and press Model. Then press Export to export the pre and post-operative scans as surface tessellation language in the highest resolution. Then open suitable software and press Recombine.

Upload the pre and post-operative scans to the software by pressing Import. Next press Analysis to visualize the volumetric changes from pre to post-operative scans. Select the tooth sites where volumetric changes presumably occurred by choosing Region under the section Tools.

Analyze the volumetric changes using the linear and volumetric measurement software tools Distances and Volume Analysis respectively. Press Distances under the section Tools for linear quantification of tooth substance loss and composite resin remnants in color. Use the color bar on the left to quantify linear volumetric changes.

Additionally, locate the cursor on the relevant tooth sites and observe the exact cursor distance in the box on the left. The representative tooth model with several composite resin restorations and trauma splint fixed with composite resin is shown here. The usage of the fluorescence-aided identification technique made most composite resin materials brighter than sound tooth structures.

A tooth model after trauma splint removal under conventional illumination and using the fluorescence-aided identification technique is shown here. A volumetric assessment showed quantification of the composite remnants and tooth substance loss. The discrepancy of the pre and post-operative scan revealed composite remnants and substance loss in teeth 13, 12, and 11.

In contrast, teeth 21, 22, and 23 did not show any surface changes after trauma splint removal. Moreover, the composite remnants were undetected under conventional light illumination and became visible using the fluorescence-aided identification technique. Any fluorescence-inducing light source is applicable for the FIT method.

Darken the room to avoid interference with other light sources. FIT is applicable not only for the detection and removal of composite resin restorations and trauma splints. It can also be applied in bracket debonding and dental forensics.