Treatment of Dental Caries – “ICON and Diagnodent” approach
12 August 2010

Introduction
In the treatment of dental caries, dental professionals have only two options. At early stages such as incipient caries and white spot lesions, preventive fluoride therapy or other remineralization techniques are employed to attempt to treat these lesions. However, if caries develop beneath the enamel layer, a “drill and fill” approach is often employed and a restoration is placed into the tooth.

The “ICON and Diagnodent” combination encompasses a diagnostic tool and provides a minimally invasive solution for dental caries treatment. The Diagnodent Pen 2190 uses laser fluorescence technology and is designed to detect dental caries. This device effectively removes “guess work” from dentists.

ICON, an innovative product from DMG Dental, encompasses the use of micro-invasive technology. Icon preserves and prevents the unnecessary loss of healthy tooth structure, prevents lesion progression and increases the lifespan of the tooth via an infiltration method.

Clinical Use of Diagnodent in detection of dental caries
The KaVo Diagnodent Pen 2190 uses diode laser and measures reflected light laser fluorescence. The 2-way optic quantifies reflected laser light energy. A clean tooth reflects low fluorescence and a decayed tooth reflects a higher fluorescence proportionally to its severity and hence quantifying a higher value in the readings.

To use the Diagnodent effectively:

1. Clean tooth surface preferably with an air-polished device to completely remove plaque, stains and calculus from teeth.
2. Dry the tooth.
3. Perform clinical examination.
4. Diagnose and evaluate quantitative measurement of Diagnodent pen by positioning it on teeth.

Recommended therapy – Proximal caries*

Recommended therapy – Fissure caries and smooth surface caries*

*Quelle: Prof. Dr. Lussi, Universität Bern, Schweiz


Clinical Use of ICON

ICON is a product developed to bridge the gap between preventive treatment such as fluoride therapy and the need for restoration in early caries. Icon, a caries infiltrant that works by capillary action, can be used to treat smooth surface and proximal carious lesions up to the first third dentin.

Application of ICON:

1. Clean affected tooth, isolated with rubber dam and separate teeth with wedges.
2. Prepare tooth with ICON-Etch, a 15% HCL gel, for 2 minutes to open the pore system of the affected lesions on tooth.
3. Rinse off the water for 30 seconds and air-dry tooth.
4. Apply ICON-Dry, a form of ethanol to further dry the tooth for 30 seconds.
5. Apply ICON-Infiltrant; let it set for 3 minutes and light cure for 40 seconds.
6. Reapply ICON-Infiltrant for 1 minute and light cure for another 40 seconds.

With the infiltrant method of ICON, no drilling or anesthesia is required; making it very comfortable for the patient. It preserves healthy hard tissue by reinforcing and stabilizing demineralized enamel without drilling and increases the lifespan of the tooth.

Dr. Phang Hui Jing
Team GPA Dental Surgeon
BDS, National University of Singapore, 2006


About the Author
Dr. Phang Hui Jing is a Team GPA dental surgeon. She graduated with a Bachelor in Dental Surgery from the National University of Singapore in 2006.

Dr. Phang was a Valedictorian in 2006 and in the Dean’s list from 2004 to 2006.

Since Dr. Phang started practising, she is an Editorial Board member for the Singapore Dental Association Dental Surgeon newsletter. Dr. Phang has also conducted lectures for continuing dental education activities.