The use of raman-fluorescent medical technologies to assess the effect of physical and chemical factors on the mineralization of hard tooth tissues in normal and noncarious lesions

Abstract

BACKGROUND: Assessment of the rapid state of mineralization of hard tooth tissues in normal and in various carious and noncarious lesions based on objective in situ methods is an unsolved and urgent issue in dental science and practice. AIM: To substantiate the need for the clinical application in situ of express digital raman-fluorescent technology to increase the objectivity and effectiveness of assessing the degree of mineralization of hard tooth tissues in carious (initial form) and noncarious (wedge-shaped defect, pathological erasability) lesions under the influence of various physical and chemical factors on tissues. MATERIALS AND METHODS: A survey of 80 patients aged 25–50 years was conducted; the patients were divided into three groups: comparison and with carious and with noncarious (wedge-shaped defect, pathological erasability) lesions of hard dental tissues. In each group, changes in hygienic conditions and mineralization parameters of hard tooth tissues were assessed by the difference in the spectral intensity of raman-fluorescent measurements before and after controlled and/or uncontrolled hygienic treatment. Previously, under experimental conditions, the effects of various physical (mechanical processing, X-ray irradiation on the LNK-268 installation) and chemical (citric acid, hydroxylapatite (GAP) dry and moistened) factors on the hard tissues of the tooth were studied. Simultaneously, “locally” in real time, the mineralization parameters of the hard tissues of the tooth were recorded before and after hygienic treatment. In this study, we used an installation of the “InSpectrM” type in our modification. RESULTS: Experimental studies have shown the effectiveness and objectivity of the use of raman-fluorescence diagnostics to assess the hygienic condition and mineralization of hard dental tissues. The objectivity of the assessment of mineralization in a moistened state was investigated (dry GAP, 702 rel. units; wet GAP, 1520 rel. units), and the absence of the effect of radiation on the mineralization of hard tissues of the teeth (p 0.95) was revealed. Clinical observations showed that in patients with a wedge-shaped defect and increased erasability of hard tooth tissues, the hygienic condition is 5–10% worse than that in patients with intact tooth tissues and initial formation of caries. The main difference in the condition of hard tissues of teeth with noncarious lesions is a statistically significantly reduced (p 0.95) mineralization of hard tissues of the tooth, requiring remineralizing therapy immediately after hygienic treatment. CONCLUSION: In experimental and clinical conditions, the objectivity and effectiveness of the use of express raman-fluorescent technologies to assess the mineralization of hard tooth tissues when exposed to various physical and chemical factors in normal conditions, with carious (initial form) and noncarious (wedge-shaped defect, pathological erasability) lesions, are substantiated.