I use the Diagnodent to diagnose and CDD to guide me regarding what I need to remove.  Once you have decided to treat following DD diagnosis, clean the fissure entranc with CDD.  This will remove the very extreme outer layer of tooth structure (VELOTS)  This is where the pellicle becomes part of the tooth.  It is a high lipid layer with gradated mineral content that increases the deep into the velots you go.
Often if you stain with CDD befoer removing this, you can get a false negative.  Once it is removed, CDD with go where acid has been.

In slow onset caries (most common presentation  in fissures ) interprismatic enamel is lost, but macrostructure is maintained.  When you place CDD, it will soak into the carious enamel, accuately identifying all the acid damaged, nonprismatic enamel that MUST be removed if you are using resin bonded restorations.

You cannot bond to carious enamel.  It is non prismatic, ergo no bond, leaking seal, recurrent caries.

This use of CDD has been writen up in the peer reviewed literature, but is not well understood by most, ebcause CDD was first designed to be used on carious dentin.  The fact there is another application that is even more valid seems to escape some people.  Once you have used it this way, you will recognize how helpful it is.

Re using the Diagnodent.  I have created a comprehensive CD on how to use it, covering the caries process, diagnosis, false positives, false negatives etc

have a look at

http://www.advancedental-ltd.com

for some more info on the CD
Regards

(Edited by gwmilicich at 4:20 am on Nov. 6, 2002)

I use the Diagnodent to diagnose and CDD to guide me regarding what I need to remove.  Once you have decided to treat following DD diagnosis, clean the fissure entranc with CDD.  This will remove the very extreme outer layer of tooth structure (VELOTS)  This is where the pellicle becomes part of the tooth.  It is a high lipid layer with gradated mineral content that increases the deep into the velots you go.
Often if you stain with CDD befoer removing this, you can get a false negative.  Once it is removed, CDD with go where acid has been.

In slow onset caries (most common presentation  in fissures ) interprismatic enamel is lost, but macrostructure is maintained.  When you place CDD, it will soak into the carious enamel, accuately identifying all the acid damaged, nonprismatic enamel that MUST be removed if you are using resin bonded restorations.

You cannot bond to carious enamel.  It is non prismatic, ergo no bond, leaking seal, recurrent caries.

This use of CDD has been writen up in the peer reviewed literature, but is not well understood by most, ebcause CDD was first designed to be used on carious dentin.  Teh fact there is another application that is even more valid seems to escape some people.  Once you have used it this way, you will recognize how helpful it is.

Re using the Diagnodent
Regards

(Edited by gwmilicich at 4:27 am on Nov. 6, 2002)

Graeme–nice post, good read.

Pat, very nice gesture to Jose.

Bob

Looks good Ron.

Perhaps the laser treatment at least helped relieve the patients discomfort.

Al