Electronic caries monitorization ECM

Electronic caries monitorization (ECM) is based on the high electrical conduction resistance of the hard dental tissues. Enamel is a poor electrical conductor though caried enamel shows increased conductance versus intact enamel (Loesche et al., 1979). Demineralized enamel becomes more porous, fills with ion-containing fluid and minerals from saliva, and therefore exhibits increased electrical conductance (McComb & Tam, 2001).

Two devices have been developed, with tips designed for application to the occlusal surface and for measuring electrical conductance in pits or fissures (Zandona & Zero, 2006). The Electronic Caries Monitor (LODE, Groningen, the Netherlands), in the same way as its predecessor (Vanguard, Electronic Caries Detector, Massachusetts Manufacturing Cooperation Cambridge, MA, USA), was developed for diagnosing occlusal surface caries, and allows the identification of early-stage demineralization lesions. The sensitivity performance in application to permanent premolars and molars varies from 0.67 to 0.96, with specificity values of between 0.71 and 0.98 (Tran^us et al., 2005; Pereira et al., 2001; Lussi et al., 1999). The different reviews of ECM describe similar results, with sensitivity values referred to dentin lesions of 0.58 to 0.97 and specificity values between 0.56 and 0.94. One of the reasons for this range of results may be due to the differences in the way in which the technique is used. The degree of dental tissue hydration may also exert an influence, in the same way as enamel maturation and temperature variations (Tran^us et al., 2005; Pretty, 2006). Table 7 shows the sensitivity and specificity performances recorded from in vitro and in vivo studies with ECM applied to occlusal caries.

AUTHOR

LEVEL

STUDY

SENSITIVITY

SPECIFICITY

Ashley 1998

enamel

in vitro

0.65

0.73

Ekstrand 1997

enamel

in vivo

0.63

0.73

Lussi 1999

dentin

in vitro

0.58 - 0.92

0.76 - 0.94

Table 7. Sensitivity and specificity of ECM in the diagnosis of occlusal non-cavitated caries.

Table 7. Sensitivity and specificity of ECM in the diagnosis of occlusal non-cavitated caries.

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