ORTEK-ECD®

A 22-year-old patient was complaining of tooth sensitivity when eating sweets. Clinical examination showed obvious decay in the disto-occlusal pit on the maxillary first molar (site 3). Upon further examination, the mesio-occlusal pit was suspicious (site 2), but there was no evidence of cavitation from visual and radiographic methods, making a treatment decision difficult. A second mesio-occlusal pit appeared sound (site 1).

Prior to initial preparation through the enamel layer, the ECD gave the following readings: Site 1: 00, site 2: 04, and site 3: 93. In this case, the ECD scores proved extremely reliable relative to the depth of the caries lesions and the indication of a sound enamel site. More importantly, the ECD was very effective in detecting a small cavitated occlusal lesion that may have normally gone untreated.

In this case, a 49 year old male was examined during a routine dental exam: Teeth 28 and 29 displayed discoloration possibly due to staining. BW X- rays were taken and there was no sign of cavitation. Prior to preparation, the ECD provided caries scores of 10 for tooth 28, and a reading of 11 for tooth 29.

After administration of local anesthesia, a 556 burr was used. Decay was detected and excavated: Note that the decay did not spread laterally, instead it progressed deeper and deeper into the dentin. After the 556 burr was used, the final decay was removed with a small #2 round burr and the teeth were restored.  If the caries found by the ECD were not detected, it's possible further decay progression on these teeth could lead to endodontic treatment overtime.

Unlike other caries detection systems, the revolutionary ECD measures the conductivity of enamel. The ECD is fast and easy to use, portable and requires minimal training. After cleaning and drying the occlusal surface, place the novel single patient use conductive tip at the bottom of a pit or fissure. If the dentin-enamel junction is breached by demineralization, hydrostatic pressure that exists within dentinal tubules will allow minuscule amounts of conductive dentinal fluid to enter the breached enamel site allowing the ECD to complete an electrical circuit. Further loss of mineral from enamel as a result of caries activity increases porous size and enamel porosity. The more dentinal fluid detected, the higher the caries score.

Along with an audible beep, the ECD instantly displays a quantitative digital caries score from 00-100 depending on the extent of decay into the dentin, if any. Intact tooth enamel is a good insulator and is electrically non-conductive. When the enamel at the bottom of a pit or fissure is intact, no current can flow, indicating a non-cavitated lesion or just a stained enamel surface, and a zero score.