The main drivers for this body of work were a systematic review on water fluoridation by the NHS Centre for Research Dissemination (known as the York Report) and a report by the Medical Research Council entitled 'Water Fluoridation & Health'. Both documents highlighted shortcomings in the evidence base on water fluoridation. Two major projects form the basis of this thesis in an attempt to address some of the issues raised. The first project in Chiang Mai, Thailand aimed to determine the ability of QLF to discriminate between populations with differing exposures to fluoride. Populations with differing exposures to fluoride were identified through the analysis of drinking water and cooking water. Subjects were examined for fluorosis with standardized photographs and QLF to evaluate software techniques for fluorescence image analysis. The results in Thailand demonstrated that QLF was able to discriminate between populations with differing exposures to fluoride in water to a similar degree to blinded, subjective clinical scoring. There was significant agreement between the two methods (ICC 0.65 Spearman's rho). However, confounding factors for QLF were found. The aim of the second project was to assess the use of blinded and objective methods for assessing caries and fluorosis in fluoridated Newcastle and non-fluoridated Manchester in northern England. This study involved clinical and intra-oral photographic caries examinations using ICDAS, together with standardized photography and QLF imaging for fluorosis examinations. The results in Newcastle and Manchester suggested that there were significantly lower levels of caries in the fluoridated population compared to the non-fluoridated population. For early caries (Newcastle mean DMFT 2.94[clinical]/2.51[photo], Manchester mean DMFT 4.48 [clinical]/3.44[photo]) and caries into dentine (Newcastle Mean DMFT 0.65[clinical]/0.58[photo], Manchester mean DMFT 1.07 [clinical]/0.98 [photo]). This was reflected as an increase in caries as the level of deprivation increased (confirmed through intra-oral photographic scoring). The reduction in caries levels was associated with increased levels of fluorosis in Newcastle. The prevalence of fluorosis from photographic scores in fluoridated Newcastle was 55%, in non-fluoridated Manchester it was 27%. In Newcastle, 48% of subjects had TF scores of 1 or 2 and 7.1% of subjects had TF scores of 3 or greater. QLF showed significant associations with the clinical scores for fluorosis (ICC 0.405 Kendall's tau) and suggested a fluorosis prevalence for TF 3 or greater of 19% in Newcastle and 10% in Manchester. The integration of technologies such as intra-oral photographs for blind caries scoring and QLF for the detection and objective quantification of fluorosis may still prove to be useful adjunctive tools when used alongside clinical indices. The data derived from the methodologies under investigation suggest a benefit in caries reduction from community water fluoridation and this may help to reduce inequalities in oral health by reducing the social gradient between deprivation and caries.

O presente estudo teve como objetivo realizar uma revisão da literatura para verificar se os novos compostos bioativos presentes no mercado, como CPP-ACP, fosfosilicato de cálcio e sódio e o nitrato de potássio são eficazes na remineralização do esmalte dental clareado. As alterações ocorridas na superfície dental devido ao clareamento são diversas. Dentre elas, pode-se citar a rugosidade, dureza, perda de conteúdo mineral e alterações morfológicas como as mais estudadas. Muitas formas de análises tem sido utilizadas para essas avaliações, porém duas novas técnicas demonstram-se promissoras: o QLF e a nanoidentação. O QLF relaciona-se com a auto fluorescência dental, possuindo vantagens relacionadas a sua especificidade, simples manuseio e preservação do espécime. Já a nanoidentação é capaz de mensurar a dureza em sítios específicos, em uma escala nanométrica, permitindo uma criteriosa seleção da área a ser analisada. Os resultados obtidos não necessitam da mensuração visual da área demarcada pelo identador, o que se torna mais uma vantagem da técnica. Foi conclusivo que a literatura diverge quanto aos resultados apresentados até o momento relacionados aos efeitos do clareamento dental na superfície dental, e os estudos que avaliaram os diversos compostos bioativos apresentam diferentes metodologias que não permitem o estabelecimento de um protocolo de aplicação dos mesmos. Sendo assim, faz-se necessária a realização de novos estudos para avaliar os possíveis efeitos dos diferentes compostos quando da utilização destes como dentifrícios de uso terapêutico após o tratamento clareador. / This study aimed to review the literature and verify if the new bioactive compounds, like CPP-ACP, calcium sodium phosphosilicate and potassium nitrate are effective on the remineralization of the bleached dental enamel. There are several alterations occurred on the dental surface owing to the bleaching procedure. Among them: roughness, microhardness, mineral content loss and morphologic alterations are the most evaluated. Many different analysis have been used to assess the changes in the dental structure, however two of them have shown to be promising: the QLF and the nanoindentation. The QLF is related with the auto fluorescence of the teeth and has advantages related to its specificity, simple manipulation and it is not a destructive technique. On the other hand, the nanoindentation is capable to measure the surface hardness in very specific sites, in a nanometric scale, enabling a criterious selection of the area which will be analyzed. The results obtained by this equipment do not require the visual measure of the impressed area of the indentation, which is one advantage of the methodology. It was conclusive that the literature disagrees of the results presented about the effects of dental bleaching on the enamel surface and the researches that evaluated the bioactive compounds have demonstrated differences in their methodologies. These inconclusive findings interfere on the establishment of an application protocol to those new dentifrices. Thus, it is necessary to develop new researches to better understand the possible effects of the bioactive compounds when the use of these dentifrices are related to a therapeutic use after treatment with bleaching agents.

Embora seja conhecido que a irradiação com laser de CO2 reduz a desmineralização do esmalte, efeitos colaterais como danos térmicos na superfície são comumente observados. A ocorrência dessas microfraturas e fissuras é um dos fatores que ainda comprometeM uma utilização segura in vivo. Sendo assim, o objetivo desTe estudo foi encontrar parâmetros de irradiação com laser de CO2 (?= 10,6 ?m) que resultassem no máximo efeito preventivo de cárie e no menor dano térmico. Três estudos foram conduzidos para avaliar separadamente três parâmetros da irradiação com laser. No primeiro estudo cinco densidades de energia diferentes, 0,1, 0,3, 0,4, 0,5 e 0,6 J/cm2 combinadas com altas taxas de repetição, 500, 154, 167, 182, 187 Hz, respectivamente, e 10 ?s de duração de pulso foram testadas. Após ter sido avaliado, qual delas resultou na maior inibição da progressão das lesões de cárie, um segundo estudo foi conduzido com cinco diferentes larguras de pulso, 5, 10, 20, 30 e 50 ?s, combinadas à mesma densidade de energia de 0,3 J/cm2. Encontrada a duração de pulso que causou o melhor resultado, um terceiro estudo foi realizado avaliando três diferentes números de pulsos sobrepostos, para a mesma densidade de energia e duração de pulso (0,3 J/cm2 e 5 ?s). Para os três estudos foram utilizados cubos de esmalte bovino, que tiveram as suas superfícies polidas. Após o tratamento das superfícies com laser, as amostras foram submetidas ao mesmo desafio cariogênico, uma ciclagem de pH de 8 dias. A desmineralização provocada foi avaliada medindo-se a profundidade das lesões em microscópio de luz polarizada. Avaliações adicionais da desmineralização foram realizadas para os estudos 2 e 3, utilizando-se a técnica de quantificação da fluorescência induzida por luz (QLF). Análises morfológicas da superfície e também da secção transversal foram realizadas com microscópio eletrônico de varredura. Diferentes grupos irradiados por laser apresentaram profundidades de lesão estatisticamente menores do que o controle (ANOVA, p<0,05), e a maior inibição, que foi inclusive menor do que o grupo tratado com gel de flúor fosfato acidulado (1,23%), foi observada para a irradiação com 0,3 J/cm2, 5 ?s, 2036 pulsos sobrepostos. Morfologicamente, nenhum dos parâmetros testados causou danos térmicos na superfície. Pelos resultados observados, pode ser concluído que a irradiação por laser de CO2 (?= 10,6 ?m) com 0,3 J/cm2, 5 ?s, 226 Hz e 2036 pulsos sobrepostos resulta em aumento da resistência do esmalte à desmineralização e não causa danos térmicos indesejados na superfície. / Although CO2 laser irradiation can decrease enamel demineralization, thermal damages to the surface are common side effects. The occurrence of fissures and cracks may compromise an in vivo application. Therefore, the aim of the present study was to find CO2 laser (?= 10.6 ?m) parameters resulting in maximum caries preventive effect with the lowest thermal damage. Three studies were carried out to systematically evaluate different laser parameters. In the first study five low fluencies of 0.1, 0.3, 0.4, 0.5 and 0.6 J/cm2 combined with high repetition rates of 500, 154, 167, 182, 187 Hz, respectively and 10 ?s pulse duration were chosen for the experiments. After evaluating the parameter which resulted in the highest caries inhibition, a second study was conducted with five different pulse durations 5, 10, 20, 30 and 50 ?s combined with 0.3 J/cm2 fluence. Finally, a third study was conducted to evaluate which number of overlapping pulses of 0.3 J/cm2 fluence and 5 ?s duration, would result in the highest caries inhibition. For all of the three studies bovine enamel cubes, which had their surfaces polished, were used. After the laser treatment, the caries challenge was always the same, an 8-day pH-cycling regime. Demineralization was assessed by lesion depth measurements with a light polarized microscope. Additional demineralization assessments were performed for the second and third studies, using the method of quantitative light-induced fluorescence (QLF). Surface and cross-sectional morphological evaluations were accomplished with scanning electron microscope. Several laser groups resulted in statistically significant lower lesion depths than the control group (ANOVA, p<0.05). The highest inhibition was even higher than observed for the group treated with acidulated phosphate fluoride gel (1,23%) and was found for the irradiation with 0.3 J/cm2, 5 ?s and 2036 overlapped pulses. Morphologically, all of the groups resulted in no surface damages. In the present in vitro study irradiation with 0.3 J/cm2, 5 ?s, 226 Hz and 2036 overlapped pulses of CO2 laser increase enamel caries resistance without causing undesirable surface damage and excessive temperature rise.

Embora seja conhecido que a irradiação com laser de CO2 reduz a desmineralização do esmalte, efeitos colaterais como danos térmicos na superfície são comumente observados. A ocorrência dessas microfraturas e fissuras é um dos fatores que ainda comprometeM uma utilização segura in vivo. Sendo assim, o objetivo desTe estudo foi encontrar parâmetros de irradiação com laser de CO2 (?= 10,6 ?m) que resultassem no máximo efeito preventivo de cárie e no menor dano térmico. Três estudos foram conduzidos para avaliar separadamente três parâmetros da irradiação com laser. No primeiro estudo cinco densidades de energia diferentes, 0,1, 0,3, 0,4, 0,5 e 0,6 J/cm2 combinadas com altas taxas de repetição, 500, 154, 167, 182, 187 Hz, respectivamente, e 10 ?s de duração de pulso foram testadas. Após ter sido avaliado, qual delas resultou na maior inibição da progressão das lesões de cárie, um segundo estudo foi conduzido com cinco diferentes larguras de pulso, 5, 10, 20, 30 e 50 ?s, combinadas à mesma densidade de energia de 0,3 J/cm2. Encontrada a duração de pulso que causou o melhor resultado, um terceiro estudo foi realizado avaliando três diferentes números de pulsos sobrepostos, para a mesma densidade de energia e duração de pulso (0,3 J/cm2 e 5 ?s). Para os três estudos foram utilizados cubos de esmalte bovino, que tiveram as suas superfícies polidas. Após o tratamento das superfícies com laser, as amostras foram submetidas ao mesmo desafio cariogênico, uma ciclagem de pH de 8 dias. A desmineralização provocada foi avaliada medindo-se a profundidade das lesões em microscópio de luz polarizada. Avaliações adicionais da desmineralização foram realizadas para os estudos 2 e 3, utilizando-se a técnica de quantificação da fluorescência induzida por luz (QLF). Análises morfológicas da superfície e também da secção transversal foram realizadas com microscópio eletrônico de varredura. Diferentes grupos irradiados por laser apresentaram profundidades de lesão estatisticamente menores do que o controle (ANOVA, p<0,05), e a maior inibição, que foi inclusive menor do que o grupo tratado com gel de flúor fosfato acidulado (1,23%), foi observada para a irradiação com 0,3 J/cm2, 5 ?s, 2036 pulsos sobrepostos. Morfologicamente, nenhum dos parâmetros testados causou danos térmicos na superfície. Pelos resultados observados, pode ser concluído que a irradiação por laser de CO2 (?= 10,6 ?m) com 0,3 J/cm2, 5 ?s, 226 Hz e 2036 pulsos sobrepostos resulta em aumento da resistência do esmalte à desmineralização e não causa danos térmicos indesejados na superfície. / Although CO2 laser irradiation can decrease enamel demineralization, thermal damages to the surface are common side effects. The occurrence of fissures and cracks may compromise an in vivo application. Therefore, the aim of the present study was to find CO2 laser (?= 10.6 ?m) parameters resulting in maximum caries preventive effect with the lowest thermal damage. Three studies were carried out to systematically evaluate different laser parameters. In the first study five low fluencies of 0.1, 0.3, 0.4, 0.5 and 0.6 J/cm2 combined with high repetition rates of 500, 154, 167, 182, 187 Hz, respectively and 10 ?s pulse duration were chosen for the experiments. After evaluating the parameter which resulted in the highest caries inhibition, a second study was conducted with five different pulse durations 5, 10, 20, 30 and 50 ?s combined with 0.3 J/cm2 fluence. Finally, a third study was conducted to evaluate which number of overlapping pulses of 0.3 J/cm2 fluence and 5 ?s duration, would result in the highest caries inhibition. For all of the three studies bovine enamel cubes, which had their surfaces polished, were used. After the laser treatment, the caries challenge was always the same, an 8-day pH-cycling regime. Demineralization was assessed by lesion depth measurements with a light polarized microscope. Additional demineralization assessments were performed for the second and third studies, using the method of quantitative light-induced fluorescence (QLF). Surface and cross-sectional morphological evaluations were accomplished with scanning electron microscope. Several laser groups resulted in statistically significant lower lesion depths than the control group (ANOVA, p<0.05). The highest inhibition was even higher than observed for the group treated with acidulated phosphate fluoride gel (1,23%) and was found for the irradiation with 0.3 J/cm2, 5 ?s and 2036 overlapped pulses. Morphologically, all of the groups resulted in no surface damages. In the present in vitro study irradiation with 0.3 J/cm2, 5 ?s, 226 Hz and 2036 overlapped pulses of CO2 laser increase enamel caries resistance without causing undesirable surface damage and excessive temperature rise.

O presente estudo teve como objetivo realizar uma revisão da literatura para verificar se os novos compostos bioativos presentes no mercado, como CPP-ACP, fosfosilicato de cálcio e sódio e o nitrato de potássio são eficazes na remineralização do esmalte dental clareado. As alterações ocorridas na superfície dental devido ao clareamento são diversas. Dentre elas, pode-se citar a rugosidade, dureza, perda de conteúdo mineral e alterações morfológicas como as mais estudadas. Muitas formas de análises tem sido utilizadas para essas avaliações, porém duas novas técnicas demonstram-se promissoras: o QLF e a nanoidentação. O QLF relaciona-se com a auto fluorescência dental, possuindo vantagens relacionadas a sua especificidade, simples manuseio e preservação do espécime. Já a nanoidentação é capaz de mensurar a dureza em sítios específicos, em uma escala nanométrica, permitindo uma criteriosa seleção da área a ser analisada. Os resultados obtidos não necessitam da mensuração visual da área demarcada pelo identador, o que se torna mais uma vantagem da técnica. Foi conclusivo que a literatura diverge quanto aos resultados apresentados até o momento relacionados aos efeitos do clareamento dental na superfície dental, e os estudos que avaliaram os diversos compostos bioativos apresentam diferentes metodologias que não permitem o estabelecimento de um protocolo de aplicação dos mesmos. Sendo assim, faz-se necessária a realização de novos estudos para avaliar os possíveis efeitos dos diferentes compostos quando da utilização destes como dentifrícios de uso terapêutico após o tratamento clareador. / This study aimed to review the literature and verify if the new bioactive compounds, like CPP-ACP, calcium sodium phosphosilicate and potassium nitrate are effective on the remineralization of the bleached dental enamel. There are several alterations occurred on the dental surface owing to the bleaching procedure. Among them: roughness, microhardness, mineral content loss and morphologic alterations are the most evaluated. Many different analysis have been used to assess the changes in the dental structure, however two of them have shown to be promising: the QLF and the nanoindentation. The QLF is related with the auto fluorescence of the teeth and has advantages related to its specificity, simple manipulation and it is not a destructive technique. On the other hand, the nanoindentation is capable to measure the surface hardness in very specific sites, in a nanometric scale, enabling a criterious selection of the area which will be analyzed. The results obtained by this equipment do not require the visual measure of the impressed area of the indentation, which is one advantage of the methodology. It was conclusive that the literature disagrees of the results presented about the effects of dental bleaching on the enamel surface and the researches that evaluated the bioactive compounds have demonstrated differences in their methodologies. These inconclusive findings interfere on the establishment of an application protocol to those new dentifrices. Thus, it is necessary to develop new researches to better understand the possible effects of the bioactive compounds when the use of these dentifrices are related to a therapeutic use after treatment with bleaching agents.

No description available.

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / Fluoride prevents caries by decreasing demineralization and promoting remineralization of enamel crystals during lesion formation and progression. The chemical, morphological, and histologic characteristics of teeth with fluorosis may alter the response of enamel to fluoride during the caries process. However, the effectiveness of fluoride in fluorosed teeth has not been thoroughly studied. Therefore, the current study utilized an in-vitro net remineralization model to study differences between fluorosed and sound enamel with regards to caries lesion remineralization and progression. Hypotheses: There is no significant difference in the effectiveness of fluoride to enhance caries lesion remineralization between fluorosed and non-fluorosed (sound) teeth after changes in enamel fluorescence relative to the lesion baseline. Objectives: The primary objective is to investigate the relative fluoride response of caries lesions created in sound and fluorosed teeth of varying severities under remineralizing conditions in vitro. Secondary objectives: a) To investigate the impact of the presence and severity of enamel fluorosis on caries lesion formation, and b) To investigate the acquired acid resistance of pH-cycled lesions relative to their fluorosis severity. Materials and Methods: Three hundred sixty (360) extracted human molars (sound and fluorosed) were collected and divided into four main groups based on their TF score (0; 1; 2; 3), with sample size of n = 45 per group. Each group was divided into two subgroups: no fluoride/placebo and fluoride/treatment. Artificial caries lesions were created on the teeth and pH-cycled for 20 days using a net remineralization model. The lesions were assessed to determine differences in acquired acid resistance. Quantitative light-induced fluorescence (QLF) was used throughout the study to determine changes in enamel fluorescence relative to a sound enamel window, thereby providing information about enamel de- or remineralization. The results of this study demonstrated that enamel fluorosis levels had a significant effect on lesion remineralization after pH cycling (p > 0.05). The teeth with moderate dental fluorosis had a significantly better response to remineralization and more resistance to a subsequent acid challenge than sound teeth in the presence of fluoride. / indefinitely.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: Non-cavitated caries lesions form due to acid diffusion and demineralization of enamel subsurface with an intact surface layer (SL). Caries lesions progress when the outcome of demineralization and remineralization processes over time is net mineral loss. Lesions that continue to demineralize are called active, while those that display no evidence of further demineralization are called inactive. Micro-computed-tomography (µCT) analysis provides objective non-destructive measurements of the thickness of the surface layer (SL) and severity of caries lesions. Aims: 1) To investigate if visual/tactile suspected active non-cavitated early white spot lesions present a thinner surface layer than inactive ones; 2) To investigate if there is an association between the thickness of the surface layer (SLT) and caries activity, as determined by QLF during dehydration (△QD); 3) To determine lesion severity by comparing lesion volume and maximum depth correlation with △Q value at 15 s from QLF during dehydration. Materials and Methods: Thirty extracted human premolars exhibiting non-cavitated approximal white spot early lesions stored in 0.1.-percent thymol/4C and treated with 5.0-percent NaOCl/30 min were included in the study. Fifteen active and 15 inactive lesions were determined by visual/tactile examinations by consensus of two experienced examiners. Roughness measurements (Ra) were acquired using non-contact optical profilometry. Two-dimensional minimum (2D-min), maximum (2D-max), average (2D-avg) SL and three-dimensional (3D) analyses, volume and depth of lesions were determined from µCT image analysis. A series of fluorescence images were acquired at baseline (hydrated), at 1 s, at 5 s, at 10 s and at 15 s by QLF. During image acquisition, surfaces were dehydrated with continuous-compressed-air. △Q and △Q/s (△QD) were calculated. Data were analyzed using two-sample t-tests and Pearson correlation coefficients (p < 0.05). Results: Surface roughness of active and inactive lesions was not significantly different (p > 0.08). Overall lesion volume and depth in dentin were significantly larger in active lesions (p = 0.022, p = 0.009). SL thickness of active and inactive lesions was not significantly different (2D = 0.121, 3D = 0.080, 2D-avg = 0.446, 2D-min = 0.197, 2D-max = 0.122). △QD at 1s was significantly larger for active lesions (p = 0.046). ΔQ at 15 s of dehydration had a moderate positive association with lesion volume (r = 0.56). △QD had a weak negative association with SL thickness (2D-avg) and (2D-min). Conclusions: 1) Active and inactive non-cavitated lesions show no difference in SL thickness; 2) QLF during dehydration (△QD) does not correlate well with SL thickness; 3) ΔQ at 15 s of dehydration correlates moderately well with lesion volume and is consistent with caries activity assessed by visual/tactile examination.

Indiana University-Purdue University Indianapolis (IUPUI) Indiana University School of Dentistry Master Degree Thesis. / Detection of caries at an early stage is unequivocally essential for early preventive intervention. Longitudinal assessment of caries lesions, especially under the opaque preventive sealant, would be of utmost importance to the dental community. OBJECTIVES: The aim of this two-part in-vitro study is to evaluate the performance of multiple detection methods: The International Caries Detection and Assessment System (ICDAS); two quantitative light-induced fluorescence systems QLF; Inspektor™ Pro and QLF-D Biluminator™2 (Inspektor Research Systems B.V.; Amsterdam, The Netherlands); and photothermal radiometry and modulated luminescence (PTR/LUM) of The Canary System® (Quantum Dental Technologies; Toronto, Canada). All these are to be evaluated on their detection of caries on posterior human permanent teeth for 1) of primary occlusal lesions, and 2) under the sealant of primary occlusal lesions. METHODS: One hundred and twenty (N = 120) human posterior permanent teeth, selected in compliance with IU-IRB “Institutional Review Board” standards, with non-cavitated occlusal lesions ICDAS (scores 0 to 4) were divided into two equal groups. The second group (N = 60) received an opaque resin dental sealant (Delton® Light-Curing Pit and Fissure Sealant Opaque, Dentsply, York, PA). All lesions were assessed with each detection method twice in a random order except for ICDAS, which was not used following the placement of the sealant. Histological validation was used to compare methods in regard to sensitivity, specificity, % correct, and the area under receiver- operating characteristic curve (AUC). Intra-examiner repeatability and inter-examiner agreement were measured using intraclass correlation coefficient (ICC). RESULTS: 1) Of primary occlusal lesions, sensitivity, specificity, and AUC values were respectively: 0.82, 0.86 and 0.87 (ICDAS); 0.89, 0.60 and 0.90 (Inspektor Pro); 0.96, 0.57 and 0.94 (QLF-D Biluminator 2); and 0.85, 0.43 and 0.79 (The Canary System). Intra-examiner repeatability and inter-examiner agreement were respectively: 0.81 to 0.87: 0.72 (ICDAS); 0.49 to 0.97: 0.73 (Inspektor Pro); 0.96 to 0.99: 0.96 (QLF-D Biluminator 2); and 0.33 to 0.63: 0.48 (The Canary System). 2) Of primary occlusal lesions under the opaque dental sealants, sensitivity, specificity, and AUC values were respectively: 0.99, 0.03 and 0.67 (Inspektor Pro); 1.00, 0.00 and 0.70 (QLF-D Biluminator 2); and 0.54, 0.50 and 0.58 (The Canary System). Intra-examiner repeatability and inter-examiner agreement were respectively: 0.24 to 0.37: 0.29 (Inspektor Pro); 0.80 to 0.84: 0.74 (QLF-D Biluminator 2); and 0.22 to 0.47: 0.01 (The Canary System). CONCLUSION: Limited to these in-vitro conditions, 1) ICDAS remains the method of choice for detection of early caries lesion due to its adequately high accuracy and repeatability. QLF systems demonstrate potential in longitudinal monitoring due to an almost perfect repeatability of QLF-D Biluminator 2. The Canary System performance and repeatability were not acceptable as a valid method of early caries detection. 2) None of the methods demonstrated acceptable ability in detecting of occlusal caries under the opaque sealant. However, QLF-D Biluminator 2, with limitation to these in-vitro conditions and Delton opaque sealant, demonstrated a fair accuracy AUC (0.70) in detecting of caries under sealants at an experimental threshold of 12.5% ΔF.