Products in Practice: SoproLIFE in my practice

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Fig. 1 Fractured and defective restorations.
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Fig. 2 Large cavities.
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Fig. 3 Cracked teeth.
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Fig. 4 An asymptomatic broken tooth and restoration.
View the full image $Fig. 5 Detected a horizontal fracture from mesio to distal of the crown.$

Fig. 5 Detected a horizontal fracture from mesio to distal of the crown.
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Fig. 6 SoproLIFE in Macro mode.
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Fig. 7 Large composite filling and crack.
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Fig. 8 Images from prep.
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Fig. 9 Final delivered crown.

$Fig. 5 Detected a horizontal fracture from mesio to distal of the crown.$

Practice Pyramid Series
In coordination with the Pride Institute, this is one more opportunity to interact with the technologies recognized as “Best of Class.” You’ve heard the brochure-side of what these products can do. Now, the people perspective on what makes these products stand out.

The Product

SoproLIFE, distributed by ACTEON North America, is the world’s first multi-function intraoral camera combining caries detection with a high-end intraoral video camera function.

SoproLIFE, like all Sopro cameras, connects to a Windows® or Apple® PC via a USB 2.0 port and generates a live video stream that is encapsulated and displayed via the USB connection. Software drivers allow the video stream to be delivered to the Windows® or Apple® Operating System (OS) and the OS “delivers” the video stream to whichever imaging application is chosen by the practitioner.
Intraoral camera
SoproLIFE’s intraoral camera provides outstanding color images. It is a fixed–focus camera with four pre-set focal ranges offering excellent depth-of-field in all four ranges. The ranges are Macro (0 mm-5 mm), LIFE (single tooth), Intraoral (5 mm-30 mm), and Portrait (30 mm+) providing sharp, focused shots at any distance. Its driver architecture allows LIFE to integrate into any image management application in either Windows® or Apple® environments, seamlessly integrating into the image management software of the practitioner’s choice. New generation LEDs provide either white or blue light to illuminate the field being recorded while using half the power of the previous generation and an updated digital signal processor (DSP) allows the camera to be powered by the host computer’s USB port.
Caries detection
For caries detection, four integrated LEDs emit harmless blue light at a wavelength of 450 nm when the device is placed in Diagnostic Mode. When directed toward dental tissues, this light penetrates the translucent nature of the enamel and generates an auto-fluorescent signal. In this case, a fluorescent signal is defined as the emitted signal from a dental structure that occurs after subjecting those tissues to a specific wavelength of light. This emitted signal is processed by electronics within the camera that will show, in a real-time video stream, areas that are affected by dental caries. In the live video stream, the soft tissues of the mouth (tongue, gums, et al) will be colorless (i.e. monochromatic), healthy hard dental tissues will be green or blue (depending on enamel thickness) and any carious lesions will be red.

A carious lesion is identified by the change it causes in the fluorescent signal. With this methodology, the actual tissues and structures of the tooth are evaluated, which greatly reduces the chance for false positives. All the normal treatment protocols will be followed once the caries has been identified.

SoproLIFE is not only an aid for the detection of caries; it also has a mode for the treatment of the condition once a diagnosis is complete. Treatment Mode is available via a simple switch on the bottom side of the camera and once selected this mode clearly and definitively guides the practitioner through the complete removal of the affected tissues. Excavation efforts can be guided by viewing the treatment progress with the camera, stopping once all the red areas have been excised. Please note that tertiary or scar dentin is affected and will have an orange tint versus the bright red tint of active caries. This tissue can be preserved during the restoration.

The caries detection and treatment functions of SoproLIFE are all performed in real-time video without the need for interpretive software or other arbitrary guidelines. This leaves the practitioner’s expertise and judgment at the center of treatment. Further, the caries detection functionality is built into the device’s video system making it a simple process to capture an image and save it directly into a patient’s clinical record. Alternately, because there is no dependence on external software applications to interpret the captured data, SoproLIFE’s video stream can optionally be displayed on any s-video or composite enabled monitor.

I remember when Andrew Allison (our SoproLIFE rep) came to my office for an intraoral camera demonstration in the fall of 2009. He said, “Dr. Vasquez, I’m going to show you a breakthrough in dental technology—an intraoral camera and caries detection device all in one.”

He explained how the camera works: using auto fluorescence technology, the user can easily switch lighting from white LED (or Daylight mode) that allows you to use SoproLIFE as a normal intraoral camera with quality images, to blue LED (light-induce fluorescence evaluator) caries detection mode.

While enabling the detection of caries more easily missed by eye or x-ray, SoproLIFE works with three different settings in imaging taking:

Portrait (Daylight Mode)
Intraoral (Diagnosis Mode)
Macro (Treatment Mode)

I told Andrew I needed to see the product in use on real patients, and I can say that after seeing SoproLIFE in action, I was sold.

I want my diagnosis to be the most accurate and I want my patients to understand the diagnosis and treatment proposed. This process has been simplified by the excellent images taken with SoproLIFE.

Now one of the most important diagnostic tools in my practice, SoproLIFE is my go-to for the detection of early caries, defective amalgams or composites and broken restorations; and part of my armamentarium during treatment using the Macro mode for the detection of cracked teeth, broken cuspids.

Our case acceptance, productivity, patient satisfaction and insurance payments all increased in 2011, in no small part because of the impact of SoproLIFE.

Benefits in action
With this technology, I can practice minimally invasive dentistry—where the principal philosophy is to be more conservative and preserve more tooth structure—by early detection of decay and repairing the effects of old, fractured and defective restorations, large cavities and cracked teeth (Figs. 1-3).

Here are two cases worth referencing:

Case I
A 43-year-old male came to the office for a routine checkup. After taking an x-ray and intraoral images we detected an asymptomatic broken tooth and restoration (Fig 4). After removal of the restoration we detected a horizontal fracture from mesio to distal of the crown (Fig. 5), changing the treatment plan to endodontic treatment and possible extraction. After accessing the pulp chamber and using SoproLIFE in Macro mode (Fig. 6) we determined how best to finish the root canal, build up and crown. Risk, benefits and options were given and the patient understands if he starts having any pain or infection, extraction and implant will be the next step.

Case II
A 37-year-old female patient came in for a routine exam and cleaning. FMX and intraoral images are taken, and tooth No. 2 presented with a large composite filling and crack (Fig 7). We recommended full coverage. Images from preparation (Fig. 8) and for the final delivered crown (Fig 9).