Precision of Raman depolarization and optical attenuation measurements of sound tooth enamel

A Study of the Peculiarities of the Formation of a Hybrid Interface Based on Polydopamine between Dental Tissues and Dental Composites, Using IR and Raman Microspectroscopy, at the Submicron Level

The creation of buffer (hybrid) layers that provide improved adhesion to two heterogeneous materials is a promising and high-priority research area in the field of dental materials science. In our work, using FTIR and Raman microspectroscopy at the submicron level in a system of dental composites/intact dental enamel, we assessed the molecular features of formation and chemically visualized the hybrid interface formed on the basis of a nature-like adhesive, polydopamine (PDA). It is shown that a homogeneous bioinspired PDA-hybrid interface with an increased content of O-Ca-O bonds can be created using traditional methods of dental tissue pretreatment (diamond micro drilling, acid etching), as well as the subsequent alkalinization procedure and the developed synthesis technology. The development of the proposed technology for accelerated deposition of PDA-hybrid layers, as well as the creation of self-assembled biomimetic nanocomposites with antibacterial properties, may in the future find clinical application for minimally invasive dental restoration procedures.

Compositional Analysis of the Dental Biomimetic Hybrid Nanomaterials Based on Bioinspired Nonstoichiometric Hydroxyapatite with Small Deviations in the Carbonate Incorporation

In our paper, we discuss the results of a comprehensive structural-spectroscopic and microscopic analysis of non-stoichiometric nanocrystalline hydroxyapatite (CHAp) with low carbonate anion content and biomimetic hybrid nanomaterials produced on its basis. It was shown that hydroxyapatite nanocrystals synthesized by chemical precipitation and biogenic calcium source mimic the properties of biogenic apatite and also have a morphological organization of "core-shell" type. The "core" of the CHAp nanocrystal is characterized by an overabundance of calcium Ca/P~1.9. Thus "a shell" with thickness of ~3-5 nm is formed from intermediate apatite-like phases where the most probable are octocalcium phosphate, dicalcium phosphate dihydrate and tricalcium phosphate. The multimode model of the Raman profile of samples CHAp and biomimetic composites for spectral region 900-1100 cm^-1 proposed in our work has allowed to allocate precise contribution of B-type carbonate substitution, taking into account the presence on a surface of "core" HAp nanocrystal of various third-party intermediate apatite-like phases. The calibration function constructed on the basis of the described model makes it possible to reliably determine small concentrations of carbonate in the structure of hydroxyapatite with the application of Raman express method of diagnostics. The results of our work can inspire researchers to study the processes of induced biomineralization in mineralized tissues of the human body, using non-destructive methods of control with simultaneous analysis of chemical bonding, as well as determining the role of impurity atoms in the functions exhibited by biotissue.

Assessment of demineralized tooth lesions using optical coherence tomography and other state-of-the-art technologies: a review

Tooth demineralization is one of the most common intraoral diseases, encompassing (1) caries caused by acid-producing bacteria and (2) erosion induced by acid of non-bacterial origin from intrinsic sources (e.g. stomach acid reflux) and extrinsic sources (e.g. carbonated drinks). Current clinical assessment based on visual-tactile examination and standardized scoring systems is insufficient for early detection. A combination of clinical examination and technology is therefore increasingly adapted. This paper reviews various procedures and technologies that have been invented to diagnose and assess the severity of tooth demineralization, with focus on optical coherence tomography (OCT). As a micron-resolution non-invasive 3D imaging modality, variants of OCT are now available, offering many advantages under different working principles for detailed analytical assessment of tooth demineralization. The roles, capabilities and impact of OCT against other state-of-the-art technologies in both clinical and research settings are described. (139 words).

Biomimetic Mineralization of Tooth Enamel Using Nanocrystalline Hydroxyapatite under Various Dental Surface Pretreatment Conditions

In this report, we demonstrated the formation of a biomimetic mineralizing layer obtained on the surface of dental enamel (biotemplate) using bioinspired nanocrystalline carbonate-substituted calcium hydroxyapatite (ncHAp), whose physical and chemical properties are closest to the natural apatite dental matrix, together with a complex of polyfunctional organic and polar amino acids. Using a set of structural, spectroscopy, and advanced microscopy techniques, we confirmed the formation of a nanosized ncHAp-based mineralized layer, as well as studying its chemical, substructural, and morphological features by means of various methods for the pretreatment of dental enamel. The pretreatment of a biotemplate in an alkaline solution of Ca(OH)₂ and an amino acid booster, together with the executed subsequent mineralization with ncHAp, led to the formation of a mineralized layer with homogeneous micromorphology and the preferential orientation of the ncHAp nanocrystals. It was shown that the homogeneous crystallization of hydroxyapatite on the biotemplate surface and binding of individual nanocrystals and agglomerates into a single complex by an amino acid booster resulted in an increase (~15%) in the nanohardness value in the enamel rods area, compared to that of healthy natural enamel. Obtaining a similar hierarchy and cleavage characteristics as natural enamel in the mineralized layer, taking into account the micromorphological features of dental tissue, is an urgent problem for future research.

Raman and XANES Spectroscopic Study of the Influence of Coordination Atomic and Molecular Environments in Biomimetic Composite Materials Integrated with Dental Tissue

In this work, for the first time, the influence of the coordination environment as well as Ca and P atomic states on biomimetic composites integrated with dental tissue was investigated. Bioinspired dental composites were synthesised based on nanocrystalline calcium carbonate-substituted hydroxyapatite Ca4ICa6IIPO46−xCO3x+yOH2−y (nano-cHAp) obtained from a biogenic source and a set of polar amino acids that modelled the organic matrix. Biomimetic composites, as well as natural dental tissue samples, were investigated using Raman spectromicroscopy and synchrotron X-ray absorption near edge structure (XANES) spectroscopy. Molecular structure and energy structure studies revealed several important features related to the different calcium atomic environments. It was shown that biomimetic composites created in order to reproduce the physicochemical properties of dental tissue provide good imitation of molecular and electron energetic properties, including the carbonate anion CO₃²⁻ and the atomic Ca/P ratio in nanocrystals. The features of the molecular structure of biomimetic composites are inherited from the nano-cHAp (to a greater extent) and the amino acid cocktail used for their creation, and are caused by the ratio between the mineral and organic components, which is similar to the composition of natural enamel and dentine. In this case, violation of the nano-cHAp stoichiometry, which is the mineral basis of the natural and bioinspired composites, as well as the inclusion of different molecular groups in the nano-cHAp lattice, do not affect the coordination environment of phosphorus atoms. The differences observed in the molecular and electron energetic structures of the natural enamel and dentine and the imitation of their properties by biomimetic materials are caused by rearrangement in the local environment of the calcium atoms in the HAp crystal lattice. The surface of the nano-cHAp crystals in the natural enamel and dentine involved in the formation of bonds with the organic matrix is characterised by the coordination environment of the calcium atom, corresponding to its location in the Ca^I position—that is, bound through common oxygen atoms with PO₄ tetrahedrons. At the same time, on the surface of nano-cHAp crystals in bioinspired dental materials, the calcium atom is characteristically located in the Ca^II position, bound to the hydroxyl OH group. The features detected in the atomic and molecular coordination environment in nano-cHAp play a fundamental role in recreating a biomimetic dental composite of the natural organomineral interaction in mineralised tissue and will help to find an optimal way to integrate the dental biocomposite with natural tissue.

Assessing surface characteristics of eroded dentine with optical coherence tomography: a preliminary in vitro validation study

We conducted the first pilot study to investigate the use of the attenuation coefficient from an optical coherence tomography (OCT) backscattered signal as a measure of surface roughness changes in eroded dentine at an early stage of the erosion process. Ten human premolar root samples were subjected to citric acid treatment before scanning by OCT. The extracted relative attenuation coefficient (μ_R) from backscattered OCT signals was shown to increase with the duration of acid challenge. Validated against roughness measurements (rS_a) from scanning electron microscopy scans, μ_R is significantly correlated with rS_a indicative of severity of erosion (p<0.01, r=0.9195). We conclude that the OCT attenuation coefficient of the immediate subsurface in eroded dentine is a potential surrogate measure for its surface roughness. However, further work should be performed to study how it relates to the surface and immediate subsurface changes effected by other mechanical wear before it could unequivocally be used as a surrogate measurement for surface roughness.

[Ex vivo assessment of the potency of optical coherence tomography for the detection of early occlusal caries]

OBJECTIVE

This study aimed to evaluate the potency of optical coherence tomography (OCT) to detect early occlusal caries compared with clinical visual examination.

METHODS

Approximately 97 sites of occlusal fissures on 77 extracted accessional human teeth were scored by three examiners using conventional visual examination and OCT. Results of histological examination on these sites obtained by polarimicroscope served as a gold standard to analyze the sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV). Results of the area under receiver operating characteristic (ROC) curve (AUC) by visual examination and OCT were also analyzed. The Spearman's rank correlation coefficient with histology and the inter-examiner reliability were compared.

RESULTS

For sites of enamel demineralization limited to the outer 1/2 of the enamel layer, the detection rate of OCT (14/25) was obviously higher than that of the clinical and visual examination (3/25). SE, SP, PPV and NPV of OCT during diagnosis of the early occlusal caries (0.83, 0.64, 0.87 and 0.57) were higher than that of the visual examination (0.79, 0.60, 0.85 and 0.50). AUC (95%CI) of OCT and the visual examination were 0.737 (0.569-0.822) and 0.696 (0.614-0.859), respectively. No statistically significant difference was observed between the results. Results of OCT correlated well with histology (r=0.559, P<0.05). The inter-examiner reliability of OCT was medium.

CONCLUSIONS

OCT can accurately detect early occlusal lesions atraumatically with high sensitivity and effectiveness. OCT exhibits the potential of auxiliary clinical diagnosis enhancing detection rate and finally implementing early diagnosis and early intervention of early occlusal lesions in clinical practice.

Optical analysis of enamel and dentin caries in relation to mineral density using swept-source optical coherence tomography

The aim of this study was to evaluate the signal intensity and signal attenuation of swept source optical coherence tomography (SS-OCT) for dental caries in relation to the variation of mineral density. SS-OCT observation was performed on the enamel and dentin artificial demineralization and on natural caries. The artificial caries model on enamel and dentin surfaces was created using Streptococcus mutans biofilms incubated in an oral biofilm reactor. The lesions were centrally cross sectioned and SS-OCT scans were obtained in two directions to construct a three-dimensional data set, from the lesion surface (sagittal scan) and parallel to the lesion surface (horizontal scan). The integrated signal up to [Formula: see text] in depth (IS200) and the attenuation coefficient ([Formula: see text]) of the enamel and dentin lesions were calculated from the SS-OCT signal in horizontal scans at five locations of lesion depth. The values were compared with the mineral density obtained from transverse microradiography. Both enamel and dentin demineralization showed significantly higher IS200 and [Formula: see text] than the sound tooth substrate from the sagittal scan. Enamel demineralization showed significantly higher IS200 than sound enamel, even with low levels of demineralization. In demineralized dentin, the [Formula: see text] from the horizontal scan consistently trended downward compared to the sound dentin.

Application of Optical Coherence Tomography (OCT) for Diagnosis of Caries, Cracks, and Defects of Restorations

Optical coherence tomography (OCT) is a noninvasive technique providing cross-sectional images of a tooth structure. This review describes the use of OCT for detecting dental caries, tooth fractures, and interfacial gaps in intraoral restorations. OCT can be a reliable and an accurate method and a safer alternative to X-ray radiography.

Precision of Raman spectroscopy measurements in detection of microcalcifications in breast needle biopsies

Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. We developed Raman spectroscopy decision algorithms to detect breast microcalcifications, based on fit coefficients (FC) derived by modeling tissue Raman spectra as a linear combination of the Raman spectra of 9 chemical and morphologic components of breast tissue. However, little or no information is available on the precision of such measurements and its effect on the ability of Raman spectroscopy to make predictions for breast microcalcification detection. Here we report the precision, that is, the closeness of agreement between replicate Raman spectral measurements--and the model FC derived from them--obtained ex vivo from fresh breast biopsies from patients undergoing stereotactic breast needle biopsy, using a compact clinical Raman system. The coefficients of variation of the model FC averaged 0.03 for normal breast tissue sites, 0.12 for breast lesions without, and 0.22 for breast lesions with microcalcifications. Imprecision in the FC resulted in diagnostic discordance among replicates only for line-sitters, that is, tissue sites with FC values near the decision line or plane. The source of this imprecision and their implications for the use of Raman spectroscopy for guidance of stereotactic breast biopsies for microcalcifications are also discussed. In summary, we conclude that the precision of Raman spectroscopy measurements in breast tissue obtained using our compact clinical system is more than adequate to make accurate and repeatable predictions of microcalcifications in breast tissue using decision algorithms based on model FC. This provides strong evidence of the potential of Raman spectroscopy guidance of stereotactic breast needle biopsies for microcalcifications.

A comparison of methods using optical coherence tomography to detect demineralized regions in teeth

Optical coherence tomography (OCT) is a three- dimensional optical imaging technique that can be used to identify areas of early caries formation in dental enamel. The OCT signal at 850 nm back-reflected from sound enamel is attenuated stronger than the signal back-reflected from demineralized regions. To quantify this observation, the OCT signal as a function of depth into the enamel (also known as the A-scan intensity), the histogram of the A-scan intensities and three summary parameters derived from the A-scan are defined and their diagnostic potential compared. A total of 754 OCT A-scans were analyzed. The three summary parameters derived from the A-scans, the OCT attenuation coefficient as well as the mean and standard deviation of the lognormal fit to the histogram of the A-scan ensemble show statistically significant differences (p < 0.01) when comparing parameters from sound enamel and caries. Furthermore, these parameters only show a modest correlation. Based on the area under the curve (AUC) of the receiver operating characteristics (ROC) plot, the OCT attenuation coefficient shows higher discriminatory capacity (AUC = 0.98) compared to the parameters derived from the lognormal fit to the histogram of the A-scan. However, direct analysis of the A-scans or the histogram of A-scan intensities using linear support vector machine classification shows diagnostic discrimination (AUC = 0.96) comparable to that achieved using the attenuation coefficient. These findings suggest that either direct analysis of the A-scan, its intensity histogram or the attenuation coefficient derived from the descending slope of the OCT A-scan have high capacity to discriminate between regions of caries and sound enamel.

Optical coherence tomography-current technology and applications in clinical and biomedical research

Optical coherence tomography (OCT) is a noninvasive imaging technique that provides real-time two- and three-dimensional images of scattering samples with micrometer resolution. By mapping the local reflectivity, OCT visualizes the morphology of the sample. In addition, functional properties such as birefringence, motion, or the distributions of certain substances can be detected with high spatial resolution. Its main field of application is biomedical imaging and diagnostics. In ophthalmology, OCT is accepted as a clinical standard for diagnosing and monitoring the treatment of a number of retinal diseases, and OCT is becoming an important instrument for clinical cardiology. New applications are emerging in various medical fields, such as early-stage cancer detection, surgical guidance, and the early diagnosis of musculoskeletal diseases. OCT has also proven its value as a tool for developmental biology. The number of companies involved in manufacturing OCT systems has increased substantially during the last few years (especially due to its success in opthalmology), and this technology can be expected to continue to spread into various fields of application.

Speckle reduction and lesion segmentation of OCT tooth images for early caries detection

The significance of identifying early non-cavitated carious lesions and monitoring the lesion extent has led to increasing prospects for prevention, early diagnosis, and implementation of conservative treatments. This paper emphasizes the importance of speckle reduction and possible lesion segmentation options of optical coherence tomography (OCT) images prior to caries detection. First, a comparison of popular speckle reduction filters is presented. These filtering algorithms were evaluated to measure the ability of different methods for reducing background noise from raw images. Both qualitative and quantitative results (signal-to-noise ratio, contrast-to-noise ratio) are reported. Image segmentation is then applied to multiple tooth images. With proper thresholding, high intensity response regions are outlined with the possibility of assessing caries and monitoring its regression. Our results show that a rotating kernel transformation (RKT) filter with 9x9 kernel size provides a good compromise between noise reduction yet preserving the pathological features of interest as required for subsequent feature segmentation analyses.

Quantification of dental erosions in patients with GERD using optical coherence tomography before and after double-blind, randomized treatment with esomeprazole or placebo

OBJECTIVES

Dental erosion, the chemical dissolution of enamel without bacterial involvement, is a rarely reported manifestation of gastroesophageal reflux disease (GERD), as well as of recurrent vomiting and dietary habits. It leads to loss of tooth substance, hypersensitivity, functional impairment, and even tooth fracture. To date, dental erosions have been assessed using only very basic visual methods, and no evidence-based guidelines or studies exist regarding the prevention or treatment of GERD-related dental erosions.

METHODS

In this randomized, double-blind study, we used optical coherence tomography (OCT) to quantify dental tissue demineralization and enamel loss before and after 3 weeks of acid-suppressive treatment with esomeprazole 20 mg b.i.d. or placebo in 30 patients presenting to the Berne University Dental Clinic with advanced dental erosions and abnormal acid exposure by 24-h esophageal pH manometry (defined as >4% of the 24-h period with pH<4). Enamel thickness, reflectivity, and absorbance as measures of demineralization were quantified by OCT before and after therapy at identical localizations on teeth with most severe visible erosions as well as several other predefined changes in teeth.

RESULTS

The mean+/-s.e.m. decrease of enamel thickness of all teeth before and after treatment at the site of maximum exposure was 7.2+/-0.16 black trianglem with esomeprazole and 15.25+/-0.17black trianglem with placebo (P=0.013), representing a loss of 0.3% and 0.8% of the total enamel thickness, respectively. The change in optical reflectivity to a depth of 25 black trianglem after treatment was-1.122 +/-0.769 dB with esomeprazole and +2.059+/-0.534 dB with placebo (P 0.012), with increased reflectivity signifying demineralization.

CONCLUSIONS

OCT non-invasively detected and quantified significantly diminished progression of dental tissue demineralization and enamel loss after only 3 weeks of treatment with esomeprazole 20 mg b.i.d. vs. placebo. This suggests that esomeprazole may be useful in counteracting progression of GERD-related dental erosions. Further validation of preventative treatment regimens using this sensitive detection method is required, including longer follow-up and correlation with quantitative reflux measures.

Polarized Raman microspectroscopy can reveal structural changes of peritumoral dermis in basal cell carcinoma

Polarized Raman microspectroscopy can provide precious information regarding the orientation and ordering of the molecules in a sample without staining or particular preparation. This technique is used for the first time on a human skin section to probe the molecular modifications of the surrounding dermis in superficial basal cell carcinoma. Spectra using polarized and conventional Raman microspectroscopies were recorded on dermis bordering either the tumor or healthy epidermis. Band areas and spectral decomposition on selected vibrations were computed. Significant differences in dermal collagen vibration bands are detected using both polarized and conventional micro-spectroscopies, but the spectral changes between tumor and healthy tissues are enhanced using polarized Raman microspectroscopy. The analysis of these spectral differences highlights structural modifications of the triple helix of collagen. We see polarized Raman microspectroscopy as a potential tool that could be implemented for clinical analyses to guide clinicians and surgeons in the treatment of aggressive skin cancers. The information obtainable could also help better elucidate the molecular mechanisms induced in basal cell carcinoma development.

Assessment of early demineralization in teeth using the signal attenuation in optical coherence tomography images

Optical coherence tomography imaging is used to improve the detection of incipient carious lesions in dental enamel. Measurements of signal attenuation in images acquired with an 850-nm light source were performed on 21 extracted molars from eight human volunteers. Stronger attenuation was observed for the optical coherence tomography (OCT) signal in healthy enamel than in carious lesions. The measured attenuation coefficients from the two groups form distinct statistical populations. The coefficients obtained from sound enamel fall within the range of 0.70 to 2.14 mm(-1) with a mean value of 1.35 mm(-1), while those in carious regions range from 0.47 to 1.88 mm(-1), with a mean value of 0.77 mm(-1). Three values are selected as the lower threshold for signal attenuation in sound enamel: 0.99, 0.94, and 0.88 mm(-1). These thresholds were selected to provide detection of sound enamel with fixed specificities of 90%, 95%, and 97.5%, respectively. The corresponding sensitivities for the detection of carious lesions are 92.8%, 90.4%, and 87%, respectively, for the sample population used in this study. These findings suggest that attenuation of OCT signal at 850 nm could be an indicator of tooth demineralization and could be used as a marker for early caries detection.