Dental optical coherence tomography

Assessing diagnostic accuracy and monitoring of caries progression using optical coherence tomography (OCT): A systematic review

OBJECTIVES

This systematic review analyzed studies concerning the effectiveness of Optical Coherence Tomography (OCT) in detecting and monitoring dental caries in enamel and dentin.

DATA

Studies comparing the diagnostic accuracy of OCT in diagnosing caries clinically or using extracted teeth were included.

SOURCES

Databases, including PubMed/MEDLINE, Web of Science, EMBASE, and Scopus were searched for clinical trials and studies conducted using human teeth between 2010 and 2024. The process of study selection and data extraction followed the PRISMA guidelines. The methodological quality of the included studies was evaluated using the Critical Appraisal Skills Programme (CASP) diagnostic study checklist.

STUDY SELECTION

Seven studies met the inclusion criteria out of 1,266 articles identified. OCT modalities used in these studies include Cross-polarization OCT (CP-OCT), Swept-source OCT (SS-OCT), and polarization-sensitive (PS-OCT), with wavelengths ranging between 1310 and 1330 nm; axial resolutions were between 7.5-22 μm. SS-OCT had a high sensitivity of 74.1 % and specificity of 95.7 % when applied to caries detection. CP-OCT was able to identify dentin-penetrating lesions with greater accuracy than conventional radiography. There were strong correlations in the OCT measurements with the established diagnostic gold standards: polarized light microscopy (PLM), r = 0.63, P < 0.01; transverse microradiography (TMR), r = 0.75, P < 0.001.

CONCLUSION

OCT has demonstrated better performance regarding early caries detection and its activity compared with traditional diagnostic methods. However, standardization of the imaging protocol and further larger clinical trials are required.

CLINICAL SIGNIFICANCE

OCT offers significant clinical advantages in the diagnosis of dental caries. This technology enables early detection of carious lesions, facilitating timely intervention and potentially preserving tooth integrity. Investigating the clinical effectiveness of OCT is crucial to validate its utility in dental practice and to establish standardized protocols for its implementation in caries diagnosis.

Human Tooth Crack Image Analysis with Multiple Deep Learning Approaches

Tooth cracks, one of the most common dental diseases, can result in the tooth falling apart without prompt treatment; dentists also have difficulty locating cracks, even with X-ray imaging. Indocyanine green (ICG) assisted near-infrared fluorescence (NIRF) dental imaging technique can solve this problem due to the deep penetration of NIR light and the excellent fluorescence characteristics of ICG. This study extracted 593 human cracked tooth images and 601 non-cracked tooth images from NIR imaging videos. Multiple imaging analysis methods such as classification, object detection, and super-resolution were applied to the dataset for cracked image analysis. Our results showed that machine learning methods could help analyze tooth crack efficiently: the tooth images with cracks and without cracks could be well classified with the pre-trained residual network and squeezenet1_1 models, with a classification accuracy of 88.2% and 94.25%, respectively; the single shot multi-box detector (SSD) was able to recognize cracks, even if the input image was at a different size from the original cracked image; the super-resolution (SR) model, SR-generative adversarial network demonstrated enhanced resolution of crack images using high-resolution concrete crack images as the training dataset. Overall, deep learning model-assisted human crack analysis improves crack identification; the combination of our NIR dental imaging system and deep learning models has the potential to assist dentists in crack diagnosis.

Deep learning based highly accurate transplanted bioengineered corneal equivalent thickness measurement using optical coherence tomography

Corneal transplantation is the primary treatment for irreversible corneal diseases, but due to limited donor availability, bioengineered corneal equivalents are being developed as a solution, with biocompatibility, structural integrity, and physical function considered key factors. Since conventional evaluation methods may not fully capture the complex properties of the cornea, there is a need for advanced imaging and assessment techniques. In this study, we proposed a deep learning-based automatic segmentation method for transplanted bioengineered corneal equivalents using optical coherence tomography to achieve a highly accurate evaluation of graft integrity and biocompatibility. Our method provides quantitative individual thickness values, detailed maps, and volume measurements of the bioengineered corneal equivalents, and has been validated through 14 days of monitoring. Based on the results, it is expected to have high clinical utility as a quantitative assessment method for human keratoplasties, including automatic opacity area segmentation and implanted graft part extraction, beyond animal studies.

Ex vivo human teeth imaging with various photoacoustic imaging systems

Dental caries cause pain and if not diagnosed, it may lead to the loss of teeth in extreme cases. Dental X-ray imaging is the gold standard for caries detection; however, it cannot detect hidden caries. In addition, the ionizing nature of X-ray radiation is another concern. Hence, other alternate imaging modalities like photoacoustic (PA) imaging are being explored for dental imaging. Here, we demonstrate the feasibility of acoustic resolution photoacoustic microscopy (ARPAM) to image a tooth with metal filling, circular photoacoustic computed tomography (cPACT) to acquire images of teeth with caries and pigmentation, and linear array-based photoacoustic imaging (lPACT) of teeth with caries and pigmentation. The cavity measured with lPACT imaging is compared with the X-ray computed tomography image. The metal filling and its boundaries are clearly seen in the ARPAM image. cPACT images at 1064 nm were a better representative of the tooth surface compared to the images acquired at 532 nm. It was possible to detect the cavities present in the dentine when lPACT imaging was used. The PA signal from the pigmented caries on the lateral surface (occlusion view) of the tooth was high when imaged using the lPACT system.

Dense Convolutional Neural Network-Based Deep Learning Pipeline for Pre-Identification of Circular Leaf Spot Disease of Diospyros kaki Leaves Using Optical Coherence Tomography

Circular leaf spot (CLS) disease poses a significant threat to persimmon cultivation, leading to substantial harvest reductions. Existing visual and destructive inspection methods suffer from subjectivity, limited accuracy, and considerable time consumption. This study presents an automated pre-identification method of the disease through a deep learning (DL) based pipeline integrated with optical coherence tomography (OCT), thereby addressing the highlighted issues with the existing methods. The investigation yielded promising outcomes by employing transfer learning with pre-trained DL models, specifically DenseNet-121 and VGG-16. The DenseNet-121 model excels in differentiating among three stages of CLS disease (healthy (H), apparently healthy (or healthy-infected (HI)), and infected (I)). The model achieved precision values of 0.7823 for class-H, 0.9005 for class-HI, and 0.7027 for class-I, supported by recall values of 0.8953 for class-HI and 0.8387 for class-I. Moreover, the performance of CLS detection was enhanced by a supplemental quality inspection model utilizing VGG-16, which attained an accuracy of 98.99% in discriminating between low-detail and high-detail images. Moreover, this study employed a combination of LAMP and A-scan for the dataset labeling process, significantly enhancing the accuracy of the models. Overall, this study underscores the potential of DL techniques integrated with OCT to enhance disease identification processes in agricultural settings, particularly in persimmon cultivation, by offering efficient and objective pre-identification of CLS and enabling early intervention and management strategies.

Microbiological and Imaging-Based Evaluations of Photodynamic Therapy Combined with Er:YAG Laser Therapy in the In Vitro Decontamination of Titanium and Zirconia Surfaces

The oral cavity's soft and hard tissues create a conducive environment for microbial proliferation and biofilm development, facilitating the colonization of prosthodontic and implant materials such as titanium (Ti) and zirconia (Zr). This study aimed to compare the efficacy of conventional decontamination methodologies (i.e., chemical and mechanical, using 0.12% digluconate chlorhexidine (CHX) solution-treatment and airflow) to adjunctive laser-based interventions on Ti and Zr substrates inoculated with Staphylococcus (S.) aureus ATCC 25923. Additionally, this investigation sought to elucidate the impact of these treatments on temperature variations and surface integrity, analyzing the laser irradiation effects on these prevalent dental materials. Experimental configurations were delineated for both Ti and Zr samples across four groups: (1) a conventional treatment group (CV); (2) a photodynamic therapy group (PDT); (3) an Er:YAG laser treatment group (Er); (4) a combined PDT and Er:YAG treatment group (PDTEr). Also, a negative control group (C) that received no treatment was considered. The decontamination of the inoculated disc samples was evaluated by quantifying the microbial colonies in colony-forming units per milliliter (CFU/mL). Temperature variations on the surface of the samples were determined during laser treatments. Surface modifications were investigated using scanning electron microscopy (SEM) and optical coherence tomography (OCT). For statistical analysis, Fisher 95% confidence intervals, Hsu's MCB method, and the Kruskal-Wallis test were applied. With regard to the 105 CFU/mL of the negative control group, results indicated average values equal for each study group to (1) 2.66 CFU/mL for Ti and 2 CFU/mL for Zr for the CV group; (2) 0.33 CFU/mL for Ti and 1 CFU/mL for Zr for the PDT group; (3) 1.25 CFU/mL for Ti and 0 CFU/mL for Zr for the Er group; (4), and 0 CFU/mL for both Ti and Zr for the PDTEr group. Therefore, the combined PDT and Er:YAG treatment (PDTEr) and the singular PDT modality outperformed conventional decontamination methods in eradicating S. aureus biofilms from both Ti and Zr surfaces. Notably, the PDTEr regime achieved a comprehensive elimination of microbial colonies on treated substrates. Surface examination employing OCT demonstrated discernible alterations in the surface morphology of samples subjected to Er:YAG and combined PDT and Er:YAG treatments. Temperature checks during treatments showed no major changes, suggesting the applied laser methods are safe. In conclusion, PDTEr and PDT eliminated bacteria more effectively, but Zr surfaces were more resilient, making them better for microbe-controlling applications. Also, the study demonstrated that the (less costly but lower resolution) OCT method can replace SEM for such investigations.

Relationship Between Cone-Beam CT Evaluation and Clinical Evaluation Before and After Orthodontic Treatment and the Rate of Gingival Recession: A Systematic Review

A systematic review was conducted to investigate the correlation between gingival recession and orthodontic treatment analysis using cone-beam CT (CBCT) dental images to provide an accurate overview of the factors that can influence gingival recession. The literature was searched across several databases (PubMed, Scopus, Web of Science, etc.) for studies using CBCT dental images. Four full-text articles describe how CBCT is used to evaluate gingival recession during orthodontic treatment. The Risk-of-Bias VISualization tool was used to assess the risk of bias. In dentistry, CBCTs are used for various imaging modalities. An accurate assessment of gingival recession was made using CBCT. There were only 35 (22.5%) cases of retraction of the gingival margin after orthodontic treatment. In most studies, various types of malocclusions were treated successfully with fixed orthodontic treatment without gingival recession. Among the studies, 50% had a low risk of bias in all four areas, while one study (25%) had an unclear risk of bias. Only one study (25%) had a high risk of bias. CBCT systems have been extensively studied to show their wide application potential in preventing gingival recession. CBCT systems should be further investigated to address limitations associated with methodology and application. Dental applications of CBCT can be enriched by overcoming these challenges.

Potential Application of Non-Invasive Optical Imaging Methods in Orthodontic Diagnosis

During orthodontic treatment, the early diagnosis of microscopic changes in soft and hard tissues, including periodontal tissue, is very important to prevent iatrogenic side effects like root resorption and periodontal diseases. Cervical periodontal tissue is the most critical area that reacts first to mal-habits or orthodontic forces, and it is also the place where bacteria deposits in the early stage of periodontal diseases. The early diagnosis of hard tissue changes, such as demineralization, is also very important in maintaining a patient's health during orthodontic treatment. Many diagnostic devices, including radiographic equipment and intra-oral scanners, are helpful in diagnosing these problems, but have certain limitations in invasiveness and precision. The purpose of this study is to verify the possible utilities of non-invasive diagnostic devices in the orthodontic field that can compensate for these limitations. For this, non-invasive optical diagnostic devices, including optical coherence tomography and optical Doppler tomography, were used in vivo with animal and human examination for hard and soft tissues. These devices can provide real-time three-dimensional images at the histological scale. The results of this study verified these devices can be used in clinical practice during orthodontic treatment and introduced a new diagnostic paradigm differentiating microstructural changes in tissues in orthodontic diagnosis.

Use of Optical Coherence Tomography in Dentistry

Optical coherence tomography (OCT) is an optics-based imaging technique, which may be called an "optical biopsy." It can be used to acquire structural information about a tissue at a resolution comparable to histopathology. OCT is based on the principle of low-coherence interferometry where near-infrared (NIR) light is shown on a tissue sample and then cross-sectional images are obtained based on backscattered light and echo time delay. Two main types of OCT are characterized as time-domain OCT (TD-OCT) and Fourier-domain OCT (FD-OCT). The applications of OCT in dentistry can be broadly divided into two groups, i.e., assessment of pathologies and assessment of surfaces and interfaces. Lately, OCT has made its transition from experimental laboratories to mainstream clinical applications. Starting from the short-term training courses, clinicians working in specialities like oral pathology, oral medicine, and oral implantology may find it a useful tool for their practices. It is now clear that OCT will be considered a gold standard diagnostic tool for the detection and characterization of several conditions and lesions of the orofacial region. However, the next challenge will be to incorporate it into the undergraduate and postgraduate curriculum and train dental healthcare staff in the use of these devices.

A Drosophila heart optical coherence microscopy dataset for automatic video segmentation

The heart of the fruit fly, Drosophila melanogaster, is a particularly suitable model for cardiac studies. Optical coherence microscopy (OCM) captures in vivo cross-sectional videos of the beating Drosophila heart for cardiac function quantification. To analyze those large-size multi-frame OCM recordings, human labelling has been employed, leading to low efficiency and poor reproducibility. Here, we introduce a robust and accurate automated Drosophila heart segmentation algorithm, called FlyNet 2.0+, which utilizes a long short-term memory (LSTM) convolutional neural network to leverage time series information in the videos, ensuring consistent, high-quality segmentation. We present a dataset of 213 Drosophila heart videos, equivalent to 604,000 cross-sectional images, containing all developmental stages and a wide range of beating patterns, including faster and slower than normal beating, arrhythmic beating, and periods of heart stop to capture these heart dynamics. Each video contains a corresponding ground truth mask. We expect this unique large dataset of the beating Drosophila heart in vivo will enable new deep learning approaches to efficiently characterize heart function to advance cardiac research.

Teeth Microcracks Research: Towards Multi-Modal Imaging

This perspective is an overview of the recent advances in teeth microcrack (MC) research, where there is a clear tendency towards a shift from two-dimensional (2D) to three-dimensional (3D) examination techniques, enhanced with artificial intelligence models for data processing and image acquisition. X-ray micro-computed tomography combined with machine learning allows 3D characterization of all spatially resolved cracks, despite the locations within the tooth in which they begin and extend, and the arrangement of MCs and their structural properties. With photoluminescence and micro-/nano-Raman spectroscopy, optical properties and chemical and elemental composition of the material can be evaluated, thus helping to assess the structural integrity of the tooth at the MC site. Approaching tooth samples having cracks from different perspectives and using complementary laboratory techniques, there is a natural progression from 3D to multi-modal imaging, where the volumetric (passive: dimensions) information of the tooth sample can be supplemented by dynamic (active: composition, interaction) image data. Revelation of tooth cracks clearly shows the need to re-assess the role of these MCs and their effect on the structural integrity and longevity of the tooth. This provides insight into the nature of cracks in natural hard materials and contributes to a better understanding of how bio-inspired structures could be designed to foresee crack propagation in biosolids.

Skin pore imaging using spectral-domain optical coherence tomography: a case report

Sebum is an important component of the skin that has attracted attention in many fields, including dermatology and cosmetics. Pore expansion due to sebum on the skin can lead to various problems. Therefore, it is necessary to analyze the morphological characteristics of sebum. In this study, we used optical coherence tomography (OCT) to evaluate facial sebum areas. We obtained the OCT maximum amplitude projection (MAP) image and a cross-sectional image of skin pores in the facial area. Subsequently, we detected the sebum in skin pores using the detection algorithm of the ImageJ software to quantitatively determine the size of randomly selected pores in the proposed MAP images. Additionally, the pore size was analyzed by acquiring images before and after facial sebum extraction. According to our research, facial sebum can be morphologically described using the OCT system. Since OCT imaging enables specific analysis of skin parameters, including pores and sebum, skin analysis employing OCT could be an effective method for further research.

Inhibition of Caries around Restoration by Ion-Releasing Restorative Materials: An In Vitro Optical Coherence Tomography and Micro-Computed Tomography Evaluation

The objective of this study was firstly to assess the demineralization inhibitory effect of ion-releasing restorations in enamel adjacent to restoration using a biofilm caries model and secondly to compare the effect to that in a chemical caries model. Fifty-six bovine incisors were filled with either Surefil one (SuO), Cention N (CN) (both ion-releasing materials), Ketac-Molar (GIC) or Powerfill resin composite (RC). The restored teeth were then randomly divided into 2 groups according to the used caries model (biofilm or chemical caries model). The micro-computed tomography (MicroCt) and optical coherence tomography (OCT) outcome measures used to evaluate demineralization inhibition effects were lesion depth, LD and increase in OCT integrated reflectivity, ΔIR, at five different depths. It was observed that all outcome measures of CN were statistically the same as those of GIC and conversely with those of RC. This was also the case for SuO except for LD, which was statistically the same as RC. When comparing the two caries models, LD of the biofilm model was statistically deeper (p < 0.05) than the chemical model for all four materials. In conclusion, CN and SuO have similar demineralization inhibitory effects as GIC, and the biofilm caries model is more discriminatory in differentiating demineralization inhibitory effects of ion-releasing restorative material.

Potential use of optical coherence tomography in oral potentially malignant disorders: in-vivo case series study

BACKGROUND

Evidence confirms that the use of Optical Coherence Tomography (OCT) in oral medicine can be a reliable aid for the diagnosis and management of Oral Potentially Malignant Disorders (OPMDs). Several authors described the ability of this system to detect the structural changes of the epithelia involved by the OPMDs. The purpose of this case series is to provide a suggestion for interpretation of OCT images from different OPMDs, compared to OCT images of healthy tissues.

METHODS

A sample of 11 OPMDs patients was recruited and analyzed with OCT. The images obtained were then compared with an OCT repertoire image. In this work the reflectance degree was considered, together with the analysis of the increased/decreased thicknesses of the various layers. Keratin Layer (KL), Epithelial Layer (EP), Lamina Propria (LP), Basal Membrane (BM) assessment, for each lesion, was performed.

RESULTS

OCT measurements of KL, EP and LP layers, together with BM assessing, should aid the physicians to recognize and describe different oral lesions, relating them to the corresponding oral pathology.

CONCLUSION

More studies like this, on larger samples, are needed to validate the results and provide, in the future, a kind of manual that could guide clinicians to correctly interpret the OCT images in relation to the causing pathologies.

TRIAL REGISTRATION

The present trial has been registered with ISRCTN (#17,893,224).

Current Approaches to Diagnosis of Early Proximal Carious Lesion: A Literature Review

Integrating technological tools with clinical visual examination for caries detection and diagnosis can improve preventative measures in dentistry, resulting in decreased treatment expenses and reduced time and costs associated with testing potential anticaries agents. This article provides an overview of the conventional and new emerging modern technologies that can assist dental professionals in the early detection and diagnosis of dental caries. These technologies aid in assessing the progression of carious lesions and monitoring them quantitatively or qualitatively over time. Traditional techniques (visual, tactile, and radiographic) have limitations in diagnosing early proximal caries accurately. Novel methods like fluorescence and transillumination, as well as advanced tools like OCT (optical coherence tomography), laser fluorescence, and QLF (quantitative light-induced fluorescence), are effective for early caries detection. Optical methods like fluorescence and transillumination are particularly successful in identifying initial caries stages. Moreover, this review highlights the clinical relevance of these methods and discusses potential future technologies like terahertz imaging and artificial intelligence (AI)-based approaches.

Rapid Cellular-Resolution Skin Imaging with Optical Coherence Tomography Using All-Glass Multifocal Metasurfaces

Cellular-resolution optical coherence tomography (OCT) is a powerful tool offering noninvasive histology-like imaging. However, like other optical microscopy tools, a high numerical aperture (N.A.) lens is required to generate a tight focus, generating a narrow depth of field, which necessitates dynamic focusing and limiting the imaging speed. To overcome this limitation, we developed a metasurface platform that generates multiple axial foci, which multiplies the volumetric OCT imaging speed by offering several focal planes. This platform offers accurate and flexible control over the number, positions, and intensities of axial foci generated. All-glass metasurface optical elements 8 mm in diameter are fabricated from fused-silica wafers and implemented into our scanning OCT system. With a constant lateral resolution of 1.1 μm over all depths, the multifocal OCT triples the volumetric acquisition speed for dermatological imaging, while still clearly revealing features of stratum corneum, epidermal cells, and dermal-epidermal junctions and offering morphological information as diagnostic criteria for basal cell carcinoma. The imaging speed can be further improved in a sparse sample, e.g., 7-fold with a seven-foci beam. In summary, this work demonstrates the concept of metasurface-based multifocal OCT for rapid virtual biopsy, further providing insights for developing rapid volumetric imaging systems with high resolution and compact volume.

A pilot study comparing optical coherence tomography, radiography, clinical photography, and polarisation microscopy for studies of hypomineralisation disturbances in enamel

Aim

To investigate the use of optical coherence tomography (OCT) as a tool to assess general and localised hypomineralisation defects in the enamel.

Design and Materials

Ten extracted permanent teeth (four teeth with localised hypomineralisation, four teeth with general hypomineralisation, and two healthy controls) were used in this study. In addition, four participants who underwent OCT served as living controls for the extracted teeth.

Methods

The OCT results were compared with clinical photographs, digital radiographs, and polarising microscopy images of tooth sections (considered the gold standard) to determine the method with the most accurate information regarding the extent of enamel disturbances: 1) visibility of enamel disturbance (visible yes/no); if yes, 2) extent of the disturbance in the enamel; and 3) determination of the plausible involvement of the underlying dentin.

Results

OCT was more accurate than digital radiography and visual assessment. OCT could provide information about the extent of localised hypomineralised disturbances in the enamel that was comparable to that with polarisation microscopy of the tooth sections.

Conclusion

Within the limitations of this pilot study, it can be concluded that OCT is suitable for investigating and evaluating localised hypomineralisation disturbances; however, it is less useful in cases with generalised hypomineralisation of the enamel. In addition, OCT complements radiographic examination of enamel; however, more studies are necessary to elucidate the full extent of the use of OCT in case of hypomineralisation.

Revelation of microcracks as tooth structural element by X-ray tomography and machine learning

Although teeth microcracks (MCs) have long been considered more of an aesthetic problem, their exact role in the structure of a tooth and impact on its functionality is still unknown. The aim of this study was to reveal the possibilities of an X-ray micro-computed tomography ([Formula: see text]CT) in combination with convolutional neural network (CNN) assisted voxel classification and volume segmentation for three-dimensional (3D) qualitative analysis of tooth microstructure and verify this approach with four extracted human premolars. Samples were scanned using a [Formula: see text]CT instrument (Xradia 520 Versa; ZEISS) and segmented with CNN to identify enamel, dentin, and cracks. A new CNN image segmentation model was trained based on "Multiclass semantic segmentation using DeepLabV3+" example and was implemented with "TensorFlow". The technique which was used allowed 3D characterization of all MCs of a tooth, regardless of the volume of the tooth in which they begin and extend, and the evaluation of the arrangement of cracks and their structural features. The proposed method revealed an intricate star-shaped network of MCs covering most of the inner tooth, and the main crack planes in all samples were arranged radially in two almost perpendicular directions, suggesting that the cracks could be considered as a planar structure.

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).

Effect of an Anaerobic Fermentation Process on 3D-Printed PLA Materials of a Biogas-Generating Reactor

3D-printed materials are present in numerous applications, from medicine to engineering. The aim of this study is to assess their suitability for an application of interest today, that of testing of 3D-printed polylactic acid (PLA)-based reactors for biogas production using anaerobic digestion. The impact of temperature, pH, and aqueous phase on the tested bioreactor is investigated, together with the effect of the gaseous phase (i.e., produced biogas). Two batches of materials used separately, one after another inside the bioreactor were considered, in a realistic situation. Two essential parameters inside the reactor (i.e., pH and temperature) were continuously monitored during a time interval of 25 to 30 days for each of the two biogas-generating processes. To understand the impact of these processes on the walls of the bioreactor, samples of 3D-printed material were placed at three levels: at the top (i.e., outside the substrate), in the middle, and at the bottom of the bioreactor. The samples were analyzed using a non-destructive imaging method, Optical Coherence Tomography (OCT). An in-house developed swept-source (SS) OCT system, master-slave (MS) enhanced, operating at a central wavelength of 1310 nm was utilized. The 3D OCT images related to the degradation level of the material of the PLA samples were validated using Scanning Electron Microscopy (SEM). The differences between the impact of the substrate on samples situated at the three considered levels inside the reactor were determined and analyzed using their OCT B-scans (optical cross-section images). Thus, the impact of the biogas-generating process on the interior of the bioreactor was demonstrated and quantified, as well as the capability of OCT to perform such assessments. Therefore, future work may target OCT for in situ investigations of such bioreactors.

Diagnosis of cracked tooth: Clinical status and research progress

Cracked tooth is a common dental hard tissue disease.The involvement of cracks directly affects the selection of treatment and restoration of the affected teeth.It is helpful to choose more appropriate treatment options and evaluate the prognosis of the affected tooth accurately to determine the actual involvement of the crack.However, it is often difficult to accurately and quantitatively assess the scope of cracks at present.So it is necessary to find a real method of early quantitative and non-destructive crack detection.This article reviews the current clinical detection methods and research progress of cracked tooth in order to provide a reference for finding a clinical detection method for cracked tooth.

Optical coherence tomography systems for evaluation of marginal and internal fit of ceramic reconstructions

Purpose

To evaluate the marginal and internal fit of lithium disilicate and zirconia crowns using two optical coherence tomography (OCT) systems in order to estimate inter-system variations.

Materials and methods

Ten lithium disilicate and 10 cubic stabilized zirconia crowns were placed on prepared artificial teeth without cement. Marginal discrepancy and internal cement gap of the crowns were assessed on images obtained using a swept source OCT (SS-OCT) and a spectral domain OCT (SD-OCT). Medians and interquartile ranges were calculated for both materials and OCT systems. Thereafter, Wilcoxon signed rank test was carried out.

Results

No significant difference was found between the two OCT systems for absolute marginal discrepancy of either lithium disilicate (SS-OCT: 182 µm, SD-OCT: 214 µm; p = .922) or zirconia crowns (SS-OCT: 116 µm, SD-OCT: 121 µm; p = .232). Regarding internal cement gap, no significant difference was found between the two OCT systems for lithium disilicate crowns (SS-OCT: 128 µm, SD-OCT: 128 µm; p = .064). However, for zirconia crowns the SD-OCT showed significantly higher (p = .027) internal cement gap (92 µm) than the SS-OCT (68 µm). Moreover, it was not possible to assess the internal fit of zirconia crowns in 47% and 34% of the sites using SD-OCT and SS-OCT, respectively.

Conclusions

No significant difference was noted in the ability of SS-OCT and SD-OCT to assess the marginal and internal fit of lithium disilicate crowns, nor the marginal fit of zirconia crowns. On the contrary, drawbacks regarding the assessment of internal fit of zirconia crowns using both OCT systems were observed.

Recent Advances in the Diagnosis of Enamel Cracks: A Narrative Review

Cracked teeth can pose a diagnostic dilemma for a clinician as they can mimic several other conditions. The constant physiological stress along with any pathological strain like trauma or iatrogenic causes can lead to the development of microcracks in the teeth. Constant exposure to immense stress can cause the progression of these often-undiagnosed tooth cracks to cause tooth fractures. This review aims to outline the etiology of tooth cracks, their classification, and recent advances in the diagnosis of enamel cracks. Diagnosing a cracked tooth can be an arduous task as symptoms differ according to the location and extension of the incomplete fracture. Early detection is critical because restorative treatment can prevent fracture propagation, microleakage, pulpal or periodontal tissue involvement, and catastrophic cusp failure. Older methods of crack detection are not sensitive or specific. They include clinical examination, visual inspection, exploratory excavation, and percussion test. The dye test used blue or gentian violet stains to highlight fracture lines. Modern methods include transillumination, optical coherence tomography Swept-Source Optical Coherence Tomography (SSOCT), near-infrared imaging, ultrasonic system, infrared thermography, and near-infrared laser. These methods appear to be more efficacious than traditional clinical dental imaging techniques in detecting longitudinal tooth cracks. Clinically distinguishing between the various types of cracks can be difficult with patient-reported signs and symptoms varying according to the location and extension of the incomplete fracture. Cracks are more common in restored teeth. Technological advances such as transillumination allow for early detection and enhanced prognosis.

Research progress on the application of optical coherence tomography in the field of oncology

Optical coherence tomography (OCT) is a non-invasive imaging technique which has become the “gold standard” for diagnosis in the field of ophthalmology. However, in contrast to the eye, nontransparent tissues exhibit a high degree of optical scattering and absorption, resulting in a limited OCT imaging depth. And the progress made in the past decade in OCT technology have made it possible to image nontransparent tissues with high spatial resolution at large (up to 2mm) imaging depth. On the one hand, OCT can be used in a rapid, noninvasive way to detect diseased tissues, organs, blood vessels or glands. On the other hand, it can also identify the optical characteristics of suspicious parts in the early stage of the disease, which is of great significance for the early diagnosis of tumor diseases. Furthermore, OCT imaging has been explored for imaging tumor cells and their dynamics, and for the monitoring of tumor responses to treatments. This review summarizes the recent advances in the OCT area, which application in oncological diagnosis and treatment in different types: (1) superficial tumors:OCT could detect microscopic information on the skin’s surface at high resolution and has been demonstrated to help diagnose common skin cancers; (2) gastrointestinal tumors: OCT can be integrated into small probes and catheters to image the structure of the stomach wall, enabling the diagnosis and differentiation of gastrointestinal tumors and inflammation; (3) deep tumors: with the rapid development of OCT imaging technology, it has shown great potential in the diagnosis of deep tumors such in brain tumors, breast cancer, bladder cancer, and lung cancer.

Ceramic Scaffolds for Bone Augmentation: Design and Characterization with SEM and Confocal Microscopy

Bone scaffolds must fulfil numerous and sometimes contradictory characteristics: biocompatibility, bioactivity, high porosity, and appropriate mechanical strength. To tackle some of these issues, this study has several aims for the development of such scaffolds for dentistry applications: (i) to utilize appropriate materials (ceramics and sponges) and to introduce a novel, potentially performant ceramic material; (ii) to characterize the obtained scaffolds by using a range of methods; (iii) to compare and to correlate the assessment results with the scope to validate them reciprocally. There are two commercially available dental ceramics (i.e., Ceramco iC Natural Enamel (E) and Ceramco iC Natural Dentine (D), (DeguDent GmbH, Hanau-Wolfgang, Deutschland)) that are considered, as well as a new-developed porcelain (ceramic C). To obtain porous structures of scaffolds, each ceramic is introduced in two different sponges: a denser one, green (G) and a less dense one, blue (B). A total of 60 samples are manufactured and divided in six study groups, obtained by combining the above materials: GE, BE, GD, BD, GC, and BC (where the first letter represents the sponge type and the second one the utilized ceramic). Several methods are applied to characterize their chemical composition, as well as their macro- and micro-porosity: X-ray Diffraction (XRD), apparent porosity measurements, scanning electronic microscopy (SEM), and confocal microscopy (CM). The latter two methods image the inner (porous) and the outer/cortical (denser) areas of the samples. The results show a good porosity (i.e., dimensions and uniformity of pores) of around 65% for the final group BC, with satisfactory values of around 51% for BD and GC. A certain correlation is made between SEM, CM, and the apparent porosity results. The biocompatibility of the new ceramic C is demonstrated. Finally, a necessary trade-off is made with the mechanical strength of the obtained scaffolds, which was also evaluated. From this point of view, Group BD has the highest compressive strength of around 4 MPa, while Group BC comes second, with around 2 MPa. This trade-off between porosity and mechanical strength suggests a choice between Groups BC and BD, which are the best with regard to the porosity and mechanical strength criterium, respectively.

Assessment of the Accuracy in Measuring the Enamel Thickness of Maxillary Incisors with Optical Coherence Tomography

Although the clinical assessment of enamel thickness is important, hardly any tools exist for accurate measurements. The purpose of this study was to verify the precision of enamel thickness measurements using swept-source optical coherence tomography (SS-OCT). Human extracted maxillary central and lateral incisors were used as specimens. Twenty-eight sites were measured in each specimen. The optical path length (OPL) at each measurement site was measured on the OCT images, and enamel thickness (e1) was calculated by dividing OPL by the mean refractive index of enamel, 1.63. The specimens were then sectioned, and a light microscope was used to measure enamel thickness (e2). e1 and e2 were then compared. Measurement errors between e1 and e2 for the central and lateral incisors were 0.04 (0.02; 0.06) mm and 0.04 (0.02; 0.07) mm [median value: (25%, 75% percentile)], respectively. No significant differences between measurement sites were noted for measurement errors between e1 and e2. These results demonstrate that OCT can be used for noninvasive, accurate measurements of enamel thickness.

Multispectral truncated-correlation photothermal coherence tomography imaging modality for detection of early stage dental caries

One of the major oral health conditions worldwide is dental caries. Light-absorption-based thermophotonic diagnostic imaging is well positioned for this challenge thanks to its speed, safety, and high molecular contrast advantages. In this work, a multispectral (MS) truncated-correlation photothermal coherence tomography (TC-PCT) imaging modality is introduced for the detection of bacterial-induced dental caries. MS TC-PCT provided thorough information about optimal lesion contrast and type of dental defects such as caries in teeth. The experimental results were validated using micro-computed tomography (µCT) including quantitative lesion depth profiles at wavelengths in the 675-700 nm range. MS TC-PCT gives rise to hard-tissue biomedical diagnostic applications such as bone and dental imaging.

Oral Cancer Screening by Artificial Intelligence-Oriented Interpretation of Optical Coherence Tomography Images

Early diagnosis of oral cancer is critical to improve the survival rate of patients. The current strategies for screening of patients for oral premalignant and malignant lesions unfortunately miss a significant number of involved patients. Optical coherence tomography (OCT) is an optical imaging modality that has been widely investigated in the field of oncology for identification of cancerous entities. Since the interpretation of OCT images requires professional training and OCT images contain information that cannot be inferred visually, artificial intelligence (AI) with trained algorithms has the ability to quantify visually undetectable variations, thus overcoming the barriers that have postponed the involvement of OCT in the process of screening of oral neoplastic lesions. This literature review aimed to highlight the features of precancerous and cancerous oral lesions on OCT images and specify how AI can assist in screening and diagnosis of such pathologies.

Biophotonics in Dentistry

The aim of this review paper is to concentrate on the use and application of photonics in dentistry. More than one hundred review and research articles were comprehensively analysed in terms of applications of photonics in dentistry, including surgical applications, as well as dental biomaterials, diagnosis and treatments. In biomedical engineering, various fields, such as biology, chemistry, material and physics, come together in to tackle a disease/disorder either as a diagnostic tool or an option for treatment. Engineers believe that biophotonics is the application of photonics in medicine, whereas photonics is simply a technology for creating and connecting packets of light energy, known as photons. This review paper provides a comprehensive discussion of its main elements, such as photoelasticity, interferometry techniques, optical coherence tomography, different types of lasers, carbon nanotubes, graphene and quantum dots.

Applications of Optical Coherence Tomography in the Diagnosis of Enamel Defects

Developmental defects of enamel (DDEs) are deviations from the normal appearance in terms of the quantity and quality of tooth enamel. They may be genetic or acquired. The most important DDEs are hypomineralization and hypoplasia. The aim of this study was to produce “in vivo” DDE in Wistar rats by administering amoxicillin to pregnant females and to highlight these lesions after sacrifice of the pups by macroscopic and microscopic examination and optical coherence tomography (OCT). Amoxicillin (100 mg/kg) was administered to two pregnant Wistar female rats for the production of DDEs. When the pups were 2 months old, they were sacrificed, and their jaws were harvested together with their teeth. The jaws were examined macroscopically, microscopically, and by OCT. Following the macroscopic and microscopic examination, it was established that four pups had a total of 42 DDE lesions. At the OCT examination, the hypomineralization was characterized by an intense, inhomogeneous OCT signal, and the hypoplasia was characterized by the absence of the signal. Administration of amoxicillin to pregnant females of Wistar rats resulted in DDEs in their offspring. The OCT examination confirmed the presence of these lesions in the teeth of rat pups.

Emerging Technologies for Dentin Caries Detection-A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed at assessing the diagnostic accuracy of emerging technologies, such as laser fluorescence (LF), transillumination, light-emitting diode devices, optical coherence tomography (OCT), alternating current impedance spectroscopy, fluorescence cameras (FC), photo-thermal radiometry, and modulated luminescence technology. In vivo and in vitro results of such non-ionizing, non-invasive, and non-destructive methods' effectiveness in non-cavitated dentin caries detection are sometimes ambiguous. Following the PRISMA guidelines, 34 relevant research articles published between 2011-2021 were selected. The risk of bias was assessed with a tool tailored for caries diagnostic studies, and subsequent quantitative uni- and bi-variate meta-analysis was carried out in separate sub-groups according to the investigated surface (occlusal/proximal) and study setting (in vivo/in vitro). In spite of the high heterogeneity across the review groups, in vitro studies on LF and FC proved a good diagnostic ability for the occlusal surface, with area under the curve (AUC) of 0.803 (11 studies) and 0.845 (five studies), respectively. OCT studies reported an outstanding performance with an overall AUC = 0.945 (four studies). Promising technologies, such as OCT or FC VistaProof, still need well-designed and well-powered studies to accrue experimental and clinical data for conclusive medical evidence, especially for the proximal surface. Registration: INPLASY202210097.

Use of optical coherence tomography in orthodontics

Optical coherence tomography (OCT) is a modern imaging method with applicability in orthodontics. In recent years, there has been an increasing trend in the use of ceramic brackets. The aim of the present study was to investigate the effects of bonding metallic and ceramic brackets on tooth enamel, using optical coherence tomography. For this purpose, 20 permanent teeth we bonded and were subsequently debonded using a side cutter or anterior bracket removal pliers. Using the OCT technique, the enamel, the amount of adhesive remaining and the bracket fragments remaining on the tooth surface were analyzed following the debonding procedure. It was demonstrated that enamel cracks were present only in the samples bonded with ceramic brackets. At the same time, it was noted that the type of pliers did not affect the incidence and extent of damage to the enamel. The type of debonding technique (using the side cutter or the anterior removal pliers) used did not markedly affect the amount of adhesive remaining on the teeth. Thus, as demonstrated herein, by analyzing the enamel structure through the use of OCT, the quality of the processes and the materials used for manufacturing brackets can be increased.

Sinus Lift and Implant Insertion on 3D-Printed Polymeric Maxillary Models: Ex Vivo Training for In Vivo Surgical Procedures

Background and Objectives: The aim of this study is to demonstrate the increased efficiency achieved by dental practitioners when carrying out an ex vivo training process on 3D-printed maxillaries before performing in vivo surgery. Materials and Methods: This developed ex vivo procedure comprises the following phases: (i) scanning the area of interest for surgery; (ii) obtaining a 3D virtual model of this area using Cone Beam Computed Tomography (CBCT); (iii) obtaining a 3D-printed model (based on the virtual one), on which (iv) the dental practitioner simulates/rehearses ex vivo (most of) the surgery protocol; (v) assess with a new CBCT the 3D model after simulation. The technical steps of sinus augmentation and implant insertion could be performed on the corresponding 3D-printed hemi-maxillaries prior to the real in vivo surgery. Two study groups were considered, with forty patients divided as follows: Group 1 comprises twenty patients on which the developed simulation and rehearsal procedure was applied; Group 2 is a control one which comprises twenty patients on which similar surgery was performed without this procedure (considered in order to compare operative times without and with rehearsals). Results: Following the ex vivo training/rehearsal, an optimal surgery protocol was developed for each considered case. The results of the surgery on patients were compared with the results obtained after rehearsals on 3D-printed models. The performed quantitative assessment proved that, using the proposed training procedure, the results of the in vivo surgery are not significantly different (p = 0.089) with regard to the ex vivo simulation for both the mezio-distal position of the implant and the distance from the ridge margin to sinus window. On the contrary, the operative time of Group 1 was reduced significantly (p = 0.001), with an average of 20% with regard to in vivo procedures performed without rehearsals (on the control Group 2). Conclusions: The study demonstrated that the use of 3D-printed models can be beneficial to dental surgeon practitioners, as well as to students who must be trained before performing clinical treatments.

Assessibility of different CAD/CAM ceramics with optical coherence tomography

OBJECTIVES

To investigate the light penetration depth of various CAD/CAM ceramics and luting agents by spectral-domain optical coherence tomography (SD-OCT).

METHODS

Six CAD/CAM ceramics: lithium disilicate (LS2), zirconia-reinforced lithium silicate (ZLS), lithium aluminosilicate (LAS), polymer infiltrated (PIC), feldspar (FEL) and zirconium oxide (ZRO) and five common luting agents, two self-adhesive and three adhesive materials, were included. SD-OCT wavelengths (1310/1550 nm) and frequencies (5/28 kHz) that are particularly suitable for these materials were investigated. Subsequently, a clinical simulation was performed with an adhesively or self-adhesively inserted partial crown made of a ceramic that had an OCT penetration depth of > 1.0 mm.

RESULTS

Best SD-OCT penetration was obtained at 1550 nm and 28 kHz. For ZLS, LS2 and LAS, SD-OCT light penetration depth of > 4 mm was shown. In contrast, the penetration depth of ZRO, PIC and FEL was less than 1 mm. Adhesive and self-adhesive luting agents could be visualized up to ≥ 0.9 mm. All clinically relevant areas (ceramic restoration, luting area, interfaces and adjacent tooth structures) can be imaged when SD-OCT-suitable ceramics are used.

CONCLUSIONS

SD-OCT can be used to analyze CAD/CAM ceramics based on ZLS, LS2 and LAS, whereas ZRO, PIC, and FEL had insufficient penetration depth for clinical application. The type of luting agent or its thickness played an insignificant role. With suitable ceramics, SD-OCT can be recommended as a non-invasive examination tool.

CLINICAL SIGNIFICANCE

This study indicates that SD-OCT is a useful non-invasive examination method for monitoring lithium silicate-based ceramic restorations and adjacent structures.

Exact Scan Patterns of Rotational Risley Prisms Obtained with a Graphical Method: Multi-Parameter Analysis and Design

Rotational Risley prisms are one of the fastest two-dimensional (2D) optomechanical scanning systems. Their drawback is the strong non-linearity of the scan patterns they produce, in contrast to the most common (but slower) raster scanning modalities of 2D dual axis galvanometer scanners (GSs) or Micro-Electro-Mechanical Systems (MEMS) with oscillatory mirrors. The aim of this work is to develop a graphical method, which, to our knowledge, we have introduced to determine and characterize, using a commercially-available mechanical design program (for example CATIA V5R20 (Dassault Systems, Paris, France)) to simulate the exact scan patterns of rotational Risley prisms. Both the maximum and minimum angular and linear deviations of this type of scanner are deduced theoretically to characterize the outer diameter/Field-of-View (FOV) and the inner diameter (of the blind zone) of its ring-shaped patterns, respectively. This multi-parameter analysis is performed in correlation with the shape of the scan patterns, considering the four possible configurations of laser scanners with a pair of rotational Risley prisms, as well as all their parameters: prisms angles, refractive indexes, rotational speeds, distance between the two prisms, and the distance from the system to the scanned plane. Marshall’s synthetic parameters are also considered, i.e., the ratios of the rotational velocities and of the angles of the prisms. Rules-of-thumb for designing this optomechanical scanner are extracted from this analysis, regarding both shapes and dimensions of the scan patterns to be produced. An example of experimental validation completes the mathematical analysis and the performed simulations.

Noninvasive monitoring of suprachoroidal, subretinal, and intravitreal implants using confocal scanning laser ophthalmoscope (cSLO) and optical coherence tomography (OCT)

To address the need for noninvasive monitoring of injectable preformed drug delivery implants in the eye, we developed noninvasive methods to monitor such implants in different locations within the eye. Cylindrical polymeric poly(lactide-co-glycolide) or metal implants were injected into isolated bovine eyes at suprachoroidal, subretinal, and intravitreal locations and imaged noninvasively using the cSLO and OCT modes of a Heidelberg Spectralis HRA + OCT instrument after adjusting for the corneal curvature. Length and diameter of implants were obtained using cSLO images for all three locations, and the volume was calculated. Additionally, implant volume for suprachoroidal and subretinal location was estimated by integrating the cross-sectional bleb area over the implant length in multiple OCT images or using the maximum thickness of the implant based on thickness map along with length in cSLO image. Simultaneous cSLO and OCT imaging identified implants in different regions of the eye. Image-based measurements of implant dimensions mostly correlated well with the values prior to injection using blade micrometer. The accuracy (82-112%) and precision (1-19%) for noninvasive measurement of length was better than the diameter (accuracy 69-130%; precision 3-38%) using cSLO image for both types of implants. The accuracy for the measurement of volume of both types of implants from all three intraocular locations was better with cSLO imaging (42-152%) compared to those obtained using OCT cross-sectional bleb area integration (117-556%) or cSLO and thickness map (32-279%) methods. Suprachoroidal, subretinal, and intravitreal implants can be monitored for length, diameter, and volume using cSLO and OCT imaging. Such measurements may be useful in noninvasively monitoring implant degradation and drug release in the eye.

Micro-CT and Microscopy Study of Internal and Marginal Gap to Tooth Surface of Crenelated versus Conventional Dental Indirect Veneers

Background and Objectives: Ceramic veneers represent the most appropriate treatment option for minimally invasive aesthetic rehabilitation. For long-term clinical success, the accurate marginal and internal adaptation of dental restorations are of paramount importance. The aim of this in vitro study is to assess the effect of a novel (patented) design of veneers compared to conventional ones on their marginal and internal gap to the prepared tooth surface. Materials and Methods: Twenty-four lithium disilicate ceramic veneers are obtained using Computer-Aided-Design (CAD) and then milled using Computer-Aided-Manufacturing (CAM). The samples are divided into two groups: 12 conventional (CO) veneers (i.e., with a linear marginal contour) and 12 crenelated (CR) veneers, the latter with the novel sinusoidal marginal design. All samples are bonded to frontal teeth, and the adhesive interfaces are analyzed using two methods, optical microscopy and micro-Computed Tomography (CT): the former for the accuracy of the marginal gap and the latter for the internal gap (as well as for the homogeneity of the luting cement) of ceramic veneers. Results: STATA and one-way ANOVA tests reveal significant differences between CO and CR veneers: (i) the marginal gap is smaller for CR (64 μm) than for CO veneers (236 μm); (ii) the internal adaptation is better for CR veneers: for a cement width of up to 120 μm, the covered surface for the CR group is 81.5%, while for the CO group it is 64.5%; (iii) the mean of the porosities within the cement is not significantly different (3.4·10⁶ μm³ for CO and 3.9·10⁶ μm³ for CR veneers), with a higher standard deviation for the CO group. Analytical modeling is achieved for internal gaps using the micro-CT results. The characteristic functions obtained allow us to compare the volume of luting cement for the two types of veneers. Conclusion: The novel veneers design produces an improvement in the marginal and internal adaptation of the restorations to the prepared tooth surface. Thus, it provides favorable premises for better clinical performances.

Three-dimensional non-destructive visualization of teeth enamel microcracks using X-ray micro-computed tomography

Although the topic of tooth fractures has been extensively analyzed in the dental literature, there is still insufficient information about the potential effect of enamel microcracks (EMCs) on the underlying tooth structures. For a precise examination of the extent of the damage to the tooth structure in the area of EMCs, it is necessary to carry out their volumetric [(three-dimensional (3D)] evaluation. The aim of this study was to validate an X-ray micro-computed tomography ([Formula: see text]CT) as a technique suitable for 3D non-destructive visualization and qualitative analysis of teeth EMCs of different severity. Extracted human maxillary premolars were examined using a [Formula: see text]CT instrument ZEISS Xradia 520 Versa. In order to separate crack, dentin, and enamel volumes a Deep Learning (DL) algorithm, part of the Dragonfly's segmentation toolkit, was utilized. For segmentation needs we implemented Dragonfly's pre-built UNet neural network. The scanning technique which was used made it possible to recognize and detect not only EMCs that are visible on the outer surface but also those that are buried deep inside the tooth. The 3D visualization, combined with DL assisted segmentation, enabled the evaluation of the dynamics of an EMC and precise examination of its position with respect to the dentin-enamel junction.

Optimization of X-ray Investigations in Dentistry Using Optical Coherence Tomography

The most common imaging technique for dental diagnoses and treatment monitoring is X-ray imaging, which evolved from the first intraoral radiographs to high-quality three-dimensional (3D) Cone Beam Computed Tomography (CBCT). Other imaging techniques have shown potential, such as Optical Coherence Tomography (OCT). We have recently reported on the boundaries of these two types of techniques, regarding. the dental fields where each one is more appropriate or where they should be both used. The aim of the present study is to explore the unique capabilities of the OCT technique to optimize X-ray units imaging (i.e., in terms of image resolution, radiation dose, or contrast). Two types of commercially available and widely used X-ray units are considered. To adjust their parameters, a protocol is developed to employ OCT images of dental conditions that are documented on high (i.e., less than 10 μm) resolution OCT images (both B-scans/cross sections and 3D reconstructions) but are hardly identified on the 200 to 75 μm resolution panoramic or CBCT radiographs. The optimized calibration of the X-ray unit includes choosing appropriate values for the anode voltage and current intensity of the X-ray tube, as well as the patient’s positioning, in order to reach the highest possible X-rays resolution at a radiation dose that is safe for the patient. The optimization protocol is developed in vitro on OCT images of extracted teeth and is further applied in vivo for each type of dental investigation. Optimized radiographic results are compared with un-optimized previously performed radiographs. Also, we show that OCT can permit a rigorous comparison between two (types of) X-ray units. In conclusion, high-quality dental images are possible using low radiation doses if an optimized protocol, developed using OCT, is applied for each type of dental investigation. Also, there are situations when the X-ray technology has drawbacks for dental diagnosis or treatment assessment. In such situations, OCT proves capable to provide qualitative images.

Doppler Optical Coherence Tomography for Otology Applications: From Phantom Simulation to In Vivo Experiment

In otology, visualization and vibratory analysis have been crucial to enhance the success of diagnosis and surgical operation. Optical coherence tomography (OCT) has been employed in otology to obtain morphological structure of tissues non-invasively, owing to the ability of measuring the entire region of tympanic membrane, which compensates the limitations of conventional methods. As a functional extension of OCT, Doppler OCT, which enables the measurement of the motion information with structural data of tissue, has been applied in otology. Over the years, Doppler OCT systems have been evolved in various forms to enhance the measuring sensitivity of phase difference. In this review, we provide representative algorithms of Doppler OCT and various applications in otology from preclinical analysis to clinical experiments and discuss future developments.

Detection and analyzing plane of non-cavitated approximal caries by cross-polarized optical coherence tomography (CP-OCT)

OBJECTIVE

The objective was to assess the detection ability and the effect of analyzing plane of CP-OCT for non-cavitated approximal caries.

METHODS

Thirty human extracted premolars were selected based on micro-computed tomography [μ-CT: μ- CT = 0: sound (n = 12), μ-CT = 1/2: caries into outer-/inner-half of enamel (n = 6 each), μ-CT = 3: caries into outer one-third of dentine (n = 6)]. Teeth were mounted in a custommade device to simulate approximal contact, and scanned from the marginal ridge above the contact area. CP-OCT images were analyzed by deepest caries extension from horizontal and coronal planes, and repeated 48-hrs later. Sensitivity, specificity,percent correct, area under the ROC curve (Az), intra-examiner repeatability and correlation with μ-CT were determined.

RESULTS

Sensitivity/specificity/Az for Horizontalplane, Coronal-plane, and Deepest from both planes were 94percent/58percent/0.76,81percent/100percent/0.90, and 94 %/58 %/0.82. Coronal-plane had significantly higher specificity than Horizontal-plane and Deepest (p = 0.004) but Horizontal-plane and Deepest were not different (p = 1.00). Horizontal-plane had significantly lower Az than Deepest (p = 0.048), but Coronal-plane was not different than Horizontal-plane (p = 0.07) or Deepest (p = 0.20). Correlation coefficients were Horizontal-plane (0.53, p < 0.001), Coronal-plane (0.84, p < 0.001), and Deepest (0.66, p < 0.001).

CONCLUSION

Within the limitations of this study, CP-OCT could be used to detect non-cavitated approximal caries. Analysis using the Coronal-plane is superior to the Horizontal-plane.

CLINICAL SIGNIFICANCE

It is challenging to detect non-cavitated approximal caries clinically due to the adjacent tooth. CP-OCT is a nondestructive, no ionized-radiation caries detection technique. CP-OCT seems suitable to detect non-cavitated approximal caries and observing the Coronal-plane appears better than Horizontal-plane.

Optical coherence tomography's current clinical medical and dental applications: a review

Optical coherence tomography (OCT) is a non-invasive investigative technique that is used to obtain high-resolution three-dimensional (3D) images of biological structures. This method is useful in diagnosing diseases of specific organs like the eye, where a direct biopsy cannot be conducted. Since its inception, significant advancements have been made in its technology. Apart from its initial application in ophthalmology for retinal imaging, substantial technological innovations in OCT brought by the research community have enabled its utilization beyond its original scope and allowed its application in many new clinical areas. This review presents a summary of the clinical applications of OCT in the field of medicine (ophthalmology, cardiology, otology, and dermatology) and dentistry (tissue imaging, detection of caries, analysis of dental polymer composite restorations, imaging of root canals, and diagnosis of oral cancer). In addition, potential advantages and disadvantages of OCT are also discussed.

Photoacoustic imaging of occlusal incipient caries in the visible and near-infrared range

Purpose

This study aimed to demonstrate the presence of dental caries through a photoacoustic imaging system with visible and near-infrared wavelengths, highlighting the differences between the 2 spectral regions. The depth at which carious tissue could be detected was also verified.

Materials and Methods

Fifteen permanent molars were selected and classified as being sound or having incipient or advanced caries by visual inspection, radiography, and optical coherence tomography analysis prior to photoacoustic scanning. A photoacoustic imaging system operating with a nanosecond pulsed laser as the light excitation source at either 532 nm or 1064 nm and an acoustic transducer at 5 MHz was developed, characterized, and used. En-face and lateral (depth) photoacoustic signals were detected.

Results

The results confirmed the potential of the photoacoustic method to detect caries. At both wavelengths, photoacoustic imaging effectively detected incipient and advanced caries. The reconstructed photoacoustic images confirmed that a higher intensity of the photoacoustic signal could be observed in regions with lesions, while sound surfaces showed much less photoacoustic signal. Photoacoustic signals at depths up to 4 mm at both 532 nm and 1064 nm were measured.

Conclusion

The results presented here are promising and corroborate that photoacoustic imaging can be applied as a diagnostic tool in caries research. New studies should focus on developing a clinical model of photoacoustic imaging applications in dentistry, including soft tissues. The use of inexpensive light-emitting diodes together with a miniaturized detector will make photoacoustic imaging systems more flexible, user-friendly, and technologically viable.

Evaluation Through the Optical Coherence Tomography Analysis of the Influence of Non-Alcoholic Fatty Liver Disease on the Gingival Inflammation in Periodontal Patients

PURPOSE

The purpose of this ex vivo study is to exhibit the inflammatory changes that occur within the gingival tissue by using optical coherence tomography (OCT) in periodontal patients with non-alcoholic fatty liver disease (NAFLD) and if NAFLD could influence the local periodontal inflammation.

PATIENTS AND METHODS

Gingival tissue samples obtained from patients were divided into three groups - P (periodontitis), NAFLD+P (NAFLD+periodontitis) and H (healthy) groups - and were scanned using an OCT light beam, in order to perform a qualitative and quantitative analysis of images. The value of average pixel density has been associated with the degree of inflammation.

RESULTS

The highest average pixel density was found in patients from the H group, while the lowest value of average pixel density was recorded in gingival tissue samples collected from patients with NAFLD+P. The image assessments from NAFLD+P group delivered lower values of average pixel density than those of P group, suggesting a possible influence of this disease on the inflammatory tissular changes produced by periodontal disease.

CONCLUSION

After comparing the OCT analysis results obtained for the three groups of patients, we can consider that NAFLD may be an aggravating factor for the inflammation of periodontal disease.

Handheld optical coherence tomography for clinical assessment of dental plaque and gingiva

SIGNIFICANCE

Optical coherence tomography (OCT) offers high spatial resolution and contrast for imaging intraoral structures, yet few studies have investigated its clinical feasibility for dental plaque and gingiva imaging in vivo. Furthermore, the accessibility is often limited to anterior teeth due to bulky imaging systems and probes.

AIM

A custom-designed, handheld probe-based, spectral-domain OCT system with an interchangeable attachment was developed to assess dental plaque and gingival health in a clinical setting.

APPROACH

Healthy volunteers and subjects with gingivitis and sufficient plaque were recruited. The handheld OCT system was operated by trained dental hygienists to acquire images of dental plaque and gingiva at various locations and after one-week use of oral hygiene products.

RESULTS

The handheld OCT can access premolars, first molars, and lingual sides of teeth to visualize the plaque distribution. OCT intensity-based texture analysis revealed lower intensity from selected sites in subjects with gingivitis. The distribution of the dental plaque after one-week use of the oral hygiene products was compared, showing the capability of OCT as a longitudinal tracking tool.

CONCLUSIONS

OCT has a strong potential to display and assess dental plaque and gingiva in a clinical setting. Meanwhile, technological challenges remain to perform systematic longitudinal tracking and comparative analyses.

Dental Diagnosis and Treatment Assessments: Between X-rays Radiography and Optical Coherence Tomography

A correct diagnosis in dental medicine is typically provided only after clinical and radiological evaluations. They are also required for treatment assessments. The aim of this study is to establish the boundaries from which a modern, although established, imaging technique, Optical Coherence Tomography (OCT), is more suitable than the common X-ray radiography to assess dental issues and treatments. The most common methods for daily-basis clinical imaging are utilized in this study for extracted teeth (but also for other dental samples and materials), i.e., panoramic, intraoral radiography, and three-dimensional (3D) cone beam computed tomography (CBCT). The advantages of using OCT as an imaging method in dentistry are discussed, with a focus on its superior image resolution. Drawbacks related to its limited penetration depth and Field-of-View (FOV) are pointed out. High-quality radiological investigations are performed, measurements are done, and data collected. The same teeth and samples are also imaged (mostly) with an in-house developed Swept Source (SS)-OCT system, Master-Slave enhanced. Some of the OCT investigations employed two other in-house developed OCT systems, Spectral Domain (SD) and Time Domain (TD). Dedicated toolbars from Romexis software (Planmeca, Helsinki, Finland) are used to perform measurements using both radiography and OCT. Clinical conclusions are drawn from the investigations. Upsides and downsides of the two medical imaging techniques are concluded for each type of considered diagnosis. For treatment assessments, it is concluded that OCT is more appropriate than radiography in all applications, except bone-related investigations and periodontitis that demand data from higher-penetration depths than possible with the current level of OCT technology.

Dental Adhesive Interfaces Reinforced with Magnetic Nanoparticles: Evaluation and Modeling with Micro-CT versus Optical Microscopy

Dental adhesives are used in a wide range of applications, including to place direct composite restorations in frontal or posterior teeth. One of the most frequent causes for the failure of composite resin restorations is microleakages. The first aim of this work is to introduce a new type of self-etched dental adhesive doped with magnetic nanoparticles (MPs) synthetized in the laboratory. The scope is to produce adhesives with a minimized width/thickness to decrease the risk of microleakages. The second aim is to assess the width/thickness of the adhesive layer in all the characteristic areas of the teeth using both the less precise but most common optical microscopy and the more accurate and volumetric micro-Computed Tomography (CT) investigations. Twenty extracted teeth have been divided into four groups: Group 1 includes 'blank' samples with adhesives that are not doped with MPs; Group 2 includes samples with adhesives doped with MPs; Groups 3 and 4 include samples with adhesives doped with MPs that are subjected to an active magnetic field for 5 and 10 min, respectively. Microscopy investigations followed by micro-CT and EDAX are performed on the adhesive. While a rather good agreement is obtained between the microscopy and micro-CT results, the capability of the latter to offer a full volumetric reconstruction of the layer is exploited to analyze the adhesion of the four considered dental materials. Thus, from micro-CT results the graphs of the surface areas as functions of the adhesive layer width are modeled mathematically, as well as the volume of sealants, for each of the four groups. To our knowledge, it is the first time that such a methodology is used. Characteristic parameters are extracted and the ascertainment of the optimal parameter that should be utilized for such assessments is discussed. The study demonstrates the adhesion improvement produced for Groups 3 and 4, where MPs are used. It also concludes that the magnetic field should be applied to the adhesive material for the longest possible exposure time (with a trade-off with the clinical duration of the treatment).

Detection and analysis of enamel cracks by ICG-NIR fluorescence dental imaging

Cracked teeth are the third most common cause of tooth loss, but there is no reliable imaging tool for the diagnosis of cracks. Here, we demonstrate the feasibility of indocyanine green near-infrared fluorescence (ICG-NIRF) dental imaging for the detection of enamel cracks and enamel-dentin cracks in vitro in the first (ICG-NIRF-I, 700-950 nm) and second (ICG-NIRF-II, 950-1700 nm) imaging windows with transmission excitation light, and compared ICG-NIRF with conventional NIR illumination-II (NIRi-II) and X-ray imaging. Dentin cracks were detected by CT scan, while most enamel cracks, undetectable under X-ray imaging, were clearly visible in NIR images. We found that ICG-NIRF-II detected cracks more effectively than NIRi-II, and that light orientation is an important factor for crack detection: an angled exposure obtained better image contrast of cracks than parallel exposure, as it created a shadow under the crack. Crack depth could be evaluated from the crack shadow in ICG-NIRF and NIRi-II images; from this shadow we could determine crack depth and discriminate enamel-dentin cracks from craze lines. Cracks could be observed clearly from ICG-NIRF images with 1-min ICG tooth immersion, although longer ICG immersion produced images with greater contrast. Overall, our data show that ICG-NIRF dental imaging is a useful tool for diagnosing cracked teeth at an early stage.