Observations of mineralised tissues of teeth in X-ray micro-computed tomography

Potential Benefits of Photon-Counting CT in Dental Imaging: A Narrative Review

Background/Objectives: Advancements in oral imaging technology are continually shaping the landscape of dental diagnosis and treatment planning. Among these, photon-counting computed tomography (PCCT), introduced in 2021, has emerged as a promising, high-quality oral technology. Dental imaging typically requires a resolution beyond the standard CT systems achievable with the specialized cone-beam CT. PCCT can offer up to 100 µm resolution, improve soft-tissue contrast, and provide faster scanning times, which are crucial for detailed dental diagnosis and treatment planning. Using semiconductor detectors, PCCT produces sharper images and can potentially reduce the number of scans required, thereby decreasing patient radiation exposure. This review aimed to explore the potential benefits of PCCT in dental imaging. Methods: This review analyzed the literature on PCCT in dental imaging from January 2010 to February 2024, sourced from PubMed, Scopus, and Web of Science databases, focusing on high-resolution, patient safety, and diagnostic efficiency in dental structure assessment. We included English-language articles, case studies, letters, observational studies, and randomized controlled trials while excluding duplicates and studies unrelated to PCCT's application in dental imaging. Results: Studies have highlighted the superiority of PCCT in reducing artifacts, which are often problematic, compared to conventional CBCT and traditional CT scans, due to metallic dental implants, particularly when used with virtual monoenergetic imaging and iterative metal artifact reduction, thereby improving implant imaging. This review acknowledges limitations, such as the potential for overlooking other advanced imaging technologies, a narrow study timeframe, the lack of real-world clinical application data in this field, and costs. Conclusions: PCCT represents a promising advancement in dental imaging, offering high-resolution visuals, enhanced contrast, and rapid scanning with reduced radiation exposure.

Encapsulation of a novel peptide derived from histatin-1 in liposomes against initial enamel caries in vitro and in vivo

OBJECTIVES

Biomimetic mineralization mediated by proteins and peptides is a promising strategy for enamel repair, and its specific application model needs more research. In this work, we exploited a liposomal delivery system for a novel peptide (DK5) derived from histatin-1 (DK5-Lips) as a new biomimetic mineralization strategy against initial enamel caries.

MATERIALS AND METHODS

The DK5-Lips was prepared using calcium acetate gradient method and then the in vitro release, salivary stability, and cytotoxicity were studied. Initial enamel caries was created in bovine enamel blocks and subjected to pH-cycling model treated with DK5-Lips. Surface microhardness testing, polarized light microscopy (PLM), and transverse microradiography (TMR) were analyzed. Then the biocompatibility of DK5-Lips was evaluated in the caries model of Sprague-Dawley rats, and the anti-caries effect was assessed using Micro-CT analysis, Keyes scores, and PLM in vivo.

RESULTS

DK5-Lips provided a mean particle size of (97.63 ± 4.94)nm and encapsulation efficiency of (61.46 ± 1.44)%, exhibiting a sustained release profile, excellent stability in saliva, and no significant toxicity on human gingival fibroblasts (HGFs). The DK5-Lips group had higher surface microhardness recovery, shallower caries depth, and less mineral loss in bovine enamel. Animal experiments showed higher volume and density values of residual molar enamel, lower Keyes score, and shallower lesion depth of the DK5-Lips group with good biocompatibility.

CONCLUSION

As a safe and effective application model, DK5-Lips could significantly promote the remineralization of initial enamel caries both in vitro and in vivo.

CLINICAL RELEVANCE

The potential of liposome utilization as vehicle for oral delivery of functional peptides may provide a new way for enamel restoration.

Evaluation of Feline Permanent Canine Tooth Mineral Density Using Micro-Computed Tomography

The tooth is made up of three mineralized tissues, enamel, dentin, and cementum, which surround a non-mineralized tissue called the dental pulp. Micro-computed tomography (mCT) is an imaging technology based on X-rays that allows non-invasive visualization of objects at a microscopic scale, according to their radiopacity and in three dimensions (3D). Likewise, it allows the subsequent execution of morphological and quantitative analysis of the objects, such as, for example, the determination of the relative mineral density (MD). The present work aimed to describe the MD of feline teeth using mCT. The studied sample consisted of four European Shorthair cats, from which nine canine teeth were extracted per medical indication. These teeth were evaluated through dental radiography before and after their extraction. Using mCT and the CTAn software, the values of the relative mineral density of the root of each tooth and of specific segments corresponding to the coronal, middle, and apical thirds of the root were determined. Mean MD of root tissues was 1.374 ± 0040 g·cm−3, and of hard root, tissues was 1.402 ± 0.035 g·cm−3. Through mCT, it was possible to determine the mean MD values of feline canine teeth. The study of MD could become an ancillary method for the diagnosis and characterization of dental pathology.

Enamel demineralization model in primary teeth: Micro-CT and SEM assessments of artificial incipient lesion

Many studies have analyzed different tooth demineralization models, which generate artificial incipient lesions; however, most of them are complex, slow, not clear and results could not be employed in both primary and permanent teeth because of chemical content differences among them. This study evaluates a demineralization model on primary enamel, under three incubation periods; quantifying artificial incipient lesions formation, and depth by micro-CT, complementing with SEM for morphological characterization. Sixteen healthy human anterior primary teeth extracted for prolonged retention and orthopedic/orthodontic reasons were included in this study, previous informed consent. The sample was randomly assigned to four groups n = 4: G_Control, G_2D, G_4D, and G_7D. Micro-CT and SEM were performed during two stages: before demineralization (BD) and after demineralization (AD). A t-student test was carried out to determine differences among groups (p ≤ .05). No incipient lesions were observed in control group. Artificial lesion depth was similar among experimental groups; values were from 38.16 ± 05.40 μm to 42.61 ± 04.75 μm. An amount of 14 to 17 artificial incipient lesions were formed per group, the extension and distribution were different for each incubation period. Five erosive lesions were produced in G_7D. All experimental groups were able to form incipient artificial lesions in primary enamel. SEM characterization revealed more pronounced changes on the enamel surface, as the days of immersion in the demineralization solution increased. The 4-day incubation period is the most recommended for the demineralization model, due to the formation of incipient lesions only and its extension, which facilitates their assessment.

Three-Dimensional Micro-Computed Tomography of the Adult Mouse Ovary

In the mouse ovary, folliculogenesis proceeds through eight main growth stages, from small primordial type 1 (T1) to fully grown antral T8 follicles. Most of our understanding of this process was obtained with approaches that disrupted the ovary three-dimensional (3D) integrity. Micro-Computed Tomography (microCT) allows the maintenance of the organ structure and a true in-silico 3D reconstruction, with cubic voxels and isotropic resolution, giving a precise spatial mapping of its functional units. Here, we developed a robust method that, by combining an optimized contrast procedure with microCT imaging of the tiny adult mouse ovary, allowed 3D mapping and counting of follicles, from pre-antral secondary T4 (53.2 ± 12.7 μm in diameter) to antral T8 (321.0 ± 21.3 μm) and corpora lutea, together with the major vasculature branches. Primordial and primary follicles (T1–T3) could not be observed. Our procedure highlighted, with unprecedent details, the main functional compartments of the growing follicle: granulosa, antrum, cumulus cells, zona pellucida, and oocyte with its nucleus. The results describe a homogeneous distribution of all follicle types between the ovary dorsal and ventral regions. Also, they show that each of the eight sectors, virtually segmented along the dorsal-ventral axis, houses an equal number of each follicle type. Altogether, these data suggest that follicle recruitment is homogeneously distributed all-over the ovarian surface. This topographic reconstruction builds sound bases for modeling follicles position and, prospectively, could contribute to our understanding of folliculogenesis dynamics, not only under normal conditions, but, importantly, during aging, in the presence of pathologies or after hormones or drugs administration.

Ten Years of Micro-CT in Dentistry and Maxillofacial Surgery: A Literature Overview

Micro-computed tomography (micro-CT) is a consolidated imaging technology allowing non-destructive three-dimensional (3D) qualitative and quantitative analysis by the observation of microstructures with high resolution. This paper aims at delivering a structured overview of literature about studies performed using micro-CT in dentistry and maxillofacial surgery (MFS) by analyzing the entire set of articles to portray the state of the art of the last ten years of scientific publications on the topic. It draws the scenario focusing on biomaterials, in vitro and in/ex vivo applications, bone structure analysis, and tissue engineering. It confirms the relevance of the micro-CT analysis for traditional research applications and mainly in dentistry with respect to MFS. Possible developments are discussed in relation to the use of the micro-CT combined with other, traditional, and not, techniques and technologies, as the elaboration of 3D models based on micro-CT images and emerging numerical methods. Micro-CT results contribute effectively with whose ones obtained from other techniques in an integrated multimethod approach and for multidisciplinary studies, opening new possibilities and potential opportunities for the next decades of developments.

The combined approach to evaluation of mechanical behavior of tooth enamel in artificially induced caries lesions

Improved knowledge of caries initiation and progression on the base of modern mechanobiology could facilitate effective preventing and therapeutic strategies. Not all of previously developed experimental models of artificial caries comply with required standards. The aim of the study was to investigate microstructural and mechanical properties of 12 artificial caries lesions, induced on human intact premolars according to original protocol. The tooth specimens were subjected to imaging by X-ray CT system Nikon Metrology XT H 225, with further morphometric analysis of lesion geometry, depth, surface layer thickness and mineral density in the areas of interest. Mechanical characteristics (penetration depth, microhardness, elastic modulus) in enamel lesion, perifocal intact enamel and remote zones were obtained using Micro CombiTester system. Clinically all lesions fully corresponded to ICDAS – 2 code. According to µCT data, LDµCT of the lesions ranged from 346.4 to 531 µm, mineral density range from 2.03±0.15 g/cm3 in transparent zone to 1.05±0.08 g/cm3 in the surface zone of the lesion. Microhardness of demineralized enamel lesion more than 5 times reduced in comparison with perifocal and remote intact enamel. Nanoindentation and µCT data are corresponds to those presenting on the base of other classical protocols of artificial caries formation and close to the typical mechanical characteristics of enamel caries in vivo.

Diagnodent and VistaCam may be unsuitable for the evaluation of dental caries in archeological teeth

OBJECTIVES

The aim of the study was to compare the usefulness of fluorescence-based caries detection systems (Diagnodent and VistaCam) for the assessment of carious lesions on archeological molars.

MATERIALS AND METHODS

The study material consisted of teeth from the Cemetery of St. Mary Magdalene (Cmentarz św. Marii Magdaleny) in Wrocław, Poland. A sample of 178 permanent molars from 38 skulls were examined. Five surfaces of teeth (occlusal, mesial, distal, buccal, and lingual) were assessed on either basically cleaned or sandblasted teeth. Six diagnostic methods were used to detect carious lesions: the visual classification of the International Caries Detection and Assessment System (ICDAS II), fluorescent methods (Diagnodent and VistaCam), X-ray, cone beam computed tomography and histological sections. The sensitivity and specificity of the methods were determined using receiver operating characteristic (ROC) curves and the correlation between the severity of dental caries and the readouts obtained with each method.

RESULTS

In most cases, Diagnodent and VistaCam yielded unsatisfactory specificity and sensitivity values. The area under curve (AUC) values in ROC curves for Diagnodent and Vistacam were lower than the AUC values obtained for the ICDAS II visual classification.

CONCLUSIONS

According to our results, in the case of archeological teeth, neither Diagnodent nor VistaCam can be regarded as a better diagnostic method than the ICDAS II visual classification of caries.