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Background: Enamel is highly transparent at short wavelength infrared imaging (SWIR) wavelengths allowing the detection of dental decay without the need for ionizing radiation. The purpose of this study was to use SWIR imaging methods including cross polarization optical coherence tomography (CP-OCT), occlusal transillumination (SWIR-OT), proximal transillumination (SWIR-PT), and occlusal reflectance (SWIR-R) to image interproximal lesions in vivo and compare the sensitivity with radiography., Methods: Participants (n = 30) aged 18-80 each with a radiopositive interproximal lesion scheduled for restoration were enrolled in the study. Studies have shown that the opposing proximal surfaces across the contact will likely also have lesions. SWIR images were acquired of the adjoining teeth at each contact with an interproximal lesion scheduled for restoration. Lesion presence and depth were assessed on each side of the contact for radiography and each SWIR imaging method. Lesions on radiographs and in CP-OCT images were identified by a single examiner while lesions in SWIR images were identified by a contrast threshold via semi-automatic image segmentation., Results: All SWIR imaging methods had significantly higher sensitivity (P < 0.05) than radiographs for the detection of interproximal lesions on the teeth opposite those restored. CP-OCT and SWIR-R imaging methods had significantly higher sensitivity than the other methods. SWIR imaging methods showed significantly higher lesion contrast than radiography., Conclusions: SWIR imaging methods can be used to detect interproximal lesions on posterior teeth with higher diagnostic performance than radiographs. CP-OCT appears well suited as a potential gold standard for the detection of interproximal lesions and assessment of their severity in vivo., (© 2024. The Author(s).)

This study tested a novel in vitro dental erosion-abrasion model and the performance of cross-polarization optical coherence tomography (CP-OCT) in longitudinally monitoring the simulated lesions. Thirty human enamel specimens were prepared and randomized to receive three dental erosion-abrasion (EA) protocols: severe (s-EA, lemon juice/pH:2.5/4.25%w/v citric acid), moderate (m-EA, grapefruit juice/pH:3.5/1.03%w/v citric acid) and no-EA (water, control). EA challenge was performed by exposing the specimens to acidic solutions 4x/day and to brushing 2x/day with 1:3 fluoridated toothpaste slurry, for 14 days. Enamel thickness measurements were obtained using CP-OCT at baseline (D0), 7 (D7) and 14 days (D14) and micro-computed tomography (micro-CT) at D14. Enamel surface loss was measured with both CP-OCT and optical profilometry at D0, D7 and D14. Data was analyzed with repeated-measures ANOVA and Pearson's correlation (r) (α = 0.05). CP-OCT enamel thickness decreased over time in the s-EA group (D0 >D7 > D14, p < 0.001) and m-EA group (D0 > D14, p = 0.019) but did not change in the no-EA group (p = 0.30). Overall, CP-OCT and micro-CT results at D14 correlated moderately (r = 0.73). CP-OCT surface loss was highest for s-EA (p <0.001) but did not differ between moderate and no-EA (p = 0.25). Enamel surface loss with profilometry increased with severity (no-EA>m-EA>s-EA, p < 0.001). D14 surface loss was higher than D7 for both methods except for the no-EA group with profilometry. CP-OCT and profilometry had moderate overall correlation (r = 0.70). Our results revealed that the currently proposed in vitro dental erosion-abrasion model is valid and could simulate lesions of different severities over time. CP-OCT was a suitable method for monitoring the EA lesions.

Significance : Leakage in the interfaces between restorative materials and tooth structure allows for fluid and bacterial acid infiltration, causing restoration failure due to secondary caries. Dentists spend more time replacing composite restorations than placing new ones. Previous in vitro and in vivo studies on enamel and root surfaces using shortwave-infrared (SWIR) and thermal imaging during dehydration with forced air have been promising for assessing lesion activity. Aim : We hypothesized that SWIR reflectance and thermal imaging methods can be used to monitor the activity of secondary caries lesions around composite restorations. The objective of this study was to employ these methods to measure the rate of fluid loss from lesions during dehydration with forced air to assess lesion activity. Approach : Sixty-three extracted human teeth with total of 109 suspected secondary lesions were examined using SWIR and thermal imaging during dehydration. The thickness of the highly mineralized transparent surface layer (TSL) at lesion interfaces indicative of lesion activity was measured by optical coherence tomography (OCT). Micro-computed tomography (MicroCT) was used to further confirm lesion severity and structure. OCT and MicroCT measurements of lesion structure, depth, and severity were correlated with fluid loss rates measured with SWIR reflectance and thermal imaging. Results : TSL thickness measured with OCT correlated with both SWIR reflectance and thermal measurements of rates of fluid loss ( p < 0.05 ). Increasing TSL thickness led to decreased permeability of lesions, potentially indicating full lesion arrest at TSL ≥ 70    μ m . SWIR performed better than thermal imaging for secondary lesion activity assessment, although both methods performed best on smooth surface lesions. Conclusions : Nondestructive SWIR reflectance and OCT imaging methods are promising for clinically monitoring the activity of secondary caries lesions., (© 2023 The Authors.)

Objectives: The purpose of this study was to show that optical coherence tomography (OCT) and thermal imaging can be used to monitor changes in the structure and activity of caries lesions over time after treatment with silver diamine fluoride (SDF)., Methods: Artificial caries lesions were formed on enamel and dentin bovine blocks. Each block was partitioned into five windows with the central three windows exposed to a demineralization solution to create lesions: one sound window served as a sound control (SC), one sound window was exposed to SDF to serve as a test control (SCT), one lesion window served as a lesion control (LC), one lesion window received one application of SDF (L1), while the other lesion window received two applications of SDF (L2). Each window was scanned using OCT before SDF application, and every week subsequently, for 12 weeks after initial SDF treatment. Changes in the mean intensity and the width of the peak of increased reflectivity due to the lesion and SDF along with the intensity at a depth of 180 µm from the surface representing optical penetration through the lesion were monitored. Changes in the heat lost, ΔQ (temperature integrated over time) of each window during drying with air were also monitored using a thermal imaging camera. Transverse microradiography (TMR), and high-resolution microscopy were also used for the analysis of selected samples., Results: The reflectivity and optical penetration of sound and lesion areas of enamel and dentin manifested significant changes in OCT images after SDF application. Thermal imaging showed significant differences in ΔQ indicative of permeability changes in the sound and lesion areas of enamel and dentin after SDF application., (© 2022 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.)

Objectives: Demineralized root dentin and cementum is made up of mostly collagen that shrinks significantly upon dehydration or drying with air. During remineralization mineral is deposited on the outside of the lesion creating a highly mineralized surface layer that inhibits diffusion, arrests the lesion and prevents shrinkage. Previous studies suggest that active root caries lesions manifest shrinkage, while arrested lesions no longer manifest shrinkage upon dehydration. The purpose of this study was to demonstrate that the shrinkage of root caries lesions can be monitored during dehydration using an optical coherence tomography probe suitable for clinical use., Methods: In this in vitro study the shrinkage of simulated and natural root caries lesions on extracted teeth was measured using a cross polarization optical coherence tomography (CP-OCT) system and a 3D printed appliance with an integrated air nozzle suitable for clinical use. Two methods were employed to assess shrinkage, changes in the position of the lesion surface and changes in the thickness of the lesion., Results: CP-OCT was successful in measuring a significant (P < 0.05) contraction of the lesion surface, significant decrease in the lesion thickness and increase in the reflectivity per micron upon drying natural lesions on extracted teeth., Conclusions: In this preclinical study, we have demonstrated that a CP-OCT handpiece modified for infection control with an attached air nozzle suitable for in vivo use can be used to monitor the shrinkage of root caries lesions. In addition, we have developed a new approach to measuring lesion shrinkage with OCT, namely monitoring changes in the lesion thickness as opposed to the position of the lesion surface, that does not require an initial reference position and is more easily implemented in vivo., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The identification of root caries and calculus on tooth roots is of increasing importance with our aging population. Exposed root surfaces are often impacted by erosion, abrasion, calculus and staining which can make the identification and management of caries challenging. Identification of dental calculus on root surfaces and verification of its removal is also important for patient education and to decrease susceptibility to caries and periodontal disease. The objective of this study was to determine how the contrast of root caries lesions and dental calculus varies with wavelength in the visible to near-infrared. The contrast of suspected root caries lesions and dental calculus on 30 extracted teeth was measured using cross-polarization reflectance measurements at wavelengths from 400 to 2350 nm. Significantly higher (P < 0.05) lesion contrast was measured at wavelengths greater than 1460 nm. Stains interfered significantly at wavelengths less than 850 nm yielding non-diagnostic contrast for root caries lesions. We postulate that the high absorption of water at longer wavelengths reduced the light scattering from the surrounding and underlying normal dentin, thus increasing the lesion contrast. This study indicates that wavelengths beyond 1400 nm are advantageous for imaging calculus and caries lesions on root surfaces due to the high contrast and lack of interference from stain., (© 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Optical coherence tomography (OCT) is a noninvasive diagnostic technique providing cross-sectional images of biologic structures based on the differences in tissue optical properties. OCT has been widely used in numerous clinical applications and is becoming popular as a promising technology in dentistry. Today, dental hard (tooth) and soft (hard palate mucosa and gingiva mucosa) tissues are visualized with OCT. With new developments in technology, the applications of OCT are being investigated in various fields in dentistry, such as to detect microleakage around restoration, tooth cracks/fractures, examination of periodontal tissues/pockets, early detection of oral cancerous tissues, and in endodontics for location of pulp canal., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The purpose of this study was to evaluate thermal and near-infrared (NIR) reflectance imaging methods for the assessment of the activity of root caries lesions. In addition, changes in the lesion structure were monitored with polarization sensitive optical coherence tomography (PS-OCT). Artificial bovine and natural root caries lesions were imaged with PS-OCT, and their dehydration rate was measured with thermal and NIR cameras. The lesion activity of the natural root caries samples was also assessed by two clinicians by conventional means according to ICDAS II guidelines. The thickness of the highly mineralized transparent surface layer measured using PS-OCT increased and the area enclosed by the time-temperature curve, ΔQ, measured with thermal imaging decreased significantly with longer periods of remineralization in simulated dentin lesions, but the NIR reflectance intensity differences, ΔI, failed to show any significant relationship with the degree of remineralization. The PS-OCT algorithm for the automated assessment of remineralization successfully detected the highly mineralized surface layer on both natural and simulated lesions. Thermal imaging provided the most accurate diagnosis of root caries lesion activity. These results demonstrate that thermal imaging and PS-OCT may be ideally suited for the nondestructive root caries lesion activity during a clinical examination., (© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Introduction: Radiographic methods have poor sensitivity for occlusal lesions and by the time the lesions are radiolucent they have typically progressed deep into the dentin. New more sensitive imaging methods are needed to detect occlusal lesions. In this study, cross-polarization optical coherence tomography (CP-OCT) and near-IR imaging were used to image questionable occlusal lesions (QOC's) that were not visible on radiographs but had been scheduled for restoration on 30 test subjects., Methods: Near-IR reflectance and transillumination probes incorporating a high definition InGaAs camera and near-IR broadband light sources were used to acquire images of the lesions before restoration. The reflectance probe utilized cross-polarization and operated at wavelengths from 1,500 to 1,700 nm where there is an increase in water absorption for higher contrast. The transillumination probe was operated at 1,300 nm where the transparency of enamel is highest. Tomographic images (6 × 6 × 7 mm 3 ) of the lesions were acquired using a high-speed swept-source CP-OCT system operating at 1,300 nm before and after removal of the suspected lesion., Results: Near-IR reflectance imaging at 1,500-1,700 nm yielded significantly higher contrast (P < 0.05) of the demineralization in the occlusal grooves compared with visible reflectance imaging. Stains in the occlusal grooves greatly reduced the lesion contrast in the visible range yielding negative values. Only half of the 26 lesions analyzed showed the characteristic surface demineralization and increased reflectivity below the dentinal-enamel junction (DEJ) in 3D OCT images indicative of penetration of the lesion into the dentin., Conclusion: This study demonstrates that near-IR imaging methods have great potential for improving the early diagnosis of occlusal lesions. Lasers Surg. Med. 49:215-224, 2017. © 2017 Wiley Periodicals, Inc., (© 2017 Wiley Periodicals, Inc.)

Introduction: Studies have shown that cross-polarization optical coherence tomography (CP-OCT) can be used to image the internal structure of carious lesions in vivo. The objective of this study was to show that CP-OCT can be used to monitor changes in the internal structure of early active carious lesions on smooth surfaces during non-surgical intervention with fluoride., Methods: Lesions on the smooth surfaces of teeth were imaged using CP-OCT on 17 test subjects. Lesion structural changes were monitored during fluoride varnish application at 6-week intervals for 30 weeks. The lesion depth (L d ), integrated reflectivity (ΔR), and surface zone thickness (S z ) were monitored., Results: A distinct transparent surface zone that may be indicative of lesion arrestment was visible in CP-OCT images on 62/63 lesions before application of fluoride varnish. The lesion depth and internal structure were resolved for all the lesions. The overall change in the mean values for L d , ΔR, and S z for all the lesions was minimal and was not significant during the study (P > 0.05). Only 5/63 lesions manifested a significant increase in S z during intervention., Conclusion: Even though it appears that most of the lesions manifested little change with fluoride varnish application in the 30 weeks of the study, CP-OCT was able to measure the depth and internal structure of all the lesions including the thickness of the important transparent surface zone located at the surface of the lesions, indicating that CP-OCT is ideally suited for monitoring lesion severity in vivo. Lasers Surg. Med. 48:915-923, 2016. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

The purpose of this study is to show that optical clearing agents can be used to increase the visibility of deeply penetrating occlusal lesions that have reached the underlying dentin and spread laterally under the enamel. Previous studies have shown that high refractive index fluids can increase the contrast of caries lesions. Extracted teeth with natural occlusal lesions were imaged with optical coherence tomography (OCT) with and without the addition of a transparent vinyl polysiloxane impression material (VPS) currently used in vivo. The relative intensity of the reflectivity from the underlying lesion area for each sample was measured before and after application of the VPS. Lesion presence was confirmed with polarized light microscopy and microradiography. Application of VPS significantly increased (P < 0.0001) the integrated reflectivity of subsurface dentinal lesions. This study shows that optical clearing agents can be used to increase the optical penetration and the visibility of subsurface lesions and the dentinal–enamel junction under sound and demineralized enamel in OCT images.

Optical coherence tomography (OCT) has been introduced in dentistry as a nondestructive diagnostic imaging tool that does not utilize ionizing radiation. This study investigated the agreement between polarization-sensitive OCT (PS-OCT), microcomputed tomography (μ-CT), and histology for enamel thickness measurements. Human enamel samples were prepared and evaluated with μ-CT and PS-OCT and then sectioned and observed via digital transversal light microscopy. For all methods, a standard transversal section (b-scan) in each sample was selected, and the enamel thickness was measured at three predetermined positions using ImageJ analysis software. The results revealed significant high agreement between all tested methods, indicating the potential of PS-OCT as a clinical tool to effectively measure enamel thickness., (© 2016 S. Karger AG, Basel.)

Several studies have demonstrated the potential of cross-polarization optical coherence tomography (CP-OCT) to quantify the severity of early caries lesions (tooth decay) on tooth surfaces. The purpose of this study is to show that 2D images of the lesion depth and the integrated reflectivity can be used to accurately represent the severity of early lesions. Simulated early lesions of varying severity were produced on tooth samples using simulated lesion models. Methods were developed to convert the 3D CP-OCT images of the samples to 2D images of the lesion depth and lesion integrated reflectivity. Calculated lesion depths from OCT were compared with lesion depths measured from histological sections examined using polarized light microscopy. The 2D images of the lesion depth and integrated reflectivity are well suited for visualization of early demineralization., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Introduction: Since optical coherence tomography (OCT) is well suited for measuring small dimensional changes on tooth surfaces, OCT has great potential for monitoring tooth erosion. Previous studies have shown that enamel areas ablated by a carbon dioxide laser manifested lower rates of erosion compared to the non-ablated areas. The purpose of this study was to develop a model to monitor erosion in vitro that could potentially be used in vivo., Methods: Thirteen bovine enamel blocks were used in this in vitro study. Each 10 mm × 2 mm block was partitioned into five regions, the central region was unprotected, the adjacent windows were irradiated by a CO2 laser operating at 9.3 µm with a fluence of 2.4 J/cm(2) , and the outermost windows were coated with acid resistant varnish. The samples were exposed to a pH cycling regimen that caused both erosion and subsurface demineralization for 2, 4 and 6 days. The surfaces were scanned using a time-domain polarization sensitive optical coherence tomography (PS-OCT) system and the degree of surface loss (erosion) and the integrated reflectivity with lesion depth was calculated for each window., Results: There was a large and significant reduction in the depth of surface loss (erosion) and the severity of demineralization in the areas irradiated by the laser., Conclusion: Irradiation of the enamel surface with a pulsed carbon dioxide laser at sub-ablative intensities results in significant inhibition of erosion and demineralization under the acid challenge employed in this study. In addition, these results suggest that it may be feasible to modify regions of the enamel surface using the laser to serve as reference marks to monitor the rate of erosion in vivo., (© 2014 Wiley Periodicals, Inc.)

Objectives: The aim of this study was to test the hypothesis that cross-polarization optical coherence tomography (CP-OCT) can be used to longitudinally monitor demineralization peripheral to orthodontic brackets in an extended clinical study., Methods: A high-speed CP-OCT system was used to acquire 3D volumetric images of the area at the base of orthodontic brackets over a period of 12 months after placement. The reflectivity was measured at 3-month intervals for 12 months to determine if there was increased demineralization. Two teeth were monitored on 20 test subjects and the brackets were bonded using two types of adhesives. This was a randomized controlled clinical study with a split mouth design such that each subject served as his or her own control. On one side, the control premolar was bonded with a bonding agent (Adper Scotchbond from 3M ESPE, St. Paul, MN) and composite (Transbond XT from 3M Unitek, Monrovia, CA) that lacked fluoride. On the other side, the experimental premolar was bonded with a fluoride releasing glass ionomer cement (GC Fuji Ortho LC from GC America, Alsip, IL)., Results: There was a small but significant increase in the calculated lesion depth and integrated reflectivity over that depth (ΔR) for both adhesive types (p<0.0001) indicating increasing demineralization with time. There was no significant difference in the lesion depth (p=0.22) and ΔR (p=0.91) between the groups with the fluoride releasing glass ionomer cement and the conventional composite., Conclusions: CP-OCT was able to measure a significant increase in demineralization (p<0.0001) at the base of orthodontic brackets over a period of 12 months., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objectives: It is difficult to completely remineralize carious lesions because diffusion into the interior of the lesion is inhibited as new mineral is deposited in the outermost layers. In previous remineralization studies employing polarization sensitive optical coherence tomography (PS-OCT), two models of remineralization were employed and in both models there was preferential deposition of mineral in the outer most layer. In this study we attempted to remineralize the entire lesion using an acidic remineralization model and demonstrate that this remineralization can be monitored using PS-OCT., Methods: Artificial lesions approximately 100-150 μm in-depth were exposed to an acidic remineralization regimen and the integrated reflectivity from the lesions was measured before and after remineralization using PS-OCT., Results: Automated integration routines worked well for assessing the integrated reflectivity for the lesion areas after remineralization. Although there was a high degree of remineralization, there was still incomplete remineralization of the body of the lesion., Conclusion: This study demonstrated that PS-OCT can be used to non-destructively measure changes in lesion structure and severity upon exposure to an acidic remineralization model. This study also demonstrated that automated algorithms can be used to assess the lesion severity even with the presence of a weakly reflective surface zone., (Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objective: Enamel is highly transparent in the near-IR (NIR) at wavelengths near 1,300 nm, and stains are not visible. The purpose of this study was to use NIR transillumination and optical coherence tomography (OCT) to estimate the severity of caries lesions on occlusal surfaces both in vivo and on extracted teeth., Methods: Extracted molars with suspected occlusal lesions were examined with OCT and polarization sensitive OCT (PS-OCT), and subsequently sectioned and examined with polarized light microscopy (PLM) and transverse microradiography (TMR). Teeth in test subjects with occlusal caries lesions that were not cavitated or visible on radiographs were examined using NIR transillumination at 1,310 nm using a custom built probe attached to an indium gallium arsenide (InGaAs) camera and a linear OCT scanner. After imaging, cavities were prepared using dye staining to guide caries removal and physical impressions of the cavities were taken., Results: The lesion severity determined from OCT and PS-OCT scans in vitro correlated with the depth determined using PLM and TMR. Occlusal caries lesions appeared in NIR images with high contrast in vivo. OCT scans showed that most of the lesions penetrated to dentin and spread laterally below the sound enamel., Conclusion: This study demonstrates that both NIR transillumination and OCT are promising new methods for the clinical diagnosis of occlusal caries., (Copyright © 2011 Wiley Periodicals, Inc.)

Introduction: The aims of this study were to test the hypothesis that polarization sensitive-optical coherence tomography (PS-OCT) can be used to non-destructively measure and quantify the severity of the early demineralization of enamel on buccal and occlusal surfaces and assess the inhibitory effect of fluoride varnish in vivo., Methods: A split mouth design was used to assess the effects of fluoride varnish on inhibiting dissolution on 20 test subjects. Orthodontic bands with a buccal window were cemented on the premolars and small incisions were produced on occlusal surfaces to serve as sites for plaque retention for enhanced demineralization. Bands were removed after 30 days and PS-OCT scans were acquired in vivo of occlusal and buccal areas. Teeth were extracted, sectioned, and analyzed using polarized light microscopy (PLM) and transverse microradiography (TMR) for comparison with the PS-OCT images., Results: High contrast PS-OCT images were acquired of both occlusal and buccal surfaces in vivo. Both occlusal and buccal surfaces, showed a significant difference (P < 0.05) in the integrated reflectivity (ΔR) between the "sound" and "carious" enamel groups. Although the mineral loss (ΔZ) and ΔR measured using TMR and PS-OCT were less for the fluoride varnish-treated buccal surfaces the difference was not statistically significant (P > 0.05)., Conclusions: Our results indicate that PS-OCT can non-destructively measure early enamel demineralization on the buccal and occulsal surfaces in vivo., (Copyright © 2010 Wiley-Liss, Inc.)

Background and Objectives: Several studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to nondestructively measure the severity of subsurface demineralization in enamel and dentin, track lesion progression over time and measure remineralization. The purpose of this study was to develop methods for the automated assessment of the depth and severity of demineralization in PS-OCT scans., Materials and Methods: Subsurface caries-like lesions of increasing depth and severity were produced in adjoining windows on 10 bovine enamel samples via exposure to demineralization for periods of 1-4 days. PS-OCT scans were acquired for each sample and analyzed using various methods to calculate the lesion depth and severity. Edge detection algorithms were most successful for measurement of the lesion depth for improved assessment of lesion severity., Results: Edge-finding algorithms were able to detect significant differences (P<0.05) in the lesion depth and severity between each of the periods of demineralization and sound enamel. The lesion depth and mineral loss were also measured with polarized light microscopy and transverse microradiography after sectioning the teeth for comparison., Conclusions: This study demonstrates that the depth and severity of early lesions can be calculated automatically for rapid analysis of PS-OCT images.

Image-guided laser ablation systems are now feasible for dentistry with the recent development of nondestructive high-contrast imaging modalities such as near-IR (NIR) imaging and optical coherence tomography (OCT) that are capable of discriminating between sound and demineralized dental enamel at the early stages of development. Our objective is to demonstrate that images of demineralized tooth surfaces have sufficient contrast to be used to guide a CO(2) laser for the selective removal of natural and artificial caries lesions. NIR imaging and polarization-sensitive optical coherence tomography (PS-OCT) operating at 1310-nm are used to acquire images of natural lesions on extracted human teeth and highly patterned artificial lesions produced on bovine enamel. NIR and PS-OCT images are analyzed and converted to binary maps designating the areas on the samples to be removed by a CO(2) laser to selectively remove the lesions. Postablation NIR and PS-OCT images confirmed preferential removal of demineralized areas with minimal damage to sound enamel areas. These promising results suggest that NIR and PS-OCT imaging systems can be integrated with a CO(2) laser ablation system for the selective removal of dental caries.

Previous studies have demonstrated that polarization-sensitive optical coherence tomography (PS-OCT) can be used to image natural and artificial caries in dentin. The purpose of this study was to measure nondestructively the severity of artificial caries lesions in dentin and determine the efficacy of intervention with anticaries agents including fluoride and lasers. Although several studies have assessed the utility of PS-OCT to image caries lesions in enamel and to quantify the lesion severity, only a few studies have focused on lesions in dentin. In this study, images of artificial dentin lesions on extracted human teeth were acquired with PS-OCT. Before exposure to an artificial demineralizing solution, three incisions were made on the sample surfaces using either Er:YAG, Nd:YAG (lambda = 355 nm), or TEA CO(2) lasers and selected areas were treated with topical fluoride to create six unique treatment areas for each of the three laser conditions investigated. The integrated reflectivity and depth of demineralization were calculated for each of the six areas on each sample using the PS-OCT images. Polarized light microscopy (PLM) and transverse microradiography (TMR) were used to measure lesion severity on histological thin sections for comparison. PS-OCT successfully measured the inhibition of demineralization by topical fluoride. Laser irradiation was not particularly effective in increasing or decreasing the rate of dentin demineralization. PLM and TMR corroborated those results. This study demonstrates that PS-OCT can be used to measure demineralization on dentin surfaces and determine the degree of inhibition of demineralization by anticaries agents.

Previous studies have demonstrated that polarization-sensitive optical coherence tomography (PS-OCT) can be used to image caries lesions in dentin, measure nondestructively the severity of dentin demineralization, and determine the efficacy of intervention with anticaries agents including fluoride and lasers. The objective of this study is to determine if PS-OCT can be used to nondestructively measure a reduction in the reflectivity of dentin lesions after exposure to a remineralization solution. Although studies have shown the ability of PS-OCT to image the remineralization of lesions in enamel, none have included dentin. PS-OCT images of dentin surfaces are acquired after exposure to an artificial demineralizing solution for six days and a remineralizing solution for 20 days. The integrated reflectivity, depth of demineralization, and thickness of the layer of remineralization are calculated for each of the two treatment groups on each sample. Polarized light microscopy and microradiography are used to measure lesion severity on histological thin sections for comparison. PS-OCT successfully measured the formation of a layer of increased mineral content near the lesion surface. Polorized light microscopy (PLM) and transverse microradiography (TMR) corroborated those results. PS-OCT can be used for the nondestructive measurement of the remineralization of dentin.

Background and Objectives: The purpose of this study was to assess the potential of polarization-sensitive optical coherence tomography (PS-OCT) to non-destructively measure the depth and severity of artificial demineralization on exposed root surfaces and measure the degree of inhibition by topical fluoride. Although PS-OCT imaging studies have demonstrated the utility of PS-OCT for imaging carious lesions on enamel and dentin surfaces the influence of the cementum layer that is present on intact root surfaces has not been investigated., Materials and Methods: In this study, extracted human tooth roots were partitioned into three sections with one partition treated with topical fluoride, one partition protected from demineralization with acid resistant varnish, and one partition exposed to a demineralization solution, producing artificial lesions approximately 200-mum deep in root dentin. The lesion depth, remaining cementum thickness and the integrated reflectivity for lesion areas were measured with PS-OCT. These measurements were also compared with more established methods of measuring demineralization, namely transverse microradiography (TMR) and polarized light microscopy (PLM)., Results: PS-OCT was able to measure a significant increase in the reflectivity between lesion areas and sound root surfaces. In contrast to dentin, the cementum layer manifests minimal reflectivity in the PS-OCT images allowing non-destructive measurement of the remaining cementum thickness. The reflectivity of the cementum layer did not increase significantly after substantial demineralization, however it did manifest considerable shrinkage in a fashion similar to dentin and that shrinkage could be measured with OCT., Significance: This study demonstrates that PS-OCT can be used to measure demineralization non-destructively on root surfaces and assess inhibition of demineralization by anti-caries agents.

Studies have shown that lasers can be used to modify the chemical composition of tooth enamel to render it less soluble. The purpose of this study was to determine if polarization-sensitive optical coherence tomography (PS-OCT) can be used to nondestructively assess the inhibition of demineralization after CO2 laser irradiation. Human and bovine enamel specimens were irradiated by a microsecond pulsed CO2 laser operating at a wavelength of 9.3 microm. Some specimen areas were also treated with topical fluoride to create six treatment groups on each sample, including protected surface (no demineralization), protected +laser, laser, fluoride, laser+fluoride, and unprotected surface. Samples were placed in an artificial demineralization solution to create lesions approximately 100-200 microm in depth and were subsequently scanned with a PS-OCT system to assess lesion severity before sectioning for analysis by polarized light microscopy and transverse microradiography for comparison. PS-OCT was able to measure a significant reduction in the integrated reflectivity due to inhibition by the laser on both human and bovine enamel even though the laser modification of the enamel surface did cause an increase in reflectivity and decrease in optical penetration. This study shows that the PS-OCT is well suited for the clinical assessment of caries inhibition after laser treatments.

Polarization-sensitive optical coherence tomography (PS-OCT) and near-infrared (NIR) imaging are promising new technologies under development for monitoring early carious lesions. Fluorosis is a growing problem in the United States, and the more prevalent mild fluorosis can be visually mistaken for early enamel demineralization. Unfortunately, there is little quantitative information available regarding the differences in optical properties of sound enamel, enamel developmental defects, and caries. Thirty extracted human teeth with various degrees of suspected fluorosis were imaged using PS-OCT and NIR. An InGaAs camera and a NIR diode laser were used to measure the optical attenuation through transverse tooth sections (approximately 200 microm). A digital microradiography system was used to quantify the enamel defect severity by measurement of the relative mineral loss for comparison with optical scattering measurements. Developmental defects were clearly visible in the polarization-resolved OCT images, demonstrating that PS-OCT can be used to nondestructively measure the depth and possible severity of the defects. Enamel defects on whole teeth that could be imaged with high contrast with visible light were transparent in the NIR. This study suggests that PS-OCT and NIR methods may potentially be used as tools to assess the severity and extent of enamel defects.

Background and Objective: Polarization sensitive optical coherence tomography (PS-OCT) has great promise for the non-destructive assessment of the efficacy of anti-caries agents such as fluoride and thermal laser treatments on enamel surfaces. The purpose of this study was to demonstrate that PS-OCT can be used to measure demineralization in craters/incisions prepared in enamel by a CO(2) laser operating at the high irradiation intensities required for cavity preparations., Materials and Methods: Incisions in bovine enamel surfaces were produced by a CO(2) laser used with a water spray. The laser was operated at lambda=9.3 microm with a pulse duration of 15 micros and an incident fluence of 20 J/cm(2). The laser treatments were also combined with topical fluoride treatments. A PS-OCT system operating at 1,310 nm was used to acquire polarization resolved images of six areas including sound and laser-ablated+topical fluoride treated zones on each sample. After imaging the teeth, they were sectioned and the thin sections were examined with polarized light microscopy (PLM) and transverse microradiography (TMR). The integrated reflectivity and lesion depth derived from the PS-OCT scans, the integrated mineral loss and depth measured using TMR and the lesion depth measured with PLM were acquired for each area on the fifteen samples for comparison., Results: The integrated reflectivity and depth in the areas treated by the laser and fluoride were significantly lower (P<0.05) than for the untreated enamel. Similar results were observed for TMR and PLM., Conclusions: These results suggest that PS-OCT has great potential for the non-destructive "in vivo" assessment of the inhibition of demineralization by lasers at ablative irradiation intensities with and without topical fluoride application.

Background and Objective: The objective of this study was to test the hypothesis that the inhibition of demineralization in an in vitro simulated caries model by different fluoride agents could be monitored nondestructively using polarization-sensitive optical coherence tomography (PS-OCT) on smooth enamel surfaces peripheral to orthodontic brackets., Materials and Methods: Sixty human molar samples used for this in vitro study were divided into four groups of fifteen. The groups consisted of a control, a fluoride releasing glass ionomer cement, an adhesive fluoride sealant, and fluoride in solution (2-ppm fluoride). The reflectivity from tooth surfaces was monitored using a PS-OCT system at different time points after exposure to a pH cycling demin/remin model at 3-day intervals for 15 days. Polarized light microscopy (PLM) was used to examine lesion depth after day 15., Results: PS-OCT was effective at measuring significant differences in the integrated reflectivity in depth between the control and fluoride groups (P<0.001). The fluoride sealant demonstrated a greater protective effect than the fluoride in solution and the glass ionomer cement., Conclusions: These results suggest that PS-OCT is well suited for the nondestructive assessment of caries inhibition by anti-caries agents., ((c) 2007 Wiley-Liss, Inc.)

The remineralization of enamel caries can lead to distinct optical changes within a lesion. We hypothesized that the restoration of mineral volume would result in a measurable decrease in the depth-resolved reflectivity of polarized light from the lesion. To test this hypothesis, we measured optical changes in artificial caries undergoing remineralization as a function of depth, using Polarization-sensitive Optical Coherence Tomography (PS-OCT). Lesions were imaged non-destructively before and after exposure to a remineralization regimen. After imaging, microradiographs of histological thin sections indicated that the significant reflectivity reduction measured by PS-OCT accurately represented the increase in mineral content within a larger repaired surface zone. Mineral volume changes arising from remineralization can be measured on the basis of the optical reflectivity of the lesion.

Polarization-sensitive optical coherence tomography (PS-OCT) is potentially useful for imaging the nonsurgical remineralization of dental enamel. This study uses an all-fiber-based PS-OCT system operating at 1310 nm to image demineralized and fluoride-enhanced remineralized artificial lesions. PS-OCT images of lesions before and after remineralization are compared with the relative mineral loss DeltaZ (%vol x microm), obtained from high resolution digital microradiography (DM), and chemical composition changes by infrared spectroscopy. Severe early artificial caries show a significant increase in perpendicular-axis integrated reflectivity after remineralization. After sectioning the samples, DM demonstrates that the lesions remineralized with new mineral and the lesion surface zone show significant restoration of mineral volume. PS-OCT and DM both do not show a major change in lesion depth. For less severe artificial caries, the perpendicular-axis image resolves the scattering and depolarization of an outer growth layer after remineralization. This outer layer has a mineral volume close to that of sound enamel, and spectroscopic analysis indicates that the layer is a highly crystalline phase of apatite, without carbonate substitutions that increase the solubility of sound enamel. This study determines that PS-OCT can image the effects of fluoride-enhanced remineralization of mild and severe early artificial in vitro caries.

Polarization-sensitive optical coherence tomography (PS-OCT) is a nondestructive imaging system that can utilize near-infrared (IR) light to produce depth-resolved images of dental enamel and has the potential to monitor early enamel occlusal caries. The objective of this study was to investigate the relationship between the magnitude of backscattered light and depolarization recorded by PS-OCT with changes in the enamel mineral volume in an artificial caries model. Artificial lesions were created on a selected region on the occlusal surfaces of sound posterior teeth (n=10) using a well-characterized 14-day pH cycling model. An all-fiber-based PS-OCT system operating at 1,310 nm was used to collect serial images at day 0 and day 14 prior to tooth sectioning. The quantitative mineral content profile and relative mineral loss, DeltaZ (%volxmicrom), of the carious enamel samples were obtained from transverse sections using high-resolution digital microradiography (DM). Line profiles of PS-OCT and DM images were used to evaluate the artificial caries severity and depth. The integrated reflectivity of the perpendicular-axis PS-OCT image, quantifying lesion severity, was correlated to the DeltaZ of the caries lesions. There was also a strong correlation between the lesion depth calculated from both imaging modalities. PS-OCT can image and quantify artificial occlusal caries by measuring the increase in backscattering and depolarization of near-IR light. This optical method has promising applications for in vivo detection and monitoring of early enamel occlusal caries., (Copyright (c) 2006 S. Karger AG, Basel.)

Background and Objectives: Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to image early dental caries. The purpose of this study was to compare the measured reflectivity of natural caries lesions found on smooth surfaces (interproximal lesions) with the mineral loss measured using digital microradiography (DM) in order to determine if PS-OCT can be used as a non-destructive method to measure the severity of dental decay and resolve the internal structure of caries lesions., Materials and Methods: A PS-OCT system operating at 1,310 nm was used to acquire polarization resolved images of natural white spot lesions and pigmented lesions on the smooth surfaces of extracted teeth. The integrated reflectivity from lesion areas was compared to polarized light microscopic images (PLM) and to the integrated mineral loss from the same lesion area measured using high resolution DM., Results: The frequently complex internal structure of caries lesions could be resolved with PS-OCT. Such structural information is potentially useful for determining whether or not the lesion is active and progressing or whether it has become arrested and remineralized and does not require intervention. There was a strong correlation between the integrated mineral loss of the caries lesions measured using DM and the integrated reflectivity in the perpendicular polarization axis of the PS-OCT system., Conclusions: The integrated reflectivity in the perpendicular polarization channel can be used to represent the severity of demineralization in natural early caries lesions. Therefore, PS-OCT has considerable potential as a non-destructive clinical probe of early caries lesions to assess their severity, monitor their progression over-time and potentially assess lesion activity., ((c) 2005 Wiley-Liss, Inc.)

Polarization-sensitive optical coherence tomography (PS-OCT) is used to monitor the progression of simulated caries lesions on occlusal surfaces and image the lesions underneath composite sealants. The polarization-sensitive system, recording images in both the parallel and perpendicular axes, is useful for enhancing the image contrast of the artificial caries and minimizing the interference of the strong reflections at surface interfaces. Using the perpendicular-axis signal, the mean reflectivity increase from day 0 to day 14 is 5.1 dB (p<0.01, repeated-measures analysis of variation, Tukey-Kramer). For imaging lesions underneath the sealants, the mean reflectivity of the enamel underneath 250, 500, 750, and 1000 microm of composite is calculated for demineralized and control samples. The artificial lesions can be detected under 750 microm of visibly opaque sealant, with a 5.0-dB difference from the control samples (t-test, p<0.001). Tooth colored sealants allow deeper imaging depth. The artificial lesions could be detected under 1000 microm of sealant, with a 6.6-dB difference from the control samples (t-test, p<0.001). This study demonstrates that PS-OCT can be used to track lesion progression on occlusal surfaces nondestructively with or without sealants., (Copyright 2004 Society of Photo-Optical Instrumentation Engineers.)