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17 pages, 21107 KiB

Open AccessArticle

Polarization-Sensitive Optical Coherence Tomography for Monitoring De- and Remineralization of Bovine Enamel In Vitro

by Stella M. M. Hund, Jonas Golde, Florian Tetschke, Sabine Basche, Melina Meier, Lars Kirsten, Edmund Koch, Christian Hannig and Julia Walther

Diagnostics 2024, 14(4), 367; https://doi.org/10.3390/diagnostics14040367 - 07 Feb 2024

Cited by 1 | Viewed by 769

Abstract

Early caries diagnosis still challenges dentistry. Polarization-sensitive optical coherence tomography (PS-OCT) is promising to detect initial lesions non-invasively in depth-resolved cross-sectional visualization. PS-OCT with determined degree of polarization (DOP) imaging provides an intuitive demineralization contrast. The aim of this study is to evaluate [...] Read more.

Early caries diagnosis still challenges dentistry. Polarization-sensitive optical coherence tomography (PS-OCT) is promising to detect initial lesions non-invasively in depth-resolved cross-sectional visualization. PS-OCT with determined degree of polarization (DOP) imaging provides an intuitive demineralization contrast. The aim of this study is to evaluate the suitability of DOP-based PS-OCT imaging to monitor controlled de- and remineralization progression for the first time and to introduce it as a valid, non-destructive in vitro detection method. Twelve standardized bovine enamel specimens were divided in different groups and demineralized with hydrochloric acid (HCl) as well as partly remineralized with fluoride over a 14-day pH-cycling experiment. The specimens were stored in artificial saliva and sodium chloride (NaCl), respectively. Progress measurements with PS-OCT were made with polarization-sensitive en faceand B-scan mode for qualitative evaluation. The specimens demineralized in HCl showed the most pronounced surface change (lowest DOP) and the most significant increase in depolarization. Additional fluoride treatment and the storage in artificial saliva resulted in the opposite (highest DOP). Therefore, DOP-based PS-OCT imaging appears to be a valuable technique for visualization and monitoring of enamel demineralization and remineralization processes in vitro. However, these findings need to be confirmed in human teeth ex vivo or in situ. Full article

(This article belongs to the Special Issue Advances in Dental Imaging)

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19 pages, 8320 KiB

Open AccessArticle

Auto-Segmentation and Quantification of Non-Cavitated Enamel Caries Imaged with Swept-Source Optical Coherence Tomography

by Tamer Abdelrehim, Maha Salah, Heather J. Conrad and Hooi Pin Chew

Diagnostics 2023, 13(23), 3586; https://doi.org/10.3390/diagnostics13233586 - 03 Dec 2023

Viewed by 787

Abstract

(1) Background: OCT imaging has been used to assess enamel demineralization in dental research, but it is not yet developed enough to qualify as a diagnostic technique in clinics. The current capabilities of most commercial acquisition software allow for visual and qualitative assessments. [...] Read more.

(1) Background: OCT imaging has been used to assess enamel demineralization in dental research, but it is not yet developed enough to qualify as a diagnostic technique in clinics. The current capabilities of most commercial acquisition software allow for visual and qualitative assessments. There is a need for a fast and verified batch-processing algorithm to segment and analyze demineralized enamel. This study suggests a GUI MATLAB algorithm for the processing and quantitative analysis of demineralized enamel. (2) Methods: A group of artificially demineralized human enamels was in vitro scanned under the OCT, and ROI frames were extracted. By using a selected intensity threshold colormap, Inter- (Ie) and Intra- (Ia) prismatic demineralization can be segmented. A set of quantitative measurements for the average demineralized depth, average line profile, and integrated reflectivity can be obtained for an accurate assessment. Real and simulated OCT frames were used for algorithm verification. (3) Results: A strong correlation between the automated and known Excel measurements for the average demineralization depth was found (R² > 0.97). (4) Conclusions: OCT image segmentation and quantification of the enamel demineralization zones are possible. The algorithm can assess the future development of a real-time assessment of dental diagnostics using an oral probe OCT. Full article

(This article belongs to the Special Issue Advances in Dental Imaging)

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16 pages, 2337 KiB

Open AccessArticle

Proximal Caries Detection Using Short-Wave Infrared Transillumination at Wavelengths of 1050, 1200 and 1300 nm in Permanent Posterior Human Teeth

by Katrin Heck, Karl-Heinz Kunzelmann, Elias Walter, Dalia Kaisarly, Lea Hoffmann and Friederike Litzenburger

Diagnostics 2023, 13(20), 3257; https://doi.org/10.3390/diagnostics13203257 - 19 Oct 2023

Viewed by 924

Abstract

This in vitro study aimed to investigate the diagnostic potential of short-wave infrared transillumination (SWIRT) at 1050, 1200 and 1300 nm for the detection of proximal caries in molars and premolars. It was compared to the diagnostic performance of bitewing radiography (BWR) and [...] Read more.

This in vitro study aimed to investigate the diagnostic potential of short-wave infrared transillumination (SWIRT) at 1050, 1200 and 1300 nm for the detection of proximal caries in molars and premolars. It was compared to the diagnostic performance of bitewing radiography (BWR) and micro-computed tomography (µCT) as the reference standard. 250 sound or decayed proximal surfaces of permanent posterior extracted teeth were examined using (1) SWIRT at 1050, 1200 and 1300 nm with two camera systems of different resolutions, (2) BWR and (3) µCT. Thresholds were defined for both test methods and the reference standard for caries in general, enamel caries and dentin caries. All images were assessed by two examiners twice, at an interval of two weeks. SWIRT at wavelengths of 1050, 1200 and 1300 nm achieved sensitivity values more than 2.5 times higher than BWR (enamel caries 3.2–4.4 times; dentin caries 3.25–4.25 times) for the detection of proximal caries. Sensitivity values of SWIRT improved with the higher wavelength. No significant difference was found in diagnostic quality between the two camera systems. SWIRT at 1300 nm imaged proximal enamel caries with the highest accuracy, while the physical optimum for transillumination in dentin was located at a lower wavelength (<1000 nm). Full article

(This article belongs to the Special Issue Advances in Dental Imaging)

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12 pages, 1458 KiB

Open AccessArticle

Diagnostic Performance of Multispectral SWIR Transillumination and Reflectance Imaging for Caries Detection

by Yihua Zhu, Chung Ng, Oanh Le, Yi-Ching Ho and Daniel Fried

Diagnostics 2023, 13(17), 2824; https://doi.org/10.3390/diagnostics13172824 - 31 Aug 2023

Cited by 1 | Viewed by 874

Abstract

The aim of this clinical study was to compare the diagnostic performance of dual short wavelength infrared (SWIR) occlusal transillumination and reflectance multispectral imaging with conventional visual assessment and radiography for caries detection on premolars scheduled for extraction for orthodontics reasons. Polarized light [...] Read more.

The aim of this clinical study was to compare the diagnostic performance of dual short wavelength infrared (SWIR) occlusal transillumination and reflectance multispectral imaging with conventional visual assessment and radiography for caries detection on premolars scheduled for extraction for orthodontics reasons. Polarized light microscopy (PLM) and micro-computed tomography (microCT) performed after tooth extraction were used as gold standards. The custom-fabricated imaging probe was 3D-printed and the imaging system employed a SWIR camera and fiber-optic light sources emitting light at 1300 nm for occlusal transillumination and 1600 nm for reflectance measurements. Teeth (n = 135) on 40 test subjects were imaged in vivo using the SWIR imaging prototype in the study and teeth were extracted after imaging. Our study demonstrates for the first time that near-simultaneous real-time transillumination and reflectance video can be successfully acquired for caries detection. Both SWIR imaging modalities had markedly higher sensitivity for lesions on proximal and occlusal surfaces compared to conventional methods (visual and radiographic). Reflectance imaging at 1600 nm had higher sensitivity and specificity than transillumination at 1300 nm. The combined SWIR methods yielded higher specificity but the combined sensitivity was lower than for each individual method. Full article

(This article belongs to the Special Issue Advances in Dental Imaging)

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17 pages, 5592 KiB

Open AccessArticle

Stereomicroscopic Aspects of Non-Carious Cervical Lesions

by Andreea Stănuşi, Adrian Ştefan Stănuşi, Oana Gîngu, Veronica Mercuţ and Eugen Osiac

Diagnostics 2023, 13(15), 2590; https://doi.org/10.3390/diagnostics13152590 - 03 Aug 2023

Viewed by 1143

Abstract

Non-carious cervical lesions (NCCLs) represent a form of tooth wear, characterized by the irreversible loss of dental hard tissues at the enamel–cement junction, without the involvement of caries and dental trauma. The aim of this study was to highlight the morphological elements of [...] Read more.

Non-carious cervical lesions (NCCLs) represent a form of tooth wear, characterized by the irreversible loss of dental hard tissues at the enamel–cement junction, without the involvement of caries and dental trauma. The aim of this study was to highlight the morphological elements of NCCLs via their stereomicroscopic examination and to confirm the role of this examination in the diagnosis of early lesions. In addition, the association between the morphological aspects identified during the stereomicroscopic examination of NCCLs and their etiological factors was determined. For this study, extracted teeth with NCCLs were examined with a stereomicroscope. The morphological aspects of NCCLs were evaluated at magnifications up to 75×. In wedge-shaped NCCLs, the stereomicroscopic examination allowed the identification and measurement of scratches, furrows and cracks. In saucer-shaped NCCLs, the stereomicroscopic examination highlighted the smooth appearance of the walls. The presented study highlighted the role of stereomicroscopic examination in the assessment of NCCL morphology and in their early diagnosis. The study confirmed, in particular, the role of occlusal overloads and tooth brushing in determining the morphology of NCCLs. Full article

(This article belongs to the Special Issue Advances in Dental Imaging)

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12 pages, 570 KiB

Open AccessArticle

Exploratory Analysis of Objective Outcome Measures for the Clinical Assessment of Erosive Tooth Wear

by Maria Jacinta Rosario H. Romero, Peter S. Ungar, Daniel Fried, Frank Lippert, Domenick T. Zero, Susan Zunt, George J. Eckert, Ana Gutierrez Gossweiler, Dylan Jacob Elkington-Stauss, Guillermo Tamayo-Cabeza, Adam B. Kelly, Troy Bartels, Camille Kita, Elizabeth Wewers and Anderson T. Hara

Diagnostics 2023, 13(15), 2568; https://doi.org/10.3390/diagnostics13152568 - 02 Aug 2023

Viewed by 756

Abstract

This study proposed using enamel surface texture and thickness for the objective detection and monitoring of erosive tooth wear (ETW), comparing them to the standard subjective Basic Erosive Wear Evaluation (BEWE). Thirty-two subjects (n = 597 teeth) were enrolled in this longitudinal [...] Read more.

This study proposed using enamel surface texture and thickness for the objective detection and monitoring of erosive tooth wear (ETW), comparing them to the standard subjective Basic Erosive Wear Evaluation (BEWE). Thirty-two subjects (n = 597 teeth) were enrolled in this longitudinal observational clinical study. Enamel thickness (by cross-polarization optical coherence tomography, CP-OCT) and 3D dental microwear parameters, i.e., area-scale fractal complexity (Asfc), anisotropy (Str), and roughness (Sa) (by white-light scanning confocal profilometry), were obtained from buccal surfaces. Buccal, occlusal, and lingual surfaces were scored for BEWE and the maximum score per tooth (BEWE_Max) was determined at baseline and 12 months (M12). Data outcome relationships were evaluated (alpha = 0.05). Enamel thickness decreased (p < 0.001), BEWE scores, Sa, and Str increased (p < 0.001), while Asfc did not change at M12. Baseline BEWE_Buccal correlated strongly with BEWE_Max (r = 0.86, p < 0.001) and moderately with BEWE_Lingual (r = 0.42, p < 0.001), but not with enamel thickness (r = 0.03, p = 0.43). Change (Δ) in surface texture outcomes correlated poorly but significantly with ΔBEWE_Buccal (r = −0.15–0.16, p < 0.001) and did not correlate with Δenamel thickness (r = 0.02–0.09, p > 0.06). Teeth with BEWE progression revealed a greater increase in ΔSa and ΔStr. These findings suggest that enamel surface roughness can potentially determine ETW severity, and CP-OCT may be relevant for clinically monitoring enamel thickness. Full article

(This article belongs to the Special Issue Advances in Dental Imaging)

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10 pages, 1138 KiB

Open AccessArticle

Morphological Assessment of Nasopalatine Canal Using Cone Beam Computed Tomography: A Retrospective Study of 124 Consecutive Patients

by Emmanouil Chatzipetros, Kostas Tsiklakis, Catherine Donta, Spyros Damaskos and Christos Angelopoulos

Diagnostics 2023, 13(10), 1787; https://doi.org/10.3390/diagnostics13101787 - 18 May 2023

Cited by 1 | Viewed by 1807

Abstract

This study aimed to assess and analyze the morphology and dimensions of the nasopalatine canal (NPC), as well as the adjacent buccal osseous plate (BOP), and to investigate the effect of gender, edentulism, NPC types, absence of maxillary central incisors (ACI) and age [...] Read more.

This study aimed to assess and analyze the morphology and dimensions of the nasopalatine canal (NPC), as well as the adjacent buccal osseous plate (BOP), and to investigate the effect of gender, edentulism, NPC types, absence of maxillary central incisors (ACI) and age on the NPC and BOP, using cone beam computed tomography (CBCT). A total of 124 CBCT examinations (67 female and 57 male patients) were retrospectively included and evaluated. The assessment of the dimensions of the NPC, as well as the dimensions of the adjacent BOP, was performed by three Oral and Maxillofacial Radiologists on reconstructed sagittal and coronal CBCT sections under standardized conditions. Regarding the dimensions of the NPC and the adjacent BOP, the mean values were significantly higher among males than females. Furthermore, edentulous patients showed a significant reduction in BOP dimensions. Additionally, NPC types showed a significant effect on the length of the NPC, and the ACI had a significant effect on reducing BOP dimensions. Age had a significant effect on the diameter of the incisive foramen, with the mean values generally increasing with an increasing age. CBCT imaging of this anatomical structure contributes significantly to its full assessment. Full article

(This article belongs to the Special Issue Advances in Dental Imaging)

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Review

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28 pages, 5094 KiB

Open AccessReview

Detection, Diagnosis, and Monitoring of Early Caries: The Future of Individualized Dental Care

by Marwa Abdelaziz

Diagnostics 2023, 13(24), 3649; https://doi.org/10.3390/diagnostics13243649 - 12 Dec 2023

Viewed by 3184

Abstract

Dental caries remains a significant global health issue. It was highlighted by the World Health Organization’s 2022 reports that despite the efforts and scientific advancements in caries detection and management, the situation has only marginally improved over the past three decades. The persistence [...] Read more.

Dental caries remains a significant global health issue. It was highlighted by the World Health Organization’s 2022 reports that despite the efforts and scientific advancements in caries detection and management, the situation has only marginally improved over the past three decades. The persistence of this problem may be linked to outdated concepts developed almost a century ago but are still guiding dentists’ approach to caries management today. There is a need to reconsider professional strategies for preventing and managing the disease. Contemporary dentistry could benefit from embracing new concepts and technologies for caries detection and management. Dentists should explore, among others, alternative methods for caries detection such as optical-based caries detection. These tools have been established for over a decade and they align with current disease understanding and international recommendations, emphasizing early detection and minimally invasive management. This narrative review presents the current state of knowledge and recent trends in caries detection, diagnosis, monitoring, and management, offering insights into future perspectives for clinical applications and research topics. Full article

(This article belongs to the Special Issue Advances in Dental Imaging)

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13 pages, 287 KiB

Open AccessReview

A Comprehensive Review of Factors That Influence the Accuracy of Intraoral Scanners

by Lubna Alkadi

Diagnostics 2023, 13(21), 3291; https://doi.org/10.3390/diagnostics13213291 - 24 Oct 2023

Cited by 2 | Viewed by 1728

Abstract

Intraoral scanners (IOSs) have become increasingly popular in the field of dentistry for capturing accurate digital impressions of patients’ teeth and oral structures. This study investigates the various factors influencing their accuracy. An extensive search of scholarly literature was carried out via PubMed, [...] Read more.

Intraoral scanners (IOSs) have become increasingly popular in the field of dentistry for capturing accurate digital impressions of patients’ teeth and oral structures. This study investigates the various factors influencing their accuracy. An extensive search of scholarly literature was carried out via PubMed, utilizing appropriate keywords. Factors evaluated in the included studies were categorized into three primary divisions: those related to the operator, the patient, and the IOS itself. The analysis demonstrated that the accuracy of intraoral scanning is influenced by various factors such as scanner selection, operator skill, calibration, patient’s oral anatomy, ambient conditions, and scanning aids. Maintaining updated software and understanding factors beyond scanner resolution are crucial for optimal accuracy. Conversely, smaller IOS tips, fast scanning speeds, and specific scanning patterns compromise the accuracy and precision. By understanding these factors, dental professionals can make more informed decisions and enhance the accuracy of IOSs, leading to improved final dental restorations. Full article

(This article belongs to the Special Issue Advances in Dental Imaging)

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