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Validation of swept source optical coherence tomography (SS-OCT) for the diagnosis of smooth surface caries in vitro.
J Dent. 2012 Oct 16;
Authors: Nakagawa H, Sadr A, Shimada Y, Tagami J, Sumi Y
Abstract
OBJECTIVE: An accurate evaluation of the extent of dental caries and possible progress of the lesion from enamel into dentin is very important in clinical dentistry. Dentists need an imaging technology that can noninvasively and reliably quantify the extentof caries. This study aimed to evaluate the effectiveness of non-polarized swept source optical coherence tomography (OCT) in evaluating the extentof caries on smooth enamel surfaces. METHODS: One-hundred and twenty-seveninvestigation sites on the enamel surfaces of 93 extracted teeth were selected randomly and examined visually. The presence and extent of caries were scored by experienced and inexperienced dentists using each observation method (0: no caries, 1: enamel demineralization without surface breakdown, 2: enamel breakdown due to caries, 3: deep caries involving the dentin). The same locations were then examined using OCT, following which the teeth were sectioned using a diamond saw and viewed directly under a confocal laser scanning microscope (CLSM). Sensitivity and specificity indices for OCT and VI were calculated and compared. The results were analyzed statistically using receiver operating characteristic (ROC) curves. RESULTS: Enamel and dentin caries were outlined by a visible boundary on the cross-sectional OCT images. The modality showed superior results for the detection of dentinal caries; higher sensitivity and Az values could be obtained in the ROC curves, especially by experienced dentists. CONCLUSIONS: Cross-sectional imaging of the natural caries lesions on smooth enamel surface by OCT enables efficient diagnosis of the lesion type, extent and dentin involvement. CLINICAL SIGNIFICANCE: SS-OCT can demonstrate the cross-sectional image of smooth surface enamel caries as highlighted zone in tomogram. It is crucial to determine the extentof the lesion, whether it reaches beyond EDJ or not by a non-invasive and safe technique. OCT can give clinicians information about internal tooth structure and will help clinical decision making on surgical intervention.
[cite source='pubmed']23084870[/cite] – as supplied by publisher]