Validation of swept source optical coherence tomography (SS-OCT) for the diagnosis of smooth surface caries in vitro
Validation of swept source optical coherence tomography (SS-OCT) for the diagnosis of smooth surface caries in vitro
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DOI：
10.1016/j.jdent.2012.10.007
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发表时间：
2013-01-01
影响因子：
4.4
通讯作者：
Sumi, Yasunori
中科院分区：
文献类型：
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作者：
Nakagawa, Hisaichi;Sadr, Alireza;Sumi, Yasunori
目的：准确评估龋齿的程度以及病变从牙釉质到牙本质的可能进展在临床牙科中非常重要。牙医需要一种能够无创且可靠地量化龋齿程度的成像技术。本研究旨在评估非偏振扫频光学相干断层扫描（OCT）评估光滑牙釉质表面龋齿程度的有效性。方法：随机选择93颗拔除牙齿牙釉质表面的127个检查部位并进行目视检查。由经验丰富和缺乏经验的牙医使用每种观察方法对龋齿的存在和程度进行评分（0：无龋齿；1：牙釉质脱矿而无表面破坏；2：由于龋齿导致牙釉质破坏；3：涉及牙本质的深部龋齿）。然后使用 OCT 检查相同的位置，然后使用金刚石锯对牙齿进行切片并直接在共焦激光扫描显微镜 (CLSM) 下观察。计算并比较 OCT 和 VI 的敏感性和特异性指数。使用受试者工作特征 (ROC) 曲线对结果进行统计分析。结果：牙釉质和牙本质龋齿在横截面 OCT 图像上通过可见边界勾勒出轮廓。该方法在检测牙本质龋齿方面显示出优异的结果； ROC曲线可以获得更高的灵敏度和Az值，特别是对于有经验的牙医。结论：通过OCT对光滑牙釉质表面的天然龋病病变进行横截面成像，可以有效诊断病变类型、范围和牙本质受累情况。临床意义：SS-OCT可以将光滑表面牙釉质龋病的横截面图像显示为断层扫描中的突出区域。通过非侵入性且安全的技术来确定病变的范围（无论其是否超出 DEJ）至关重要。 OCT可以为临床医生提供有关牙齿内部结构的信息，并有助于临床决策的手术干预。 (C) 2012 Elsevier Ltd. 保留所有权利。
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 extent of caries. This study aimed to evaluate the effectiveness of non-polarized swept source optical coherence tomography (OCT) in evaluating the extent of caries on smooth enamel surfaces.Methods: One-hundred and twenty-seven investigation 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 analysed 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 extent of the lesion, whether it reaches beyond DEJ 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. (C) 2012 Elsevier Ltd. All rights reserved.