DEVELOPMENT OF A SMARTPHONE-BASED INFRARED-FLUORESCENCEIMAGING INTRAORAL DEVICE (SMART-IR-ID) FOR DENTIST-GUIDED REALTIME SELF-MONITORING OF PERIODONTAL DISEASE

项目总结： 牙周病(PD)是一种常见的传染病/炎症性疾病，在大多数情况下是可以预防的 人口通过早期发现和治疗；然而，帕金森病的高患病率(47%的美国成年人 患有牙周炎)使其成为公共卫生问题，造成高达4420亿美元的社会经济负担 每年。帕金森病通常由跟踪牙槽骨的牙科卫生师、牙医或牙周病医生诊断。 通过口腔内X光片(X光)和牙周探查测量身高和牙龈高度。牙科X光是 最可靠的口腔内成像工具，用于识别牙齿/洞穴状况和骨骼损伤；然而，牙科 X光不能发现早期牙周病变，也不能显示牙周袋的形态。另外， 牙科X光不能作为一种常规的筛查工具来检查帕金森病的进展 这是因为其电离辐射对健康构成风险和令人担忧。因此，牙周探查是 完整的帕金森病诊断和后续检查的标准方法。牙周组织的结构状态 软组织可以通过口袋深度测量、牙龈出血和牙龈视觉征象来估计。 炎症(发红和肿胀)。据我们所知，目前还没有可靠的技术可以 提供PD进展过程中PP和炎症牙龈的3D结构信息。这样做的目的是 建议开发一种基于智能手机的红外荧光成像口腔内设备(Smart-IR-ID)来 测量PP和牙周炎的三维结构，用于牙医指导下的自查和追踪PD。 我们建议通过两个具体目标来解决这一目标：1)研究红外(IR)荧光 开发能够精确传递和释放所需最低限度的红外线口腔内装置的成像方法 2)研制双模光传感器 和基于智能手机的3D建模系统，用于数字3D红外成像和报告3D测量 PP和牙周炎。我们提议的项目是创新的，作为基于智能手机的口腔内IR 荧光成像系统显示牙周炎及感染牙周软组织的三维结构 完全未被开发的研究领域。这项工作的预期结果是提供了开拓性的 我们的基于精确医学的口腔内成像设备的原型集成到mHealth平台中。智能- 特别是IR-ID，为下一阶段结合成像和治疗能力提供了可能性。 我们的项目意义重大，因为这项研究将开发一个特定于平台的模型，该模型可以链接到 其他口腔内诊断和治疗设备，将PD管理从现场临床护理转变为 诊所设施在牙医的指导下在需要的时候进行自我护理。

PROJECT SUMMARY: Periodontal disease (PD), a common infectious/inflammatory disease, is preventable for much of the population by early detection and treatment; however, the high prevalence of PD (47% of Americans adults having periodontitis) makes it a public health concern, having a socio-economic burden of up to $442 billion each year. PD is typically diagnosed by the dental hygienist, dentist, or periodontist tracking alveolar bone height and gingival height through intraoral radiographs (X-rays) and periodontal probing. Dental X-rays are the most reliable intraoral imaging tool for identifying tooth/cavity conditions and bone lesions; however, dental X-rays cannot detect early periodontal lesions and visualize the topography of periodontal pocket (PP). Also, dental X-rays cannot be used as a routine screening tool to exam the progression of PD during the follow-up period because its ionizing radiation poses health risks and concerns. Periodontal probing is, therefore, the standard approach for complete PD diagnosis and follow-up checkups. The structural status of the periodontal soft tissues can be estimated by pocket depth measurement, gingival bleeding, and visual signs of gingival inflammation (redness and swelling). To the best of our knowledge, there is still no reliable technology that can provide 3D structure information of the PP and inflamed gingiva during PD progression. The objective of this proposal is to develop a smartphone-based infrared-fluorescence-imaging intraoral device (Smart-IR-ID) to measure the 3D structure of the PP and gingival inflammation for dentist-guided self-exam and tracking of PD. We propose to address this objective through 2 specific aims: 1) To investigate the infrared (IR) fluorescence imaging approach to develop IR intraoral devices that can precisely deliver and release the minimal required dosage of imaging agents into inflamed gingiva and PP; and 2) To develop the dual-module optical sensors and smartphone-based 3D modeling system for digital 3D IR-imaging and reporting the 3D measurements of PP and gingival inflammation. Our proposed project is innovative as a smartphone-based intraoral IR fluorescence imaging system in visualizing the 3D structure of PP and infected soft tissue of periodontium is a completely underexplored research area. The expected outcome of this work is to provide the pioneering prototype for our precision medicine-based intraoral imaging device integrated into a mHealth platform. Smart- IR-ID, in particular, opens the possibility of combining imaging and therapeutic capabilities at the next stage. Our project is significant because this research will develop a platform-specific model that can be linked to other intraoral diagnostic and therapeutic devices, transforming PD management from on-site clinical care in clinic facilities to dentist-guided self-care at the point-of-need.