Low-cost, noninvasive method to assess pulpal vitality

描述(由申请人提供)：需要一种快速、可靠的方法来评估牙髓血流，这一需求尚未得到满足。我们的长期目标是开发一种快速、廉价、可靠的方法，使牙医和牙髓医生能够(I)评估牙髓活力，(Ii)就适当的治疗计划做出明智的决定，以及(Iii)监测每颗牙齿的治疗反应。在我们的初步研究中确定了基于牙科激光散斑成像(DLSI)的牙髓诊断的可行性后，这一应用的总体目标是量化由PI联合开发的dLSI方法的性能，以快速、可重复的方式评估牙髓血流和生存能力。我们的中心假设是，dLSI测量牙髓血流导致牙髓活力的阳性预测值和阴性预测值都超过了电动牙髓测试仪(EPT)或热测试仪的预测值。这项研究的基本原理是，我们希望证明dLSI是一种可靠的体内评估牙髓活力的方法。在强大的初步数据的指导下，我们将通过追求以下两个具体目标来检验假设：1)开发第二代临床友好的dLSI仪器，以及2)确定与体内dLSI、EPT和热试验相关的阳性和阴性预测值，以评估牙髓活力。在第一个目标下，我们将结合计算建模和我们在临床LSI器械设计方面的丰富经验，开发用于口腔的第二代dLSI器械。在第二个目标下，我们将把这台dLSI仪器部署到附近的牙髓诊所进行临床研究，并评估dLSI测试牙髓活力的能力。在我们看来，这种方法是创新的，因为我们建议开发一种与过去研究人员在口腔中使用的成像方法和技术有本质不同的成像方法和技术。这项拟议的研究意义重大，因为它是朝着开发一种简单、低成本、快速的方法迈出的第一步，该方法使牙医和牙髓医生最终能够准确地评估牙髓健康状况。

DESCRIPTION (provided by applicant): There is an unmet need for a quick, reliable method to assess pulpal blood flow. Our long-term goal is to develop a quick, inexpensive, reliable method to enable dentists and endodontists to (i) assess pulpal vitality, (ii) make an informed decision on the appropriate treatment plan, and (iii) monitor treatment response for each individual tooth. Having determined the feasibility of dental Laser Speckle Imaging (dLSI)-based pulpal diagnosis in our preliminary studies, the overall objective of this application is to quantiy the performance of the dLSI method developed jointly by the PIs to assess pulpal blood flow and viability in a quick repeatable fashion. Our central hypothesis is that dLSI measurement of pulpal blood flow results in a positive and negative predictive value of pulpal vitality that excees the values found with either an Electrical Pulp Tester (EPT) or thermal tests. The rationale that underlies the proposed research is that we expect to demonstrate that dLSI is a reliable in-vivo method to assess pulpal vitality. Guided by strong preliminary data, we will test the hypothesis by pursuing the following two Specific Aims: 1) Develop second-generation, clinic-friendly dLSI instrument, and 2) Determine the positive and negative predictive values associated with in-vivo dLSI, EPT, and thermal tests, to assess pulpal vitality. Under the first aim, we will couple computational modeling with our extensive previous experience with clinical LSI instrument design, to develop a second- generation dLSI instrument that is designed for use in the oral cavity. Under the second aim, we will deploy this dLSI instrument to a nearby endodontic clinic to perform a clinical study and assess the capabilities of dLSI for pulpal vitality testing. The approach is innovative, in our opinion, because we propose development of an imaging approach and technology that is substantially different from that used in the oral cavity by past investigators. The proposed research is significant, because it is a first step towards development of a simple, low-cost, quick method that enables dentists and endodontists finally to assess accurately pulpal health status.