Validating OCT and Raman spectroscopy for assessment of tooth de/remineralization

描述（申请人提供）：检测早期龋齿并监测其损伤和修复的动态过程是牙医目前可用的方法具有挑战性的任务。传统的诊断方法依赖于主观的临床标准，早期病变往往未被发现。因此，许多病变要么在发展到空化状态之前未被诊断出来，要么尽管有可能通过再矿化方法（如氟化物策略）阻止和修复病变，但病变仍被不必要地修复。因此，需要具有高灵敏度和特异性的新技术来早期发现和监测非空化病变。近年来，各种新方法被开发出来作为潜在的诊断工具。然而，这些技术仍然存在主观性、考官内部和考官之间的高度可变性和假阳性结果的问题。此外，在将这些技术应用于龋齿临床试验并最终应用于评估牙齿表面脱矿和再矿化的临床环境之前，还需要进一步的验证。本提案的目的是验证一种新的多模态技术，该技术结合了成像（光学相干断层扫描，OCT）和光谱（拉曼光谱，RS）技术，以改进早期龋齿病变的检测和纵向评估。为了实现这一目标，将改进用于近似龋齿检测的口腔内多模态探针，以进行更广泛的龋齿筛查。使用多模态OCT-RS方法的有效性将被验证，以评估不同牙齿表面和结构的牙齿表面脱矿/再矿化。该程序包括在拔出的人类牙齿上测试方法，并将结果与金标准方法（横向显微放射照相）进行比较。接下来，将进行几项患者自愿研究，以验证该技术在体内的临床牙面评估。在为期四年的项目结束时，这个新工具的有效性和实用性将得到证明。提出的研究研究了一种涉及两种基于光的技术的新方法，用于早期蛀牙的检测和持续监测。早期识别可以让牙医使用保守的方法（如氟化物治疗）阻止和逆转损害，而不是不可逆转地切割和修复牙齿结构。更好的诊断和管理龋齿与成本效益和侵入性较小的方法将改善患者的口腔健康和个人的整体福祉。

DESCRIPTION (provided by applicant): Detecting early dental caries and monitoring its dynamic process of damage and repair are challenging tasks with current methods available to dentists. Conventional diagnostic methods rely on subjective clinical criteria with early lesions often going undetected. As a result, many lesions are either undiagnosed until they have progressed to a cavitated state, or lesions are unnecessarily restored despite the potential to arrest and repair the lesion with remineralization methods such as fluoride strategies. Therefore the need exists for new techniques with high sensitivity and specificity for early detection and monitoring of non-cavitated lesions. Recently, various new methods have been developed as potential diagnostic tools. However, these techniques still suffer from subjectivity, high intra- and inter-examiner variability and false positive results. In addition, these techniques require further validation before they are implemented into caries clinical trials and eventually into clinical settings for assessing tooth surface demineralization and remineralization. The objective of this proposal is to validate a new multi-modal technology that combines imaging (optical coherence tomography, OCT) and spectroscopic (Raman spectroscopy, RS) techniques for improved detection and longitudinal assessment of early caries lesions. To achieve this goal, an intra-oral multi-modal probe designed for approximal caries detection will be refined for broader caries screening. The validity of using the multi-modal OCT-RS approach will be validated for assessing tooth surface de-/remineralization at various tooth surfaces and structures. This procedure involves testing the methodology on extracted human teeth and comparing the findings with a gold-standard method (transverse microradiography). Next, several patient volunteer studies will be conducted to validate the technology in vivo for clinical tooth surface assessment. At the end of the four-year project, the validity and utility of this new tool will be demonstrated. The proposed research studies a novel method that involves two light-based technologies for the detection and on-going monitoring of early dental decay. Early identification allows dentists to arrest and reverse the damage using conservative methods such as fluoride treatment, rather than the irreversible cutting and restoration of tooth structure. Better diagnosis and management of dental decay with cost-effective and less invasive methods will improve the patient's oral health and overall general well-being of the individual.