Low-cost, noninvasive method to assess pulpal vitality

描述（由申请人提供）：目前需要一种快速、可靠的方法来评估牙髓血流量。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（i）评估牙髓活力，（ii）对适当的治疗计划做出明智的决定，（iii）监测每个牙齿的治疗反应。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，本申请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活力。我们的中心假设是，牙髓血流的dLSI测量导致牙髓活力的阳性和阴性预测值，其与用电动牙髓测试仪（EPT）或热测试发现的值一致。所提出的研究的基本原理是，我们希望证明dLSI是一种可靠的体内方法来评估牙髓活力。在强有力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型dLSI仪器，以及2）确定与体内dLSI、EPT和热测试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，我们将把计算建模与我们以前在临床LSI仪器设计方面的丰富经验结合起来，开发出设计用于口腔的第二代dLSI仪器。根据第二个目标，我们将部署这个dLSI仪器到附近的牙髓诊所进行临床研究，并评估dLSI的牙髓活力测试的能力。在我们看来，这种方法是创新的，因为我们提出了一种成像方法和技术的发展，这与过去的研究人员在口腔中使用的方法和技术有很大的不同。这项研究意义重大，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，这种方法使牙科医生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.