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

描述(申请人提供)：龋齿在儿童和青少年中仍然很普遍，在一些人群中存在着严重的口腔健康差距。当病理因素(如致龋菌)和保护因素(如唾液流动)之间的平衡倾向于脱矿时，就会发生这种疾病。龋病的流行表明，这种疾病没有得到有效的控制，传统上强调的是龋损已经很严重的修复程序。牙科正在从龋齿的外科治疗向疾病预防和管理的医学模式转变。这一变化旨在通过风险评估微创龋齿管理(Cambra)努力解决疾病原因。为了让这一范例取得成功，牙医需要更好的工具来检测早期病变。及早发现将使牙医 在管理龋齿危险因素方面对患者进行监测和咨询，以帮助防止疾病进展。我们推测，光学相干断层扫描(OCT)和偏振拉曼光谱(PRS)分别提供的形态和生化信息的组合，可以为临床医生提供一种更好的工具来检测和评估早期龋损，并用于短期和长期监测，以更好地进行龋病管理。这项竞争性更新建议的总体目标是开发一种基于OCT-PRS口腔内探头的新型软硬件临床平台，用于早期龋齿检测和评估。为了实现这一目标，我们计划：1)建立一个临床友好的软件平台，从OCT-PRS数据中提取龋病相关参数；2)开发OCT-PRS联合龋病评估近牙面和咬合面的口腔内探头；3)通过两项小规模的临床研究，验证硬件和软件在龋病检测和评估中的临床实用价值。我们的研究将提供新的自动化软件算法，为临床医生提供测量龋齿存在、病变范围、定量评估龋损活动和患者检查期间矿化状态的方法。拟议的发展和基于证据的发现将支持将龋病视为一种疾病的范式转变。这项研究支持新的美国健康人2020计划，该计划的口腔健康目标是减少儿童和青少年的龋齿和未经治疗的龋齿。

DESCRIPTION (provided by applicant): Dental caries continues to be prevalent in children and youth, with significant oral health disparities existing in some population groups. This disease arises when the balance between pathological factors (e.g. cariogenic bacteria) and protective factors (e.g. saliva flow) is tipped in favour of demineralization. The prevalence of caries suggests that the disease is not being effectively managed with an emphasis traditionally on restorative procedures where caries lesions are already serious. Dentistry is undergoing a paradigm shift away from surgical treatment of caries to a medical model of disease prevention and management. This change aims to address the disease cause with minimally invasive CAries Management By Risk Assessment (CAMBRA) efforts. For this paradigm to be successful, dentists need better tools to detect early lesions. Early detection will allow dentists to monitor and counsel patients in managing caries risk factors to help prevent disease progression. We hypothesize that the combination of morphological and biochemical information provided by optical coherence tomography (OCT) and polarized Raman spectroscopy (PRS), respectively, can provide clinicians with an improved tool to detect and assess early caries lesions as well as to be used for both short- and long-term monitoring for better caries management. The overall objective of this competitive renewal proposal is to develop a novel software and hardware clinical platform based on a combined OCT-PRS intra-oral probe for early dental caries detection and assessment. To achieve this goal we plan to: 1) establish a clinic-friendly software platform to derive caries relevant parameters from the OCT-PRS data, 2) develop combined OCT-PRS caries assessment intra-oral probes for proximal and occlusal surfaces, and finally 3) validate the hardware and software for clinical utility in caries detectio and assessment through two small scale clinical studies. Our research will provide novel automated software algorithms to provide clinicians with measures of caries presence, lesion extent, quantitative assessment of caries lesion activity and mineralization status during the examination of the patient. The proposed developments and evidence-based findings will support a paradigm shift in treating caries as a disease. This research supports the new US Healthy People 2020 program in which an oral health objective is to reduce caries and untreated decay among children and adolescents.