Low-cost, noninvasive method to assess pulpal vitality

描述（由申请人提供）：目前尚不需要一种快速、可靠的方法来评估髓血流量。我们的长期目标是开发一种快速、廉价、可靠的方法，使牙医和牙髓医生能够(i)评估牙髓活力，（ii）对适当的治疗计划做出明智的决定，（iii）监测每颗牙齿的治疗反应。在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，本应用程序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，dLSI测量髓血流量导致髓活力的阳性和阴性预测值超过电髓测试仪（EPT）或热测试的值。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。在强有力的初步数据指导下，我们将通过以下两个具体目标来验证这一假设：1)开发第二代临床友好型dLSI仪器；2)确定体内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，我们将把计算模型与我们之前在临床LSI仪器设计方面的丰富经验结合起来，开发用于口腔的第二代dLSI仪器。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用于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，与过去研究人员在口腔中使用的方法和技术有本质上的不同。这项提议的研究意义重大，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，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.