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

描述（由申请人提供）：儿童和青少年中龋齿仍然普遍存在，某些人群的口腔健康状况存在显着差异。当病理因素（如致龋细菌）和保护因素（如唾液流）之间的平衡倾向于脱矿作用时，就会出现这种疾病。龋齿的流行表明，这种疾病没有得到有效的管理，传统上强调龋齿病变已经严重的修复程序。牙科正在经历一个范式转变，从外科治疗龋齿的疾病预防和管理的医学模式。该变更旨在通过风险评估（CAMBRA）的微创CAries管理来解决疾病原因。为了使这种模式取得成功，牙医需要更好的工具来检测早期病变。早期发现可以让牙医 监测和指导患者管理龋齿风险因素，以帮助预防疾病进展。我们假设，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个改进的工具，以检测和评估早期龋齿病变，以及用于短期和长期监测更好的龋齿管理。这项竞争性更新提案的总体目标是开发一种基于OCT-PRS口腔内探头组合的新型软件和硬件临床平台，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数据中获得龋齿相关参数，2）开发用于近端和咬合面的组合OCT-PRS龋齿评估口内探针，最后3）通过两项小规模临床研究验证龋齿检测和评估的硬件和软件的临床实用性。我们的研究将提供新的自动化软件算法，为临床医生提供龋齿存在的措施，病变程度，龋齿病变活动和矿化状态的定量评估，在检查病人。拟议的发展和循证调查结果将支持在治疗龋齿作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，其中口腔健康的目标是减少儿童和青少年的龋齿和未经治疗的蛀牙。

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.