Methods for Assessing Lesion Depth and Severity with Near-IR Light

 描述(申请人提供)：这项拟议研究的总体目标是提高近红外(NIR)成像的能力，以评估龋损(龋齿)的深度和严重程度。如果在疾病过程的早期阶段被诊断，龋病进展可以通过非手术方法通过氟化物治疗、抗菌治疗或低强度激光照射来阻止/再矿化。临床医生需要新的成像技术，利用非电离光发挥作用，并通过可靠地跟踪龋损的病理，从其初始阶段到空化，帮助龋病诊断和管理/干预，以确定病变是否正在积极扩张或已被阻止。声牙釉质和牙本质中的光散射是限制牙齿在400-700 nm可见光范围内光传输的主要因素。由于主要光散射的大小，牙釉质中的光散射随着波长的增加而减少(1/λ3)，其中λ代表波长1，3。推动这一应用的中心假设是，由于光学透过率的显著增加和水吸收的多光谱差异，从1300-1700 nm的近红外区域具有最大的新光学成像技术的潜力。先前的体外和活体研究已经证明，在近红外光谱区域内使用不同的最佳波长进行近红外反射和透光成像效果最好，这是因为吸收水的衰减不同，以及牙齿硬组织内部水分含量的差异4-6。这项申请的总体目标将通过以下具体目标来实现。(1)验证咬合龋损的多光谱近红外反射率和透射率测量可用于改善病变深度和严重程度的评估的假设。(2)验证多光谱近红外反射率测量可用于从咬合面观察近邻面龋损的假设。该项目的成功完成可能会通过提供必要的技术来检测早期龋齿并定量监测其进展情况，从而极大地促进临床牙科医学的发展。此外，由于近红外光成像不会对健康造成风险，而且这项技术可以低成本微型化为近红外成像探头，因此近红外成像有可能成为全球通用的常规龋齿筛查方法。

 DESCRIPTION (provided by applicant): The overall objective of this proposed research is to advance the ability of near-IR (NIR) imaging to assess the depth and severity of carious lesions (dental decay). If diagnosed during early stages in the disease process, caries progression can be arrested/remineralized by non-surgical means through fluoride therapy, anti-bacterial therapy, or by low intensity laser irradiation. Clinicians need new imaging technologies that function using non- ionizing light and that aid in caries diagnosis and management/intervention by reliably tracking the pathology of carious lesions, from their initial stages until cavitation, n order to determine if the lesion is actively expanding or has been arrested. Light scattering in sound enamel and dentin is the principal factor limiting optical transmission through the tooth in the visible range from 400-700-nm. Light scattering in enamel decreases as the wavelength increases (1/λ3), where λ represents the wavelength, due to the size of the principal light scatters1,3. The central hypothesis motivating this application is that the near-infrared region from 1300- 1700-nm holds the greatest potential for new optical imaging technologies due to markedly increased optical transmission and multispectral differences in water absorption. Previous in vitro and in vivo studies have demonstrated that NIR reflectance and transillumination images work best using different optimal wavelengths within the NIR spectral region, due to varying attenuation from water absorption and endogenous differences in water content among dental hard tissues4-6. The overall objectives of this application will be achieved through the following specific aims. (1) To test the hypothesis that multispectral NIR reflectance and transillumination measurements of occlusal carious lesions can be combined for improved assessment of lesion depth and severity. (2) To test the hypothesis that multispectral NIR reflectance measurements can be used to detect interproximal carious lesions viewed from the occlusal surface. The successful completion of this project is likely to substantially advance clinical dentistry by providing the necessary technology to detect early stages of caries and quantitatively monitor their progression. Furthermore, because there are no health risks from imaging with NIR light, and this technology can be miniaturized into NIR imaging probes at low cost, NIR imaging has the potential to be a universal caries screening method used globally and routinely to detect dental decay.