Objectives

The use of near infrared transillumination for caries detection is gaining recognition in daily practice. Differentiation between cavitated and non cavitated proximal lesions is recognized as a threshold for restorative treatment. This investigation focused on the use of a near infrared absorbent dye which may enhance the detection of cavitation on near infrared transillumination images.

Materials and methods

1: Natural teeth with artificial proximal cavitation were images with 3 different dyes to establish that near infrared absorbent dye can act like a contrast medium. 2: Natural teeth with natural cavitated lesions were used to investigate the contrast enhancing effect of indocyanine green (ICG) on near infrared transillumination images. 3: Artificial teeth with artificial cavitations were used to determine the best consistency of ICG as a contrast medium. 4: natural teeth with proximal lesions were used to confirm that ICG can differentiate between cavitated and non cavitated proximal lesions.

Results

1: ICG enhanced the contrast of cavitations compared to other dyes (ANOVA; p < 0.05). 2: ICG enhanced the contrast of the cavitated area on natural lesions but not significantly (t-test; p > 0.05). 3: ICG in a gel form enhanced the detection of cavitated lesions when compared to liquid ICG (t-test; p < 0.05). 4: ICG gel was able to differentiate between cavitated and non cavitated proximal lesions (ANOVA; p < 0.05).

Conclusion

ICG can potentially be used as a contrast medium to enhance the detection of cavitated proximal lesions in vitro on near infrared transillumination images. A clinical study is required to validate these results in vivo.

Significance

It is not sufficient to detect caries lesions on tooth surfaces; it is also necessary to measure the activity of the lesions to determine if intervention is needed. Changes in the reflectivity of lesion areas during dehydration with forced air at short wavelength infrared (SWIR) wavelengths can be used to assess lesion activity since these changes represent the evaporation dynamics of water from the lesion.

Aim

The aim of this study is to develop new optical methods for assessing lesion activity on tooth surfaces utilizing the strong water absorption band near 1950-nm.

Approach

The time-resolved reflectivity of 20 active and arrested caries lesions on the surfaces of human extracted teeth was monitored at 1300 to 2000 nm using broadband light sources and an extended range InGaAs camera during drying with air.

Results

Multiple parameters representing the rate of change of the lesion reflectivity correlated with the presence of a highly mineralized outer surface zone indicative of lesion arrest measured with x-ray microtomography (microCT). Performance at 1950-nm was higher than for other wavelengths.

Conclusions

This study demonstrates that SWIR imaging near 1950-nm has great potential for the assessment of lesion activity.

Background and objectives

Previous studies have shown that large changes in the diffuse reflectivity of caries lesions during drying with air can be used to assess lesion activity. The largest changes occur at short wavelength infrared (SWIR) wavelengths coincident with high water absorption. The strongest water absorption in the SWIR occurs at 1950 nm. In this study changes in the reflectivity of simulated lesions with varying degrees of remineralization was measured at 1500-2340 nm and at 1950 nm as the samples were dried with air.

Study design/materials and methods

Twenty bovine enamel surfaces each with five treatment windows were exposed to two demineralization/remineralization regimens to produce simulated lesions of varying depth, severity, and mineral gradients. An extended range tungsten-halogen lamp with a long pass filter (1500-2340 nm) and a broadband amplified spontaneous emission source centered near the peak of the water-absorption band at 1950-nm were used as light sources and an extended range InGaAs camera (1000-2340 nm) was used to acquire reflected light images as the samples were dried with air. Lesions were also assessed using digital microscopy, polarized light microscopy, optical coherence tomography, and transverse microradiography.

Results

Both wavelength ranges showed extremely high lesion contrast (>0.9) for all six lesion treatment windows in both models. The change in contrast (ΔI) was significantly higher for the 1950 nm broadband source for all the intact lesion windows compared with the 1500-2340 nm wavelength range.

Conclusion

SWIR light at 1950 nm yields extremely high contrast of demineralization and appears to be the optimum wavelength for the assessment of lesion activity on tooth coronal surfaces. Lasers Surg. Med. 00:00-00, 2020. © 2020 Wiley Periodicals LLC.

Significance

We have developed a clinical probe capable of acquiring near-simultaneous short-wavelength infrared (SWIR) reflectance and occlusal transillumination images of lesions on tooth proximal and occlusal surfaces. We hypothesize that dual images will aid in differentiating between shallow and deep occlusal lesions and reduce the potential of false positives (FPs).

Aim

The aim of this study was to test the performance of the dual reflectance and occlusal transillumination probe on extracted teeth prior to commencing clinical studies.

Approach

The dual probe was 3D printed and the imaging system uses an InGaAs camera and broadband superluminescent diode light sources that emit broadband light at 1300 nm for occlusal transillumination and 1600-nm light for cross-polarization reflectance. The diagnostic performance of the dual probe was assessed using 120 extracted teeth with approximal and occlusal lesions. Reflectance and transillumination images were fused into single images to enhance the contrast between sound and lesion areas. The lesion contrast in both modes did not increase significantly with either the lesion depth or the distance from the occlusal surface for approximal lesions. In addition, the diagnostic performance of radiography, the individual reflectance and transillumination images, dual images, and fused images were compared using micro-computed tomography as the gold standard.

Results

Reflectance imaging at 1600 nm yielded the highest diagnostic accuracy for lesions on both occlusal and proximal surfaces while radiography yielded the lowest number of FPs.

Conclusion

This study demonstrates that simultaneous acquisition of both reflectance and transillumination SWIR images is possible with a single clinical device.

Objectives

The purpose of this study was to show that optical coherence tomography (OCT) and thermal imaging can be used to monitor changes in the structure and activity of caries lesions over time after treatment with silver diamine fluoride (SDF).

Methods

Artificial caries lesions were formed on enamel and dentin bovine blocks. Each block was partitioned into five windows with the central three windows exposed to a demineralization solution to create lesions: one sound window served as a sound control (SC), one sound window was exposed to SDF to serve as a test control (SCT), one lesion window served as a lesion control (LC), one lesion window received one application of SDF (L1), while the other lesion window received two applications of SDF (L2). Each window was scanned using OCT before SDF application, and every week subsequently, for 12 weeks after initial SDF treatment. Changes in the mean intensity and the width of the peak of increased reflectivity due to the lesion and SDF along with the intensity at a depth of 180 µm from the surface representing optical penetration through the lesion were monitored. Changes in the heat lost, ΔQ (temperature integrated over time) of each window during drying with air were also monitored using a thermal imaging camera. Transverse microradiography (TMR), and high-resolution microscopy were also used for the analysis of selected samples.

Results

The reflectivity and optical penetration of sound and lesion areas of enamel and dentin manifested significant changes in OCT images after SDF application. Thermal imaging showed significant differences in ΔQ indicative of permeability changes in the sound and lesion areas of enamel and dentin after SDF application.

Transparent remineralized surface zones found on natural caries lesions may reduce the permeability to water and plaque generated acids. Near-IR (NIR) reflectance imaging coupled with dehydration can be used to measure changes in the fluid permeability of lesions in enamel and dentin. Previous work demonstrated a negative association between the surface zone thickness and the rate of dehydration in simulated enamel lesions. In this study, the rates of dehydration and thickness of transparent surface layer of coronal lesions of extracted teeth were measured and correlated. Reflectance imaging at NIR wavelengths from 1695-1750 nm, which coincides with higher water absorption and manifests the greatest sensitivity to contrast changes during dehydration measurements, was used to image these enamel lesions. The remineralized surface layer thickness was determined using optical coherence tomography (OCT).

Transparent remineralized surface zones found on natural caries lesions may reduce the permeability to water and plaque generated acids. Near-IR (NIR) reflectance imaging coupled with dehydration can be used to measure changes in the fluid permeability of lesions in enamel and dentin. Previous work demonstrated a negative association between the surface zone thickness and the rate of dehydration in simulated enamel lesions. In this study, the rates of dehydration and thickness of transparent surface layer of coronal lesions of extracted teeth were measured and correlated. Reflectance imaging at NIR wavelengths from 1695-1750 nm, which coincides with higher water absorption and manifests the greatest sensitivity to contrast changes during dehydration measurements, was used to image these enamel lesions. The remineralized surface layer thickness was determined using optical coherence tomography (OCT).