Significance: Leakage in the interfaces between restorative materials and tooth structure allows for fluid and bacterial acid infiltration, causing restoration failure due to secondary caries. Dentists spend more time replacing composite restorations than placing new ones. Previous in vitro and in vivo studies on enamel and root surfaces using shortwave-infrared (SWIR) and thermal imaging during dehydration with forced air have been promising for assessing lesion activity. Aim: We hypothesized that SWIR reflectance and thermal imaging methods can be used to monitor the activity of secondary caries lesions around composite restorations. The objective of this study was to employ these methods to measure the rate of fluid loss from lesions during dehydration with forced air to assess lesion activity. Approach: Sixty-three extracted human teeth with total of 109 suspected secondary lesions were examined using SWIR and thermal imaging during dehydration. The thickness of the highly mineralized transparent surface layer (TSL) at lesion interfaces indicative of lesion activity was measured by optical coherence tomography (OCT). Micro-computed tomography (MicroCT) was used to further confirm lesion severity and structure. OCT and MicroCT measurements of lesion structure, depth, and severity were correlated with fluid loss rates measured with SWIR reflectance and thermal imaging. Results: TSL thickness measured with OCT correlated with both SWIR reflectance and thermal measurements of rates of fluid loss ( p < 0.05 ). Increasing TSL thickness led to decreased permeability of lesions, potentially indicating full lesion arrest at TSL ≥ 70    μ m . SWIR performed better than thermal imaging for secondary lesion activity assessment, although both methods performed best on smooth surface lesions. Conclusions: Nondestructive SWIR reflectance and OCT imaging methods are promising for clinically monitoring the activity of secondary caries lesions.

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).

Objective

Ultraviolet (UV) and infrared (IR) lasers can be used to specifically target protein, water, and mineral, respectively, in dental hard tissues to produce varying changes in surface morphology, permeability, reflectivity, and acid resistance. The purpose of this study was to explore the influence of laser irradiation and topical fluoride application on the surface morphology, permeability, reflectivity, and acid resistance of enamel and dentin to shed light on the mechanism of interaction and develop more effective treatments.

Methods

Twelve bovine enamel surfaces and twelve bovine dentin surfaces were irradiated with various combinations of lasers operating at 0.355 (Freq.-tripled Nd:YAG (UV) laser), 2.94 (Er:YAG laser), and 9.4 μm (CO₂ laser), and surfaces were exposed to an acidulated phosphate fluoride gel and an acid challenge. Changes in the surface morphology, acid resistance, and permeability were measured using digital microscopy, polarized light microscopy, near-IR reflectance, fluorescence, polarization sensitive-optical coherence tomography (PS-OCT), and surface dehydration rate measurements.

Results

Different laser treatments dramatically influenced the surface morphology and permeability of both enamel and dentin. CO₂ laser irradiation melted tooth surfaces. Er:YAG and UV lasers, while not melting tooth surfaces, showed markedly different surface roughness. Er:YAG irradiation led to significantly rougher enamel and dentin surfaces and led to higher permeability. There were significant differences in acid resistance among the various treatment groups.

Conclusion

Surface dehydration measurements showed significant changes in permeability after laser treatments, application of fluoride and after exposure to demineralization. CO₂ laser irradiation was most effective in inhibiting demineralization on enamel while topical fluoride was most effective for dentin surfaces. Lasers Surg. Med. 49:913-927, 2017. © 2017 Wiley Periodicals, Inc.