Proceedings Volume 8929

Lasers in Dentistry XX

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Proceedings Volume 8929

Lasers in Dentistry XX

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Volume Details

Date Published: 3 March 2014
Contents: 6 Sessions, 27 Papers, 0 Presentations
Conference: SPIE BiOS 2014
Volume Number: 8929

Table of Contents

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Table of Contents

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  • Front Matter: Volume 8929
  • Lasers in Diagnostics and Caries
  • Lasers in Hard Tissue: Structure, Ablation, and Microleakage
  • Lasers in Endodontics and Imaging
  • Lasers in Periodontal Treatment and LLLT
  • Poster Session
Front Matter: Volume 8929
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Front Matter: Volume 8929
This PDF file contains the front matter associated with SPIE Proceedings Volume 8929, including the Title Page, Copyright information, Table of Contents, Invited Panel Discussion, and Conference Committee listing.
Lasers in Diagnostics and Caries
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Characterization, diagnosis and ablation of human teeth using blue laser at 457 nm
The light interaction with tissue is governed by the specific wavelength of the laser used and the optical properties of target tissue. Absorption, scattering and fluorescence together can probably be used as the basis of quantitative diagnostic methods for teeth caries. The absorption coefficient of human teeth was determined from detached wet teeth (incisors and premolars). Laser absorption of these teeth was measured using compact blue laser source at wavelength of 457 nm and a high resolution spectrometer equipped with an integrating sphere. The average absorption coefficient of abnormal caries tissue of human teeth is observed to be higher than the normal ones. Detection and diagnosis of caries tissues were monitored by high resolution translational scanning of human teeth. We have a powerful tool to diagnosis a caries region of human teeth using blue laser at 457 nm. Ablations of caries region are investigated using higher power of blue laser at 457 nm.
Does ozone enhance the remineralizing potential of nanohydroxyapatite on artificially demineralized enamel? A laser induced fluorescence study
Samuelraj Srinivasan, Vijendra Prabhu, Subhash Chandra, et al.
The present era of minimal invasive dentistry emphasizes the early detection and remineralization of initial enamel caries. Ozone has been shown to reverse the initial demineralization before the integrity of the enamel surface is lost. Nano-hydroxyapatite is a proven remineralizing agent for early enamel caries. In the present study, the effect of ozone in enhancing the remineralizing potential of nano-hydroxyapatite on artificially demineralized enamel was investigated using laser induced fluorescence. Thirty five sound human premolars were collected from healthy subjects undergoing orthodontic treatment. Fluorescence was recorded by exciting the mesial surfaces using 325 nm He-Cd laser with 2 mW power. Tooth specimens were subjected to demineralization to create initial enamel caries. Following which the specimens were divided into three groups, i.e ozone (ozonated water for 2 min), without ozone and artificial saliva. Remineralization regimen was followed for 3 weeks. The fluorescence spectra of the specimens were recorded from all the three experimental groups at baseline, after demineralization and remineralization. The average spectrum for each experimental group was used for statistical analysis. Fluorescence intensities of Ozone treated specimens following remineralization were higher than that of artificial saliva, and this difference was found to be statistically significant (P<0.0001). In a nutshell, ozone enhanced the remineralizing potential of nanohydroxyapatite, and laser induced fluorescence was found to be effective in assessing the surface mineral changes in enamel. Ozone can be considered an effective agent in reversing the initial enamel caries there by preventing the tooth from entering into the repetitive restorative cycle.
Guided fluorescence diagnosis of childhood caries: preliminary measures correlate with depth of carious decay
Mari-Alina Timoshchuk, Liang Zhang, Brian A. Dickinson, et al.
The current rise in childhood caries worldwide has increased the demand for portable technologies that can quickly and accurately detect and diagnose early stage carious lesions. These lesions, if identified at an early stage, can be reversed with remineralization treatments, education, and improvements in home care. A multi-modal optical prototype for detecting and diagnosing occlusal caries demineralization in vivo has been developed and pilot tested. The device uses a 405-nm laser as a scanned illumination source to obtain high resolution and high surface contrast reflectance images, which allows the user to quickly image and screen for any signs of demineralized enamel. When a suspicious region is located, the device can be switched to perform dual laser fluorescence spectroscopy using 405-nm and 532-nm laser excitations. These spectra are used to compute an auto-fluorescence (AF) ratio of the suspicious region and the percent difference of AF ratios from a healthy region of the same tooth. The device was tested on 7 children’s teeth in vivo with clinically diagnosed carious lesions. Lesion depth was then visually estimated from the video image using the 405-nm scanned light source, and within a month the maximum drill depth was assessed by a clinician. The researcher and clinicians were masked from previous measurements in a blinded study protocol. Preliminary results show that the ratiometric percent difference measurement of the AF spectrum of the tooth correlates with the severity of the demineralization as assessed by the clinician after drilling.
Viability of imaging structures inside human dentin using dental transillumination
C. L. Grandisoli, F. D. Alves-de-Souza, M. M. Costa, et al.
Dental Transillumination (DT) is a technique for imaging internal structures of teeth by detecting infrared radiation transmitted throughout the specimens. It was successfully used to detect caries even considering dental enamel and dentin scatter infrared radiation strongly. Literature reports enamel’s scattering coefficient is 10 to 30 times lower than dentin; this explain why DT is useful for imaging pathologies in dental enamel, but does not disable its using for imaging dental structures or pathologies inside the dentin. There was no conclusive data in the literature about the limitations of using DT to access biomedical information of dentin. The goal in this study was to present an application of DT to imaging internal structures of dentin. Slices of tooth were confectioned varying the thickness of groups from 0.5 mm up to 2,5 mm. For imaging a FPA InGaAs camera Xeva 1.7- 320 (900-1700 nm; Xenics, Inc., Belgium) and a 3W lamp-based broadband light source (Ocean Optics, Inc., USA) was used; bandpass optical filters at 1000±10 nm, 1100±10 nm, 1200±10 nm and 1300±50 nm spectral region were also applied to spectral selection. Images were captured for different camera exposure times and finally a computational processing was applied. The best results revealed the viability to imaging dent in tissue with thickness up to 2,5 mm without a filter (900-1700nm spectral range). After these results a pilot experiment of using DT to detect the pulp chamber of an incisive human tooth was made. New data showed the viability to imaging the pulp chamber of specimen.
SOPROCARE - 450 nm wavelength detection tool for microbial plaque and gingival inflammation: a clinical study
P. Rechmann, Shasan W. Liou, Beate M.T. Rechmann, et al.
Gingivitis due to microbial plaque and calculus can lead over time if left untreated to advanced periodontal disease with non-physiological pocket formation. Removal of microbial plaque in the gingivitis stage typically achieves gingival health. The SOPROCARE camera system emits blue light at 450 nm wavelength using three blue diodes. The 450 nm wavelength is located in the non-ionizing, visible spectral wavelength region and thus is not dangerous. It is assumed that using the SOPROCARE camera in perio-mode inflamed gingiva can easily be observed and inflammation can be scored due to fluorescence from porphyrins in blood. The assumption is also that illumination of microbial plaque with blue light induces fluorescence due to the bacteria and porphyrin content of the plaque and thus can help to make microbial plaque and calculus visible. Aim of the study with 55 subjects was to evaluate the ability of the SOPROCARE fluorescence camera system to detect, visualize and allow scoring of microbial plaque in comparison to the Turesky modification of the Quigley and Hein plaque index. A second goal was to detect and score gingival inflammation and correlated the findings to the Silness and Löe gingival inflammation index. The study showed that scoring of microbial plaque as well as gingival inflammation levels similar to the established Turesky modified Quigley Hein index and the Silness and Löe gingival inflammation index can easily be done using the SOPROCARE fluorescence system in periomode. Linear regression fits between the different clinical indices and SOPROCARE scores in fluorescence perio-mode revealed the system’s capacity for effective discrimination between scores.
Lasers in Hard Tissue: Structure, Ablation, and Microleakage
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Structure and chemical composition of the dentin-enamel junction analyzed by Confocal Raman Microscopy
A. Desoutter, H. Salehi, A. Slimani, et al.
The structure and chemical composition of the human dentin-enamel junction (DEJ) was studied using confocal Raman microscopy - a chemical imaging technique. Slices of non-fixed, sound teeth were prepared with an Isomet diamond saw and scanned with Witec Alpha300R system. The combination of different characteristics peaks of phosphate, carbonate and organic matrix (respectively 960, 1072 and 1545 cm-1), generates images representing the chemical composition of the DEJ area. Images are also calculated using peak ratios enabling precise determination of the chemical composition across the DEJ. Then, with two characterized peaks, different pictures are calculated to show the ratio of two components. The images of the spatial distribution of mineral phosphate (960cm-1) to organic matrix (1545 cm-1) ratios, mineral carbonates (1072cm-1) to mineral phosphate ratios; and mineral carbonates to organic matrix ratios were reconstructed. Cross sectional and calculated graphic profile show the variations of the different chemical component ratios through the enamel and the dentin. Phosphate to organic ratio shows an accumulation of organic material under the enamel surface. The cross sectional profile of these pictures shows a high phosphate content compared to enamel in the vicinity of the DEJ. The Confocal Raman imaging technique can be used to further provide full chemical imaging of tooth, particularly of the whole DEJ and to study enamel and dentin decay.
Ablation of human carious dentin with a nanosecond pulsed laser at a wavelength of 5.85 µm: relationship between hardness and ablation depth
Katsunori Ishii, Tetsuya Kita, Kazushi Yoshikawa, et al.
Less invasive treatment and preservation of teeth, referred to as minimal intervention, are strong requirements in dentistry. In our previous study, the fundamental ablation properties of human dentin at wavelengths around 5.8 μm were investigated, and the results indicated that the wavelength of 5.85 μm was optimal for selective removal of carious dentin with less damage to normal dentin. The purpose of this study was to investigate the relationship between the ablation depth and hardness of human dentin including carious lesion. A nanosecond pulsed laser produced by difference-frequency generation was used for irradiations to human carious dentin. It was observed that correlation between ablation depth and Vickers hardness after 2 s laser irradiation at the wavelength of 5.85 μm and the average power density of 30 W/cm2. On the other hand, ablations did not depend on Vickers hardness at the wavelength of 6.00 μm. A nanosecond pulsed laser with the wavelength at 5.85 μm is useful for selective ablation of human carious dentin in accordance with the hardness.
Er:YAG laser delivery sytems and sonic-activated bulk composite restoration: sculpturing and microleakage evaluation
The comparison of tissue quality and its restoration after contact, non-contact, and non-contact scanned Er:YAG (2940 nm) laser radiation ablation was evaluated. Laser setting for contact ablation was 250 mJ/pulse, pulse repetition rate 15 Hz, average power 3.75 W. For non-contact ablation these values were 600 mJ/pulse, 6 Hz, 3.6 W. The scanning ablation was provided in non-contact mode (1440 pulses/1 cavity). All cavities were filled by sonic activated composite resin. Microleakage was assessed quantitatively by the degree of dye penetration. Cavity prepared by contact mode with sonic-activated composite filling protects microleakage formation.
3D photomechanical model of tooth enamel ablation by Er-laser radiation
Andrey V. Belikov, Ksenia V. Shatilova, Alexei V. Skrypnik
The three-dimensional (3D) photomechanical model of human tooth enamel ablation is described. It takes into account: the structural peculiarities of enamel, Er-laser beam energy spatial distribution and laser radiation attenuation in the tissue. Dynamics change of enamel coefficient of absorption during ablation is also discussed. We consider the 3D photomechanical model of incomplete removal (modification) of the enamel rods by the pressure of water contained in the enamel pores and heated by laser radiation, and complete removal (ablation) of the enamel rods as result of hydroxyapatite heated by laser radiation and evaporation. Modeling results are in close agreement with the experimental results.
Lasers in Endodontics and Imaging
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Cavitation bubbles induced by Erbium lasers: implications for dentistry
Marja Verleng, Rudolf Verdaasdonk, Albert van der Veen, et al.
With new fiber systems available for 3 μm, Erbium lasers become more interesting for precise tissue ablation in a water environment enabling new application in e.g. dentistry. The dynamics of explosive bubble formation was investigated at 2.78 μm (Er,Cr;YSGG) and 2.94 μm (Er:YAG), in relation to energy (10-50 mJ), pulse length (20–150 μs) and fiber tip shape (flat or taper). The dynamics of exploding and imploding vapor bubbles were captured with high speed imaging (10 - 300 μs range). Increasing the pulse length and energy, the vapor bubble became more elongated with an opaque surface for flat tip fibers. Tapered fibers produced spherical vapor bubbles with an optically transparent surface expected to be more forceful for creating mechanical effects in both hard and soft tissues. There was no significant difference between bubbles formed at 2.78 μm (Er,Cr;YSGG) and 2.94 μm (Er:YAG).
Transillumination and reflectance probes for in vivo near-IR imaging of dental caries
Jacob C. Simon, Seth A. Lucas, Michal Staninec, et al.
Previous studies have demonstrated the utility of near infrared (NIR) imaging for caries detection employing transillumination and reflectance imaging geometries. Three intra-oral NIR imaging probes were fabricated for the acquisition of in vivo, real time videos using a high definition InGaAs SWIR camera and near-IR broadband light sources. Two transillumination probes provide occlusal and interproximal images using 1300-nm light where water absorption is low and enamel manifests the highest transparency. A third reflectance probe utilizes cross polarization and operates at >1500-nm, where water absorption is higher which reduces the reflectivity of sound tissues, significantly increasing lesion contrast. These probes are being used in an ongoing clinical study to assess the diagnostic performance of NIR imaging for the detection of caries lesions in teeth scheduled for extraction for orthodontic reasons.
Automated detection of remineralization in simulated enamel lesions with PS-OCT
Previous in vitro and in vivo studies have demonstrated that polarization-sensitive optical coherence tomography (PS-OCT) can be used to nondestructively image the subsurface structure and measure the thickness of the highly mineralized transparent surface zone of caries lesions. There are structural differences between active lesions and arrested lesions, and the surface layer thickness may correlate with activity of the lesion. The purpose of this study was to develop a method that can be used to automatically detect and measure the thickness of the transparent surface layer in PS-OCT images. Automated methods of analysis were used to measure the thickness of the transparent layer and the depth of the bovine enamel lesions produced using simulated caries models that emulate demineralization in the mouth. The transparent layer thickness measured with PS-OCT correlated well with polarization light microscopy (PLM) measurements of all regions (r2=0.9213). This study demonstrates that PS-OCT can automatically detect and measure thickness of the transparent layer formed due to remineralization in simulated caries lesions.
Monitoring the inhibition of erosion by a CO2 laser with OCT
Since optical coherence tomography (OCT) is well suited for measuring small dimensional changes on tooth surfaces, OCT has great potential for monitoring tooth erosion. Previous studies have shown that enamel areas ablated by a carbon dioxide laser manifested lower rates of erosion compared to the nonablated areas. The purpose of this study was to develop a model to monitor erosion in vitro that could potentially be used in vivo. Teeth surfaces were irradiated with a carbon dioxide laser at low sub-ablative fluence to create an acid-resistant reference layer without damaging the enamel. The laser treated areas were compared with the unprotected areas using OCT during exposure to a pH cycling model for up to 6 days. The laser treated areas markedly reduced the rate of erosion.
Lasers in Periodontal Treatment and LLLT
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Change in clinical indices following laser or scalpel treatment for periodontitis: A split-mouth, randomized, multi-center trial
David M. Harris, Dawn M. Nicholson D.D.S., Delwin McCarthy D.D.S., et al.
Data are presented from a multi-center, prospective, longitudinal, clinical trial comparing four different treatments for periodontitis, (1) the LANAPTM protocol utilizing a FR pulsed-Nd:YAG laser; (2) flap surgery using the Modified Widman technique (MWF); (3) traditional scaling and root planing (SRP); and (4) coronal debridement (CD). Each treatment was randomized to a different quadrant. Fifty-one (54) subjects were recruited at five centers that included both private practice and university-based investigators. At 6-months and 12 months post-treatment the LANAPTM protocol and MWF yielded equivalent results based on changes in probing depths. The major difference observed between the two procedures was that patients reported significantly greater comfort following the LANAP™ procedure than following the MWF (P<0.001). There was greater reduction in bleeding in the LANAPTM quadrant than in the other three at both 6 and 12 months. Improvements following SRP were better than expected at 6 months and continued to improve, providing outcomes that were equivalent to both LANAPTM and MWF at 12 months. The improvement in the SRP quadrants suggests the hypothesis that an aspect of the LANAPTM protocol generated a significant, positive and unanticipated systemic (or trans-oral) effect on sub-gingival wound healing.
Pulsed Nd:YAG laser treatment for failing dental implants due to peri-implantitis
Dawn Nicholson D.D.S., Kris Blodgett D.D.S., Charles Braga D.D.S., et al.
A large percentage of dental implants experience complications, most commonly, infection leading to peri-implantitis and peri-mucositis, inflammatory disease involving pathogen contamination. It presents with radiographic findings of crestal bone loss. At this time there appears to be no compelling evidence for an effective intervention. The LANAP protocol is a FDA cleared surgical protocol that produces new attachment and bone regeneration when applied to periodontally infected natural teeth. The LANAP protocol and laser dosimetry have been modified to treat ailing and failing implants. Twenty-one clinicians who have been trained to perform the LANAP protocol and the LAPIPTM protocol have volunteered 26 LAPIP case reports. The time from implant to intervention ranges from 3 months to 16 years. Post-LAPIP radiographs range from 2-48 months. Ten cases were excluded for technical reasons. All 16 remaining cases provide radiographic evidence of increase in crestal bone mass around the implant and, when reported, probe depth reductions. All treating clinicians report control of the infection, reversal of bone loss and rescue of the incumbent implant. Although the success/failure rate cannot be judged from these data, any successes in this area deserve reporting and further study.
Effect of simvastatin versus low level laser therapy (LLLT) on bone regeneration in rabbit's tibia
Mostafa E. Gheith, Maggie A. Khairy
Simvastatin is a cholesterol lowering drug which proved effective on promoting bone healing. Recently low level laser therapy (LLLT) proved its effect as a biostimulator promoting bone regeneration. This study aims to compare the effect of both Simvastatin versus low level laser on bone healing in surgically created bone defects in rabbit’s tibia. Material and methods: The study included 12 New Zealand white rabbits. Three successive 3mm defects were created in rabbits tibia first defect was left as control, second defect was filled with Simvastatin while the third defect was acted on with Low Level Laser (optical fiber 320micrometer). Rabbits were sacrificed after 48 hours, 1 week and 2 weeks intervals. Histopathology was conducted on the three defects Results: The histopathologic studies showed that the bony defects treated with the Low Level Laser showed superior healing patterns and bone regeneration than those treated with Simvastatin. While the control defect showed the least healing pattern.
Poster Session
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Evaluation of the effect of a CO2 laser and fluoride on the reduction of carious lesions progression in primary teeth: an in vitro study
Bruna R. Zancopé, Marina Moron C. Cesar, Lidiany Karla A. Rodrigues, et al.
This study aimed at investigating if CO2 laser irradiation (λ =10.6μm - 11.3 J/cm2) combined with fluoridated products, enhances the CaF2 formation on enamel surface and inhibits lesion progression of demineralized primary enamel. Thus, 135 demineralized primary enamel specimens (DES) were allocated to 9 groups (n=15) as follows: 1- DES only, 2- DES + pH cycling (control), 3- 1.23% acidulated phosphate fluoride gel (APF), 4- 1.23% fluoride foam (FF), 5- 5% fluoride varnish (FV), 6- CO2 Laser (L), 7 - Laser during APF application, 8-Laser during FF application and 9-Laser during FV application. Except for the demineralized enamel group, all specimens were submitted to a 7 day pH cycling regime. The knoop hardness number (KHN) was determined by cross-sectional microhardness analysis. After treatments application, three specimens of each group had their surface examined for CaF2 formation by scanning electron microscopy (SEM). The data was analyzed by ANOVA and Student's t-test (α= 0.05). Enamel mineral loss (ΔS) for groups 1 to 9 were respectively,(8,676.28±1,077.46b),(12,419.54±1,050.21a),(8,156.80±1,279.90b),(8,081.32±1,019.69b),(8,820.86±1,805. 99b),(8,723.45±1,167.14b),(9,003.17±796.90b),(8.229,03±961.25b),(9,023.32±1,1069b). The results showed statistically significant difference between control and all treatments groups (p<0.05). However there was no difference among them (p>0.05). SEM observations showed evidences of melting, fusion and calcium fluoride formation on enamel surface. In conclusion, laser irradiation alone or combined with fluoridated products inhibited lesion progression of demineralized primary enamel surface. However, no synergistic effect was observed when CO2 laser irradiation and fluoridated products application were combined.
Longitudinally excited CO2 laser with short laser pulse for hard tissue drilling
Kazuyuki Uno, Hiroyuki Hayashi, Tetsuya Akitsu, et al.
We developed a longitudinally excited CO2 laser that produces a short laser pulse with a circular beam and a low divergence angle. The laser was very simple and consisted of a 45-cm-long alumina ceramic pipe with an inner diameter of 9 mm, a pulse power supply, a step-up transformer, a storage capacitance, and a spark-gap switch. The laser pulse had a spike pulse width of 103 ns and a pulse tail length of 32.6 μs. The beam cross-section was circular and the full-angle beam divergence was 1.7 mrad. The laser was used to drill ivory samples without carbonization at fluences of 2.3–7.1 J/cm2. The drilling depth of the dry ivory increased with the fluence. The drilling mechanism of the dry ivory was attributed to absorption of the laser light by the ivory.
Attenuation of near-IR light through dentin at wavelengths from 1300-1650-nm
Andrew C. Chan, Cynthia L. Darling, Kenneth H. Chan, et al.
Light scattering in dental enamel decreases markedly from the UV to the near-IR and recent studies employing near-IR transillumination and reflectance imaging including optical coherence tomography indicate that this wavelength region is ideally suited for imaging dental caries due to the high transparency of enamel. The opacity of dentin is an important factor in optimizing the contrast of demineralization in reflectance measurements. It also influences the contrast of occlusal lesions in transillumination. Light scattering in dentin is an order of magnitude larger than in enamel, it is highly anisotropic and has a different spectral light scattering dependence than enamel. The objective of this study was to measure the optical attenuation of near-IR light through dentin at near-IR wavelengths from 1300-1650-nm. In this study the collimated transmission of near-IR light through polished thin sections of dentin of 0.05 to 0.6 mm thickness was measured. Beer-Lambert plots show that the attenuation coefficients range in magnitude from 20 to 40 cm-1. Attenuation increased significantly with increasing wavelength and the increases were not entirely consistent with increased water absorption.
Integral ceramic superstructure evaluation using time domain optical coherence tomography
Cosmin Sinescu, Adrian Bradu, Florin Ionel Topala, et al.
Optical Coherence Tomography (OCT) is a non-invasive low coherence interferometry technique that includes several technologies (and the corresponding devices and components), such as illumination and detection, interferometry, scanning, adaptive optics, microscopy and endoscopy. From its large area of applications, we consider in this paper a critical aspect in dentistry - to be investigated with a Time Domain (TD) OCT system. The clinical situation of an edentulous mandible is considered; it can be solved by inserting 2 to 6 implants. On these implants a mesostructure will be manufactured and on it a superstructure is needed. This superstructure can be integral ceramic; in this case materials defects could be trapped inside the ceramic layers and those defects could lead to fractures of the entire superstructure. In this paper we demonstrate that a TD-OCT imaging system has the potential to properly evaluate the presence of the defects inside the ceramic layers and those defects can be fixed before inserting the prosthesis inside the oral cavity. Three integral ceramic superstructures were developed by using a CAD/CAM technology. After the milling, the ceramic layers were applied on the core. All the three samples were evaluated by a TD-OCT system working at 1300 nm. For two of the superstructures evaluated, no defects were found in the most stressed areas. The third superstructure presented four ceramic defects in the mentioned areas. Because of those defects the superstructure may fracture. The integral ceramic prosthesis was send back to the dental laboratory to fix the problems related to the material defects found. Thus, TD-OCT proved to be a valuable method for diagnosing the ceramic defects inside the integral ceramic superstructures in order to prevent fractures at this level.
Enhancing the detection of hidden occlusal caries lesions with OCT using high index liquids
In a previous study, we investigated the influence of several high refractive index fluids on the performance of polarization sensitive optical coherence tomography (PS-OCT). That study showed that these liquids can increase the effective imaging depth and lesion contrast. Other in vitro and in vivo studies have shown that OCT can be used to show whether occlusal lesions have penetrated to the dentinal-enamel junction (DEJ) and spread laterally under the enamel. The purpose of this study was to determine if high index fluids can enhance the ability of OCT to detect hidden occlusal lesions and show if these lesions have penetrated through the enamel into the underlying dentin. Ten extracted teeth with occlusal lesions were imaged using OCT after the application of water, glycerol, BABB (33% Benzyl Alcohol + 67% Benzyl Benzoate) and a Cargille Liquid (Cedar Grove, NJ) (hydrogenated terphenyl 1- bromo-naphthalene) with a refractive index of 1.61. The intensity of the reflectance from the underlying lesion area for each sample was compared with the reflectance of the sound tooth surface for each fluid. The use of high index fluids significantly (P< 0.0001) increased the reflectivity of subsurface occlusal lesions under the surrounding sound enamel.
High contrast optical imaging methods for image guided laser ablation of dental caries lesions
Nicole R. LaMantia, Henry Tom, Kenneth H. Chan, et al.
Laser based methods are well suited for automation and can be used to selectively remove dental caries to minimize the loss of healthy tissues and render the underlying enamel more resistant to acid dissolution. The purpose of this study was to determine which imaging methods are best suited for image-guided ablation of natural non-cavitated carious lesions on occlusal surfaces. Multiple caries imaging methods were compared including near-IR and visible reflectance and quantitative light fluorescence (QLF). In order for image-guided laser ablation to be feasible, chemical and physical modification of tooth surfaces due to laser irradiation cannot greatly reduce the contrast between sound and demineralized dental hard tissues. Sound and demineralized surfaces of 48 extracted human molar teeth with non-cavitated lesions were examined. Images were acquired before and after laser irradiation using visible and near-IR reflectance and QLF at several wavelengths. Polarization sensitive-optical coherence tomography was used to confirm that lesions were present. The highest contrast was attained at 1460-nm and 1500-1700-nm, wavelengths coincident with higher water absorption. The reflectance did not decrease significantly after laser irradiation for those wavelengths.
Near-IR imaging of cracks in teeth
William A. Fried, Jacob C. Simon, Seth Lucas, et al.
Dental enamel is highly transparent at near-IR wavelengths and several studies have shown that these wavelengths are well suited for optical transillumination for the detection and imaging of tooth decay. We hypothesize that these wavelengths are also well suited for imaging cracks in teeth. Extracted teeth with suspected cracks were imaged at several wavelengths in the near-IR from 1300-1700-nm. Extracted teeth were also examined with optical coherence tomography to confirm the existence of suspected cracks. Several teeth of volunteers were also imaged in vivo at 1300-nm to demonstrate clinical potential. In addition we induced cracks in teeth using a carbon dioxide laser and imaged crack formation and propagation in real time using near-IR transillumination. Cracks were clearly visible using near-IR imaging at 1300-nm in both in vitro and in vivo images. Cracks and fractures also interfered with light propagation in the tooth aiding in crack identification and assessment of depth and severity.
Multispectral near-infrared imaging of composite restorations in extracted teeth
Cooper M. Logan, Katrina U. Co, William A. Fried, et al.
One major advantage of composite restoration materials is that they can be color matched to the tooth. However, this presents a challenge when composites fail and they need to be replaced. Dentists typically spend more time repairing and replacing composites than placing new restorations. Previous studies have shown that near-infrared imaging can be used to distinguish between sound enamel and decay due to the differences in light scattering. The purpose of this study was to use a similar approach and exploit differences in light scattering to attain high contrast between composite and tooth structure. Extracted human teeth with composites (n=16) were imaged in occlusal transmission mode at wavelengths of 1300-nm, 1460-nm and 1550-nm using an InGaAs image sensor with a tungsten halogen light source with spectral filters. All samples were also imaged in the visible range using a high definition 3D digital microscope. Our results indicate that NIR wavelengths at 1460-nm and 1550-nm, coincident with higher water absorption yield the highest contrast between dental composites and tooth structure.
Near-IR imaging of demineralization under sealants
Henry Tom, Kenneth H. Chan, Cynthia L. Darling, et al.
Previous studies have shown that near-IR reflectance and transillumination imaging can be used to acquire high contrast images of early caries lesions and composite restorative materials. The aim of the study was to determine the optimum near-IR wavelengths for imaging demineralized areas under dental sealants. Fifteen natural human premolars and molars with occlusal lesions were used in this in vitro study. Images before and after application of sealants were acquired using near-IR reflectance and near-IR transillumination at wavelengths of 1300 nm, 1460 nm, and 1500 - 1700 nm. Images were also acquired using polarization sensitive optical coherence tomography for comparison. The highest contrast for near- IR reflectance was at 1460 nm and 1500 - 1700 nm. These near-IR wavelengths are coincident with higher water absorption. The clear Delton sealant investigated was not visible in either co-polarization or crosspolarization OCT images. The wavelength region between 1500-1700-nm yielded the highest contrast of lesions under sealants for near-IR reflectance measurements.
Indocyanine green (ICG) as a new adjuvant for the antimicrobial photo-dynamic therapy (aPDT) in dentistry
Joerg Meister, Michael Hopp, Johannes Schäfers, et al.
Clinical surveys show a continuous increase of antimicrobial resistance related to the frequency of the administrated medication. The antimicrobial photodynamic therapy (aPDT) is an effective adjuvant to reduce the need of antibiotics in dentistry, especially in periodontics. The antimicrobial effect of lightactivated photosensitizers in periodontics is demonstrated in clinical studies and case reports. Indocyanine green (ICG) as a new adjuvant shows the high potential of antiphlogistic and antimicrobial effects in combination with laser-light activation. In trying to answer the question of just how far the influence of temperature is acting on bacteria, this study was carried out. The influences of ICG at different concentrations (0.01 up to 1 mg/ml) in combination with a culture medium (brain-heart-infusion) and a bacteria culture (Streptococcus salivarius) at different optical densities (OD600 0.5 and 0.1) were investigated under laser-light activation. Laser activation was carried out with diode laser at 810 nm and two different power settings (100 mW/300 mW). The pulse repetition rate was 2 kHz. Taking account of the fiber diameter, distance and spot size on the sample surface, the applicated intensities were 6.2 and 18.7 W/cm2. Total irradiation time was 20 s for all meaurements. Transmitted laser power and temperature increase in the culture medium as well as in the bacteria culture were determined. Additionally the influence of ICG regarding bacterial growth and bactericidal effect was investigated in the bacteria culture without laser irradiation. Without laser, no bactericidal effect of ICG was observed. Only a bacteriostatic effect could be proved. In dependence of the ICG concentration and the applied intensities a temperature increase of ΔT up to 80°C was measured.