An Intraoral OCT Probe to Enhanced Detection of Approximal Carious Lesions and Assessment of Restorations.

Caries, the world's most common chronic disease, remains a major cause of invasive restorative dental treatment. To take advantage of the diagnostic potential of optical coherence tomography (OCT) in contemporary dental prevention and treatment, an intraorally applicable spectral-domain OCT probe has been developed based on an OCT hand-held scanner equipped with a rigid 90°-optics endoscope. The probe was verified in vitro. In vivo, all tooth surfaces could be imaged with the OCT probe, except the vestibular surfaces of third molars and the proximal surface sections of molars within a "blind spot" at a distance greater than 2.5 mm from the tooth surface. Proximal surfaces of 64 posterior teeth of four volunteers were assessed by intraoral OCT, visual-tactile inspection, bitewing radiography and fiber-optic transillumination. The agreement in detecting healthy and carious surfaces varied greatly between OCT and established methods (18.2-94.7%), whereby the established methods could always be supplemented by OCT. Direct and indirect composite and ceramic restorations with inherent imperfections and failures of the tooth-restoration bond were imaged and qualitatively evaluated. The intraoral OCT probe proved to be a powerful technological approach for the non-invasive imaging of healthy and carious hard tooth tissues and gingiva as well as tooth-colored restorations.

Visualization of the pulp chamber roof and residual dentin thickness by spectral-domain optical coherence tomography in vitro.

The aim of this study was to evaluate the ability of spectral-domain optical coherence tomography (SD-OCT) to display the roof of the pulp chamber and to estimate the residual dentin thickness (RDT) of the pulp complex. The roots of 20 extracted human molars were embedded in epoxy resin, and crowns were longitudinally sectioned in the mesial-distal direction, exposing the pulp chamber. The coronal part of the crown was removed up to an RDT to the pulp chamber roof of 2 mm. Samples were imaged by SD-OCT from coronal view and by light microscopy (LM) in the sagittal plane. Using a microtome, dentin was subsequently removed in four levels from the occlusal aspect in steps of 250 µm. At each level, RDT was documented and measured by both methods. The data were compared (Spearman's rho correlation coefficient, Wilcoxon signed-rank test). Using OCT, the roof of the pulp chamber was first displayed at a maximum RDT of 1.94 mm. The minimal RDT that could be imaged by OCT was 0.06 mm. Values from both methods were strongly correlated (r, 0.83-0.95; pi ≤ 0.05) and differed significantly for large RDTs (dentin levels 1, 2; pi < 0.05) but not for small RDTs (levels 3, 4; pi ≥ 0.226). The roof of the dental pulp chamber could be already visualized by SD-OCT with a RDT of 1.94 mm. Therefore, the method could be a useful diagnostic tool during the preparation of deep dentin cavities and might help to preserve the integrity of the pulp chamber.

Effects of artificial aging and progression of cracks on thin occlusal veneers using SD-OCT.

OBJECTIVES: The purpose of this study was to evaluate the effects of artificial aging on thin glass-ceramic occlusal premolar veneers, adhesively bonded to dentin, by examining the changes caused by artificial aging using spectral domain optical coherence tomography (SD-OCT). In addition, the development of cracks in the ceramic veneers and their possible influence on the behavior of the ceramic restorations were examined. METHODS: In total, 48 extracted sound upper premolars were prepared in the dentin for occlusal veneers milled from lithium disilicate ceramic blocks (IPS e.max CAD, Ivoclar Vivadent, Liechtenstein). All restorations were adhesively bonded using resin cement (Variolink Esthetic DC, Ivoclar Vivadent). Specimens were 3-dimensionally and 2-dimensionally imaged by SD-OCT (Telesto II, Thorlabs GmbH, Germany), then subjected to thermal-dynamic loading in a chewing simulator with 1,200,000 cycles at a load of 10 kg. Specimens were 2D and 3D imaged again after the artificial aging. Finally, they were subjected to quasi-static loading using a universal testing machine until failure occurred and later examined microscopically to assess the mode of failure. ANOVA test was performed for statistical analysis of data and Tukey's post-hoc test was used to compare the groups at 5% significance level. Chi-Square Test and Fischer's Exact Test of Independence were conducted to test the association between nominal variables. RESULTS: No changes or irregularities were observed in the cement layer or tooth substrate after the aging process. However, wear of the ceramic was noticed at the surface of contact with the antagonist during the test. The development of cracks was detected in 23% of the specimens. Cracks did not affect the fracture strength (p > 0.05) but influenced the mode of failure (p ≤ 0.001). SIGNIFICANCE: Optical coherence tomography allows an easy and non-invasive method to internally scan teeth and restorations. Development of cracks in the ceramic did not affect the fracture strength of the restorations but might lead to a more catastrophic type of failure.