Abstract

Dental enamel manifests high transparency in the near-IR. Previous work demonstrated that near-IR light at 1310-nm is ideally suited for the transillumination of interproximal dental caries (dental decay in between teeth) [1]. However, most new dental decay occurs in the pits and fissures of the occlusal (biting) surfaces of posterior teeth. These caries lesions cannot be detected by x-rays during the early stages of decay due to the overlapping topography of the crown of the tooth. In this study, a near-IR imaging system operating at 1310-nm was used to acquire occlusal images by launching the near-IR light into the buccal surface of the tooth just above the gingival margin (gum-line). The near-IR light diffuses through the highly scattering dentin providing uniform back illumination of the enamel of the crowns allowing imaging of the occlusal surfaces. The near-IR images show high contrast between sound and demineralized areas. Demineralization (decay) can be easily differentiated from stains, pigmentation, and hypomineralization (fluorosis). Moreover, the high transparency of the enamel enables imaging at greater depth for the detection of subsurface decay hidden under the enamel. These early images suggest that the near-IR offers significant advantages over conventional visual, tactile and radiographic caries detection methods.

© 2005 Optical Society of America

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References

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  1. R. S. Jones, G. D. Huynh, G. C. Jones, and D. Fried, "Near-IR Transillumination at 1310-nm for the Imaging of Early Dental Caries," Opt. Express 11, 2259-2265, (2003).
    [CrossRef] [PubMed]
  2. J. D. B. Featherstone and D. Young, "The need for new caries detection methods," in Lasers in Dentistry V, San Jose, CA, Proc. SPIE 3593, 134-140 (1999).
  3. G. Jones, R. S. Jones, and D. Fried, "Transillumination of interproximal caries lesions with 830-nm light," in Lasers in Dentistry X, San Jose, Proc. SPIE 5313, 17-23 (2004
  4. C. M. Pine, "Fiber-Optic Transillumination (FOTI) in Caries Diagnosis," in Early Detection of dental caries, Indianapolis, Proc. SPIE 51-66 (1996).
  5. A. Schneiderman, M. Elbaum, T. Schultz, S. Keem, M. Greenebaum, and J. Driller, "Assessment of Dental caries with Digital Imaging Fiber-Optic Transillumination (DIFOTI):In vitro Study," Caries Res. 31, 103-110 (1997).
    [CrossRef] [PubMed]
  6. R. R. Alfano, W. Lam, H. J. Zarrabi, M. A. Alfano, J. Cordero, and D. B. Tata, "Human teeth with and without caries studied by laser scattering, fluorescence and absorption spectroscopy," IEEE J Quant Electron. 20, 1512- 1515 (1984).
    [CrossRef]
  7. R. Hibst, R. Paulus, and A. Lussi, "Detection of Occlusal Caries by laser Fluorescence:Basic and Clinical Investigations," Med. Laser Appl. 16, 205-213 (2001).
    [CrossRef]
  8. X. Q. Shi, U. Welander, and B. Angmar-Mansson, "Occlusal caries detection with Kavo DIAGNOdent and Radiography:An in vitro comparison," Caries Res. 34, 151-158 (2000).
    [CrossRef] [PubMed]
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    [CrossRef]
  12. D. Fried, J. Xie, S. Shafi, J. D. B. Featherstone, T. Breunig, and C. Q. Lee, "Early detection of dental caries and lesion progression with polarization sensitive optical coherence tomography," J. Biomed. Optics 7, 618-627 (2002).
    [CrossRef]
  13. A. Lussi, S. Imwinkelreid, N. B. Pitts, C. Longbottom, and E. Reich, "Performance and Reproducibility of a Laser Fluorescence System for Detection of Occlusal Caries in vitro," Caries Res. 33, 261-266 (1999).
    [CrossRef] [PubMed]
  14. H. Eggertsson, M. Analoui, M. H. van der Veen, C. Gonzalez-Cabezas, G. J. Eckert, and G. K. Stookey, "Detection of early interproximal caries in vitro using laser fluorescence, dye-enhanced laser fluorescence and direct visual examination," Caries Res. 33, 227-233 (1999).
    [CrossRef] [PubMed]
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Annual Indiana Conference (1999). (1)

J. J. ten Bosch, "Summary of Research of Quanitative Light Fluorescence," in Early Detection of Dental Caries II: Proceedings of 4th Annual Indiana Conference, Indianapolis, IN, 261-278 (1999).

Appl. Opt. (1)

Caries Res. (5)

A. Schneiderman, M. Elbaum, T. Schultz, S. Keem, M. Greenebaum, and J. Driller, "Assessment of Dental caries with Digital Imaging Fiber-Optic Transillumination (DIFOTI):In vitro Study," Caries Res. 31, 103-110 (1997).
[CrossRef] [PubMed]

X. Q. Shi, U. Welander, and B. Angmar-Mansson, "Occlusal caries detection with Kavo DIAGNOdent and Radiography:An in vitro comparison," Caries Res. 34, 151-158 (2000).
[CrossRef] [PubMed]

A. Baumgartner, S. Dicht, C. K. Hitzenberger, H. Sattmann, B. Robi, A. Moritz, W. Sperr, and A. F. Fercher, "Polarization-sensitive optical coherence tomography of dental structures," Caries Res. 34, 59-69 (2000).
[CrossRef]

A. Lussi, S. Imwinkelreid, N. B. Pitts, C. Longbottom, and E. Reich, "Performance and Reproducibility of a Laser Fluorescence System for Detection of Occlusal Caries in vitro," Caries Res. 33, 261-266 (1999).
[CrossRef] [PubMed]

H. Eggertsson, M. Analoui, M. H. van der Veen, C. Gonzalez-Cabezas, G. J. Eckert, and G. K. Stookey, "Detection of early interproximal caries in vitro using laser fluorescence, dye-enhanced laser fluorescence and direct visual examination," Caries Res. 33, 227-233 (1999).
[CrossRef] [PubMed]

IEEE J Quant Electron. (1)

R. R. Alfano, W. Lam, H. J. Zarrabi, M. A. Alfano, J. Cordero, and D. B. Tata, "Human teeth with and without caries studied by laser scattering, fluorescence and absorption spectroscopy," IEEE J Quant Electron. 20, 1512- 1515 (1984).
[CrossRef]

J. Biomed. Optics (1)

D. Fried, J. Xie, S. Shafi, J. D. B. Featherstone, T. Breunig, and C. Q. Lee, "Early detection of dental caries and lesion progression with polarization sensitive optical coherence tomography," J. Biomed. Optics 7, 618-627 (2002).
[CrossRef]

Med. Laser Appl. (1)

R. Hibst, R. Paulus, and A. Lussi, "Detection of Occlusal Caries by laser Fluorescence:Basic and Clinical Investigations," Med. Laser Appl. 16, 205-213 (2001).
[CrossRef]

Opt. Express (2)

Proc. SPIE (3)

J. D. B. Featherstone and D. Young, "The need for new caries detection methods," in Lasers in Dentistry V, San Jose, CA, Proc. SPIE 3593, 134-140 (1999).

G. Jones, R. S. Jones, and D. Fried, "Transillumination of interproximal caries lesions with 830-nm light," in Lasers in Dentistry X, San Jose, Proc. SPIE 5313, 17-23 (2004

C. M. Pine, "Fiber-Optic Transillumination (FOTI) in Caries Diagnosis," in Early Detection of dental caries, Indianapolis, Proc. SPIE 51-66 (1996).

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Figures (9)

Fig. 1.
Fig. 1.

New caries lesions are found in either contact sites between teeth, interproximal, or in the pits and fissures of occlusal surfaces.

Fig. 2.
Fig. 2.

Imaging setup: (A) InGaAs FPA with video lens, (B) tooth, (C) cylindrical lens, (D) collimator, (E) fiber-pigtail from SLD.

Fig. 3.
Fig. 3.

Occlual image contrast model, areas of occlusal decay appear darker as diffuse light from within the tooth is attenuated by occlusal caries. (A) shallow caries in fissures, (B) caries that penetrate deep and spread in the underlying dentin may create a larger opacity on the FPA.

Fig. 4.
Fig. 4.

(A) Reflected light image (visible) of molar with extensive flourosis and a large lesion (yellow circle) in the central pit, (B) Radiograph (D-speed film), (C) NIR image of tooth, the lesion is the large opacity in the yellow circle.

Fig. 5.
Fig. 5.

(A) Reflected light image (visible) of molar with demineralization in the fissures, (B) radiograph (F-speed film), (C) NIR image of tooth showing localized areas of decay.

Fig. 6.
Fig. 6.

(A) Reflected light image (visible) of sound molar without demineralization, (B) Radiograph (F-speed film), (C) NIR image of tooth.

Fig. 7.
Fig. 7.

Premolar with a hidden subsurface lesion, the reflected light image (A) contains a deep, pigmented fissure, but it is not clear whether there is decay. (B) Radiograph (D-speed film) shows no decay. The NIR image (C) contains a large opacity in the yellow square. The tooth was cut in half along the dotted line in (C), and the tooth hemi-section (D) shows the lesion at the base of the pit (red circle). Note that there is no decay along the walls of the fissure. The decay does not show up very well in the PS-OCT parallel axis scan (E) taken transverse to the fissure while the PS-OCT perpendicular axis scan (F) clearly shows the decay at the base of the pit. Areas of high reflectivity are in red, moderate reflectivity in white, and low reflectivity in blue in the PS-OCT scans.

Fig. 8.
Fig. 8.

Molar with an extensive network of fissures (A) the reflected light image shows dark areas that may be either stains or demineralization (B) NIR image shows that some fissures have demineralization and others are sound or normal.

Fig. 9.
Fig. 9.

Comparison of illumination with a 20-mm in diameter gaussian beam (A) from the right side of the tooth and a (B) thin elliptical beam (20-mm major axis) generated with the cylindrical lens.

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