Abstract
Accurate measurement of the highly mineralized transparent surface layer that forms on caries lesions is important for diagnosis of the lesion activity because chemical intervention can slow or reverse the caries process via remineralization. Previous in-vitro and in-vivo studies have demonstrated that polarization-sensitive optical coherence tomography (PS-OCT) can nondestructively image the subsurface lesion structure and the highly mineralized transparent surface zone of caries lesions. The purpose of this study was to develop an approach to automatically process 3-dimensional PS-OCT images and to accurately assess the remineralization process in simulated enamel lesions. Artificial enamel lesions were prepared on twenty bovine enamel blocks using two models to produce varying degree of demineralization and remineralization. The thickness of the transparent surface layer and the integrated reflectivity of the subsurface lesion were measured using PS-OCT. The automated transparent surface layer detection algorithm was able to successfully detect the transparent surface layers with high sensitivity ( = 0.92) and high specificity ( = 0.97). The estimated thickness of the transparent surface layer showed a strong correlation with polarized light microscopy (PLM) measurements of all regions (R(2) = 0.90). The integrated reflectivity, ΔR, and the integrated mineral loss, ΔZ, showed a moderate correlation (R(2) = 0.32). This study demonstrates that PS-OCT can automatically measure the changes in artificial enamel lesion structure and severity upon exposure to remineralization solutions.
Highlights
The caries process is potentially preventable and curable [1]
Calcium and phosphate ions are lost from the tooth enamel during the demineralization process and the surface layer may erode with more severe acid challenge or mechanical abrasion and form a cavity [5]
A transparent surface layer due to remineralization is clearly visible in both models with polarized light microscopy (PLM), transverse microradiography (TMR) and OCT
Summary
The caries process is potentially preventable and curable [1]. It is widely accepted that fluoride reduces the incidence of dental caries and slows or reverses the progression of existing lesions [2]. Calcium and phosphate ions are lost from the tooth enamel during the demineralization process and the surface layer may erode with more severe acid challenge or mechanical abrasion and form a cavity [5]. There is growth of existing partially demineralized crystals as well as growth of new crystals within the lesion body due to the increased influx of calcium and phosphate ions [6]. With a thick enough fluorapatite layer, diffusion of calcium and phosphate ions at the lesion body, can be dramatically reduced [5, 7, 8]. This leads to the arrest of lesion progression and no further intervention is necessary
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