Abstract

IntroductionFixed orthodontic appliances, despite years of research and development, still raise a lot of controversy because of its potentially destructive influence on enamel. Therefore, it is necessary to quantitatively assess the condition and therein the thickness of tooth enamel in order to select the appropriate orthodontic bonding and debonding methodology as well as to assess the quality of enamel after treatment and clean-up procedure in order to choose the most advantageous course of treatment. One of the assessment methods is computed tomography where the measurement of enamel thickness and the 3D reconstruction of image sequences can be performed fully automatically.Material and methodOCT images of 180 teeth were obtained from the Topcon 3D OCT-2000 camera. The images were obtained in vitro by performing sequentially 7 stages of treatment on all the teeth: before any interference into enamel, polishing with orthodontic paste, etching and application of a bonding system, orthodontic bracket bonding, orthodontic bracket removal, cleaning off adhesive residue. A dedicated method for the analysis and processing of images involving median filtering, mathematical morphology, binarization, polynomial approximation and the active contour method has been proposed.ResultsThe obtained results enable automatic measurement of tooth enamel thickness in 5 seconds using the Core i5 CPU M460 @ 2.5GHz 4GB RAM. For one patient, the proposed method of analysis confirms enamel thickness loss of 80 μm (from 730 ± 165 μm to 650 ± 129 μm) after polishing with paste, enamel thickness loss of 435 μm (from 730 ± 165 μm to 295 ± 55 μm) after etching and bonding resin application, growth of a layer having a thickness of 265 μm (from 295 ± 55 μm to 560 ± 98 μm after etching) which is the adhesive system. After removing an orthodontic bracket, the adhesive residue was 105 μm and after cleaning it off, the enamel thickness was 605 μm. The enamel thickness before and after the whole treatment decreased by about 125 μm.ConclusionsThis paper presents an automatic quantitative method for the assessment of tooth enamel thickness. This method has proven to be an effective diagnostic tool that allows evaluation of the surface and cross section of tooth enamel after orthodontic treatment with fixed thin-arched braces and proper selection of the methodology and course of treatment.

Highlights

  • Fixed orthodontic appliances, despite years of research and development, still raise a lot of controversy because of its potentially destructive influence on enamel

  • The proposed method of analysis confirms enamel thickness loss of 80 μm after polishing with paste, enamel thickness loss of 435 μm after etching and bonding resin application, growth of a layer having a thickness of 265 μm which is the adhesive system

  • This paper presents an automatic quantitative method for the assessment of tooth enamel thickness

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Summary

Results

The obtained images from LROIa to LROIg containing information about the thickness of the enamel layer are the basis for the calculation of mean thickness, standard deviation, and minimum and maximum values. The other known methods of enamel thickness analysis do not enable automatic, quantitative measurement of the enamel thickness present in the ROI and automatic comparison of image groups This is the case in [32], where comparisons between specific areas of the tooth enamel were made manually in OCT images. The algorithm of OCT image analysis and processing has the following features: works fully automatically - without any operator intervention, allows to quantify the changes in the structure of enamel, allows for quantitative assessment of the effectiveness of cleaning the tooth surface and the effectiveness of the use of selected methods of enamel development, analysis time of a sequence of 2D images does not exceed 5 seconds when using the.

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