Diagnosis of Occlusal Tooth Wear Using 3D Imaging of Optical Coherence Tomography Ex Vivo.

Misa Kashiwa,Junji Tagami,Yasunori Sumi,Masahiro Yoshiyama,Yasushi Shimada,Alireza Sadr

doi:10.3390/s20216016

Abstract

The aim of this study was to assess the utility of 3D imaging of optical coherence tomography (OCT) for the diagnosis of occlusal tooth wear ex vivo. Sixty-three extracted human molars with or without visible tooth wear were collected to take digital intraoral radiography and 3D OCT images. The degree of tooth wear was evaluated by 12 examiners and scored using 4-rank scale: 1—slight enamel wear; 2—distinct enamel wear; 3—tooth wear with slight dentin exposure; 4—tooth wear with distinct involvement of dentin. The degree of tooth wear was validated by the histological view of confocal laser scanning microscopy (CLSM). The sensitivity, specificity, and area under the curve (AUC) of receiver operating characteristic analysis were calculated. Diagnostic accuracy was compared with the agreement with CLSM observation using weighted kappa. The results were statistically analyzed at a significance level of α = 0.05. Three-dimensional OCT showed significantly higher sensitivity (p < 0.05) for all the diagnostic thresholds of enamel wear and dentin exposure than digital radiography (0.82, 0.85, and 0.79 vs. 0.56, 0.52, and 0.57, respectively). Three-dimensional OCT showed higher AUC and kappa coefficients than digital radiography (p < 0.05), where mean AUC and Kappa values were 0.95 and 0.76 for OCT and 0.92 and 0.47 for radiography, respectively. No significant difference of specificity was observed (p > 0.05). Three-dimensional OCT could visualize and estimate the degree of tooth wear and detect the dentin exposure at the tooth wear surface accurately and reproducibly. Consequently, a new guideline for tooth wear assessment can be proposed using OCT.

Highlights

Tooth wear is defined as the loss of dental hard tissue by physical or chemical factors that occur throughout life [1]
The aims of this study were to evaluate the diagnostic accuracy of 3D imaging of SS-Optical coherence tomography (OCT) for tooth wear and to compare the results with those of digital dental radiography
The 63 teeth included 16 teeth with slight enamel wear, 18 teeth with distinct enamel wear, 13 teeth with tooth wear with slight dentin exposure, and 16 teeth with tooth wear with distinct involvement of dentin exposure

Summary

Introduction

Tooth wear is defined as the loss of dental hard tissue by physical or chemical factors that occur throughout life [1]. The progression of tooth wear is irreversible and its prevalence increases with age [2,3]. The literature considers tooth wear resulting from a multifactorial etiology with interactions of physical and chemical agents. The changes resulting from physiological tooth wear are usually subtle and asymptomatic, excessive physical or chemical stimulation can lead. Sensors 2020, 20, 6016 to abnormal tooth loss at a pathological level, which may require treatment [3,4]. As healthy life expectancy is essential in an aging society, the importance of long-term maintenance of healthy and functional teeth is increasingly recognized. Advanced tooth wear leads to oral symptoms such as pain and loss of masticatory function and esthetics

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