Handheld optical coherence tomography for clinical assessment of dental plaque and gingiva.

Jungeun Won,Ralf Adam,Malgorzata Klukowska,Eric J Chaney,Pin-Chieh Huang,Stephen A Boppart,Darold R Spillman,Ronit Barkalifa

doi:10.1117/1.jbo.25.11.116011

Abstract

.Significance: Optical coherence tomography (OCT) offers high spatial resolution and contrast for imaging intraoral structures, yet few studies have investigated its clinical feasibility for dental plaque and gingiva imaging in vivo. Furthermore, the accessibility is often limited to anterior teeth due to bulky imaging systems and probes.Aim: A custom-designed, handheld probe-based, spectral-domain OCT system with an interchangeable attachment was developed to assess dental plaque and gingival health in a clinical setting.Approach: Healthy volunteers and subjects with gingivitis and sufficient plaque were recruited. The handheld OCT system was operated by trained dental hygienists to acquire images of dental plaque and gingiva at various locations and after one-week use of oral hygiene products.Results: The handheld OCT can access premolars, first molars, and lingual sides of teeth to visualize the plaque distribution. OCT intensity-based texture analysis revealed lower intensity from selected sites in subjects with gingivitis. The distribution of the dental plaque after one-week use of the oral hygiene products was compared, showing the capability of OCT as a longitudinal tracking tool.Conclusions: OCT has a strong potential to display and assess dental plaque and gingiva in a clinical setting. Meanwhile, technological challenges remain to perform systematic longitudinal tracking and comparative analyses.

Highlights

Dental plaque, a bacterial biofilm constantly forming on surfaces within the mouth, is responsible for dental caries and periodontal diseases.[1]
Prior to subject recruitment for the longitudinal study, oral cavity imaging using the handheld Optical coherence tomography (OCT) probe was performed on healthy volunteers
Dental plaque was readily visible on the top surface of the enamel [Fig. 2(b)], and the presence of the hardened plaque was often detected at the junction between gingiva and enamel [Fig. 2(d)] and between teeth [Fig. 2(e)]

Summary

Introduction

A bacterial biofilm constantly forming on surfaces within the mouth, is responsible for dental caries and periodontal diseases.[1] When soft dental plaque is not removed, the dental plaque may develop into calculus (hardened plaque) under or above the gumline. The presence of plaque and calculus can irritate the gingiva (or the gums), leading to the gingival inflammation called gingivitis.[2,3] The common symptoms of gingivitis include swollen, bleeding, and receding gingiva. Gingivitis is one of the most common oral diseases worldwide, and around 56% of adults in the United States have mild to severe gingivitis.[4] If gingivitis is left untreated, gingivitis can advance to periodontitis, tooth loss, and other severe oral diseases

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