Dental Diagnosis and Treatment Assessments: Between X-rays Radiography and Optical Coherence Tomography

Abstract

A correct diagnosis in dental medicine is typically provided only after clinical and radiological evaluations. They are also required for treatment assessments. The aim of this study is to establish the boundaries from which a modern, although established, imaging technique, Optical Coherence Tomography (OCT), is more suitable than the common X-ray radiography to assess dental issues and treatments. The most common methods for daily-basis clinical imaging are utilized in this study for extracted teeth (but also for other dental samples and materials), i.e., panoramic, intraoral radiography, and three-dimensional (3D) cone beam computed tomography (CBCT). The advantages of using OCT as an imaging method in dentistry are discussed, with a focus on its superior image resolution. Drawbacks related to its limited penetration depth and Field-of-View (FOV) are pointed out. High-quality radiological investigations are performed, measurements are done, and data collected. The same teeth and samples are also imaged (mostly) with an in-house developed Swept Source (SS)-OCT system, Master-Slave enhanced. Some of the OCT investigations employed two other in-house developed OCT systems, Spectral Domain (SD) and Time Domain (TD). Dedicated toolbars from Romexis software (Planmeca, Helsinki, Finland) are used to perform measurements using both radiography and OCT. Clinical conclusions are drawn from the investigations. Upsides and downsides of the two medical imaging techniques are concluded for each type of considered diagnosis. For treatment assessments, it is concluded that OCT is more appropriate than radiography in all applications, except bone-related investigations and periodontitis that demand data from higher-penetration depths than possible with the current level of OCT technology.

Optimization of X-ray Investigations in Dentistry Using Optical Coherence Tomography

“…One may also remark that X-ray imaging is not able to resolve the features that OCT can do even if fully optimized. While this is correct for a range of investigations, as we studied for example in [ 40 ], based on the quantitative assessments performed in [ 28 ] we demonstrated that radiography can spot relevant details such as small cavities, but cannot correctly measure them like OCT can (i.e., errors around 50% are possible even with CBCT). This shows that OCT can serve as a calibration tool for X-ray images that resolve such relevant dental conditions.…”

“…The OCT system is presented in detail in [ 28 ]. It is centered at a wavelength of 1310 nm and uses a 2D dual axis galvanometer scanner (GS) for the lateral scanning of samples [ 38 , 39 ].…”

“…It also has the advantages of non-invasive investigation and of the possibility to perform in vivo imaging, when necessary using dedicated handheld scanning probes [ 16 , 17 , 18 , 19 , 20 ]. As a plus, it benefits from mobile units [ 18 ] and, as studied in detail in [ 28 ], it proves to be complementary to radiography for diagnosis, treatment monitoring and assessment. Therefore, there is a clear motivation for dental clinics to utilize such systems: using OCT for the calibration of X-ray units just adds to their range of dental applications.…”

“…In a recent study we explored the boundaries between OCT and the common radiography when applied to maxillo-facial medical imaging [ 28 ]. The study concluded that dental radiography and OCT can complement each other in assessing the oral cavity, with certain areas where only one of the above techniques would be applicable in diagnosing and monitoring clinical aspects, but also with areas where the two techniques may validate each other.…”

Optical coherence tomography’s current clinical medical and dental applications: a review

“…2 This technique has several clinical applications that include (but are not limited to) detection of diabetic macular edema, 3 epithelial mapping for refractive surgery, 4 diagnosing and managing patients with neuro-ophthalmic conditions, 5 imaging of retinal microcirculation to detect hemodynamic disturbances, 6 detection of age associated changes in teeth, 7 diagnosing dental caries 8 and tooth wear, 9 and post-treatment assessments in dentistry. 10 The aim of this review is to summarize the clinical applications of OCT in the field of medicine and dentistry, and highlight its potential advantages and disadvantages. Google Scholar and PubMed databases were searched using keywords including "optical coherence tomography," "OCT," and "OCT and its clinical applications."…”