Imaging caries lesions and lesion progression with polarization sensitive optical coherence tomography

Nondestructive assessment of the inhibition of enamel demineralization by CO2 laser treatment using polarization sensitive optical coherence tomography

Studies have shown that lasers can be used to modify the chemical composition of tooth enamel to render it less soluble. The purpose of this study was to determine if polarization-sensitive optical coherence tomography (PS-OCT) can be used to nondestructively assess the inhibition of demineralization after CO2 laser irradiation. Human and bovine enamel specimens were irradiated by a microsecond pulsed CO2 laser operating at a wavelength of 9.3 microm. Some specimen areas were also treated with topical fluoride to create six treatment groups on each sample, including protected surface (no demineralization), protected +laser, laser, fluoride, laser+fluoride, and unprotected surface. Samples were placed in an artificial demineralization solution to create lesions approximately 100-200 microm in depth and were subsequently scanned with a PS-OCT system to assess lesion severity before sectioning for analysis by polarized light microscopy and transverse microradiography for comparison. PS-OCT was able to measure a significant reduction in the integrated reflectivity due to inhibition by the laser on both human and bovine enamel even though the laser modification of the enamel surface did cause an increase in reflectivity and decrease in optical penetration. This study shows that the PS-OCT is well suited for the clinical assessment of caries inhibition after laser treatments.

Assessment of early demineralization in teeth using the signal attenuation in optical coherence tomography images

Optical coherence tomography imaging is used to improve the detection of incipient carious lesions in dental enamel. Measurements of signal attenuation in images acquired with an 850-nm light source were performed on 21 extracted molars from eight human volunteers. Stronger attenuation was observed for the optical coherence tomography (OCT) signal in healthy enamel than in carious lesions. The measured attenuation coefficients from the two groups form distinct statistical populations. The coefficients obtained from sound enamel fall within the range of 0.70 to 2.14 mm(-1) with a mean value of 1.35 mm(-1), while those in carious regions range from 0.47 to 1.88 mm(-1), with a mean value of 0.77 mm(-1). Three values are selected as the lower threshold for signal attenuation in sound enamel: 0.99, 0.94, and 0.88 mm(-1). These thresholds were selected to provide detection of sound enamel with fixed specificities of 90%, 95%, and 97.5%, respectively. The corresponding sensitivities for the detection of carious lesions are 92.8%, 90.4%, and 87%, respectively, for the sample population used in this study. These findings suggest that attenuation of OCT signal at 850 nm could be an indicator of tooth demineralization and could be used as a marker for early caries detection.

Topographical variations in the polarization sensitivity of articular cartilage as determined by polarization-sensitive optical coherence tomography and polarized light microscopy

To understand the influence of topographical variations in collagen fibril orientation of articular cartilage on optical phase images of polarization-sensitive optical coherence tomography (PS-OCT), we use polarized light microscopy (PLM) to quantify the orientation and phase retardation of the collagen architecture in cartilage at the same locations imaged by PS-OCT. The PS-OCT experiments demonstrate that articular cartilage has normal variations in polarization sensitivity at different locations over an intact bovine tibial plateau. Articular cartilage is not polarization sensitive along the vertical axis on the medial edge and central areas of the joint surface, but becomes polarization sensitive on the lateral edge of the tibia. This difference in optical phase retardation, as demonstrated by PS-OCT, is verified by PLM to be caused by differences in collagen fibril orientation at different locations of the tibial plateau. This study demonstrates that normal topographical variations in the collagen architecture of articular cartilage within a joint have a profound influence on the optical phase retardation detected by PS-OCT imaging, and therefore must be understood and mapped for specific joints before PS-OCT imaging can be used for the evaluation of the health status of individual joint surfaces.

Quality assessment of dental treatments using en-face optical coherence tomography

The present study evaluates the potential of en-face optical coherence tomography (OCT) as a possible noninvasive high resolution method for supplying necessary information on the material defects of dental prostheses and microleakage at prosthetic interfaces. Teeth are also imaged after several treatment methods to asses material defects and microleakage at the tooth-filling interface, and the presence or absence of apical microleakage, as well as to evaluate the quality of bracket bonding on dental hard tissue. C-scan and B-scan OCT images as well as confocal images are acquired from a large range of samples. Gaps between the dental interfaces and material defects are clearly exposed.

Near-infrared imaging of developmental defects in dental enamel

Polarization-sensitive optical coherence tomography (PS-OCT) and near-infrared (NIR) imaging are promising new technologies under development for monitoring early carious lesions. Fluorosis is a growing problem in the United States, and the more prevalent mild fluorosis can be visually mistaken for early enamel demineralization. Unfortunately, there is little quantitative information available regarding the differences in optical properties of sound enamel, enamel developmental defects, and caries. Thirty extracted human teeth with various degrees of suspected fluorosis were imaged using PS-OCT and NIR. An InGaAs camera and a NIR diode laser were used to measure the optical attenuation through transverse tooth sections (approximately 200 microm). A digital microradiography system was used to quantify the enamel defect severity by measurement of the relative mineral loss for comparison with optical scattering measurements. Developmental defects were clearly visible in the polarization-resolved OCT images, demonstrating that PS-OCT can be used to nondestructively measure the depth and possible severity of the defects. Enamel defects on whole teeth that could be imaged with high contrast with visible light were transparent in the NIR. This study suggests that PS-OCT and NIR methods may potentially be used as tools to assess the severity and extent of enamel defects.

Polarization-sensitive swept-source optical coherence tomography with continuous source polarization modulation

We present fiber-based polarization-sensitive swept-source optical coherence tomography (SS-OCT) based on continuous source polarization modulation. The light source is a frequency swept laser centered at 1.31 microm with a scanning rate of 20 kHz. The incident polarization is modulated by a resonant electro-optic modulator at 33.3 MHz, which is one-third of the data acquisition frequency. The zeroth- and first-order harmonic components of the OCT signals with respect to the polarization modulation frequency have the polarimetric information of the sample. By algebraic and matrix calculations of the signals, this system can measure the depth-resolved Jones matrices of the sample with a single wavelength scan. The phase fluctuations of the starting trigger of wavelength scan and the polarization modulation are cancelled by monitoring the OCT phase of a calibration mirror inserted into the sample arm. We demonstrate the potential of the system by the measurement of chicken breast muscle and the volumetric measurement of an in vivo human anterior eye segment. The phase retardation image shows an additional contrast in the fibrous tissue such as the collagen fiber in the trabecular meshwork and sclera.

High-resolution PS-OCT of Enamel Remineralization

Previous studies have demonstrated that Polarization Sensitive Optical Coherence Tomography (PS-OCT) can be used to image the remineralization of early artificial caries lesions. However, the depth resolution of the imaging system employed in those previous studies was limited and the outer surface structure of the lesions were not resolved as clearly as desired. The purpose of this study was to repeat the earlier remineralization study using a broadband light-source of higher resolution to determine if there can be improved resolution of the remineralized surface zones of the lesions. An all polarization-maintaining fiber based PS-OCT system operating at 1310-nm was used to acquire polarization resolved images of bovine enamel surfaces exposed to a demineralizing solution at pH-4.9 followed by a fluoride containing remineralizing solution at pH-7.0 containing 2-ppm fluoride. The structure of the surface zones could be clearly resolved using PS-OCT in the samples that underwent remineralization. The PS-OCT measurements indicated a significant (p<0.05) reduction in the integrated reflectivity between the severity of the lesions that were exposed to the remineralization solution and those that were not. The lesion depth and mineral loss were also measured with polarized light microscopy and transverse microradiography after sectioning the enamel blocks. These results show that PS-OCT can be used to non-destructively monitor the remineralization potential of anti-caries agents.

High-speed polarization sensitive optical frequency domain imaging with frequency multiplexing

Polarization sensitive optical coherence tomography (PS-OCT) provides a cross-sectional image of birefringence in biological samples that is complementary in many applications to the standard reflectance-based image. Recent ex vivo studies have demonstrated that birefringence mapping enables the characterization of collagen and smooth muscle concentration and distribution in vascular tissues. Instruments capable of applying these measurements percutaneously in vivo may provide new insights into coronary atherosclerosis and acute myocardial infarction. We have developed a polarization sensitive optical frequency domain imaging (PS-OFDI) system that enables high-speed intravascular birefringence imaging through a fiber-optic catheter. The novel design of this system utilizes frequency multiplexing to simultaneously measure reflectance of two incident polarization states, overcoming concerns regarding temporal variations of the catheter fiber birefringence and spatial variations in the birefringence of the sample. We demonstrate circular cross-sectional birefringence imaging of a human coronary artery ex vivo through a flexible fiber-optic catheter with an A-line rate of 62 kHz and a ranging depth of 6.2 mm.

Development of fibre-optic confocal microscopy for detection and diagnosis of dental caries

We report on the development of a fibre-optics-based confocal imaging system for the detection and potential diagnosis of early dental caries. A novel optical instrument, capable of recording axial profiles through caries lesions using single-mode optical fibres, has been developed. The practical study illustrates that miniature confocal devices based around single-mode optical fibres may provide additional diagnostic information for the general dental practitioner.

Spectral domain polarization sensitive optical coherence tomography achieved by single camera detection

We present a spectral domain polarization sensitive optical coherence tomography (PSOCT) system that incorporates: 1) a spectrometer configured with a single line-scan camera for spectral interferogram detection, 2) a reference delay line assembly that provides a fixed optical pathlength delay between the lights of two orthogonal polarization states, and 3) a moving reference mirror that introduces a constant modulation frequency in the spatial spectral interferograms while the probe beam is scanned over the sample. The system utilizes the full range of complex Fourier plane for polarization sensitive imaging, where OCT images formed by the vertical and horizontal polarization beam components appear adjacent to each other. It is able to provide imaging of retardation, fast optic axis and backscattered intensity of the interrogated biological tissue. The system is experimentally demonstrated both in vitro and in vivo with an imaging rate at 10,000 A scans per second.

Low-level laser use in dentistry

The use of laser light at power levels below that capable of direct tissue change (protein denaturation, water vaporisation and tissue ablation), has been advocated in diverse branches of medicine and veterinary practice, yet its acceptance in general dental practice remains low. However, the scope for using low-level laser light (LLLT) has emerged through many applications, either directly or indirectly tissue-related, in delivering primary dental care. The purpose of this article is to explain the mechanisms of action and to explore the uses of this group of lasers in general dental practice.

Remineralization of enamel caries can decrease optical reflectivity

The remineralization of enamel caries can lead to distinct optical changes within a lesion. We hypothesized that the restoration of mineral volume would result in a measurable decrease in the depth-resolved reflectivity of polarized light from the lesion. To test this hypothesis, we measured optical changes in artificial caries undergoing remineralization as a function of depth, using Polarization-sensitive Optical Coherence Tomography (PS-OCT). Lesions were imaged non-destructively before and after exposure to a remineralization regimen. After imaging, microradiographs of histological thin sections indicated that the significant reflectivity reduction measured by PS-OCT accurately represented the increase in mineral content within a larger repaired surface zone. Mineral volume changes arising from remineralization can be measured on the basis of the optical reflectivity of the lesion.

Nondestructive measurement of the inhibition of demineralization on smooth surfaces using polarization-sensitive optical coherence tomography

BACKGROUND AND OBJECTIVE

The objective of this study was to test the hypothesis that the inhibition of demineralization in an in vitro simulated caries model by different fluoride agents could be monitored nondestructively using polarization-sensitive optical coherence tomography (PS-OCT) on smooth enamel surfaces peripheral to orthodontic brackets.

MATERIALS AND METHODS

Sixty human molar samples used for this in vitro study were divided into four groups of fifteen. The groups consisted of a control, a fluoride releasing glass ionomer cement, an adhesive fluoride sealant, and fluoride in solution (2-ppm fluoride). The reflectivity from tooth surfaces was monitored using a PS-OCT system at different time points after exposure to a pH cycling demin/remin model at 3-day intervals for 15 days. Polarized light microscopy (PLM) was used to examine lesion depth after day 15.

RESULTS

PS-OCT was effective at measuring significant differences in the integrated reflectivity in depth between the control and fluoride groups (P<0.001). The fluoride sealant demonstrated a greater protective effect than the fluoride in solution and the glass ionomer cement.

CONCLUSIONS

These results suggest that PS-OCT is well suited for the nondestructive assessment of caries inhibition by anti-caries agents.

Fiber-based polarization-sensitive Fourier domain optical coherence tomography using B-scan-oriented polarization modulation method

Fiber-based high-speed polarization-sensitive Fourier domain optical coherence tomography (PS-FD-OCT) is developed at 840 nm wavelength using polarization modulation method. The incident state of polarization is modulated along B-scan. The spectrometer has a polarizing beamsplitter and two line-CCD cameras operated at a line rate of 27.7 kHz. From the 0th and 1st orders of the spatial frequencies along the B-scanning, a depth-resolved Jones matrix can be derived. Since continuous polarization modulation along B-scan causes fringe washout, equivalent discrete polarization modulation is applied to biological measurements. For the demonstration, an in vitro chicken breast muscle, an in vivo finger pad, and an in vivo caries lesion of a human tooth are measured. Three dimensional phase retardation images show the potentials for applying the system to biological and medical studies.

Light scattering properties of natural and artificially demineralized dental enamel at 1310 nm

A fundamental understanding of how near-IR light propagates through sound and carious dental hard tissues is essential for the development of clinically useful optical diagnostic systems, since image contrast is based on changes in the optical properties of these tissues on demineralization. During the caries (decay) process, micropores are formed in the lesion due to partial dissolution of the individual mineral crystals. Such small pores behave as scattering centers, strongly scattering visible and near-IR light. The optical properties of enamel can be quantitatively described by the absorption and scattering coefficients, and the scattering phase function. Our aim is to measure the optical scattering behavior of natural and artificial enamel caries. Near-IR attenuation measurements and angular-resolved goniometer measurements coupled with Monte Carlo simulations are used to determine changes in the scattering coefficient and the scattering anisotropy on demineralization at 1310 nm. An ultra-high resolution digital microradiography system is used to quantify the lesion severity by measurement of the relative mineral loss for comparison with optical scattering measurements. The scattering coefficient increases exponentially with increasing mineral loss. Natural and artificial demineralization increases the scattering coefficient more than two orders of magnitude at 1310 nm, and the scattering is highly forward directed.

Ability of laser fluorescence device associated with fluorescent dyes in detecting and quantifying early smooth surface caries lesions

A laser fluorescence (LF) device is a portable tool, but it does not measure minor mineral changes. Our in vitro study aim is to propose the association of an LF with two fluorescent dyes and to evaluate the performance in detecting and quantifying early demineralization. Artificial caries lesions are created in 40 primary canine teeth using a demineralizing solution (pH=4.8) for 12, 24, 48, and 96 h. LF measurements are performed with DIAGNOdent after demineralization in these samples and in 20 sound primary teeth. Measurements with LF with 0.2-mM tetrakis(N-methylpyridyl)porphyrin (LF TMPyP) and with 4-mM protoporphyrin IX (LF PPIX) are made. The amount of calcium loss is determined by atomic emission spectrometry. A correlation between LF and LF with dyes and mineral loss and receiver operating characteristics analysis are performed, as well as comparisons of sensitivity, specificity, and accuracy values. Significant correlation is obtained with LF TMPyP and mineral loss of lesions demineralized for 24, 48, and 96 h. Better performance is achieved with LF TMPyP for all parameters than with LF alone. LF PPIX does not present good results. In conclusion, LF TMPyP provides good performance in detecting and quantifying very early enamel caries lesions.

Imaging Artificial Caries on the Occlusal Surfaces with Polarization-Sensitive Optical Coherence Tomography

Polarization-sensitive optical coherence tomography (PS-OCT) is a nondestructive imaging system that can utilize near-infrared (IR) light to produce depth-resolved images of dental enamel and has the potential to monitor early enamel occlusal caries. The objective of this study was to investigate the relationship between the magnitude of backscattered light and depolarization recorded by PS-OCT with changes in the enamel mineral volume in an artificial caries model. Artificial lesions were created on a selected region on the occlusal surfaces of sound posterior teeth (n=10) using a well-characterized 14-day pH cycling model. An all-fiber-based PS-OCT system operating at 1,310 nm was used to collect serial images at day 0 and day 14 prior to tooth sectioning. The quantitative mineral content profile and relative mineral loss, DeltaZ (%volxmicrom), of the carious enamel samples were obtained from transverse sections using high-resolution digital microradiography (DM). Line profiles of PS-OCT and DM images were used to evaluate the artificial caries severity and depth. The integrated reflectivity of the perpendicular-axis PS-OCT image, quantifying lesion severity, was correlated to the DeltaZ of the caries lesions. There was also a strong correlation between the lesion depth calculated from both imaging modalities. PS-OCT can image and quantify artificial occlusal caries by measuring the increase in backscattering and depolarization of near-IR light. This optical method has promising applications for in vivo detection and monitoring of early enamel occlusal caries.

Early caries imaging and monitoring with near-infrared light

Enamel is highly transparent in the near infrared (NIR); therefore, this region of the electromagnetic spectrum is suited ideally for the development of new optical diagnostic tools for the detection and imaging of early dental caries. This article discusses the NIR optical properties of sound and demineralized dental enamel and the potential use of polarization sensitive optical coherence tomography and NIR transillumination for the imaging of dental caries.

Remineralization of in vitro dental caries assessed with polarization-sensitive optical coherence tomography

Polarization-sensitive optical coherence tomography (PS-OCT) is potentially useful for imaging the nonsurgical remineralization of dental enamel. This study uses an all-fiber-based PS-OCT system operating at 1310 nm to image demineralized and fluoride-enhanced remineralized artificial lesions. PS-OCT images of lesions before and after remineralization are compared with the relative mineral loss DeltaZ (%vol x microm), obtained from high resolution digital microradiography (DM), and chemical composition changes by infrared spectroscopy. Severe early artificial caries show a significant increase in perpendicular-axis integrated reflectivity after remineralization. After sectioning the samples, DM demonstrates that the lesions remineralized with new mineral and the lesion surface zone show significant restoration of mineral volume. PS-OCT and DM both do not show a major change in lesion depth. For less severe artificial caries, the perpendicular-axis image resolves the scattering and depolarization of an outer growth layer after remineralization. This outer layer has a mineral volume close to that of sound enamel, and spectroscopic analysis indicates that the layer is a highly crystalline phase of apatite, without carbonate substitutions that increase the solubility of sound enamel. This study determines that PS-OCT can image the effects of fluoride-enhanced remineralization of mild and severe early artificial in vitro caries.

Measurement of the severity of natural smooth surface (interproximal) caries lesions with polarization sensitive optical coherence tomography

BACKGROUND AND OBJECTIVES

Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to image early dental caries. The purpose of this study was to compare the measured reflectivity of natural caries lesions found on smooth surfaces (interproximal lesions) with the mineral loss measured using digital microradiography (DM) in order to determine if PS-OCT can be used as a non-destructive method to measure the severity of dental decay and resolve the internal structure of caries lesions.

MATERIALS AND METHODS

A PS-OCT system operating at 1,310 nm was used to acquire polarization resolved images of natural white spot lesions and pigmented lesions on the smooth surfaces of extracted teeth. The integrated reflectivity from lesion areas was compared to polarized light microscopic images (PLM) and to the integrated mineral loss from the same lesion area measured using high resolution DM.

RESULTS

The frequently complex internal structure of caries lesions could be resolved with PS-OCT. Such structural information is potentially useful for determining whether or not the lesion is active and progressing or whether it has become arrested and remineralized and does not require intervention. There was a strong correlation between the integrated mineral loss of the caries lesions measured using DM and the integrated reflectivity in the perpendicular polarization axis of the PS-OCT system.

CONCLUSIONS

The integrated reflectivity in the perpendicular polarization channel can be used to represent the severity of demineralization in natural early caries lesions. Therefore, PS-OCT has considerable potential as a non-destructive clinical probe of early caries lesions to assess their severity, monitor their progression over-time and potentially assess lesion activity.

Evaluation of enamel dental restoration interface by optical coherence tomography

Evaluation of molar dental restorations on enamel is performed using optical coherence tomography (OCT) with 10 microm resolution. Images of approximately 50 microm failure gaps in the restorations are demonstrated and the OCT images are compared with x-ray and optical microscopy pictures. The results demonstrate the potential of the technique for clinical evaluation of dental restorations.

Influence of laser irradiation on the constant composition kinetics of enamel dissolution

The influence of 9.6 microm CO2 laser irradiation on enamel dissolution kinetics was investigated using a constant composition method designed for rate measurements of enamel dissolution as a function of depth, on a micrometer scale. In contrast to lower irradiation intensities (< or =1.0 J cm(-2)), which consistently showed reduced dissolution rates, higher fluences (energy per surface area) resulted in initially increased dissolution rates, which rapidly decreased, after dissolution times corresponding to removal of a few micrometers, to rates similar to those acquired using lower fluences. It was also demonstrated that surface damage during laser irradiation could be limited to the first 1-2 microm by lowering the number of pulses per spot during the irradiation procedure. The constant composition method can be used to measure detailed kinetics of inhibition of acid dissolution of dental enamel that has been treated by low fluence 9.6-microm CO2 laser irradiation.

Real-time fiber-based multi-functional spectral-domain optical coherence tomography at 1.3 microm

We demonstrate a high-speed multi-functional spectral-domain optical coherence tomography system, using a broadband light source centered at 1.3 microm and two InGaAs line scan cameras capable of acquiring individual axial scans in 24.4 micros, at a rate of 18,500 axial scans per second. Fundamental limitations on the accuracy of phase determination as functions of signal-to-noise ratio and lateral scan speed are presented and their relative contributions are compared. The consequences of phase accuracy are discussed for both Doppler and polarization-sensitive OCT measurements. A birefringence artifact and a calibration procedure to remove this artifact are explained. Images of a chicken breast tissue sample acquired with the system were compared to those taken with a time-domain OCT system for birefringence measurement verification. The ability of the system to image pulsatile flow in the dermis and to perform functional imaging of large volumes demonstrates the clinical potential of multifunctional spectral-domain OCT.

Ex vivo detection and characterization of early dental caries by optical coherence tomography and Raman spectroscopy

Early dental caries detection will facilitate implementation of nonsurgical methods for arresting caries progression and promoting tooth remineralization. We present a method that combines optical coherence tomography (OCT) and Raman spectroscopy to provide morphological information and biochemical specificity for detecting and characterizing incipient carious lesions found in extracted human teeth. OCT imaging of tooth samples demonstrated increased light backscattering intensity at sites of carious lesions as compared to the sound enamel. The observed lesion depth on an OCT image was approximately 290 microm matching those previously documented for incipient caries. Using Raman microspectroscopy and fiber-optic-based Raman spectroscopy to characterize the caries further, spectral changes were observed in PO4 (3-) vibrations arising from hydroxyapatite of mineralized tooth tissue. Examination of various ratios of PO4 (3-) nu2, nu3, nu4 vibrations against the nu1 vibration showed consistent increases in carious lesions compared to sound enamel. The changes were attributed to demineralization-induced alterations of enamel crystallite morphology and/or orientation. OCT imaging is useful for screening carious sites and determining lesion depth, with Raman spectroscopy providing biochemical confirmation of caries. The combination has potential for development into a new fiber-optic diagnostic tool enabling dentists to identify early caries lesions with greater sensitivity and specificity.

Characterization of dentin, enamel, and carious lesions by a polarization-sensitive optical coherence tomography system

Enamel and dentin are the primary components of human teeth. Both of them have a strong polarization effect. We designed a polarization-sensitive optical coherence tomography (PSOCT) system to study the spatially resolved scattering and polarization phenomena of teeth. The system is constructed in free space to avoid the complexity of polarization control in fiber-based PSOCT. The structural features of enamel were evaluated in five human teeth that had no visible evidence of caries. The teeth were subsequently sectioned in mesial distal orientation and coronal orientation. Then the structural aspects of dentin were evaluated. OCT images were made of the mantel dentin near the dentin-enamel junction. Five teeth with interproximal and occlusal caries were also studied. With two channel and phase-retardation images, PSOCT provided better functional contrast and more detailed structural information than conventional OCT. For a better description of the measured PSOCT data, we classify these features by two types, i.e., the local textural features and the global structural features. This study indicates that PSOCT has the potential to be a powerful tool for research of dental formation and caries diagnosis.

En-face scanning optical coherence tomography with ultra-high resolution for material investigation

Optical coherence tomography (OCT) is an emerging technique for cross-sectional imaging, originally developed for biological structures. When OCT is employed for material investigation, high-resolution and short measurement times are required, and for many applications, only transversal (en-face) scans yield substantial information which cannot be obtained from cross-sectional images oriented perpendicularly to the sample surface alone. In this work, we combine transversal with ultra-high resolution OCT: a broadband femto-second laser is used as a light source in combination with acousto-optic modulators for heterodyne signal generation and detection. With our setup we are able to scan areas as large as 3 x 3 mm2 with a sensitivity of 100 dB, representing areas 100 times larger compared to other high-resolution en-face OCT systems (full field). We demonstrate the benefits of en-face scanning for different applications in materials investigation.

Peripheral thermal and mechanical damage to dentin with microsecond and sub-microsecond 9.6 microm, 2.79 microm, and 0.355 microm laser pulses

BACKGROUND AND OBJECTIVES

It is desirable to minimize peripheral thermal damage during laser irradiation, since thermal damage to collagen and mineral compromises the bond strength to restorative materials in dentin and inhibits healing and osteointegration in bone. There were two primary objectives of this study. The first objective was to measure the degree of thermal damage peripheral to incisions in dentin produced with lasers resonant to the specific absorption bands of water, collagen, and hydroxyapatite with varying pulse duration using polarized-light microscopy (PLM). The second objective was to use synchrotron radiation infrared spectromicroscopy (SR-FTIR) to identify the specific chemical nature of the optical changes observed under PLM in the respective zones of thermal damage peripheral to the laser incisions.

STUDY DESIGN/MATERIALS AND METHODS

Precise incisions were produced in 3 x 3 mm2 blocks of human dentin using CO2 (9.6 microm), Er:YSGG (2.79 microm), and Nd:YAG (355 nm) lasers with and without a computer controlled water-spray. Optical coherence tomography (OCT) was used to obtain optical cross-sections of each incision to determine the rate of ablation. The peripheral thermal damage zone around each incision was analyzed using PLM and SR-FTIR.

RESULTS

Thermally induced chemical changes to both mineral and the collagen matrix were observed with SR-FTIR with a 10 microm spatial resolution and those changes were correlated with optical changes observed with PLM. Minimal (<10 microm) thermal damage was observed for pulse durations less than the thermal relaxation time (Tr) of the deposited laser energy, with and without applied water at 9.6 microm and with only applied water at 2.79 microm. For pulse durations greater than Tr, greater peripheral thermal damage was observed for both IR laser wavelengths with and without the water-spray. There was minimal thermal damage for 355 nm laser pulses less than Tr with and without applied water; however, extensive mechanical damage (cracks) was observed.

CONCLUSIONS

High resolution SR-FTIR is well suited for characterization of the chemical changes that occur due to thermal damage peripheral to laser incisions in proteinaceous hard tissues. Sub-microsecond pulsed IR lasers resonant with water and mineral absorption bands ablate dentin efficiently with minimal thermal damage. Similar laser parameters are expected to apply to the ablation of alveolar bone.

Variables affecting polarization-sensitive optical coherence tomography imaging examined through the modeling of birefringent phantoms

Characteristics of tissue birefringence provide valuable diagnostic information when optical coherence tomography (OCT) imaging is performed. We mathematically model single-detector polarization-sensitive (PS) OCT (PS-OCT) for imaging an alternating layered phantom with birefringence. The theoretical analysis and the simulated data all reveal complexities associated with PS-OCT imaging. Various tissue parameters affect the retrieved PS-OCT signal and hence the image features. A better understanding of the mechanisms that control PS-OCT imaging would be useful for interpretation of tissue images and ultimately useful to provide more diagnostic information.

Selective removal of composite sealants with near-ultraviolet laser pulses of nanosecond duration

It is often necessary to replace pit and fissure sealants and composite restorations. This task is complicated by the necessity for complete removal of the remaining composite to enable suitable adhesion of new composite. Previous studies have shown that 355-nm laser pulses from a frequency-tripled Nd:YAG laser can selectively remove residual composite after orthodontic bracket removal on enamel surfaces. Our objective is to determine if such laser pulses are suitable for selective removal of composite pit and fissure sealants and restorations. Optical coherence tomography is used to acquire optical cross sections of the occlusal topography nondestructively before sealant application, after sealant application, and after sealant removal. Thermocouples are used to monitor the temperature in the pulp chamber during composite removal under clinically relevant ablation rates, i.e., 30 Hz and 30 mJ/pulse. At an irradiation intensity of 1.3 J/cm2, pit and fissure sealants are completely removed without visible damage to the underlying enamel. At intensities above 1.5 J/cm2, incident laser pulses remove the resin layer while at the same time preferentially etching the surface of the enamel. Temperature excursions in the pulp chamber of extracted teeth are limited to less than 5 degrees C if air-cooling is used during the rapid removal (1 to 2 min) of sealants, water-cooling is not necessary. Selective removal of composite restorative materials is possible without damage to the underlying sound tooth structure.

Influence of an optically thick water layer on the bond-strength of composite resin to dental enamel after IR laser ablation

BACKGROUND AND OBJECTIVES

Several studies of hard tissue ablation with Er:YAG lasers have shown that the addition of an optically thick water layer ( approximately 1 mm) added to the surface of dental enamel before each incident laser pulse, profoundly influences the rate and efficiency of ablation and the resulting surface morphology. The objective of this study was the determination of laser parameters which result in clinically useful bond strengths without the need for phosphoric acid etching. The hypothesis to be tested was that laser irradiation through a relatively thick layer of water would result in a surface to which composite could be bonded with bond strength similar to surfaces etched with phosphoric acid. This hypothesis is predicated on the assumption that the water prevents the formation of non-apatite calcium phosphate phases on the enamel surface.

MATERIALS AND METHODS

In this study, a calibrated syringe pump and a motion control system were used to uniformly treat flat enamel surfaces using free-running Er:YAG laser pulses with and without water, and 9.6 mum CO(2) laser pulses on a dry surface for comparison. The rate of water delivery that resulted in the most efficient ablation was determined by profiling the resulting laser incisions using optical coherence tomography. In addition, enamel surfaces of 5 x 5 mm(2) were uniformly treated and the resulting surface morphology was examined using synchrotron radiation-fourier transform infrared spectroscopy (SR-FTIR), and optical and electron microscopy. The influence of the modified surface morphology on the adhesion of composite resin was investigated.

RESULTS

The shear-bond strength of composite bonded to enamel surfaces irradiated at intensities clinically relevant for caries removal approached values measured for conventional acid etching when the water delivery rate was optimized.

CONCLUSIONS

This study demonstrates that composite restorative materials can be directly bonded to laser prepared surfaces without the necessity of further surface preparation and acid etching and that the addition of a thick water layer ( approximately 1 mm) prevents the formation of undesirable CaP phases that compromise adhesion to restorative materials. 2003.

Correlation of quantitative light-induced fluorescence and optical coherence tomography applied for detection and quantification of early dental caries

Fluorescence loss in enamel following demineralization has been correlated with the amount of mineral lost during the demineralization. The correlation between fluorescence loss measured by quantitative light-induced fluorescence (QLF) and the reflectivity loss measured by a versatile en face optical coherence tomography (OCT) system was investigated in a demineralization process to produce artificial dental caries. We used an OCT system that can collect A-scans (reflectivity versus depth), B-scans (longitudinal images), and C-scans (en face images). The power to the sample was 250 microW, the wavelength lambda = 850 nm, and the depth resolution in air 16 microm. A-scans, which show the profile of the reflectivity versus the depth of penetration into the tooth tissue, were used for quantitative analysis of the reflectivity loss. The results have shown that both the fluorescence radiance and reflectivity of the enamel decrease with increasing de- mineralization time. A linear correlation was observed between the percentage of fluorescence loss measured by QLF and the percentage of reflectivity loss measured by OCT. It was concluded that the decrease in reflectivity of the enamel during demineralization, measured by OCT, could be related to the amount of mineral lost during the de- mineralization process.

Real-time multi-functional optical coherence tomography

We demonstrate real-time acquisition, processing, and display of tissue structure, birefringence, and blood flow in a multi-functional optical coherence tomography (MF-OCT) system. This is accomplished by efficient data processing of the phase-resolved inteference patterns without dedicated hardware or extensive modification to the high-speed fiber-based OCT system. The system acquires images of 2048 depth scans per second, covering an area of 5 mm in width x 1.2 mm in depth with real-time display updating images in a rolling manner 32 times each second. We present a video of the system display as images from the proximal nail fold of a human volunteer are taken.