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Guo Y, Huang Y, Huang C, Sun X, Luan Q, Zhang L. Non-invasive assessment of periodontal inflammation by continuum-removal hemodynamic spectral indices. Eur J Med Res 2024; 29:193. [PMID: 38528571 DOI: 10.1186/s40001-024-01748-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/26/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Hyperspectral techniques have aroused great interest in non-invasively measuring periodontal tissue hemodynamics. However, current studies mainly focused on three typical inflammation stages (healthy, gingivitis and periodontitis) and practical approaches for using optical spectroscopy for early and precisely detection of periodontal inflammation at finer disease stages have not been well studied. METHODS This study provided novel spectroscopic insights into periodontitis at different stages of disease, and developed six simple but physically meaning hemodynamic spectral indices (HSIs) including four spectral absorption depths of oxyhemoglobin ( D HbO 2 ), deoxyhemoglobin ( D Hb ), total hemoglobin ( t Hb ) and tissue water ( D water ), and two normalized difference indices of oxyhemoglobin( N D HbO 2 I ) and deoxyhemoglobin ( N D Hb I ) from continuum-removal spectra (400-1700 nm) of periodontal tissue collected from 47 systemically healthy subjects over different severities from healthy, gingivitis, slight, moderate to severe periodontitis for early and precision diagnostics of periodontitis. Typical statistical analyses were conducted to explore the effectiveness of the proposed HSIs. RESULTS D Hb and t Hb exerted significant increasing trends as inflammation progressed, whereas D HbO 2 exhibited significant difference (P < 0.05) from the healthy sites only at moderate and severe periodontitis and D water presented unstable sensitives to disease severity. By contrast, N D HbO 2 I and N D Hb I showed more steadily downward trends as severity increased, and demonstrated the highest correlations with clinical gold standard parameters. Particularly, the proposed normalized HSIs ( N D HbO 2 I and N D Hb I ) yielded high correlations of - 0.49 and - 0.44 with probing depth, respectively, far outperforming results achieved by previous studies. The performances of the HSIs were also confirmed using the periodontal therapy group. CONCLUSIONS These results indicated great potentials of combination optical spectroscopy and smart devices to non-invasively probe periodontitis at earlier stages using the simple and practical HSIs. Trial registration This study was retrospectively registered in the Chinese Clinical Trial Registry on October 24, 2021, and the clinical registration number is ChiCTR2100052306.
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Affiliation(s)
- Yuan Guo
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
- Second Dental Center, School and Hospital of Stomatology, Peking University, Beijing, 100081, China
| | - Yixiang Huang
- Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, 100094, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Changping Huang
- Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, 100094, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xuejian Sun
- Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, 100094, China
| | - Qingxian Luan
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China.
| | - Lifu Zhang
- Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, 100094, China.
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Duarte PM, Sowa MG, Xiang X, Zhang C, Santos VR, Miranda TS, Reis AF, Liu KZ. Assessment of the hemodynamic profile in periodontal tissues of diabetic subjects with periodontitis by optical spectroscopy. J Periodontal Res 2014; 50:594-601. [PMID: 25369875 DOI: 10.1111/jre.12239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The influence of diabetes mellitus (DM) on the hemodynamics of periodontal tissues has not been assessed previously. The primary objective of this study was to validate optical spectroscopy as a periodontal diagnostic tool for subjects with type 2 DM and chronic periodontitis. MATERIAL AND METHODS Using a portable optical near-infrared spectrometer, optical spectra were obtained from healthy (n = 127), gingivitis (n = 115), and periodontitis (n = 109) sites of 65 subjects with type 2 DM and chronic periodontitis. Healthy (n = 65) sites of 15 nondiabetic subjects without periodontitis were used as controls. A modified Beer-Lambert unmixing model that incorporates a nonparametric scattering-loss function was used to determine the relative contribution of deoxygenated hemoglobin and oxygenated hemoglobin (HbO2 ) to the overall spectrum. The balance between tissue oxygen delivery and oxygen utilization in periodontal tissues was assessed. RESULTS In diabetic subjects, tissue oxygen saturation and HbO2 concentration were significantly decreased in the periodontitis sites (p < 0.01) compared with the healthy and gingivitis sites. Furthermore, tissue oxygenation in healthy sites of control subjects was significantly higher than that in sites of diabetic subjects (p < 0.01). CONCLUSION In summary, the results of this study suggest that optical spectroscopy can monitor the hemodynamic profile in diabetic subjects with chronic periodontitis. Furthermore, healthy sites of diabetic subjects presented lower tissue oxygenation than did those of nondiabetic subjects.
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Affiliation(s)
- P M Duarte
- Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil
| | - M G Sowa
- Medical Devices Portfolio, National Research Council of Canada, Winnipeg, Manitoba, Canada
| | - X Xiang
- Department of Dental Diagnostics and Surgical Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - C Zhang
- The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China
| | - V R Santos
- Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil
| | - T S Miranda
- Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil
| | - A F Reis
- Dental Research Division, Department of Operative Dentistry, Guarulhos University, Guarulhos, SP, Brazil
| | - K-Z Liu
- Medical Devices Portfolio, National Research Council of Canada, Winnipeg, Manitoba, Canada.,Department of Dental Diagnostics and Surgical Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Zhang C, Xiang X, Xu M, Fan C, Sowa MG, Liu KZ. Assessment of tissue oxygenation of periodontal inflammation in patients with coronary artery diseases using optical spectroscopy. BMC Oral Health 2014; 14:25. [PMID: 24666796 PMCID: PMC3987688 DOI: 10.1186/1472-6831-14-25] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 03/19/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We have recently developed a non-invasive periodontal diagnostic tool that was validated in periodontitis patients without systemic disorders like coronary artery disease (CAD). The purpose of present study is to verify whether this optical instrument can also be used in periodontitis patients with CAD. METHODS A total of 62 periodontitis patients with CAD were recruited along with a control group consisting of 59 age and gender matched periodontitis volunteers without systemic disorders. Using a portable optical near-infrared spectrometer, optical spectra were obtained, processed and evaluated from the two groups. A modified Beer-Lambert unmixing model that incorporates a nonparametric scattering loss function was used to determine the relative contribution of deoxygenated hemoglobin (Hb) and oxygenated hemoglobin (HbO2) to the overall spectrum. The balance between tissue oxygen delivery and utilization in periodontal tissues was then assessed. RESULTS Tissue oxygen saturation was significantly decreased in the periodontitis sites (p < 0.01), compared to the healthy sites in those individuals with CAD. There was a trend towards increased concentration of Hb and decreased concentration of HbO2 from healthy to diseased sites, without statistical significance (p > 0.05). No statistical differences were found in tissue oxygen saturation between the CAD and control groups either in periodontal healthy or inflammatory sites. CONCLUSION This study supports the hypothesis that optical spectroscopy can determine the periodontal inflammation in patients with certain systemic disorders like CAD. And the overall periodontal oxygenation profiles in CAD patients resemble those in non-CAD individuals either in healthy or inflammatory sites.
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Affiliation(s)
| | | | | | | | | | - Kan-Zhi Liu
- Medical Devices Portfolio, National Research Council of Canada, 435 Ellice Ave,, Winnipeg, MB R3B 1Y6, Canada.
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Liu KZ, Duarte PM, Santos VR, Xiang X, Xu M, Miranda TS, Fermiano D, Gonçalves TED, Sowa MG. Assessment of tissue oxygenation of periodontal inflammation in smokers using optical spectroscopy. J Clin Periodontol 2014; 41:340-7. [DOI: 10.1111/jcpe.12225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Kan-Zhi Liu
- Medical Devices Portfolio; National Research Council of Canada; Winnipeg Canada
- Department of Dental Diagnostics and Surgical Sciences; University of Manitoba; Winnipeg Canada
| | - Poliana Mendes Duarte
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos Brazil
| | - Vanessa Renata Santos
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos Brazil
| | - Xiaoming Xiang
- Department of Dental Diagnostics and Surgical Sciences; University of Manitoba; Winnipeg Canada
| | - Minqi Xu
- Medical Devices Portfolio; National Research Council of Canada; Winnipeg Canada
| | | | - Daiane Fermiano
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos Brazil
| | | | - Micheal G. Sowa
- Medical Devices Portfolio; National Research Council of Canada; Winnipeg Canada
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Sekhar PC, Betsy J, Presanthila J, Subhash N. Discrimination of periodontal diseases using diffuse reflectance spectral intensity ratios. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:027001. [PMID: 22463048 DOI: 10.1117/1.jbo.17.2.027001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This clinical study was to demonstrate the applicability of diffuse reflectance (DR) intensity ratio R620/R575 in the quantification and discrimination of periodontitis and gingivitis from healthy gingiva. DR spectral measurements were carried out with white-light illumination from 70 healthy sites in 30 healthy volunteers, and 63 gingivitis- and 58 periodontitis-infected sites in 60 patients. Clinical parameters such as probing pocket depth, clinical attachment level, and gingival index were recorded in patient population. Diagnostic accuracies for discrimination of gingivitis and periodontitis from healthy gingiva were determined by comparison of spectral signatures with clinical parameters. Divergence of average DR spectral intensity ratio between control and test groups was studied using analysis of variance. The mean DR spectrum on normalization at 620 nm showed marked differences between healthy tissue, gingivitis, and periodontitis. Hemoglobin concentration and apparent SO(2) (oxygen saturation) were also calculated for healthy, gingivitis, and periodontitis sites. DR spectral intensities at 545 and 575 nm showed a decreasing trend with progression of disease. Among the various DR intensity ratios studied, the R620/R575 ratio provided a sensitivity of 90% and specificity of 94% for discrimination of healthy tissues from gingivitis and a sensitivity of 91% and specificity of 100% for discrimination of gingivitis from periodontitis.
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Affiliation(s)
- Prasanth Chandra Sekhar
- Centre for Earth Science Studies, Biophotonics Laboratory, P. O. Box 7250, Thiruvananthapuram 695031, Kerala, India
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Xiang X, Sowa MG, Iacopino AM, Maev RG, Hewko MD, Man A, Liu KZ. An update on novel non-invasive approaches for periodontal diagnosis. J Periodontol 2010; 81:186-98. [PMID: 20151796 DOI: 10.1902/jop.2009.090419] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
For decades there has been an ongoing search for clinically acceptable methods for the accurate, non-invasive diagnosis and prognosis of periodontitis. There are several well-known inherent drawbacks with current clinical procedures. The purpose of this review is to summarize some of the newly emerging diagnostic approaches, namely, infrared spectroscopy, optical coherence tomography (OCT), and ultrasound. The history and attractive features of these new approaches are briefly illustrated, and the interesting and significant inventions related to dental applications are discussed. The particularly attractive aspects for the dental community are that some of these methods are totally non-invasive, do not impose any discomforts to the patients during the procedure, and require no tissue to be extracted. For instance, multiple inflammatory indices withdrawn from near infrared spectra have the potential to identify early signs of inflammation leading to tissue breakdown. Morphologically, some other non-invasive imaging modalities, such as OCT and ultrasound, could be employed to accurately measure probing depths and assess the status of periodontal attachment, the front-line of disease progression. Given that these methods reflect a completely different assessment of periodontal inflammation, if clinically validated, these methods could either replace traditional clinical examinations for the diagnosis of periodontitis or at least serve as attractive complementary diagnostic tools. However, the potential of these techniques should be interpreted more cautiously given the multifactorial character of periodontal disease. In addition to these novel tools in the field of periodontal inflammatory diseases, other alternative modalities like microbiologic and genetic approaches are only briefly mentioned in this review because they have been thoroughly discussed in other comprehensive reviews.
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Affiliation(s)
- Xiaoming Xiang
- Institute for Biodiagnostics, National Research Council of Canada, Winnipeg, MB
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Liu KZ, Xiang XM, Man A, Sowa MG, Cholakis A, Ghiabi E, Singer DL, Scott DA. In vivo determination of multiple indices of periodontal inflammation by optical spectroscopy. J Periodontal Res 2008; 44:117-24. [PMID: 18973538 DOI: 10.1111/j.1600-0765.2008.01112.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE Visible, near-infrared (optical) spectroscopy can be used to measure regional tissue hemodynamics and edema and therefore may represent an ideal tool with which to study periodontal inflammation in a noninvasive manner. The study objective was to evaluate the ability of optical spectroscopy to determine simultaneously multiple inflammatory indices (tissue oxygenation, total tissue hemoglobin, deoxyhemoglobin, oxygenated hemoglobin and tissue edema) in periodontal tissues in vivo. MATERIAL AND METHODS Spectra were obtained, processed and evaluated from healthy, gingivitis and periodontitis sites (n = 133) using a portable optical, near-infrared spectrometer. A modified Beer-Lambert unmixing model that incorporates a nonparametric scattering loss function was used to determine the relative contribution of each inflammatory component to the overall spectrum. RESULTS Optical spectroscopy was harnessed to generate complex inflammatory profiles of periodontal tissues. Tissue oxygenation at periodontitis sites was significantly decreased (p < 0.05) compared to sites with gingivitis and healthy controls. This was largely the result of an increase in deoxyhemoglobin in the periodontitis sites compared with healthy (p < 0.01) and gingivitis (p = 0.05) sites. Tissue water content per se showed no significant difference between the sites, but a water index associated with tissue electrolyte levels and temperature differed significantly between periodontitis sites and both healthy and gingivitis sites (p < 0.03). CONCLUSION This study established that optical spectroscopy can simultaneously determine multiple inflammatory indices directly in the periodontal tissues in vivo. Visible, near-infrared spectroscopy has the potential to be developed into a simple, reagent-free, user-friendly, chairside, site-specific, diagnostic and prognostic test for periodontitis.
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Affiliation(s)
- K Z Liu
- Institute for Biodiagnostics, National Research Council of Canada, Winnipeg, MB, Canada.
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