title: Validation of swept-source optical coherence tomography (SS-OCT) for the diagnosis of occlusal caries.
abstract: OBJECTIVE
  In this laboratory study, we examined the use of a swept-source optical coherence tomography (SS-OCT) as a diagnostic tool for occlusal caries.
  
  
  METHODS
  One-hundred and eleven investigation sites of occlusal fissures were selected from 62 extracted teeth and examined visually using conventional dental equipment without any magnification. SS-OCT observations were carried out on the same locations as where the conventional examination had been performed. The teeth were then sectioned using a diamond saw and directly viewed under a confocal laser scanning microscope (CLSM). Presence and extent of caries was scored in each observation and the obtained results from SS-OCT and conventional visual inspection were compared with the CLSM. The reproducibility and indices of sensitivity and specificity of SS-OCT were calculated and compared with those of the visual inspection. The results were statistically analyzed using receiver operating characteristic (ROC) curve and Spearman rank correlation test.
  
  
  RESULTS
  SS-OCT could clearly detect the presence of enamel demineralization lesion in a tomography image synthesized based on the backscatter signal (sensitivity=0.98). Although the sensitivity for dentine caries of SS-OCT was over that of the visual inspection, the detection level was decreased to 0.60. When the methods were compared to the CLSM, the diagnostic accuracy of SS-OCT was better than that of the conventional visual inspection (Az values of visual inspection and SS-OCT, 0.74 versus 0.86 for enamel demineralization, 0.68 versus 0.80 for dentine caries; Spearman's correlation coefficients to CLSM; visual inspection: 0.665, SS-OCT: 0.824).
  
  
  CONCLUSIONS
  The carious demineralization, especially in enamel, can be clearly discriminated as a highlighted area due to scattering of light matches the location of demineralized area at the base of the fissure and the results correlated well with the CLSM.
authors.affiliation: Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549, Japan. shimada.ope@tmd.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shimada
authors.forename: Alireza
authors.initials: A
authors.lastname: Sadr
authors.forename: Michael F
authors.initials: MF
authors.lastname: Burrow
authors.forename: Junji
authors.initials: J
authors.lastname: Tagami
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Ozawa
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Sumi
mesh_terms: D003731:Dental Caries / Q000175:diagnosis*; D006801:Humans; D018613:Microscopy, Confocal; D015588:Observer Variation; D015203:Reproducibility of Results; D012542:Scattering, Radiation; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D041623:Tomography, Optical Coherence / Q000379:methods*