title: Validation of swept source optical coherence tomography (SS-OCT) for the diagnosis of smooth surface caries in vitro.
abstract: OBJECTIVE
  An accurate evaluation of the extent of dental caries and possible progress of the lesion from enamel into dentin is very important in clinical dentistry. Dentists need an imaging technology that can noninvasively and reliably quantify the extent of caries. This study aimed to evaluate the effectiveness of non-polarized swept source optical coherence tomography (OCT) in evaluating the extent of caries on smooth enamel surfaces.
  
  
  METHODS
  One-hundred and twenty-seven investigation sites on the enamel surfaces of 93 extracted teeth were selected randomly and examined visually. The presence and extent of caries were scored by experienced and inexperienced dentists using each observation method (0: no caries; 1: enamel demineralization without surface breakdown; 2: enamel breakdown due to caries; 3: deep caries involving the dentin). The same locations were then examined using OCT, following which the teeth were sectioned using a diamond saw and viewed directly under a confocal laser scanning microscope (CLSM). Sensitivity and specificity indices for OCT and VI were calculated and compared. The results were analysed statistically using receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  Enamel and dentin caries were outlined by a visible boundary on the cross-sectional OCT images. The modality showed superior results for the detection of dentinal caries; higher sensitivity and Az values could be obtained in the ROC curves, especially by experienced dentists.
  
  
  CONCLUSIONS
  Cross-sectional imaging of the natural caries lesions on smooth enamel surface by OCT enables efficient diagnosis of the lesion type, extent and dentin involvement.
  
  
  CONCLUSIONS
  SS-OCT can demonstrate the cross-sectional image of smooth surface enamel caries as highlighted zone in tomogram. It is crucial to determine the extent of the lesion, whether it reaches beyond DEJ or not by a non-invasive and safe technique. OCT can give clinicians information about internal tooth structure and will help clinical decision making on surgical intervention.
authors.affiliation: Cariology and Operative Dentistry, Oral Restitution Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
authors.forename: Hisaichi
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Alireza
authors.initials: A
authors.lastname: Sadr
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shimada
authors.forename: Junji
authors.initials: J
authors.lastname: Tagami
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Sumi
mesh_terms: D019412:Anatomy, Cross-Sectional / Q000706:statistics & numerical data; D003731:Dental Caries / Q000175:diagnosis* / Q000473:pathology; D003743:Dental Enamel / Q000473:pathology*; D003804:Dentin / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D007834:Lasers; D018613:Microscopy, Confocal / Q000706:statistics & numerical data; D010808:Physical Examination; D012372:ROC Curve; D012542:Scattering, Radiation; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000706:statistics & numerical data*; D017001:Tooth Demineralization / Q000175:diagnosis / Q000473:pathology; D014075:Tooth Discoloration / Q000175:diagnosis