title: Multispectral near-IR reflectance imaging of simulated early occlusal lesions: variation of lesion contrast with lesion depth and severity.
abstract: OBJECTIVE
  Early demineralization appears with high contrast at near-IR wavelengths due to a 10- to 20-fold difference in the magnitude of light scattering between sound and demineralized enamel. Water absorption in the near-IR has a significant effect on the lesion contrast and the highest contrast has been measured in spectral regions with higher water absorption. The purpose of this study was to determine how the lesion contrast changes with lesion severity and depth for different spectral regions in the near-IR and compare that range of contrast with visible reflectance and fluorescence.
  
  
  METHODS
  Forty-four human molars were used in this in vitro study. Teeth were painted with an acid-resistant varnish, leaving a 4 mm × 4 mm window on the occlusal surface of each tooth exposed for demineralization. Artificial lesions were produced in the unprotected windows after 12-48 hours exposure to a demineralizing solution at pH 4.5. Near-IR reflectance images were acquired over several near-IR spectral distributions, visible light reflectance, and fluorescence with 405-nm excitation and detection at wavelengths >500-nm. Crossed polarizers were used for reflectance measurements to reduce interference from specular reflectance. Cross polarization optical coherence tomography (CP-OCT) was used to non-destructively assess the depth and severity of demineralization in each sample window. Matching two-dimensional CP-OCT images of the lesion depth and integrated reflectivity were compared with the reflectance and fluorescence images to determine how accurately the variation in the lesion contrast represents the variation in the lesion severity.
  
  
  RESULTS
  Artificial lesions appear more uniform on tooth surfaces exposed to an acid challenge at visible wavelengths than they do in the near-IR. Measurements of the lesion depth and severity using CP-OCT show that the lesion severity varies markedly across the sample windows and that the lesion contrast in the visible does not accurately reflect the large variation in the lesion severity. Reflectance measurements at certain near-IR wavelengths more accurately reflect variation in the depth and severity of the lesions.
  
  
  CONCLUSIONS
  The results of the study suggest that near-IR reflectance measurements at longer wavelengths coincident with higher water absorption are better suited for imaging early caries lesions.
authors.affiliation: Department of Preventive and Restorative Dental Sciences, University of California, San Francisco.
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Simon
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Chan
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Darling
authors.forename: Daniel
authors.initials: D
authors.lastname: Fried
mesh_terms: D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D066298:In Vitro Techniques; D008963:Molar; D061848:Optical Imaging / Q000379:methods*; D013050:Spectrometry, Fluorescence; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D041623:Tomography, Optical Coherence; D017001:Tooth Demineralization / Q000175:diagnosis*
keywords: demineralization; dental caries; enamel; near-IR imaging; polarization