de Oliveira Mota Cláudia Cristina Brainer, Gueiros Luiz Alcino, Maia Ana Marly Araújo, Santos-Silva Alan Roger, Gomes Anderson Stevens Leonidas, Alves Fábio de Abreu, Leão Jair Carneiro, de Freitas Anderson Zanardi, Goes Mário, Lopes Márcio Ajudarte
Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife-PE, Brazil.
Photomed Laser Surg. 2013 Jul;31(7):301-6. doi: 10.1089/pho.2012.3415.
The aim of this study was to evaluate the morphological alterations of radiation-related caries using optical coherence tomography.
Thirty-six extracted teeth from 11 patients who had undergone radiotherapy were sectioned in the sagittal axis in the center of the carious lesion, and 100 μm thick sections were obtained from each specimen. One sample from each tooth was investigated by an optical coherence tomography (OCT) system, and the results were compared with histological images from polarized light microscopy.
In OCT dentin caries images, the demineralized area appeared as a white region, whereas the translucent zone appeared as a dark area, a similar pattern also seen in coronal caries. In noncavitated enamel lesions clinically observed as brown discoloration, the area of high porosity, and also the dark color, absorbs part of the light, resulting in a dark pattern. Finally, the involvement of dentin-enamel junction (DEJ) or cement-enamel junction (CEJ) could be clearly observed, when present and marked alterations along the CEJ could be noted, as junction continuity loss, gap formation, and mineral loss tissue.
The OCT technique was able to characterize radiation-related caries, from a morphological point of view. Also demonstrated was its potential benefit for use in the clinical monitoring of radiation-related carious process.
本研究旨在利用光学相干断层扫描技术评估放射性龋齿的形态学改变。
对11例接受过放射治疗患者的36颗离体牙在龋损中心矢状轴方向进行切片，从每个标本获取100μm厚的切片。每颗牙齿的一个样本通过光学相干断层扫描（OCT）系统进行研究，并将结果与偏振光显微镜下的组织学图像进行比较。
在OCT牙本质龋图像中，脱矿区域呈现为白色区域，而透明带呈现为黑色区域，这与冠部龋的模式相似。在临床上观察为褐色变色的非龋性釉质病变中，高孔隙率区域以及深色区域吸收部分光线，导致出现黑色模式。最后，当存在牙本质-釉质界（DEJ）或牙骨质-釉质界（CEJ）受累时，可以清晰观察到沿CEJ的明显改变，如界连续性丧失、间隙形成和矿物质丢失组织。
从形态学角度来看，OCT技术能够对放射性龋齿进行特征性描述。同时还证明了其在放射性龋病过程临床监测中的潜在应用价值。
