Zhu Yihua, Ng Chung, Le Oanh, Ho Yi-Ching, Fried Daniel
Department of Preventive and Restorative Dental Sciences, University of California, 707 Parnassus Ave, San Francisco, CA 94143, USA.
Department of Stomatology, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
Diagnostics (Basel). 2023 Aug 31;13(17):2824. doi: 10.3390/diagnostics13172824.
The aim of this clinical study was to compare the diagnostic performance of dual short wavelength infrared (SWIR) occlusal transillumination and reflectance multispectral imaging with conventional visual assessment and radiography for caries detection on premolars scheduled for extraction for orthodontics reasons. Polarized light microscopy (PLM) and micro-computed tomography (microCT) performed after tooth extraction were used as gold standards. The custom-fabricated imaging probe was 3D-printed and the imaging system employed a SWIR camera and fiber-optic light sources emitting light at 1300 nm for occlusal transillumination and 1600 nm for reflectance measurements. Teeth (n = 135) on 40 test subjects were imaged in vivo using the SWIR imaging prototype in the study and teeth were extracted after imaging. Our study demonstrates for the first time that near-simultaneous real-time transillumination and reflectance video can be successfully acquired for caries detection. Both SWIR imaging modalities had markedly higher sensitivity for lesions on proximal and occlusal surfaces compared to conventional methods (visual and radiographic). Reflectance imaging at 1600 nm had higher sensitivity and specificity than transillumination at 1300 nm. The combined SWIR methods yielded higher specificity but the combined sensitivity was lower than for each individual method.
本临床研究的目的是比较双短波长红外（SWIR）咬合透照和反射多光谱成像与传统视觉评估及X线摄影在因正畸原因计划拔除的前磨牙龋病检测中的诊断性能。拔牙后进行的偏光显微镜（PLM）和显微计算机断层扫描（microCT）被用作金标准。定制的成像探头采用3D打印，成像系统使用一台SWIR相机和光纤光源，其中1300 nm波长的光用于咬合透照，1600 nm波长的光用于反射测量。在本研究中，使用SWIR成像原型对40名受试对象的135颗牙齿进行了活体成像，并在成像后拔牙。我们的研究首次证明，可成功获取近同步实时透照和反射视频用于龋病检测。与传统方法（视觉和X线摄影）相比，两种SWIR成像模式对邻面和咬合面病变的敏感性均显著更高。1600 nm的反射成像比1300 nm的透照具有更高的敏感性和特异性。联合使用SWIR方法可产生更高的特异性，但联合敏感性低于每种单独方法。
