This PDF file contains the front matter associated with SPIE Proceedings Volume 8208, including the Title Page, Copyright information, Table of Contents, and the Conference Committee listing.

Frequent monitoring of gingival sulcus will provide valuable information for judging the presence and severity of periodontal disease. Optical coherence tomography, as a 3D high resolution high speed imaging modality is able to provide information for pocket depth, gum contour, gum texture, gum recession simultaneously. A handheld forward-viewing miniature resonant fiber-scanning probe was developed for in-vivo gingival sulcus imaging. The fiber cantilever driven by magnetic force vibrates at resonant frequency. A synchronized linear phase-modulation was applied in the reference arm by the galvanometer-driven reference mirror. Full-range, complex-conjugate-free, real-time endoscopic SD-OCT was achieved by accelerating the data process using graphics processing unit. Preliminary results showed a real-time in-vivo imaging at 33 fps with an imaging range of lateral 2 mm by depth 3 mm. Gap between the tooth and gum area was clearly visualized. Further quantification analysis of the gingival sulcus will be performed on the image acquired.

The purpose of this study was to evaluate the shear bond strength of a self-etch adhesive to caries-affected dentin after caries removal by erbium: yttrium, aluminum garnet (Er:YAG) laser and analyze the resin-dentin interface. The caries-infected dentin of human molars were removed by Er:YAG laser with energy density of 20 J/cm² and pulse repetition rate of 20 Hz. The conventional bur was used as control group. After bonding procedures, specimens were subjected to shear bond strength test and the adhesive interface was examined by laser confocal scanning microscope (LCSM). The result showed that Er:YAG laser could effectively remove dentin caries. There was no statistical difference in shear bond strength between two groups and the adhesive interface created on laser-irradiated dentin surface presented similar feature to that on bur-ground surface.

Objectives: Formation of microgaps under the composite restorations due to polymerization stress and other causes compromise the adhesion to the dental substrate and restoration durability. However, the relationship between cavity adaptation and bond strength is not clear. In this paper, we introduce a new testing method to assess cavity adaptation by swept-source optical coherence tomography (SS-OCT) and microtensile bond strength (MTBS) in the same class-I cavity. Methods: Round class-I cavities 3 mm in diameter and 1.5 mm in depth were prepared on 10 human premolars. After application of Tokuyama Bond Force adhesive, the cavities were filled by one of the two techniques; incremental technique using Estelite Sigma Quick universal composite or flowable lining using Palfique Estelite LV with bulk filling using the universal composite. Ten serial B-scan images were obtained throughout each cavity by SS-OCT. Significant peaks in the signal intensity were detected at the bonded interface of the cavity floor and to compare the different filling techniques. The specimens were later cut into beams (0.7x0.7 mm) and tested to measure MTBS at the cavity floor. Results: Flowable lining followed by bulk filling was inferior in terms of cavity adaptation and MTBS compared to the incremental technique (p<0.05, t-test). The adaptation (gap free cavity floor) and MTBS followed similar trends in both groups. Conclusion: Quantitative assessment of dental restorations by OCT can provide additional information on the performance and effectiveness of dental composites and restoration techniques. This study was supported by Global Center of Excellence, Tokyo Medical and Dental University and King Abdulaziz University.

A cross-polarization 1310-nm optical coherence tomography system (CP-OCT), using a beam splitter based design, was used to assess ex vivo growth of complex multi-species dental biofilms. These biofilm microcosms were derived from plaque samples along the interface of composite or amalgam restoration in children with a history of early childhood caries. This paper presents a method of measuring the mean biofilm height of mature biofilms using CP-OCT. For our in vivo application, the novel swept source based CP-OCT intraoral probe (Santec Co. Komaki, Japan) dimensions and system image acquisition speed (20 image frames/second) allowed imaging pediatric subjects as young as 4 years old. The subsurface enamel under the interface of composite resin restorations of pediatric subjects were imaged using CP-OCT. Cavitated secondary caries is clearly evident from sound resin composite restorations.

The exposition of nanoparticles caused by laser application in dental health care is an open discussion. Based on the fact that nanoparticles can penetrate through the mucosa, the knowledge about particle characteristics after irradiation with an USPL is of high importance. Therefore, the aim of this study was to investigate the particle characteristics, especially the size of the ablated debris after USPL irradiation. The irradiation was carried out with an USP Nd:YVO₄ laser with a center wavelength of 1064 nm. Based on the pulse duration of 8 ps and a pulse repetition rate of 500 kHz the laser emits an average power of 9 W. The materials investigated were dental tissues and dental restorative materials (composite and amalgam), ceramic and different metals (gold and aluminium). The samples were irradiated with a power density in the order of 300 GW/cm² at distances of 5, 10, 15, and 20 mm. The debris was collected on an object plate. SEM pictures were used for analysis of the ablation debris. Depending on the irradiated material, we observed different kinds of structures: vitreous, flocculent, and pellet-like. The mean particle sizes were 10 x 10 up to 30 x 30 μm². In addition, a cluster of ablated matter (nanometer range) distributed over the whole irradiated area was found. With increasing distances the cluster structure reduced from multi-layer to mono-layer clusters. Particle sizes in the micrometer and nanometer range were found after irradiation with an USPL. The nanoparticles create a cluster structure which is influenced by increasing distances.

Distributed-feedback gallium-arsenide-based lasers with metal-gratings can generate stable wavelength at 980nm for applications in dentistry. This model uses the periodic optical waveguide method to calculate the coupling coefficient, which is a key parameter of laser performance. This model shows how the optical, geometrical, and material parameters depending on each other and how they affect the coupling coefficients in the laser waveguides. Numerical results compare the coupling coefficients of 980 nm lasers with those of 810 nm lasers. The modeling processes, including results, discussions, and physical interpretations, help to design and analyze lasers for more clinical and research applications in dentistry.

The successful clinical application of the Er:YAG-laser in dentistry is well known, documented by numerous published studies. These lasers are flash lamp pumped systems and emit pulses of typically some 100 μs duration with energies of up to 1 J. Pulse repetition rates can reach up to 100Hz, and mean powers are up to about 8W. As an alternative to these laser systems recently a novel diode pumped Er:YAG laser system (Pantec Engineering AG) became available. This laser can provide a pulse repetition rate up to 2kHz and a mean laser power up to 15W. The aim of the presented study is to investigate the effect of this laser system on dental hard and soft tissue at various irradiation parameters, particular at repetition rates more than 100 Hz. At first an appropriate experimental set-up was realized with a beam delivery and focusing unit, a computer controlled stepper unit with sample holder, and a shutter unit. The stepper unit allows to move the samples (dentin or enamel slides of extracted human teeth, chicken breast, pig bone) with a defined velocity during irradiation by various laser parameters. For rinsing the sample surface a water spray was also included. The laser produced grooves and cuts were analyzed by light microscopy and laser scanning microscopy regarding to the ablation quality, geometry, ablation efficacy, and thermal effects. The grooves in dentin and enamel show a rough surface, typical for Er:YAG laser ablation. The craters are slightly cone shaped with sharp edges on the surface. Water cooling is essential to prevent thermal injury. The ablation efficacy in dentin is comparable to literature values of the flash lamp pumped Er:YAG laser. The cutting of bone and soft tissue is excellent and appears superior to earlier results obtained with flash lamp pumped system. As a further advantage, the broad range of repetition rates allows to widely vary the thermal side effects. In conclusion, these first experiments with a diode pumped Er:YAG laser system on dental hard and soft tissue demonstrate its ability for use in dentistry.

Dental caries is a disease characterized by demineralization of enamel crystals leading to the penetration of bacteria into the dentine and pulp. Early detection of enamel demineralization resulting in increased enamel porosity, commonly known as white spots, is a difficult diagnostic task. Laser induced autofluorescence was shown to be a useful method for early detection of demineralization. The existing studies involved either a single point spectroscopic measurements or imaging at a single spectral band. In the case of spectroscopic measurements, very little or no spatial information is acquired and the measured autofluorescence signal strongly depends on the position and orientation of the probe. On the other hand, single-band spectral imaging can be substantially affected by local spectral artefacts. Such effects can significantly interfere with automated methods for detection of early caries lesions. In contrast, hyperspectral imaging effectively combines the spatial information of imaging methods with the spectral information of spectroscopic methods providing excellent basis for development of robust and reliable algorithms for automated classification and analysis of hard dental tissues. In this paper, we employ 405 nm laser excitation of natural caries lesions. The fluorescence signal is acquired by a state-of-the-art hyperspectral imaging system consisting of a high-resolution acousto-optic tunable filter (AOTF) and a highly sensitive Scientific CMOS camera in the spectral range from 550 nm to 800 nm. The results are compared to the contrast obtained by near-infrared hyperspectral imaging technique employed in the existing studies on early detection of dental caries.

Short-wavelength 405 nm laser illumination of surface dental enamel using an ultrathin scanning fiber endoscope (SFE) produced enhanced detail of dental topography. The surfaces of human extracted teeth and artificial erosions were imaged with 405 nm, 444 nm, 532 nm, or 635 nm illumination lasers. The obtained images were then processed offline to compensate for any differences in the illumination beam diameters between the different lasers. Scattering and absorption coefficients for a Monte Carlo model of light propagation in dental enamel for 405 nm were scaled from published data at 532 nm and 633 nm. The value of the scattering coefficient used in the model was scaled from the coefficients at 532 nm and 633 nm by the inverse third power of wavelength. Simulations showed that the penetration depth of short-wavelength illumination is localized close to the enamel surface, while long-wavelength illumination travels much further and is backscattered from greater depths. Therefore, images obtained using short wavelength laser are not contaminated by the superposition of light reflected from enamel tissue at greater depths. Hence, the SFE with short-wavelength illumination may make it possible to visualize surface manifestations of phenomena such as demineralization, thus better aiding the clinician in the detection of early caries.

Despite major improvements in dental healthcare and oral hygiene, dental caries remains one of the most prevalent oral diseases and represents the primary cause of oral pain and tooth loss. The initial stages of dental caries are characterized by demineralization of enamel crystals and are difficult to diagnose. Near infrared (NIR) hyperspectral imaging is a new promising technique for detection of early changes in the surfaces of carious teeth. This noninvasive imaging technique can characterize and differentiate between the sound tooth surface and initial or advanced tooth caries. The absorbing and scattering properties of dental tissues reflect in distinct spectral features, which can be measured, quantified and used to accurately classify and map different dental tissues. Specular reflections from the tooth surface, which appear as bright spots, mostly located around the edges and the crests of the teeth, act as a noise factor which can significantly interfere with the spectral measurements and analysis of the acquired images, degrading the accuracy of the classification and diagnosis. Employing cross-polarized imaging setup can solve this problem, however has yet to be systematically evaluated, especially in broadband hyperspectral imaging setups. In this paper, we employ cross-polarized illumination setup utilizing state-of-the-art high-contrast broadband wire-grid polarizers in the spectral range from 900 nm to 1700 nm for hyperspectral imaging of natural and artificial carious lesions of various degrees.

We previously demonstrated that a swept-source optical coherence tomography system (SS-OCT) without polarization-sensing could quantitatively estimate the progress of cavitated dentin lesions in vitro. The purpose of the current study was to investigate the ability to estimate the lesion development in non-cavitated dentin lesions with a surface layer. Bovine root dentin specimens were subjected to different periods of demineralization (1 to 14 days). Cross-sectional images of the specimens before and after the demineralization were captured by SS-OCT at 1310 nm center wavelength. Following each period, the specimens were cut into sections for transverse microradiography (TMR) and correlations between SS-OCT data and TMR parameters were examined. TMR images of the specimens showed subsurface lesions ranging 100 to 400 μm in lesion depth (LD) and 1,000-5,000 volume in mineral loss (ΔZ). SS-OCT images showed a boundary suggesting the lesion front. Reflectivity increased with demineralization progress. A strong correlation was found between the boundary depth from the lesion surface and LD. Integrated dB values from the lesion surface to the boundary depth before and after the demineralization (R_S and R_D, respectively) were calculated. There was a significant positive relationship between ΔZ and R_D; but not between ΔZ and ΔR, where ΔR=R_D-R_S. A clear indication of surface layer thickness was not found on OCT images. In conclusion, SS-OCT system could provide quantitative estimation of caries progress in artificial subsurface dentin lesion in terms of lesion depth. Further studies are needed to investigate whether other parameters of the dentin lesion with surface layer could be determined by this technique. Study supported by Global Center of Excellence at TMDU and NCGG.

New methods are needed for the nondestructive measurement of tooth demineralization and remineralization to monitor the progression of incipient caries lesions (tooth decay) for effective nonsurgical intervention and to evaluate the performance of anti-caries treatments such as chemical treatments or laser irradiation. Studies have shown that optical coherence tomography (OCT) has great potential to fulfill this role since it can be used to measure the depth and severity of early lesions with an axial resolution exceeding 10-μm, it is easy to apply in vivo and it can be used to image the convoluted topography of tooth occlusal surfaces. In this paper we present early results using a new cross-polarization OCT system introduced by Santec. This system utilizes a swept laser source and a MEMS scanner for rapid acquisition of cross polarization images. Preliminary studies show that this system is useful for measurement of the severity of demineralization on tooth surfaces and for showing the spread of occlusal lesions under the dentinal-enamel junction.

During ablation of oral hard tissue with an USPL system a small amount of the incident laser power does not contribute to the ablation process and is being transmitted. Partial transmission of ultra-short laser pulses could potentially affect the dental pulp. The aim of this study was to assess the transmission during ablation and to deduce possible risks for the patient. The study was performed with an Nd:YVO₄ laser, emitting pulses with a duration of 8 ps at a wavelength of 1064 nm. A repetition rate of 500 kHz and an average power of 9 W were chosen to achieve high ablation efficiency. A scanner system created square cavities with an edge length of 1 mm. Transmission during ablation of mammoth ivory and dentin slices with a thickness of 2 mm and 5 mm was measured with a power meter, placed directly beyond the samples. Effects on subjacent blood were observed by ablating specimens placed in contact to pork blood. In a separate measurement the temperature increase during ablation was monitored using an infrared camera. The influence of transmission was assessed by tuning down the laser to the corresponding power and then directly irradiating the blood. Transmission during ablation of 2 mm specimens was about 7.7% (ivory) and 9.6% (dentin) of the incident laser power. Ablation of specimens directly in contact to blood caused coagulation at longer irradiation times (t≈18s). Direct irradiation of blood with the transmitted power provoked bubbling and smoke formation. Temperature measurements identified heat generation as the main reason for the observed coagulation.

Conventional lasers, Er:YAG laser and Er,Cr:YSGG laser, lack the ability for selective excavation to discriminate carious tissue only because they use the laser tissue interaction derived from a strong absorption of water. Based on the absorption property of carious dentin, characteristic absorption bands around 6 μm are candidate for selective excavation. Our group has already observed the difference of ablation depth between demineralized and normal dentin in the wavelength range from 5.75 to 6.60 μm. Also this study has showed the effectiveness of 5.8 μm. Objective of this study is to determine optimal irradiation parameters of selective excavation by using 5.8 μm. Bovine dentin plates demineralized by soaking in lactic acid solution were used as a carious dentin model. A nanosecond pulsed laser at 5.8 μm wavelength was obtained by difference-frequency generation technique. The laser delivers 5 ns pulse width at a repetition rate of 10 Hz. After irradiation, morphological change and measurement of ablation depth was observed with a scanning electron microscope and a confocal laser microscope, respectively. In 5.8 μm wavelength, high ablation efficiency with a low thermal side effect was observed. 5.8 μm wavelength provides a selective excavation technique for minimal intervention.

The aim of this work was to investigate relationship between refractive index (n) and mineral content (MC) (vol %) of enamel and dentin using swept-source optical coherence tomography (SS-OCT) and transverse microradiography (TMR). Enamel and dentin blocks were partitioned into three regions. The middle partition of each sample was covered with a nail polish to protect the sound area during exposure to the treatment solutions. Samples were demineralized in a demineralizing solution, which was refreshed once a week, for 2 months. One window was covered with acid-resistant varnish, leaving the other window exposed; the samples were placed in a solution for remineralization. Samples then were sliced into disks with thickness of 300 μm to 400 μm and placed on metal plate in order to capture cross-sectional images of sound, demineralized and remineralized regions by OCT at 1319 nm center wavelength. The n then was calculated via formula using image analysis software. Following n measurement, these specimens were further polished for the TMR analysis. Correlation between OCT n and TMR MC was examined. A significant and highly positive correlation was found between the measured n and the actual MC at the corresponding locations (Pearson correlation coefficients (r) were 0.94 and 0.97 in enamel and 0.95 and 0.91 in dentin after de-/remineralization process, respectively p < 0.05). OCT showed a potential for quantitative analysis of the mineral loss or gain by measuring of the n in vitro. Supported by the grant from the Japanese Ministry of Education, Global Center of Excellence (GCOE) Program, "International Research Center for Molecular Science in Tooth and Bone Diseases."

Epulis fissuratum refers to tissue growth into the oral cavity, located over the alveolar ridges or the soft tissues of the vestibular sulcus. Trauma and irritation are important aetiological factors for epulis fissuratum and lesions arise in areas of persistent mucosal injury. This report presents a case of a 68-year old male patient with two soft tissue hyperplastic growths seen in the buccal vestibule in the lower anterior region. These lesions were removed using an Er,Cr:YSGG laser. The healing was uneventful and no suture or analgesic was required. The histopathological report confirmed the presurgical diagnosis. No relapse was observed till one year after surgery.

Some photosensitizers (PSs) used for PACT (Antimicrobial Photodynamic Therapy) show an affinity for bacterial walls and can be photo-activated to cause the desired damage. However, on dentine bacterias may be less susceptible to PACT as a result of limited penetration of the PS. The aim of this study was to evaluate the diffusion of one PS based on hematoporphyrin on dentine structures. Twelve bovine incisors were used. Class III cavities (3 x 3 x 1mm) were prepared on the mesial or distal surfaces using a diamond bur. Photogem® solution at 1 mg/mL (10 uL for each cavity) was used. The experimental Groups were divided according to thickness of dentine remaining and etched or no-etched before the PS application. The fluorescence excitation source was a VelScope® system. For image capture a scientific CCD color camera PixelFly® was coupled to VelScope. For image acquisition and processing, a computational routine was developed at Matlab®. Fick's Law was used to obtain the average diffusion coefficient of PS. Differences were found between all Groups. The longitudinal temporal diffusion was influenced by the different times, thickness and acid etching.

The use of composite resins for restorative procedure in anterior and posterior cavities is highly common in Dentistry due to its mechanical and aesthetic properties that are compatible with the remaining dental structure. Thus, the aim of this study was to evaluate the optical characterization of one dental composite resin using bovine enamel as reinforcing filler. The same organic matrix of the commercially available resins was used for this experimental resin. The reinforcing filler was obtained after the gridding of bovine enamel fragments and a superficial treatment was performed to allow the adhesion of the filler particles with the organic matrix. Different optical images as fluorescence and reflectance were performed to compare the experimental composite with the human teeth. The present experimental resin shows similar optical properties compared with human teeth.

Mandibular propulsive appliance (MPA) stimulates cell proliferation and gene expression on mandible condylar cartilage (Marques et al., 2008). However, its association with low level laser therapy (LLLT) is unknown. This study evaluated the effects of LLLT associated to MPA on mandibular condyle. Twenty Wistar rats were divided into four groups. Group I received any treatment. Group II was bilaterally irradiated on temporomandibular joint with 10 J/cm² low level laser (780nm, 40mW and 10s) on alternate days. Group III used the propulsive appliance for ten hours daily and Group IV used the appliance daily and was irradiated on alternate days. After 15 days the animals were killed by lethal doses of anesthetics. The condyles were fixed in Methacarn solution and decalcified in 4.13% EDTA solution for 30 days. Seriate saggital 5 μm-thick sections were stained by the hematoxilin-eosin method. Morphological and morphometric analyses were performed to measure the length and the height of the mandibular condyle, the thickness of the condilar cartilage and the bone mass. Results were expressed as mean ± standard deviation (one-way ANOVA, Tukey's post-test.) The appliance increased all measures compared to the control group, except bone mass. Alone, LLLT had no effects on all measures, however, the association of the appliance with the LLLT increased condylar cartilage and bone mass significantly compared to the others groups. These results suggest that LLLT improves the effects of mandibular propulsive appliance in the condylar cartilage growth and formation of bone mass.

Lasers can ablate/remove tissue in a non-contact mode of operation and a pulsed laser beam does not interfere with the ability to image the tooth surface, therefore lasers are ideally suited for integration with imaging devices for image-guided ablation. Laser energy can be rapidly and efficiently delivered to tooth surfaces using a digitally controlled laser beam scanning system for precise and selective laser ablation with minimal loss of healthy tissues. Under the appropriate irradiation conditions such laser energy can induce beneficial chemical and morphological changes in the walls of the drilled cavity that can increase resistance to further dental decay and produce surfaces with enhanced adhesive properties to restorative materials. Previous studies have shown that images acquired using near-IR transillumination, optical coherence tomography and fluorescence can be used to guide the laser for selective removal of demineralized enamel. Recent studies have shown that NIR reflectance measurements at 1470-nm can be used to obtain images of enamel demineralization with very high contrast. The purpose of this study was to demonstrate that image guided ablation of occlusal lesions can be successfully carried out using a NIR reflectance imaging system coupled with a carbon dioxide laser operating at 9.3-μm with high pulse repetition rates.

Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to image caries lesions in dentin, measure nondestructively the severity of dentin demineralization, and determine the efficacy of intervention with anticaries agents including fluoride and lasers. However, those studies were limited to artificial lesions on dentin and roots surfaces. The objective of this study is to determine if a cross polarization OCT system (CP-OCT) can be used to nondestructively measure a reduction in the reflectivity of natural root caries lesions after exposure to a remineralization solution. CPOCT images of 11 teeth with existing root lesions were acquired before and after exposure to a remineralizing solution for 20 days. The integrated reflectivity was calculated after integrating to a fixed depth of 200-μm. There was a significant decrease in the integrated reflectivity after exposure to the remineralizing solution.

A carbon dioxide laser operating at the highly absorbed wavelength of 9.3μm with a pulse duration of 10-15μs is ideally suited for caries removal and caries prevention. The enamel thermally modified by the laser has enhanced resistance to acid dissolution. This is an obvious advantage for caries prevention; however, it is often necessary to etch the enamel surface to increase adhesion to composite restorative materials and such surfaces may be more resistant to etching. The purpose of the study was to non-destructively measure the susceptibility of laser-ablated enamel surfaces to acid dissolution before and after acid-etching using Polarization Sensitive Optical Coherence Tomography (PS-OCT). PS-OCT was used to acquire images of bovine enamel surfaces after exposure to laser irradiation at ablative fluence, acid-etching, and a surface softened dissolution model. The integrated reflectivity from lesion and the lesion depth were measured using PS-OCT. Samples were also sectioned for examination by Polarized Light Microscopy (PLM). PS-OCT images showed that acid-etching greatly accelerated the formation of subsurface lesions on both laser-irradiated and non-irradiated surfaces (P<0.05). A 37.5% phosphoric acid etch removed the laser modified enamel layer after 5-10 seconds.

Previous remineralization studies employing cross polarization sensitive optical coherence tomography (CP-OCT), have been limited to the repair of artificial enamel-like lesions. In this study we attempted to remineralize existing occlusal lesions on extracted teeth. Lesions were imaged before and after exposure to an acidic remineralization regimen and the integrated reflectivity and lesion depth was calculated. Automated integration routines worked well for assessing the integrated reflectivity for the lesion areas after remineralization. Polarized light microscopy was also used to examine the lesions areas after sectioning the teeth. An acidic remineralization solution was used to remineralize the lesions. The integrated reflectivity significantly increased after exposure to the remineralization solution which suggests that the acidic solution caused additional demineralization as opposed to the desired remineralization.