Diagnostic performance of swept-source optical coherence tomography in the detection of tooth cracks: a narrative review
DOI:
https://doi.org/10.2340/aos.v85.45800Keywords:
tomography, optical coherence, tooth fractures, diagnostic imaging, dental enamel, tooth crackAbstract
Objectives: Tooth cracks are among the most common clinical findings that can affect the prognosis of the tooth. The swept-source optical coherence tomography (SS-OCT) is a non-invasive technique that was developed to identify cracks or fractures. Even though the diagnostic value of SS-OCT has been studied by several researchers, the available evidence is still inconclusive. This review aims to evaluate the reported performance of SS-OCT in detecting tooth cracks and to identify factors described in the literature that may affect it.
Materials and methods: An electronic search was conducted on PubMed, Scopus, Web of Science, and Google Scholar to extract and review the English articles published between January 2012 and December 2024. The keywords were optical coherence tomography, swept-source OCT, SS-OCT, tooth crack, dental crack, enamel crack, dentin crack, and fracture detection. Studies published in English that investigated SS-OCT for the detection of enamel, dentin, or root cracks were included, whereas review articles, non-dental OCT studies, and studies focusing solely on other diagnostic methods were excluded.
Results: The literature search identified 121 articles; 14 of them met the criteria and were included. Out of the 14 included articles, only one clinical article was included.
Conclusions: The SS-OCT is a non-invasive and radiation-free imaging method for detecting tooth cracks, with higher diagnostic performance reported for enamel cracks. However, its performance in deeper dentin and root cracks appears to be affected by light penetration limitations and light scattering. Further technological development and well-designed clinical studies are needed to clarify its clinical utility.
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References
Cameron CE. Cracked-tooth syndrome. J Am Dent Assoc. 1964;68:405–11.
https://doi.org/10.14219/jada.archive.1964.0108 DOI: https://doi.org/10.14219/jada.archive.1964.0108
American Association of Endodontists. Glossary of endodontic terms. 10th ed. Chicago, IL: American Association of Endodontists; 2020.
Zidane B. Recent advances in the diagnosis of enamel cracks: a narrative review. Diagnostics. 2022;12:2027.
https://doi.org/10.3390/diagnostics12082027 DOI: https://doi.org/10.3390/diagnostics12082027
Shimada Y, Sadr A, Sumi Y, Tagami J. Application of optical coherence tomography (OCT) for diagnosis of caries, cracks, and defects of restorations. Curr Oral Health Rep. 2015;2:73–80.
https://doi.org/10.1007/s40496-015-0045-z DOI: https://doi.org/10.1007/s40496-015-0045-z
Imai K, Shimada Y, Sadr A, Sumi Y, Tagami J. Noninvasive cross-sectional visualization of enamel cracks by optical coherence tomography in vitro. J Endod. 2012;38:1269–74.
https://doi.org/10.1016/j.joen.2012.05.008 DOI: https://doi.org/10.1016/j.joen.2012.05.008
Bergenholtz G. Pathogenic mechanisms in pulpal disease. J Endod. 1990;16:98–101.
https://doi.org/10.1016/S0099-2399(06)81571-2 DOI: https://doi.org/10.1016/S0099-2399(06)81571-2
de Oliveira BP, Câmara AC, Duarte DA, Gomes ASL, Heck RJ, Antonino ACD, et al. Detection of apical root cracks using spectral domain and swept-source optical coherence tomography. J Endod. 2017;43:1148–51.
https://doi.org/10.1016/j.joen.2017.01.019 DOI: https://doi.org/10.1016/j.joen.2017.01.019
Wada I, Shimada Y, Ikeda M, Sadr A, Nakashima S, Tagami J, et al. Clinical assessment of non-carious cervical lesion using swept-source optical coherence tomography. J Biophotonics. 2015;8:846–54.
https://doi.org/10.1002/jbio.201400113 DOI: https://doi.org/10.1002/jbio.201400113
Yang SE, Jo AR, Lee HJ, Kim SY. Analysis of the characteristics of cracked teeth and evaluation of pulp status according to periodontal probing depth. BMC Oral Health. 2017;17:135.
https://doi.org/10.1186/s12903-017-0434-x DOI: https://doi.org/10.1186/s12903-017-0434-x
Lee SH, Lee JJ, Chung HJ, Park JT, Kim HJ. Dental optical coherence tomography: new potential diagnostic system for cracked-tooth syndrome. Surg Radiol Anat. 2016;38:49–54.
https://doi.org/10.1007/s00276-015-1514-8 DOI: https://doi.org/10.1007/s00276-015-1514-8
Guo J, Wu Y, Chen L, Long S, Chen D, Ouyang H, et al. A perspective on the diagnosis of cracked tooth: imaging modalities evolve to AI-based analysis. Biomed Eng Online. 2022;21:36.
https://doi.org/10.1186/s12938-022-01008-4 DOI: https://doi.org/10.1186/s12938-022-01008-4
Ei TZ, Shimada Y, Abdou A, Tagami J, Sumi Y, Sadr A. Three-dimensional assessment of proximal contact enamel using optical coherence tomography. Dent Mater. 2019;35:e74–82.
https://doi.org/10.1016/j.dental.2019.01.008 DOI: https://doi.org/10.1016/j.dental.2019.01.008
Hausdörfer T, Harms L, Kanzow P, Hülsmann M. Three visual–diagnostic methods for the detection of enamel cracks: an in vitro study. J Clin Med. 2023;12:973.
https://doi.org/10.3390/jcm12030973 DOI: https://doi.org/10.3390/jcm12030973
Hovander D, Chyz G, Shimada Y, Tagami J, Sadr A. Optical coherence tomography evaluation of deep dentin crack removal techniques. JADA Found Sci. 2022;1:100012.
https://doi.org/10.1016/j.jfscie.2022.100012 DOI: https://doi.org/10.1016/j.jfscie.2022.100012
Heck K, Litzenburger F, Geitl T, Kunzelmann KH. Near-infrared reflection at 780 nm for detection of early proximal caries in posterior permanent teeth in vitro. Dentomaxillofac Radiol. 2021;50:20210005.
https://doi.org/10.1259/dmfr.20210005 DOI: https://doi.org/10.1259/dmfr.20210005
Macey R, Walsh T, Riley P, Hogan R, Glenny AM, Worthington HV, et al. Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries. Cochrane Database Syst Rev. 2021;1:CD013855.
https://doi.org/10.1002/14651858.CD013855 DOI: https://doi.org/10.1002/14651858.CD013855
Rashed B, Iino Y, Ebihara A, Okiji T. Evaluation of crack formation and propagation with ultrasonic root-end preparation and obturation using a digital microscope and optical coherence tomography. Scanning. 2019;2019:5240430.
https://doi.org/10.1155/2019/5240430 DOI: https://doi.org/10.1155/2019/5240430
Huang D, Swanson EA, Lin CP, Schuman JS, Stinson WG, Chang W, et al. Optical coherence tomography. Science. 1991;254:1178–81.
https://doi.org/10.1126/science.1957169 DOI: https://doi.org/10.1126/science.1957169
Alqussier AM. Different modalities in caries detection and diagnosis. In: Askar H, editor. Dentistry. London: IntechOpen; 2024.
https://doi.org/10.5772/intechopen.113363 DOI: https://doi.org/10.5772/intechopen.113363
Yu M, Li J, Liu S, Xie Z, Liu J, Liu Y. Diagnosis of cracked tooth: clinical status and research progress. Jpn Dent Sci Rev. 2022;58:357–64.
https://doi.org/10.1016/j.jdsr.2022.11.002 DOI: https://doi.org/10.1016/j.jdsr.2022.11.002
Segarra MS, Shimada Y, Sadr A, Sumi Y, Tagami J. Three-dimensional analysis of enamel crack behavior using optical coherence tomography. J Dent Res. 2017;96:308–14.
https://doi.org/10.1177/0022034516680156 DOI: https://doi.org/10.1177/0022034516680156
Shimada Y, Yoshiyama M, Tagami J, Sumi Y. Evaluation of dental caries, tooth crack, and age-related changes in tooth structure using optical coherence tomography. Jpn Dent Sci Rev. 2020;56:109–18.
https://doi.org/10.1016/j.jdsr.2020.08.001 DOI: https://doi.org/10.1016/j.jdsr.2020.08.001
Abu Saleah S, Cho H, Amrin Luna J, Seong D, Eranga Wijesinghe R, Han S, et al. Development of optical coherence tomography incorporated image processing algorithms for the multidimensional assessment of concealed enamel micro-crack. Infrared Phys Technol. 2024;140:105377.
https://doi.org/10.1016/j.infrared.2024.105377 DOI: https://doi.org/10.1016/j.infrared.2024.105377
[24] Chen C, Zhang W, Liang Y. Evaluation of apical root defects during canal instrumentation with two different nickel-titanium (NiTi) systems by optical coherence tomography (OCT) scan. J Dent Sci. 2022;17(2):763–70.
https://doi.org/10.1016/j.jds.2021.10.009 DOI: https://doi.org/10.1016/j.jds.2021.10.009
Kim JM, Kang SR, Yi WJ. Automatic detection of tooth cracks in optical coherence tomography images. J Periodontal Implant Sci. 2017;47:41–50.
https://doi.org/10.5051/jpis.2017.47.1.41 DOI: https://doi.org/10.5051/jpis.2017.47.1.41
Dao Luong MN, Shimada Y, Turkistani A, Tagami J, Sumi Y, Sadr A. Fractography of interface after microtensile bond strength test using swept-source optical coherence tomography. Dent Mater. 2016;32:862–9.
https://doi.org/10.1016/j.dental.2016.03.019 DOI: https://doi.org/10.1016/j.dental.2016.03.019
Nakajima Y, Shimada Y, Miyashin M, Takagi Y, Tagami J, Sumi Y. Noninvasive cross-sectional imaging of incomplete crown fractures (cracks) using swept-source optical coherence tomography. Int Endod J. 2012;45:933–41.
https://doi.org/10.1111/j.1365-2591.2012.02052.x DOI: https://doi.org/10.1111/j.1365-2591.2012.02052.x
Shimada Y, Tagami J, Sumi Y. Potential and limitations of OCT for assessing dental caries and tooth crack. J Jpn Soc Laser Dent. 2014;25:159–64.
https://doi.org/10.5984/jjpnsoclaserdent.25.159 DOI: https://doi.org/10.5984/jjpnsoclaserdent.25.159
Fried WA, Simon JC, Lucas S, Chan KH, Darling CL, Staninec M, et al. Near-IR imaging of cracks in teeth. Proc SPIE Int Soc Opt Eng. 2014;8929:89290Q.
https://doi.org/10.1117/12.2045686 DOI: https://doi.org/10.1117/12.2045686
Hariri I, Sadr A, Nakashima S, Shimada Y, Tagami J, Sumi Y. Estimation of the enamel and dentin mineral content from the refractive index. Caries Res. 2013;47:18–26.
https://doi.org/10.1159/000342416 DOI: https://doi.org/10.1159/000342416
Meng Z, Yao XS, Yao H, Liang Y, Liu T, Li Y, et al. Measurement of the refractive index of human teeth by optical coherence tomography. J Biomed Opt. 2009;14:034010.
https://doi.org/10.1117/1.3130322 DOI: https://doi.org/10.1117/1.3130322
Jones RS, Huynh GD, Jones GC, Fried D. Near-infrared transillumination at 1310-nm for the imaging of early dental decay. Opt Express. 2003;11:2259–65.
https://doi.org/10.1364/OE.11.002259 DOI: https://doi.org/10.1364/OE.11.002259
Fried D, Featherstone JDB, Darling CL, Jones RS, Ngaotheppitak P, Bühler CM. Early caries imaging and monitoring with near-infrared light. Dent Clin North Am. 2005;49:771–93.
https://doi.org/10.1016/j.cden.2005.05.008 DOI: https://doi.org/10.1016/j.cden.2005.05.008
Hariri I, Sadr A, Shimada Y, Tagami J, Sumi Y. Effects of structural orientation of enamel and dentine on light attenuation and local refractive index: an optical coherence tomography study. J Dent. 2012;40:387–96.
https://doi.org/10.1016/j.jdent.2012.01.017 DOI: https://doi.org/10.1016/j.jdent.2012.01.017
Tabata T, Shimada Y, Sadr A, Tagami J, Sumi Y. Assessment of enamel cracks at adhesive cavosurface margin using three-dimensional swept-source optical coherence tomography. J Dent. 2017;61:28–32.
https://doi.org/10.1016/j.jdent.2017.04.005 DOI: https://doi.org/10.1016/j.jdent.2017.04.005
Kang SR, Kim JM, Kim SH, Park HJ, Kim TI, Yi WJ. Tooth cracks detection and gingival sulcus depth measurement using optical coherence tomography. Annu Int Conf IEEE Eng Med Biol Soc. 2017;2017:4403–6.
https://doi.org/10.1109/EMBC.2017.8037832 DOI: https://doi.org/10.1109/EMBC.2017.8037832
Sahyoun CC, Subhash HM, Peru D, Ellwood RP, Pierce MC. An experimental review of optical coherence tomography systems for noninvasive assessment of hard dental tissues. Caries Res. 2020;54:43–54.
https://doi.org/10.1159/000502375 DOI: https://doi.org/10.1159/000502375
Luong MN, Shimada Y, Sadr A, Yoshiyama M, Sumi Y, Tagami J. Cross-sectional imaging of tooth bonding interface after thermal stresses and mechanical fracture. Dent Mater J. 2018;37:754–60.
https://doi.org/10.4012/dmj.2017-289 DOI: https://doi.org/10.4012/dmj.2017-289
Aguirre AD, Zhou C, Lee HC, Ahsen OO, Fujimoto JG. Optical coherence microscopy. In: Drexler W, Fujimoto JG, editors. Optical coherence tomography. Cham: Springer; 2015. p. 865–911.
https://doi.org/10.1007/978-3-319-06419-2_29 DOI: https://doi.org/10.1007/978-3-319-06419-2_29
Li Z, Holamoge YV, Li Z, Zaid W, Osborn ML, Ramos A, et al. Detection and analysis of enamel cracks by ICG-NIR fluorescence dental imaging. Ann N Y Acad Sci. 2020;1475:52–63.
https://doi.org/10.1111/nyas.14374 DOI: https://doi.org/10.1111/nyas.14374
Nakagawa H, Sadr A, Shimada Y, Tagami J, Sumi Y. Validation of swept source optical coherence tomography (SS-OCT) for the diagnosis of smooth surface caries in vitro. J Dent. 2013;41:80–9.
https://doi.org/10.1016/j.jdent.2012.10.007 DOI: https://doi.org/10.1016/j.jdent.2012.10.007
Austin RS, Haji Taha M, Festy F, Cook R, Andiappan M, Gomez J, et al. Quantitative swept-source optical coherence tomography of early enamel erosion in vivo. Caries Res. 2017;51:410–8.
https://doi.org/10.1159/000477098 DOI: https://doi.org/10.1159/000477098
Nazari A, Sadr A, Campillo-Funollet M, Nakashima S, Shimada Y, Tagami J, et al. Effect of hydration on assessment of early enamel lesion using swept-source optical coherence tomography. J Biophotonics. 2013;6:171–7.
https://doi.org/10.1002/jbio.201200012 DOI: https://doi.org/10.1002/jbio.201200012
Tofighi Zavareh A, Barajas O, Hoyos S. An efficient estimation algorithm for the calibration of low-cost SS-OCT systems. In: Proceedings of the IEEE 14th International Symposium on Biomedical Imaging (ISBI 2017). p. 1169–72.
https://doi.org/10.1109/ISBI.2017.7950724 DOI: https://doi.org/10.1109/ISBI.2017.7950724
Hu J, Wu S, Shi G, Fan J, Yu H, Chen S. Design of an endoscopic OCT probe based on piezoelectric tube with quartered outside electrodes. Front Bioeng Biotechnol. 2024;12:1391630.
https://doi.org/10.3389/fbioe.2024.1391630 DOI: https://doi.org/10.3389/fbioe.2024.1391630
Kim H, Cho H, Lee W, Son K, Lee K, Jeon M, et al. Development of handheld optical coherence tomography based on commercial intra-oral scanner shape for extended clinical utility in dentistry. Int J Imaging Syst Technol. 2024;34:e23024.
https://doi.org/10.1002/ima.23024 DOI: https://doi.org/10.1002/ima.23024
Alghilan MA, Lippert F, Platt JA, Eckert GJ, González-Cabezas C, Fried D, et al. Impact of surface micromorphology and demineralization severity on enamel loss measurements by cross-polarization optical coherence tomography. J Dent. 2019;81:52–8.
https://doi.org/10.1016/j.jdent.2018.12.009 DOI: https://doi.org/10.1016/j.jdent.2018.12.009

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