Cross-sectional visual comparison of remineralization efficacy of various agents on early smooth surface caries of primary teeth with swept source optical coherence tomography

Abstract

Purpose: Sweptsource optical coherence tomography (SS-OCT) permits cross-sectional observation of surface/subsurface characteristics of enamel including early carious lesions (ECL) or remineralization non-invasively.This study aimed to visually compare the cross-sectional remineralizing efficacy of various agents on ICDAS-II scores-1&2 by using SS-OCT and histology. Methods: Baseline SS-OCT (grey-scale/false-colour) and histology was performed on the randomly selected two samples with scores-1&2. Four remineralizing agents [fluoride-varnish (FV), CPP-ACP, nanohydroxy-paste (NHP) and silver-diamine-fluoride (SDF)]were evaluated for 2-or 6-weeks post-remineralization using SS-OCT and histology. Results: Score-1&2 baseline SS-OCT images showed a linear-shaped demineralization with dentino-enamel junction (DEJ) visible; and bowl-shaped demineralization with DEJ invisible respectively. Remineralizing agents were assessed on the basis of their ability to remineralize the surface, subsurface and made visualize the DEJ in score-2. SS-OCT showed an outer growth layer in post-remineralization score-1, 2-weeks samples with FV and NHP. All the agents showed progressive subsurface remineralization in 6 weeks. Active lesions showed rapid uptake of minerals on surface. Subsurface mineralization in pigmented score-2 matched sound enamel with NHP and SDF. Surface remineralization was comparable in FV and SDF followed by NHP. SDF demonstrated deeper subsurface remineralization followed by NHP and CPP-ACP. Conclusion: SS-OCT images correlated to histology. SS-OCT could monitor surface/subsurface in-situde/remineralization activity non-invasively.

Keywords

• Early carious lesions
• Enamel
• ICDAS-II
• Remineralization
• Smooth surface caries
• SS-OCT