Optical coherence tomography imaging application in endodontics
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Abstract
INTRODUCTION: Optical Coherence Tomography (OCT) is a non-invasive imaging modality that uses near-infrared light to visualize microstructural details of biological tissues. In endodontics, OCT presents an opportunity for real-time, radiation-free assessment of root canal anatomy. The objective of this study was to evaluate the feasibility and accuracy of Optical Coherence Tomography (OCT) as a diagnostic imaging modality for quantifying internal root canal defects. OCT measurements were compared against Micro-Computed Tomography (MCT), the gold standard, and Digital Caliper Measurements (DCM), a conventional external reference, to determine their relative reliability in detecting and measuring standardized canal defects. METHODS: Twelve extracted human teeth were standardized and prepared with simulated root canal defects of four perforation sizes (using Munce burs #1/4 to #2) and internal resorption lesions. OCT scans were obtained using a modified Dragonfly OPTIS Imaging Catheter adapted for endodontic use. Measurements were also taken using MCT and DCM. A three-way ANOVA and linear regression were used to assess the consistency and accuracy of measurements. A paired t-test was performed to evaluate the agreement between OCT and MCT measurements for internal resorption defects. RESULTS: All three modalities demonstrated a statistically significant increase in measured defect size with increasing perforation level (p < 0.001). OCT showed the lowest rate of increase compared to MCT and DCM, indicating potential underestimation for smaller defects. However, this discrepancy diminished as defect size increased. The paired t-test comparing OCT and MCT for internal resorption lesions revealed no significant difference (p = 0.56), supporting OCT’s ability to reliably assess larger defects. Differences in measurement methodology—specifically internal (OCT and MCT) versus external (DCM)—were identified as contributing factors to observed discrepancies. CONCLUSION: OCT demonstrates promising accuracy for moderate to large internal root canal defects, showing potential advantages over traditional methods in specific clinical scenarios. While its resolution may limit the detection of small structural irregularities, its high-resolution capabilities, combined with a non-ionizing radiation profile, make it a valuable adjunct for diagnostic imaging. Further technological advancements, including catheter miniaturization and improved resolution, are necessary to expand its clinical applicability, particularly in narrow or calcified canals.
Description
2025