Clinical Monitoring of Early Occlusal Caries on Primary Teeth with Optical Coherence Tomography

Purpose: The purpose of this study is to observe structural changes and lesion activity of early occlusal pit and fissure caries on primary teeth using CP-OCT. The hypothesis is that CP-OCT will be able to successfully identify the presence of a transparent surface zone of reduced reflectivity that is indicative of remineralization and an arrested lesion.Methods: Participants (n=30 with 61 primary molars) aged 6 to 10 years old participated in the study. All lesions were clinically examined and given a diagnosis according to the ICDAS codes. All lesions were then scanned with CP-OCT. Images were converted and analyzed with image analysis software.Results: OCT scans showed that 57 teeth (93%) had pit and fissure lesions and 4 teeth (7%) were without lesions. Several teeth, n=16 (26%), showed a distinct surface zone that indicated arrested lesions. Most of the teeth, n=45 (74%), did not show evidence of surface zone, indicative of active lesions. Several of the teeth, n=11 (18%), had lesions that were visible with OCT but were not visible in the visual examination.Conclusions: OCT can detect early occlusal caries that cannot be identified on radiographs or through a clinical exam. OCT can provide information on lesion activity by detecting the presence of a transparent surface zone, indicative of lesion arrest, and can precisely show the depth of the lesions. OCT will be a valuable tool in the future that can provide useful information to the clinicians to aid with their diagnosis of early occlusal pit and fissure caries