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OCT in Dentistry

The OCT Dental Imaging System(TM)
OCT is the first modality in dentistry capable of imaging both “hard” tissue (teeth) and “soft” tissue (gums) in the mouth at a very high resolution. Using the hand-held scanner, the operator captures cross-sectional images, or tomographic slices, at up to 3 mm deep into dental tissue.  These cross-sectional images are then displayed individually in real-time on a chairside monitor and can be saved to the patient digital file. Because of the high resolution images and method of information capture, the OCT System enables the dentist to:


• Detect demineralization of enamel – the FIRST stage of decay.
• Detect decay at an early stage – BEFORE it shows up on x-ray.
• Detect decay in occlusal (biting) surfaces – CANNOT be done with x-ray.
• Detect root surface decay which is difficult to detect by other means.
• Detect secondary caries around restorations at an early stage.
• Examine the marginal integrity of restorations – the bond to tooth structure.
• Document the need for early stage treatment for insurance reimbursement. (Early stage decay is not visible on traditional x-ray and there is currently no formal means of documenting the need for treatment.)
• For the first time, images of soft tissue (gums) can be captured in the mouth and the depth of periodontal pockets can be measured without physical probing. Early detection of gum disease is made possible with OCT.

The OCT Dental Imaging System(TM) will have a significant impact on the practice of dentistry. High resolution and detailed visual characterization dramatically enhance the diagnostic capability of dentists to detect early stage disease in oral tissue.
The OCT System consists of the processor that is similar in footprint size to a laptop computer and is driven by proprietary software to process and display images. The handpiece consists of the scanner with an enclosed probe, similar in size to a dental handpiece, which feeds the information back to the processor. The processor is connected to a computer and monitor, which displays the images on the monitor.

The OCT Dental Imaging System(TM) will initially be available in a cart configuration with computer and monitor that would capture and transfer information to the office computer for inclusion into patient files.  This would significantly enhance the scope and effectiveness of chairside modalities by providing an advanced chairside computer-based platform for diagnostics, patient communication and digital storage of patient information. 

The Need for OCT in DentistryChairside OCT Imaging
Decay is more extensive than it appears on an x-ray because it is a two dimensional image. Due to the use of fluorides, detection of decay has become more complex. Dental explorers are no longer a viable tool for detecting decay. At very early stages of decay, when intervention would be ideal, decay openings in enamel are too small for an explorer to detect a tactile “catch”. There is a consensus that the use of an explorer to probe forcefully in a tooth may be damaging since it may open the enamel surface further, interfering with the remineralization repair process.
 
Fluoride has changed the behavior of decay. A slower initial progression has afforded the opportunity to diagnose and manage decay at an early stage. There is scientific evidence that early decay can be arrested and possibly reversed. OCT is a diagnostic aid which will make possible the prevention and early intervention of decay by remineralization. Fluorides and amorphous calcium phosphate remineralization gels are now being introduced to the dental profession which will initiate a repair process so that filling of large cavities, at a later stage of tooth decay, may not be required. No other diagnostic aid is presently available that will enable the dentist and hygienist to visibly monitor this repair process and validate it.
 
Recognizing decay lesions at the later stage of cavitation, when larger in size and depth, is no longer acceptable by the dental profession. OCT meets this challenge by early demineralization recognition (precavitation) and the ability to evaluate remineralization activity. Published literature by recognized dental researchers and clinicians are emphasizing the immediate need for such a diagnostic aid as OCT.
 
OCT is a diagnostic aid which meets the challenges of prevention and early decay intervention without over treating. The dental professional will be able to differentiate between stain and early decay and determine whether preventive intervention or a combination of preventive and restorative intervention (fillings) is appropriate. The decisions made by the clinician, along with the diagnostic aid of OCT, can be documented for validation purposes. This is important for insurance payment since visual proof of early treatment of decay is now being requested by insurance companies. X-rays will not image early decay. These images are important to place in the digital office patient file in order to follow up and for medical-legal purposes.
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