The clinical diagnosis of secondary caries has been found to account for the replacement of the majority of
intra-coronal restorations. Current methods to diagnose the presence of these lesions at early stages are
considered insufficient due to their low sensitivity. Polarization-sensitive optical coherence tomography
(PS-OCT) imaging studies have confirmed its effectiveness for imaging carious subsurface lesions in
enamel and dentin. The objective of this study was to determine if PS-OCT can be used to nondestructively
image demineralization through resin restorations on extracted teeth with both simulated and
natural lesions. Simulated secondary caries lesions were created by exposing cavity preparations made in
extracted human teeth to a demineralizing solution for 48 hours and subsequently restoring with resin.
Negative control restorations were also prepared on each tooth. Optical changes in demineralized versus
control preparations beneath restorations were measured as a function of depth using PS-OCT. PS-OCT
images indicated that a significant increase in reflectivity and depth occurred in the simulated lesions
compared with the control preparations. This study suggests that PS-OCT is well-suited to nondestructively
detect early caries lesions in enamel beneath composite restorations.
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