Cone-beam computed tomography (CBCT) is one of the most useful diagnostic techniques in dentistry but it involves
ionizing radiation, while swept source optical coherence tomography (SS-OCT) has been introduced recently as a
nondestructive, real-time, high resolution imaging technique using low-coherence interferometry, which involves no
ionizing radiation. The purpose of this study was to evaluate the ability of SS-OCT to detect the pulp horn (PH) in
comparison with that of CBCT. Ten extracted human mandibular molars were used. After horizontally removing a half of
the tooth crown, the distance from the cut dentin surface to PH was measured using microfocus computed tomography
(Micro CT) (SL) as the gold standard, by CBCT (CL) and by SS-OCT (OL). In the SS-OCT images, only when PH was
observed beneath the overlying dentin, the distance from the cut dentin surface to PH was recorded. If the pulp was exposed,
it was defined as pulp exposure (PE). The results obtained by the above three methods were statistically analyzed by
Spearman's rank correlation coefficient at a significance level of p < 0.01. SS-OCT detected the presence of PH when the
distance from the cut dentin surface to PH determined by SL was 2.33 mm or less. Strong correlations of the measured
values were found between SL and CL (r=0.87), SL and OL (r=0.96), and CL and OL (r=0.86). The results showed that
SS-OCT images correlated closely with CBCT images, suggesting that SS-OCT can be a useful tool for the detection of
PH.
Apicoectomy is performed for the management of apical periodontitis when orthograde root canal treatment is not
possible or is ineffective. Prior to the surgery, cone beam computed tomography (CBCT) examination is often performed
to evaluate the lesion and the adjacent tissues. During the surgical procedure, the root apex is resected and the resected
surface is usually observed under dental operating microscope (DOM). However, it is difficult to evaluate the details and
the subsurface structure of the root using CBCT and DOM. A new diagnostic system, swept source optical coherence
tomography (SS-OCT), has been developed to observe the subsurface anatomical structure. The aim of this study was to
observe resected apical root canals of human maxillary premolars using SS-OCT and compare the findings with those
observed using CBCT and DOM. Six extracted human maxillary premolars were used. After microfocus computed
tomography (Micro CT; for gold standard) and CBCT scanning of the root, 1 mm of the apex was cut perpendicular to
the long axis of the tooth. Each resected surface was treated with EDTA, irrigated with saline solution, and stained with
methylene blue dye. The resected surface was observed with DOM and SS-OCT. This sequence was repeated three
times. The number of root canals was counted and statistically evaluated. There was no significant difference in the
accuracy of detecting root canals among CBCT, DOM and SS-OCT (p > 0.05, Wilcoxon test). Because SS-OCT can be
used in real time during surgery, it would be a useful tool for observing resected apical root canals.
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