1. The use of digital imaging methods in dental epidemiology and clinical trials
- Author
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Hogan, Richard, Pretty, Iain, and Walsh, Tanya
- Subjects
617.6 ,Digital Imaging ,Dental Diagnostics ,Intraoral Scanner ,Red Fluorescence ,Polarised White-Light Imaging ,Oral Health - Abstract
Background: The enduringly high prevalence of many oral diseases have provoked critical reviews of intervention-centric care models whilst elevating the focus on prevention. Accurate, standardised methods of surveillance are required for the continued development of meaningful prevention-focused oral health policy and the monitoring of oral health interventions. Whilst the use of imaging methods in dental research has been explored for the indirect assessment of oral conditions, there is an ongoing need for further development of existing methods and a clear opportunity for exploration of new approaches as technology advances at an even faster rate. Aims: (i) To assess the use of polarised white light imaging and intraoral scanners for the indirect assessment of plaque, gingivitis & enamel defects in an epidemiological setting; (ii) To assess the use of intraoral scanners for the longitudinal evaluation of gingival inflammatory changes during an experimental gingivitis challenge; (iii) To assess the utility of red autofluorescence imaging in a novel consumer device for the real-time detection of dental plaque; (iv) To assess the relationship between red fluorescent plaque and gingival inflammation during an experimental gingivitis challenge. Methods: (i) Two cross-sectional observational studies were conducted in a school setting to provide comparative direct (clinical) and indirect (polarised white light and intraoral scan) data; (ii & iv) A longitudinal induced gingivitis study was conducted employing clinical assessment, red fluorescence plaque imaging and intraoral scanning; (iii) Two clinical studies were conducted employing a prototype toothbrush capable of red fluorescence detection. Qualitative methods were also employed to explore the perceived feedback from users. Results: (i) The cross-sectional assessment of plaque, gingivitis & enamel defects appears possible using polarised white light imaging and intraoral scans; (ii) The monitoring of changes in gingival inflammation over time was found to be feasible using remotely assessed intraoral scans. The use of imaging modalities may result in higher estimates of the respective conditions, which may be attributable to magnification and unrestricted examination time; (iii) The novel consumer device appears capable of detecting red fluorescent plaque in real-time, even during brushing, and encourages users to be more aware of their oral hygiene; (iv) Red fluorescent plaque increases over a period of oral hygiene abstinence and appears correlated with the inflammatory response. The use of red fluorescent plaque levels early in the challenge appears prognostically valuable as an indicator of the gingival inflammatory response. Conclusions: The use of imaging methods in dental research facilitates indirect assessment in both observational and interventional studies. Advances in technology are enabling the development of powerful monitoring tools with emerging prognostic value and consumerisation potential.
- Published
- 2020