Identification of occlusal sealants using optical coherence tomography

Optical coherence tomography (OCT) is a new imaging technique that uses light to image dental structures interferometrically. OCT creates cross-sectional images that have potential diagnostic value for dental applications. When used in epidemiological studies, OCT offers a safe, non-invasive technique to discriminate occlusal sealants and composite restorations. This paper summarizes a study in which dentists were asked to interpret and discriminate between OCT images.

Twenty-one dentists were asked to interpret OCT images of nine extracted premolars that were either not restored, contained an occlusal sealant or were restored with a composite restoration.

Although the dentists were previously unfamiliar with OCT images, they adapted well and felt confident in their diagnoses using this new technology. The sensitivity of OCT to discriminate composite and sealants was > 0.92, while the specificity of discrimination was > 0.94. The capacity of OCT to discriminate sealants from non-restored occlusal surfaces was slightly less (sensitivity 0.88; specificity 0.86), but still within a clinically acceptable level. Inter- and intra-rater reliability, as measured by the kappa statistic, also revealed excellent performance by dentists using this new imaging technology. Intra-rater reliability was very good, ranging from 0.82 to 1.0. Inter-rater reliability was also high, predominately in the "Good" to "Very Good" agreement range.

This preliminary study indicates OCT imaging may be an important new technology for discriminating occlusal sealants and composite restorations.