A system for simultaneous near-infrared reflectance and transillumination imaging of occlusal carious lesions

Clinicians need technologies to improve the diagnosis of questionable occlusal carious lesions (QOC's) and determine if decay has penetrated to the underlying dentin. Assessing lesion depth from near-infrared (NIR) images holds great potential due to the high transparency of enamel and stain to NIR light at λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. Unfortunately, NIR reflectance measurements alone are limited in utility for approximating occlusal lesion depth >200-μm due to light attenuation from the lesion body. Previous studies sought to combine NIR reflectance and transillumination measurements taken at λ=1300-nm in order to estimate QOC depth and severity. The objective of this study was to quantify the change in lesion contrast and size measured from multispectral NIR reflectance and transillumination images of natural occlusal carious lesions with increasing lesion depth and severity in order to determine the optimal multimodal wavelength combinations for estimating QOC depth. Extracted teeth with varying amounts of natural occlusal decay were measured using a multispectral-multimodal NIR imaging system at prominent wavelengths within the λ=1300-1700-nm spectral region. Image analysis software was used to calculate lesion contrast and area values between sound and carious enamel regions.