Impact of Optical Coherence Tomography (OCT) for Periodontitis Diagnostics: Current Overview and Advances

Optical coherence tomography (OCT) is a non-invasive imaging technique that provides high-resolution, real-time visualization of soft and hard periodontal tissues. It offers micrometer-level resolution (typically ~10-15 μm) and a scan depth ranging from approximately 0.5 to 2 mm, depending on tissue type and system configuration. The field of view generally spans a few millimeters, which is sufficient for imaging gingiva, sulcus, and superficial bone contours. Over the past two decades, its application in periodontology has gained increasing attention due to its ability to detect structural changes in gingival and alveolar tissues without the need for ionizing radiation. Various OCT modalities, including time-domain, Fourier-domain, and swept-source OCT, have been explored for periodontal assessment, offering valuable insights into tissue morphology, disease progression, and treatment outcomes. Recent innovations include the development of three-dimensional (3D) OCT imaging and OCT angiography (OCTA), enabling the volumetric visualization of periodontal structures and microvascular patterns in vivo. Compared to conventional imaging techniques, such as radiography and cone beam computed tomography (CBCT), OCT offers superior soft tissue contrast and the potential for dynamic in vivo monitoring of periodontal conditions. Recent advancements, including the integration of artificial intelligence (AI) and the development of portable OCT systems, have further expanded its diagnostic capabilities. However, challenges, such as limited penetration depth, high costs, and the need for standardized clinical protocols, must be addressed before widespread clinical implementation. This narrative review provides an updated overview of the principles, applications, and technological advancements of OCT in periodontology. The current limitations and future perspectives of this technology are also discussed, with a focus on its potential role in improving periodontal diagnostics and personalized treatment approaches.