.jpg)
METHOD FOR THE DIAGNOSISING DENTAL DEMINERALISATION PROCESSES
US2018146857
The present invention relates to a quantitative ex vivo method for the complementary diagnosis of the degree of dental demineralization through the use of Raman spectroscopy, which comprises quantifying the intensities and areas of a plurality of Stoke bands of the spectrum, and defining and calculating indices that result from dividing the areas of certain bands of interest. The diagnosis is determined by the proximity of the values of these indices to the values previously obtained for the normal pattern of dental mineralization established by analysing healthy dental parts. <p> This method provides a complementary biomedical technique for quantitative ex vivo analysis of the degree of dental demineralization on dental tissue remains extracted by medical prescription, and the information obtained will facilitate the prescription of suitable treatment to reduce or prevent said demineralization.
This method: <br> - facilitates the diagnosis of early dental demineralization without external signs that indicate its presence, which is currently difficult with the in vivo routine techniques; <br> - can use a variety of laser types that emit in the visible range; <br> - is applicable as a complementary technique to different types of diseases that affect hard tissues of the tooth, starting with dental caries but also including fluorosis or amelogenesis imperfect; <br> - can be easily transferred to the clinics. It may be implemented in addition to software to calculate mineralization indices, which facilitates and streamlines the processing of diagnostic information. <p> Facilitating the early diagnosis of demineralization processes is essential in order to apply the least aggressive treatment possible as to ensure good oral health. As a quantitative and objective complement to the usual diagnosis, allows to develop treatments according to the quantified degree of dental demineralization.
Dental demineralization processes are a significant oral health problem nowadays, especially in the most industrialized countries wherein it is the disease with the highest prevalence and incidence in the population, largely affecting schoolchildren (60-90%) and the vast majority of adults ( Petersen P. E. World Oral Health report 2003. World Health Organization Geneva, Switzerland, http://www.who.int/oral_health/publications/report03 /en/). <p>
To apply the least aggressive treatment possible and ensure good oral health, early diagnosis of demineralization processes is essential. Currently, visual check followed by x-rays is still considered to be the most effective method for the in vivo caries diagnosis (Lizmar et. al. 2011, vide supra). However, given the lack of improvements related to specificity, it would interesting to provide results beyond the simple presence/absence of the disease and be able to determine aspects such as the extent of the affected tissue, the degree of activity of the lesion or improve the diagnostic sensitivity to early stages dental demineralization. <p>
<p>
We have developed a complementary biomedical technology that allows for the ex vivo study of dental tissue composition, with great interest to complement the dental health diagnosis. <p>
The results obtained for the case studies using the proposed mineralization indices have clearly validated Raman spectroscopy, and the normal pattern established for the levels of mineralization in healthy enamel, as a complementary quantitative technique that is reliable, objective and self-sufficient to diagnose dental demineralization. <p>
The diagnostics obtained provided high levels of specificity and sensitivity, both on a surface level, as well as in inner teeth tissues. <p>
The mineralization indices of the ex vivo dental parts object of study are obtained almost in real time, and their correspondence with the confidence interval, or normal pattern for health states of dental mineralization, are checked.<p>
<p>
We hereby describe a particular embodiment, with two dental parts having a different external appearance of demineralization: upper molar (Figure 3(a)) and upper premolar (Figure 3(b)), extracted from two patients by medical instruction after the diagnosis of periodontal disease due to having high mobility, were evaluated by Raman spectroscopy. Both figures show the ex vivo dental parts analysed from different angles: oral, occlusal and longitudinal cross section in detail. <p>
In the images of the upper molar (Figure 3(a)), clear external signs of dental demineralization are observed. In the case of the premolar tooth (Figure 3(b)), it presents inner demineralization without clear external signs of an imbalance in demineralization and dental caries, which would make it possible to assess the depth of detection of the Raman signal in the tissue. By providing a longitudinal cross-section the inner dental caries can be observed. Thus, zone 1 of Figure 3 corresponds in both cases to the healthy enamel, zone 2 to the dentin affected by caries and zone 3 to the external area of interest, to be assessed by the quantitative Raman methodology by indices.