A Multimodal Approach to Pulpal Diagnosis and Treatment Monitoring
Objectives: Pulpal exposure usually leads to loss of pulp vitality, but occasionally tooth vitality can be maintained by the treating the exposed pulp with medicaments. The ability to monitor pulpal response is crucial to avoid detrimental treatment outcome. This is not possible using existing techniques. The aim of this study was to develop a non-invasive technique for monitoring pulpal response to trauma and treatment.
Methods: 10 Hamsters were selected for study and randomly divided into two groups of five. In one group, cavities were prepared on the buccal surface of the teeth with a 3mm length and 0.5mm width. The pulp remained covered with 100-micrometer thichness of dentin. In the 2nd group, an additional 0.5mm diameter pulpal exposure was created. The operative sides were imaged non-invasively in-vivo using MPM (Multi-photon Fluorescence Microscopy) and OCT (optical coherence tomography) directly after preparation until day 30. The images were mapped and quantified using 3-D processing software (AMIRA™).
Results: Optimal results were obtained using 1300 nm wavelength OCT imaging and 760 nm MPM imaging. Merging MPM and OCT permitted visualization and quantification of structural change in hard and soft tissues as well as vascular response.
Conclusions: 3-D reconstruction of MPM and OCT images at the appropriate wavelengths provides an excellent tool for the evaluation of pulpal health and therapeutic response.