Red fluorescence of dental biofilm as an indicator for assessing the efficacy of antimicrobials

Lee, Eun-Song,de Josselin de Jong, Elbert SOCIETY OF PHOTO-OPTICAL INSTRUMENTATION ENGINEERS 2018 JOURNAL OF BIOMEDICAL OPTICS Vol.23 No.1

Quantitative light-induced fluorescence technology for quantitative evaluation of tooth wear

Kim, Sang-Kyeom,Lee, Hyung-Suk,Park, Seok-Woo,Lee, Eun-Song,de Josselin de Jong, Elbert,Jung, Hoi-In,Kim, Baek-Il SOCIETY OF PHOTO-OPTICAL INSTRUMENTATION ENGINEERS 2017 JOURNAL OF BIOMEDICAL OPTICS Vol.22 No.12

<P>Various technologies used to objectively determine enamel thickness or dentin exposure have been suggested. However, most methods have clinical limitations. This study was conducted to confirm the potential of quantitative light-induced fluorescence (QLF) using autofluorescence intensity of occlusal surfaces of worn teeth according to enamel grinding depth in vitro. Sixteen permanent premolars were used. Each tooth was gradationally ground down at the occlusal surface in the apical direction. QLF-digital and swept-source optical coherence tomography images were acquired at each grinding depth (in steps of 100 mu m). All QLF images were converted to 8-bit grayscale images to calculate the fluorescence intensity. The maximum brightness (MB) values of the same sound regions in grayscale images before (MBbaseline) and phased values after (MBwom) the grinding process were calculated. Finally, 13 samples were evaluated. MBwom increased over the grinding depth range with a strong correlation (r = 0.994, P < 0.001). In conclusion, the fluorescence intensity of the teeth and grinding depth was strongly correlated in the QLF images. Therefore, QLF technology may be a useful non-invasive tool used to monitor the progression of tooth wear and to conveniently estimate enamel thickness. (C) 2017 Society of Photo-Optical Instrumentation Engineers (SPIE)</P>

Caries detection and quantification around stained pits and fissures in occlusal tooth surfaces with fluorescence

Lee, Hyung-Suk,Kim, Sang-Kyeom,Park, Seok-Woo,de Josselin de Jong, Elbert,Kwon, Ho-Keun SOCIETY OF PHOTO-OPTICAL INSTRUMENTATION ENGINEERS 2018 JOURNAL OF BIOMEDICAL OPTICS Vol.23 No.9

Development of a fluorescence-image scoring system for assessing noncavitated occlusal caries

Jung, Eun-Ha,Lee, Eun-Song,Jung, Hoi-In,Kang, Si-Mook,de Josselin de Jong, Elbert,Kim, Baek-Il Elsevier 2018 Photodiagnosis and photodynamic therapy Vol.21 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>This study aimed (1) to develop a scoring system based on a quantitative light-induced fluorescence (QLF) score for the occlusal caries (QS-Occlusal) that standardizes the fluorescence properties of noncavitated lesions from QLF images, (2) to confirm the validity and reliability of QS-Occlusal, and (3) to determine whether it is possible to replace existing clinical examinations by image evaluations based on the developed QS-Occlusal for assessing occlusal caries lesions.</P> <P><B>Methods</B></P> <P>This clinical study investigated 791 teeth of 94 subjects. The teeth were assessed by visual and tactile examinations using ICDAS criteria and quantitative light-induced fluorescence-digital (QLF-D) image examinations. QS-Occlusal was divided into four stages (from 0 to 3) based on the progression level of the lesion and the fluorescence loss and red fluorescence on captured QLF-D images. Two trained examiners who were not involved in the visual examination evaluated occlusal fluorescence images using QS-Occlusal. The maximum loss of fluorescence (|Δ<I>F</I> <SUB>max</SUB>|) and the maximum change in the ratio of red and green fluorescence (Δ<I>R</I> <SUB>max</SUB>) were quantitatively analyzed by the QA2 software to detect differences between the QS-Occlusal groups. The modalities were compared in terms of sensitivity, specificity, and area under the receiver operating characteristics (AUROC) curve for three different thresholds of the ICDAS codes: 0 vs 1–4 (D<SUB>1</SUB>), 0–2 vs 3/4 (D<SUB>2</SUB>), and 0–3 vs 4 (D<SUB>3</SUB>).</P> <P><B>Results</B></P> <P>|Δ<I>F</I> <SUB>max</SUB>| increased significantly by about 4.7-fold (from 15.94 to 75.63) when QS-Occlusal increased from 0 to 3. Δ<I>R</I> <SUB>max</SUB> was about 6.2-fold higher for QS-Occlusal=1 (49.74) than for QS-Occlusal=0 (8.04), and 21.6-fold higher for QS-Occlusal=3 (<I>P<</I> 0.05). The new QS-Occlusal showed an excellent AUROC (ranging from 0.807 to 0.976) in detecting occlusal caries when optimum cutoff values were applied. The intra- and interexaminer agreements indicated excellent reliability, with ICC values of 0.94 and 0.86, respectively.</P> <P><B>Conclusions</B></P> <P>The QS-Occlusal proposed in this study can be used in the clinical detection of noncavitated lesions with an excellent diagnostic ability. This makes it possible to replace clinical examinations and intuitively evaluate the lesion severity and status relatively easily and objectively by applying this scoring system to fluorescence images.</P> <P><B>Highlights</B></P> <P> <UL> <LI> QLF technology can be a useful screening tool for noncavitated occlusal lesion. </LI> <LI> QLF score can be used to evaluate the severity and status of occlusal caries lesion nondestructively. </LI> <LI> QLF score may be able to replace existing clincal examination in the future with excellent diagnostic ability for detecting noncavitated caries. </LI> </UL> </P>

A new screening method to detect proximal dental caries using fluorescence imaging

Kim, Eun-Soo,Lee, Eun-Song,Kang, Si-Mook,Jung, Eun-Ha,de Josselin de Jong, Elbert,Jung, Hoi-In,Kim, Baek-Il Elsevier 2017 Photodiagnosis and photodynamic therapy Vol.20 No.-

<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>This study aimed to assess the screening performance of the quantitative light-induced fluorescence (QLF) technology to detect proximal caries using both fluorescence loss and red fluorescence in a clinical situation. Moreover, a new simplified QLF score for the proximal caries (QS-Proximal) is proposed and its validity for detecting proximal caries was evaluated as well.</P> <P><B>Methods</B></P> <P>This clinical study included 280 proximal surfaces, which were assessed by visual-tactile and radiographic examinations and scored by each scoring system according to lesion severity. The occlusal QLF images were analysed in two different ways: (1) a quantitative analysis producing fluorescence loss (Δ<I>F</I>) and red fluorescence (Δ<I>R</I>) parameters; and (2) a new QLF scoring index. For both quantitative parameters and QS-Proximal, the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were calculated as a function of the radiographic scoring index at the enamel and dentine caries levels.</P> <P><B>Results</B></P> <P>Both Δ<I>F</I> and Δ<I>R</I> showed excellent AUROC values at the dentine caries level (Δ<I>F</I> =0.860, Δ<I>R</I> =0.902) whereas a relatively lower value was observed at the enamel caries level (Δ<I>F</I> =0.655, Δ<I>R</I> =0.686). The QS-Proximal also showed excellent AUROC ranged from 0.826 to 0.864 for detecting proximal caries at the dentine level.</P> <P><B>Conclusion</B></P> <P>The QS-Proximal, which represents fluorescence changes, showed excellent performance in detecting proximal caries using the radiographic score as the gold standard.</P> <P><B>Highlights</B></P> <P> <UL> <LI> QLF technology can be a useful screening tool prior to radiographic examinations. </LI> <LI> Both quantitative parameters detected from QLF images showed excellent performance for detecting proximal caries. </LI> <LI> New QLF scoring system can be used to evaluate the severity of proximal caries non-destructively. </LI> </UL> </P>

법랑질 병소 회복율 평가를 위한 QLF 기술의 적용

김경민(Gyung-Min Kim),구혜민(Hye-Min Ku),이은송(Eun-Song Lee),강시묵(Si-Mook Kang),Elbert de Josselin de Jong,권호근(Ho-Keun Kwon),김백일(Baek-Il Kim) 대한치과의사협회 2017 대한치과의사협회지 Vol.55 No.2

Purpose: The aim of this in vitro study was to assess changes in remineralization by stimulated human saliva over a short period of 48 hours with quantitative light-induced fluorescence (QLF) technology. Materials and Methods: Bovine incisor surfaces were demineralized for 10 days. Two types of stimulated saliva were collected from 7 healthy persons. 24 hours after tooth brushing (Stimulated saliva group) and immediately after tooth brushing with 1,000 ppm NaF dentifrice (Dentifrice saliva group). The specimens were immersed in saliva and fluorescence images were obtained by QLF-digital (QLF-D biluminator<SUP>TM</SUP>‚) at 2, 4, 6, 12, 24, and 48 hours fluorescence loss (⊿F%) of the lesions. A paired t-test was performed to assess fluorescence differences between before (⊿Fbaseline) and after (⊿Ftreatment time) the remineralization process. Results: Before the remineralization, the mean ⊿Fbaseline of the initial demineralized specimens was -18.42±0.15 (%). In both groups, the ⊿F values obtained at baseline and after 2 hours were statistically significant (P < 0.001), indicating recovery of the lesions by approximately 40% after 2 hours. After 48 hours, remineralization rates were slightly higher (49%) for the stimulated saliva group than for the dentifrice saliva group (41%), but the difference was not statistically significant. Conclusions: With QLF minute degrees of remineralization by saliva can be measured in periods as short as 2 hours. Additionally no significantly higher effects of remineralization were observed in the dentifrice saliva group when compared to the stimulated saliva group.

세대별 QLF 기기의 평활면 비와동형 법랑질 우식 병소 탐지에 관한 진단정확도 비교

박석우(Seok-Woo Park),이형석(Hyung-Suk Lee),김상겸(Sang-Kyeom Kim),이은송(Eun-Song Lee),Elbert de Josselin de Jong,김백일(Baek-Il Kim) 대한치과의사협회 2018 대한치과의사협회지 Vol.56 No.1

Purpose: The aim of in vitro study was to compare the diagnostic accuracy to detect non-cavitated enamel caries on smooth surface by using four kinds of the QLF devices. Materials and Methods: A total of 52 human permanent premolars and molars were used. Fluorescence images were captured by the QLF devices (Inspektor Pro, QLF-D, Qraycam, and Qraypen). Fluorescence loss of the QLF was calculated. The severity of lesions was categorized into the following 3 scores using polarized light microscopy: normal (S), enamel demineralization to outer half of enamel (D1), and inner half of the enamel up to the dentin-enamel junction (D2). The Kruskal-Wallis test was used to compare the fluorescence loss among the QLF devices. Spearman rank correlation coefficient between histological scores and fluorescence loss of the devices was calculated. The sensitivity, specificity, and area under the receiver operating curve (AUROC) were calculated to compare their diagnostic accuracies. Results: The correlation coefficients between histological scores and the fluorescence loss of the devices showed 0.77 to 0.81 (P < 0.001). All histological scores, the fluorescence loss among the devices showed no statistical difference. Among the devices, sensitivity, specificity, and AUC values of the fluorescence loss showed 0.84 to 0.94, 0.76 to 0.90, and 0.90 to 0.92, respectively. Conclusions: All QLF devices had no difference with excellent diagnostic accuracies to detect non-cavitated enamel caries on smooth surface.