Three-dimensional assessment of proximal contact enamel using optical coherence tomography

Thwe Zin Ei, Yasushi Shimada, Ahmed Abdou, Alireza Sadr, Masahiro Yoshiyama, Yasunori Sumi, Junji Tagami

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Objective: The purpose of this study was to detect and investigate the association of enamel microcracks with demineralization at proximal contact areas of premolars, using 3D swept-source optical coherence tomography (SS-OCT). Methods: Extracted maxillary and mandibular premolars (n = 50 each), without any visible tooth cracks, were examined for demineralization of interproximal contact areas, using the International Caries Detection and Assessment System (ICDAS). SS-OCT was used to evaluate demineralization and detect microcracks. Demineralization progression was divided into 4 types by depth: 0 for sound enamel and Type I, II, and III for enamel demineralization penetrating into the outer third, the middle third, and the inner third of the enamel thickness, respectively. Enamel microcracks were classified according to the predominant crack pattern: Type O, no cracks; Type A, subsurface microdefects; Type B, enamel microcrack running along the direction of the enamel prism; Type C, enamel microcrack running transverse to the enamel prism direction; and Type D, a combination of patterns A, B, and C. SS-OCT findings were confirmed by confocal laser scanning microscopy observation. Results: Microcracks confined within the superficial enamel in proximal contact areas were seen as bright lines on SS-OCT. There were significant positive correlations among ICDAS codes, demineralization levels, and microcrack distribution (p ≤ 0.001). The mesial side of maxillary premolars showed significantly more demineralization (n = 36) and microcracks (n = 27) than that of the mandibular premolars (n = 20 and n = 14, respectively; p < 0.001). Significance: The presence of microcracks within the superficial enamel in proximal contact areas could be determined using SS-OCT, and correlated with the level of demineralization. 3D SS-OCT is a valuable diagnostic tool for comprehensive assessment of microstructural changes related to enamel demineralization and crack development.

Original languageEnglish
Pages (from-to)e74-e82
JournalDental Materials
Issue number4
Publication statusPublished - Apr 2019


  • 3D imaging
  • Demineralization
  • Enamel
  • International Caries Detection and Assessment System (ICDAS)
  • Microcrack
  • Optical coherence tomography
  • Proximal contact

ASJC Scopus subject areas

  • Materials Science(all)
  • Dentistry(all)
  • Mechanics of Materials


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