Multimodal intraoral camera

ABSTRACT The WHO Global Oral Health Status Report (2022) estimated that oral diseases affect close to $3.5 billion people worldwide. Dental caries and cracks are two common dental diseases. Globally, an estimated $2 billion people suffer from caries of permanent teeth and $514 million children suffer from caries of primary teeth. Cracked tooth is a common dental hard tissue disease and is the third major cause of tooth loss after caries and periodontal disease. While there are some adjuncts based on autofluorescence and transillumination for detecting caries and crack, none of them can provide quantitative and internal tooth structural information for accurate diagnosis and monitoring treatment progress. To address the need of a quantitative device for earlier detection and more accurate diagnosis of caries and crack, Light Research Inc (LRI) proposes to optimize and commercialize a compact multimodal intraoral camera which uniquely integrates polarized white light imaging (pWLI), autofluorescence imaging (AFI), optical coherence tomography (OCT) imaging, and novel NIR transillumination imaging (NIR-TI) modalities. Four imaging modalities with distinct and complementary contrast mechanisms will improve the sensitivity and specificity in detecting caries and crack significantly. The novel system design facilitates the compact integration of four different imaging modalities and enables the seamless transition between imaging modalities. The proposed camera is clinically innovative in that it will screen the tooth in wide field of view (FOV) imaging modes (pWLI, AFI, and/or NIR-TI) to detect and segment suspicious region, and then guide OCT scan to obtain internal tooth structural information of the suspicious region for accurate diagnosis. Earlier caries and crack detection will enable the dental practitioner to initiate early prophylactic treatment, the internal tooth structural information from OCT image and the registered wide-FOV pWLI and AFI images will facilitate the monitoring of treatment progress. To achieve the project goal, LRI has assembled a multidisciplinary team with expertise in developing (Dr. Wilder-Smith) and validating (Dr. Amaechi) optical technologies for oral diseases including caries and crack, developing commercial dental products (Dr. Liang), and developing advanced image processing (Dr. Song). The project team members have collaboratively or independently investigated different imaging modalities for caries and crack detection, as well as for oral cancer detection and diagnosis. In this project, the team will first optimize and prototype two compact multimodal intraoral cameras and develop deep learning-based image segmentation algorithms (Aim 1), optimize system settings and evaluate the proposed multimodal intraoral camera (Aim 2), and then conduct a pilot clinical study to evaluate performance of the multimodal intraoral camera in detecting caries and cracks in human subjects (Aim 3).