Swept-source optical coherence tomographic observation on prevalence and variations of cemento-enamel junction morphology. 2020

Sandeep Kumar Araveti, and Noriko Hiraishi, and Nao Kominami, and Masayuki Otsuki, and Yasunori Sumi, and Cynthia K Y Yiu, and Junji Tagami
Cariology and Operative Dentistry, Oral Restoration Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.

To investigate the prevalence of different patterns of cemento-enamel junction (CEJ) morphology under swept-source optical coherence tomography (SS-OCT). One hundred extracted human teeth were used consisting of incisors, premolars, and molars. Each sample was observed for every 500 μm circumferentially along CEJ and OCT images of the pattern were noted. Microscopic observations were done for the representative sample using confocal laser scanning microscope (CLSM) and transmission electron microscope (TEM). The OCT images exhibited four CEJ patterns: edge-to-edge (type I), exposed dentin (type II), cementum overlapping enamel (type III), and enamel overlapping cementum (type IV). The prevalence of CEJ patterns was further statistically considered for mesial, distal, buccal, and lingual surfaces. The real-time imaging by SS-OCT instantly determined CEJ morphology. CLSM and TEM observation revealed morphological features along CEJ, which corresponded to OCT images of CEJ anatomy. OCT results showed 56.8% of type I pattern predominantly found on proximal surfaces, followed by 36.5% of type II pattern on buccal and lingual surface, 6.4% of type III pattern, and 0.3% of type IV pattern. There was a significant difference in prevalence of CEJ patterns among different types of teeth, but there was no statistically significant difference among the four surfaces in each type of teeth. OCT is a non-invasive diagnostic tool to examine the CEJ patterns along the entire circumference. OCT observation revealed even minor dentin exposure that would need clinical and home procedures to prevent any symptoms.

UI MeSH Term Description Entries
D008963 Molar The most posterior teeth on either side of the jaw, totaling eight in the deciduous dentition (2 on each side, upper and lower), and usually 12 in the permanent dentition (three on each side, upper and lower). They are grinding teeth, having large crowns and broad chewing surfaces. (Jablonski, Dictionary of Dentistry, 1992, p821) Molars
D003743 Dental Enamel A hard thin translucent layer of calcified substance which envelops and protects the dentin of the crown of the tooth. It is the hardest substance in the body and is almost entirely composed of calcium salts. Under the microscope, it is composed of thin rods (enamel prisms) held together by cementing substance, and surrounded by an enamel sheath. (From Jablonski, Dictionary of Dentistry, 1992, p286) Enamel,Enamel Cuticle,Dental Enamels,Enamel, Dental,Enamels, Dental,Cuticle, Enamel,Cuticles, Enamel,Enamel Cuticles,Enamels
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001641 Bicuspid One of the eight permanent teeth, two on either side in each jaw, between the canines (CUSPID) and the molars (MOLAR), serving for grinding and crushing food. The upper have two cusps (bicuspid) but the lower have one to three. (Jablonski, Dictionary of Dentistry, 1992, p822) Premolar,Bicuspids,Premolars
D046529 Microscopy, Electron, Transmission Electron microscopy in which the ELECTRONS or their reaction products that pass down through the specimen are imaged below the plane of the specimen. Electron Diffraction Microscopy,Electron Microscopy, Transmission,Microscopy, Electron Diffraction,Transmission Electron Microscopy,Diffraction Microscopy, Electron,Microscopy, Transmission Electron
D018613 Microscopy, Confocal A light microscopic technique in which only a small spot is illuminated and observed at a time. An image is constructed through point-by-point scanning of the field in this manner. Light sources may be conventional or laser, and fluorescence or transmitted observations are possible. Confocal Microscopy,Confocal Microscopy, Scanning Laser,Laser Microscopy,Laser Scanning Confocal Microscopy,Laser Scanning Microscopy,Microscopy, Confocal, Laser Scanning,Confocal Laser Scanning Microscopy,Confocal Microscopies,Laser Microscopies,Laser Scanning Microscopies,Microscopies, Confocal,Microscopies, Laser,Microscopies, Laser Scanning,Microscopy, Laser,Microscopy, Laser Scanning,Scanning Microscopies, Laser,Scanning Microscopy, Laser
D019237 Tooth Cervix The constricted part of the tooth at the junction of the crown and root or roots. It is often referred to as the cementoenamel junction (CEJ), the line at which the cementum covering the root of a tooth and the enamel of the tooth meet. (Jablonski, Dictionary of Dentistry, 1992, p530, p433) CEJ,Cementoenamel Junction,Cervix Dentis,Cementoenamel Junctions,Cervix, Tooth,Junction, Cementoenamel,Junctions, Cementoenamel
D041623 Tomography, Optical Coherence An imaging method using LASERS that is used for mapping subsurface structure. When a reflective site in the sample is at the same optical path length (coherence) as the reference mirror, the detector observes interference fringes. OCT Tomography,Optical Coherence Tomography,Coherence Tomography, Optical,Tomography, OCT

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