DENTAL
Imaging bites back
Keely Portway investigates how vision technology is being used in the dental sector, from initial diagnosis, to quality control of prostheses
T
he use of digital technology in dentistry has been acknowledged for some time as a way to make these procedures more
efficient than the more traditional mechanical tools. But, with clinics gradually beginning to invest in this kind of technology – which itself is developing at pace – ‘digital dentistry’ is starting to become more mainstream. In research and academia the technology
is not new. In the early 1970s, Francois Duret was credited with inventing the first computer-assisted design/computer-assisted manufacturing (CAD/CAM) tool for oral healthcare aſter conceptualising how the kind of 3D digital technology used in other industries could be adapted to this market. To use a more recent example, Pete Tomlins,
senior lecturer in oral biometrics at Queen Mary University of London, is currently undertaking research on using optical coherence tomography (OCT) to diagnose and understand oral diseases of hard and soſt tissue, such as oral epithelial dysplasia, periodontal inflammation, caries and erosion. Tomlins is focusing on the translation of his laboratory-based studies into clinical use.
Bit between the teeth Tomlins explained: ‘Dentistry currently uses lots of x-rays and my interest in is replacing these x-rays with alternative technologies.’ Te reason, he continued, is that there is ‘no level of safe x-ray’. Te OCT imaging technique can look both inside and between teeth, which is oſten what a dental x-ray is used for. X-rays can identify whether tooth decay
is beginning in between the teeth, where a mirror cannot reach. If decay is starting, the
earliest stage is called de-mineralisation or white spot lesions. ‘Te problem with x-rays,’ continued
Tomlins, ‘is, for one, they are not really good at seeing any lesions, because all the information is compressed down into 2D.’ In addition, tooth density will vary because of the curvature of the tooth. ‘Tere are all these confounders that could make a lesion either look smaller or bigger, or it might not even show up at all. Early lesions are quite difficult
26 Imaging and Machine Vision Europe • August/September 2019
to spot on a dental x-ray, as they’re not very high-quality images.’
Safe and sound Te other issue is the safety of x-rays, especially when treating children for white spot lesions. Treating the lesions involves monitoring the re-mineralisation process over time, which potentially means exposing the child to more x-rays. A solution, Tomlins believes, is to use
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