Alsabah, Dalal Khaled; (2018) The investigation of optical coherence tomography as a clinical tool to determine the extent of molar incisor hypomineralisation (MIH) lesions. Doctoral thesis (D.Dent), UCL (University College London).

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Abstract

Molar incisor hypomineralisation (MIH) is a qualitative developmental defect in enamel, defined as hypomineralisation of systemic origin affecting first permanent molars and less frequently associated with permanent central incisors. It’s prevalence worldwide ranges from 2.4-40%. MIH poses challenges to both patients and clinicians, and a burden on global health. Therefore, prompt diagnosis and treatment is crucial to prevent its complications. The current diagnostic measures are clinical visual examination by means of indices, and radiographic examination. However, current diagnostic tools are subject to limitations, bias and drawbacks, therefore there is a need for better diagnostic tools to determine the extent and depth of MIH lesions to determine the tooth’s prognosis. The aim of this study is to expand the use of Optical Coherence Tomography (OCT) imaging in dentistry, using it as a routine clinical diagnostic tool in MIH, and to compare the results with conventional clinical methods i.e. radiographs and clinical indices. In addition, to define some markers in the OCT scan and scattering profile intensity plots for both sound and MIH affected teeth, to help aid in their diagnosis. The major outcome of this study to date came from observing and comparing the OCT scattering intensity profiles for both control and MIH lesions. These were investigated in greater detail and different empirical markers were extracted to stereotype each defect. This led us to establish scattering fingerprints for each type of MIH lesion. A multi-assessors analysis followed by a kappa analysis was done to evaluate the selectivity and accurateness of our makers. In addition, evaluating the lesion as a 17 whole, progressing it from a 2D to a 3D perspective which helps interpret the data easier. In conclusion, OCT has been recognised to be a safe and useful diagnostic method when studying MIH lesions, providing an understanding of the lesion in terms of depth and extent, therefore helping in predicting the lesion’s prognosis, which is not found in conventional methods. In addition, OCT helps to differentiate between MIH and sound teeth, and additionally between different types of MIH lesions.

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