Near-infrared imaging in orthodontic intraoral scanners for early interproximal caries detection.

INTRODUCTION: Intraoral scanners commonly used in orthodontic offices now offer near-infrared imaging (NIRI) technology, advertised as a screening tool to identify interproximal caries. This study aimed to evaluate the reliability and validity of NIRI detection of interproximal carious lesions in a common intraoral scanner (iTero Element 5D; Align Technology, San Jose, Calif) with and without bitewing radiograph complement, compared with a microcomputed tomography (micro-CT) reference standard. METHODS: Extracted human posterior teeth (premolars and molars) were selected for early (noncavitated) interproximal carious lesions (n = 39) and sound control surfaces (n = 47). The teeth were scanned via micro-CT for evaluation by 2 blinded evaluators using consensus scoring. The teeth were mounted to simulate anatomic interproximal contacts and underwent a NIRI scan using iTero Element 5D and bitewing radiographs. Two trained, calibrated examiners independently evaluated (1) near-infrared images alone with clinical photograph, (2) bitewing radiograph alone with clinical photograph, and (3) near-infrared images with bitewing radiograph and clinical photograph in combination, after at least a 10-day washout period between each evaluation. RESULTS: Interrater reliability was highest for NIRI alone (k = 0.533) compared with bitewing radiograph alone (k = 0.176) or in combination (k = 0.256). NIRI alone showed high specificity (0.83-0.96) and moderate sensitivity (0.42-0.63) compared with a micro-CT reference standard. Dentin lesions were significantly more reliably detected than enamel lesions. CONCLUSIONS: After rigorous training and calibration, NIRI can be used with moderate reliability, high specificity, and moderate sensitivity to detect noncavitated interproximal carious lesions.

Microcomputed Tomography Mineral Density Profile as Reference Standard for Early Carious Lesion Activity Assessment.

Early caries diagnosis is crucial to treatment decisions in dentistry and requires identification of lesion activity: whether a carious lesion is active (progressively demineralizing) or arrested (progressively remineralizing). This study aimed to identify microtomographic (micro-CT) differences between active and arrested smooth surface enamel lesions, to quantify those micro-CT differences by creating thresholds for ex vivo caries activity assessment to serve as a future reference standard, and to validate those thresholds against the remaining sample. Extracted human permanent teeth (n = 59) were selected for sound surfaces and non-cavitated smooth surface carious lesions. Each surface was then examined for caries activity by calibrated individuals via visual-tactile examination using the International Caries Classification and Management System (ICCMS) activity criteria. Each tooth was scanned via micro-CT and the mineral density was plotted against lesion depth. The area under the curve (AUC) was calculated and represented the loss of density for the outermost 96 µm of enamel. AUC thresholds obtained from micro-CT were established to classify sound, remineralized, and demineralized surfaces against the gold standard examiner's lesion assessment of sound, inactive, and active lesions, respectively. The established AUC thresholds demonstrated moderate agreement with the assessment in identifying demineralized lesions (k = 0.45), with high sensitivity (0.73) and specificity (0.77). This study demonstrated quantifiable differences among demineralized lesions, remineralized lesions, and sound surfaces, which contributes to the establishment of micro-CT as a reference standard for caries activity that may be used to improve clinical and laboratorial dental caries evaluations.

Interface Engineering of Colloidal CdSe Quantum Dot Thin Films as Acid-Stable Photocathodes for Solar-Driven Hydrogen Evolution.

Colloidal semiconductor quantum dot (CQD)-based photocathodes for solar-driven hydrogen evolution have attracted significant attention because of their tunable size, nanostructured morphology, crystalline orientation, and band gap. Here, we report a thin film heterojunction photocathode composed of organic PEDOT:PSS as a hole transport layer, CdSe CQDs as a semiconductor light absorber, and conformal Pt layer deposited by atomic layer deposition (ALD) serving as both a passivation layer and cocatalyst for hydrogen evolution. In neutral aqueous solution, a PEDOT:PSS/CdSe/Pt heterogeneous photocathode with 200 cycles of ALD Pt produces a photocurrent density of -1.08 mA/cm2 (AM-1.5G, 100 mW/cm2) at a potential of 0 V versus reversible hydrogen electrode (RHE) ( j0) in neutral aqueous solution, which is nearly 12 times that of the pristine CdSe photocathode. This composite photocathode shows an onset potential for water reduction at +0.46 V versus RHE and long-term stability with negligible degradation. In the acidic electrolyte (pH = 1), where the hydrogen evolution reaction is more favorable but stability is limited because of photocorrosion, a thicker Pt film (300 cycles) is shown to greatly improve the device stability and a j0 of -2.14 mA/cm2 is obtained with only 8.3% activity degradation after 6 h, compared with 80% degradation under the same conditions when the less conformal electrodeposition method is used to deposit the Pt layer. Electrochemical impedance spectroscopy and time-resolved photoluminescence results indicate that these enhancements stem from a lower bulk charge recombination rate, higher interfacial charge-transfer rate, and faster reaction kinetics. We believe that these interface engineering strategies can be extended to other colloidal semiconductors to construct more efficient and stable heterogeneous photoelectrodes for solar fuel production.