Tooth caries detection by curve fitting of laser‐induced fluorescence emission: A comparative evaluation with reflectance spectroscopy

Abstract Background and Objectives Nitrogen laser‐induced fluorescence (LIF) spectra of sound tooth consists of two broad bands centered at 440 and 490 nm, with two apparent side bands on either side. In order to locate the exact peak position of these bands and to effectively utilize the LIF spectral signatures for detection of tooth caries, the LIF spectra were curve‐fitted using Gaussian spectral functions and the results were compared with those from diffuse reflectance spectral measurements. Study Design/Materials and Methods The excitation light at 337.1 nm was guided to the sound and caries‐affected tooth samples through the central fiber of the fiber‐optic probe of a laser‐induced fluorescence reflectance spectroscopy (LIFRS) system. Six surrounding fibers of the probe collect tooth fluorescence or diffuse reflectance from the lesion and direct it to a miniature spectrometer. The in vitro spectra were obtained from healthy enamel, dentin, and pulp level tooth caries. Results As compared to sound tooth, the caries tooth showed lower fluorescence and reflectance intensities in the 350–700 nm region. The deconvoluted peaks in the LIF spectra of sound tooth were found centered at 403.80, 434.20, 486.88, and 522.45 nm, whereas in the case of pulp level caries, a new peak was observed at 636.78 nm. Curve‐fitted parameters, such as peak center, Gaussian curve area, full width at half intensity maximum (FWHM), and their ratios, were also found to vary with the stage of tooth caries. The ratios involving the 435 nm band, such as F405/F435, F435/F490, and F435/F525 ratios derived from curve‐fitted areas and amplitudes, were found to be sensitive to discriminate between sound, dentin, and pulp level caries. Among the various diffuse reflectance spectral intensity ratios, the R500/R700 was found to be most sensitive to distinguish between pulp and dentin level caries. Conclusions Nitrogen laser‐excited fluorescence spectral studies were found to be more suited for detection of caries lesions. The LIF measurement with spectral analysis, done by curve fitting, outscores the diffuse reflectance methodology and shows the potential to screen different levels of tooth decay in a clinical setting. Lasers Surg. Med. 00:1–9,2005. © 2005 Wiley‐Liss, Inc.