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Title: The investigation of Optical Coherence Tomography as a clinical tool to determine the extent of Molar Incisor Hypomineralisation (MIH) lesions
Author: Al-Azri, K. M. H.
ISNI:       0000 0004 8502 6479
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2015
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Molar incisor hypomineralisation (MIH) is associated with abnormal mineralisation of enamel during tooth development. It is probably related to systemic upset during this stage of enamel formation. Diagnosing this condition at an early stage is essential in its management, due to complications such as hypersensitivity, post-eruptive breakdown and rapid carious progression in the affected teeth. The current diagnostic measures are clinical visual examination with the aid of indices which are used to describe the defects and radiographic examination of the affected teeth. These diagnostic tools have their limitations and therefore there is a need for better diagnostic tools to give more information about the extent of these defects into the enamel. Optical coherence tomography (OCT) was investigated in this project as an alternative diagnostic tool for MIH defects. The aim of this study was to develop the use of OCT in diagnosing the MIH and correlating it with the conventional clinical methods. In addition, OCT was verified with imaging modalities used in investigating the ultrastructure of MIH affected FPMs such as X-ray microtomography (XMT) and synchrotron X-ray diffraction (SXRD). Ethical approval was obtained for the study. Teeth were prepared immediately after collection, and stored in a refrigerator at 4°C until imaged. MIH defects were categorised using the mDDE index, then radiographic images were taken. Teeth then imaged using OCT (VivoSight diagnostic ™) in King's College London (KCL) Dental Institute where each surface was scanned separately. Teeth were taken to the Dental Physical Science Department, Queen Mary University of London (QMUL) were they were imaged using XMT (MuCat 2 scanner™). They were sectioned into thin sections of 300µm thick and polished down to 220-250µm. SXRD was done on these sections on the BM28 (XMaS) beamline at the European Synchrotron Radiation Facility (ESRF), Grenoble, France and enamel diffraction patterns were obtained. The incident light from OCT behaved differently when compared between control and MIH enamel as well as when different types of MIH defects were compared. More details about the ultrastructure of enamel and the extent of the MIH lesions were obtained from OCT images when compared to clinical examination using mDDE index and radiographs. An association between the OCT Images and the mineral density, obtained from XMT, was found. However, there was no change in enamel crystal orientation between MIH and healthy enamel, but the magnitude of the enamel crystal organisation was different in both types. Optical Coherence Tomography proved to be a potential diagnostic tool in determining the extent of MIH defects and both XMT and SXRD helped in understanding OCT imaging.
Supervisor: Bozec, L. ; Parekh, S. ; Cook, R. ; Al-Jawad, M. ; Festy, F. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available