Impact of early biofilm on the assessment of initial enamel erosion with swept-source optical coherence tomography

Objective: This study examined the impact of early biofilm on the tooth surface, during the assessment of initial enamel erosion using swept-source optical coherence tomography (SS-OCT). Method and materials: Forty-five enamel windows of 2 × 4 mm2 were prepared on 23 extracted human teeth. The specimens were exposed to citric acid (pH 3.2) for 30 minutes and randomly divided into three groups (n = 15): Group 1, no biofilm; Group 2, 1-day-old biofilm; and Group 3, 3-day-old biofilm. Specimens in Groups 2 and 3 were inoculated with oral bacteria (Streptococcus sanguinis, Streptococcus mitis, and Actinomyces naeslundii) to produce early laboratory-cultivated biofilms for 1 and 3 days respectively. Surface microhardness (SMH) measurements were taken at pre- (t1) and post-erosion (t2); and SS-OCT scans were done at t1, t2, and post-biofilm cultivation (t3). Integrated reflectivity (IR) of the tooth-air interface (IRsurface) and enamel (IRenamel) were computed from the mean A-scans. Statistical analysis was performed using paired t tests and one-way ANOVA (α = .05).
Results: A significant increase in IRenamel was observed at t2 (P .05). At t3, IRsurface between Group 1 (control) and Group 2 (P = .012) as well as Group 3 (P = .001) were significantly different. Significant variances in IRenamel were perceived between t2 and t3 for Groups 2 and 3 but not for Group 1.
Conclusion: As early biofilm affected SS-OCT assessment of initial enamel erosion, they should be removed from the tooth surface prior to OCT procedures. (Quintessence Int 2021;52:476–486; doi: 10.3290/j.qi.b912625) Keywords: assessment, biofilm, detection, enamel erosion, initial erosion, optical coherence tomography