Optical Coherence Tomography for Detection of Dental Cracks and Vertical Root Fracture: A Scoping Review.

OBJECTIVES

Vertical root fractures (VRFs) pose significant clinical challenges and may result in tooth loss. Current diagnostic methods, including conventional radiography and CBCT, are challenging to detect VRFs, especially in the early stages. Optical coherence tomography (OCT) has recently been introduced as a non-invasive imaging technique for dental diagnostics. However, current knowledge of OCT in endodontics requires further research. This Article will review current literature on OCT and evaluate its potential as a diagnostic tool for VRFs in endodontics.

METHODS

A comprehensive scoping review was conducted using electronic databases including PubMed, Scopus, Ebsco, Google Scholars, and Embase without any language restrictions up to January 2025, focusing on OCT applications in diagnosing cracks and VRFs. Google and Open-Grey were used to search for grey literature alongside handsearching. Clinical and laboratory-based studies conducted on adult human-teeth were considered eligible. A total of 28,303 studies were generated when screened in the last 20 years; 27,887 studies were found relevant, and 416 duplicates were removed. Following title and abstract screening, a total of 36 studies were considered for full-text review. Ten studies met the inclusion criteria and were included in this review.

RESULTS

OCT system demonstrated high specificity (63%-100%) and sensitivity (83%-98%) in detecting cracks and VRFs. SS-OCT demonstrated promising imaging capabilities and deep penetration. OCT offers advantages over radiographs and CBCT in non-radiation exposure and real-time imaging. OCT systems could be considered in clinical practice following improvements in relation to penetration depth and intra-oral adaptation.

CONCLUSIONS

Within the limitation of this scoping review, the use of OCT is promising for detection of cracks and VRFs. By addressing the limitations related to penetration depth, mechanical design, and soft tissue imaging, OCT may find its path into clinical adoption, including endodontics. Areas that can help includes developing OCT systems tailored for routine endodontic use and assessing long-term impacts in the field.