Diagnostic performance of swept-source optical coherence tomography in the detection of tooth cracks: a narrative review

OBJECTIVES: Tooth cracks are among the most common clinical findings that can affect the prognosis of the tooth. The swept-source optical coherence tomography (SS-OCT) is a non-invasive technique that was developed to identify cracks or fractures. Even though the diagnostic value of SS-OCT has been studied by several researchers, the available evidence is still inconclusive. This review aims to evaluate the reported performance of SS-OCT in detecting tooth cracks and to identify factors described in the literature that may affect it. MATERIALS AND METHODS: An electronic search was conducted on PubMed, Scopus, Web of Science, and Google Scholar to extract and review the English articles published between January 2012 and December 2024. The keywords were optical coherence tomography, swept-source OCT, SS-OCT, tooth crack, dental crack, enamel crack, dentin crack, and fracture detection. Studies published in English that investigated SS-OCT for the detection of enamel, dentin, or root cracks were included, whereas review articles, non-​dental OCT studies, and studies focusing solely on other diagnostic methods were excluded. RESULTS: The literature search identified 121 articles; 14 of them met the criteria and were included. Out of the 14 included articles, only one clinical article was included. CONCLUSIONS: The SS-OCT is a non-invasive and radiation-free imaging method for detecting tooth cracks, with higher diagnostic performance reported for enamel cracks. However, its performance in deeper dentin and root cracks appears to be affected by light penetration limitations and light scattering. Further technological development and well-designed clinical studies are needed to clarify its clinical utility.