Indocyanine green (ICG) has been widely used in medical imaging, such as in retinal angiography. Here, we describe a pilot ex vivo study of ICG‐assisted near‐infrared fluorescence (NIRF) dental imaging in the first (700–950 nm for ICG‐NIRF‐I) and second (1000–1700 nm for ICG‐NIRF‐II) NIR windows using human extracted teeth; our study is compared with the traditional prevalent X‐ray imaging and NIR II illumination (NIRi‐II, 1310 nm) without ICG enhancement. The results show that ICG fluorescence has much better imaging contrast in both windows compared with NIRi‐II (by quantitatively comparing NIR intensity of the critical neighboring structures, such as enamel and dentin). Cracked teeth, notoriously hard to diagnose by dental X‐ray and computed tomography, were clearly profiled in NIRF dental imaging. An insidious occlusal caries, missing in X‐ray imaging, became a bright dot that was readily observed in ICG‐NIRF‐I images. For dental decay, NIRF imaging with ICG enhancement could clearly delineate the decay boundary. NIRF in both windows distinguished interproximal and occlusal superficial caries. Overall, ICG‐assisted NIRF dental imaging has unique advantages in identifying cracked teeth and insidious caries. The two NIR imaging windows used in our study might one day serve as noninvasive and nonionizing‐radiation methods for the diagnosis of critical dental diseases in situ.

In this study, we used rat animal model to compare the efficiency of indocyanine green (ICG)-assisted dental near-infrared fluorescence imaging with X-ray imaging, and we optimized the imaging window for both unerupted and erupted molars. The results show that the morphology of the dental structures was observed clearly from ICG-assisted dental images (especially through the endoscope). A better image contrast was easily acquired at the short imaging windows (<10 minutes) for unerupted and erupted molars. For unerupted molars, there is another optimized imaging window (48-96 hours) with a prominent glowin-the-dark effect: only the molars remain bright. This study also revealed that the laser ablation of dental follicles can disrupt the molar development, and our method is able to efficiently detect laser-treated molars and acquire the precise morphology. Thus, ICG-assisted dental imaging has the potential to be a safer and more efficient imaging modality for the real-time diagnosis of dental diseases.fluorescence dental imaging, indocyanine green, laser treatment, near-infrared, optimal imaging window

On the back cover: From Zhongqiang Li et al., “Indocyanine green‐assisted dental imaging in the first and second near‐infrared windows as compared with X‐ray imaging.” https://doi.org/10.1111/nyas.14086.

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