TWI481392B - A dental calculus imaging methods - Google Patents
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本發明係為一種利用光學同調斷層掃描術來進行牙齒成像，並且再計算牙齒及牙結石的光學折射率，以提昇牙結石影像辨識品質的一種成像方法。 The invention relates to an imaging method for performing dental imaging by optical coherence tomography and recalculating the optical refractive index of teeth and calculus to improve the quality of dental calculus image recognition.
牙周病為現今感染率最高之慢性口腔疾病之一。全世界約有50%以上的人口患有或曾經患有此疾病。根據文獻與教科書記載，重度牙周病甚至可造成牙齒的脫落。世界衛生組織(World Health Organization,WHO)於2003統計，全世界牙齒脫落的原因約有5%~15%是因為重度牙周病之緣故。此外，牙周病也可能引發如吸入式肺炎等多種全身性疾病。孕婦若有嚴重之牙周病，則會增加早產的可能性。由此可知，牙周病實為一不可小覷的疾病。不但影響患者身體之健康，治癒此疾病及其後遺症所損失的金錢與時間更是難以估計。因此，若能有效且準確在牙周病初發之時將其診斷出來，並加以適當的治療，將能有效解決前述幾個問題。一般認為，牙周病會因為口腔內微生物所引起。這些微生物在口腔中形成牙菌斑，此時若不加以清除，則微生物將會大量孳生，並分泌出毒素導致周圍組織發炎及其他症狀，最終成為牙周病。與牙菌斑相關的病徵相當多樣化，最明顯的症狀為牙結石的產生。 Periodontal disease is one of the chronic infections with the highest infection rate. More than 50% of the world's population has or has had this disease. According to literature and textbooks, severe periodontal disease can even cause tooth loss. According to the World Health Organization (WHO) in 2003, about 5% to 15% of the causes of tooth loss in the world are due to severe periodontal disease. In addition, periodontal disease may also cause a variety of systemic diseases such as inhaled pneumonia. Pregnant women with severe periodontal disease will increase the likelihood of preterm birth. It can be seen that periodontal disease is a disease that cannot be underestimated. Not only does it affect the health of the patient's body, it is hard to estimate the money and time lost in curing the disease and its sequelae. Therefore, if it can be diagnosed effectively and accurately at the time of initial onset of periodontal disease, and appropriate treatment, it will be able to effectively solve the above problems. It is generally believed that periodontal disease is caused by microbes in the mouth. These microorganisms form plaque in the oral cavity. If not removed, the microorganisms will be aggravated in a large amount, and the toxins will be secreted to cause inflammation and other symptoms of the surrounding tissues, eventually becoming periodontal disease. The symptoms associated with plaque are quite diverse, the most obvious symptom being the production of calculus.
牙結石是由微生物礦化沉積而來，當發現牙結石存在之時，轉變為牙周病之機會已相當大。因此，若能早期診斷出牙結石，則診斷出牙周病之可能性亦會提高不少。傳統診斷牙結石的主流方法為利用x光片造影診斷及牙周囊探棒檢測。這些 方法的可靠度、靈敏度與重複性都略嫌不足。如x光片，容易因為牙結石本身特性而產生漏檢或誤診，而其輻射性不適合對孕婦或小孩實施。更甚者如牙周囊探棒檢測，為一破壞性方法，必須切開患部才能實施檢測，不論牙結石的有無都會造成患者的極大不適感。若施測者客觀度或經驗不足，則可能讓患者白白挨刀。其他如螢光顯影術(fluorescence)、口腔內攝影機等方法，不是需要難以清洗的顯影劑，就是本身仍不屬於成熟之技術，更重要的是，這些方法的靈敏度與解析度都相當的差，無法診斷出早期牙結石。 Dental calculus is deposited by microbial mineralization. When dental calculus is found, the chance of transformation into periodontal disease is quite large. Therefore, if the calculus can be diagnosed early, the possibility of diagnosing periodontal disease will also increase. The main method of traditional diagnosis of dental calculus is the use of x-ray angiography and periodontal sac detection. These ones The reliability, sensitivity and repeatability of the method are slightly insufficient. Such as x-ray film, it is easy to miss or misdiagnosis due to the characteristics of dental calculus itself, and its radiation is not suitable for pregnant women or children. What's more, such as the detection of periodontal sac probes, as a destructive method, the affected part must be cut to perform the test, regardless of the presence or absence of calculus, which will cause great discomfort to the patient. If the subject is not objective or inexperienced, the patient may be paralyzed. Other methods such as fluorescence imaging, intraoral camera, etc., do not require a developer that is difficult to clean, or are not mature technologies themselves, and more importantly, the sensitivity and resolution of these methods are quite poor. Unable to diagnose early calculus.
為了解決上述之問題，本發明利用光學同調斷層掃描術(Optical Coherence Tomography,OCT)來進行檢測。OCT不具有輻射性，具有高空間解析度(μm等級)，可即時成像，也可重組為三維立體影像。但是目前OCT的影像僅有黑白、若待測物有相類似時(如：牙結石與食物殘渣)則將產生相類似的特徵影像，如此一來將嚴重影響到辨識度。要提昇此辨識能力則需要一定程度的訓練，對於OCT的使用者將造成相當的門檻負擔。因此，如何成功抑制OCT影像的空間雜訊，提高待測物特徵影像的辨識品質，乃為目前臨床診斷應用上亟於突破的問題。 In order to solve the above problems, the present invention utilizes optical coherence tomography (OCT) for detection. OCT is non-radiative and has a high spatial resolution (μm rating) for immediate imaging or recombination into 3D stereo images. However, the current image of OCT is only black and white. If the objects to be tested are similar (such as dental calculus and food residue), similar feature images will be produced, which will seriously affect the recognition. To improve this recognition ability requires a certain degree of training, which will cause a considerable threshold for users of OCT. Therefore, how to successfully suppress the spatial noise of OCT images and improve the identification quality of the image of the object to be tested is a breakthrough in clinical diagnosis and application.
本發明的主要目的在於提供出一種不具輻射性，非破壞性、非侵入性及可重覆性高的牙結石成像方法。 The main object of the present invention is to provide a dental calculus imaging method which is non-radiative, non-destructive, non-invasive and highly reproducible.
本發明的次要目的在於提供出一種不受主觀意識判斷的影響，而大幅減低了誤診或漏診的牙結石成像方法。 A secondary object of the present invention is to provide a method for imaging calculus that is not subject to subjective judgment and greatly reduces misdiagnosis or missed diagnosis.
為達到上述之目的，本發明的牙結石成像方法，至少包括： (1)利用光學同調斷層掃描術(OCT)進行牙齒成像；(2)定義牙齒表面的影像區域；(3)找出牙結石影像的邊界位置，再隔離牙結石影像，並標示牙結石隔離區的顏色；(4)定義牙結石的頂端及底部的影像區域；(5)計算定義出牙結石的影像區域之光學折射率；(6)最後將牙結石隔離區的顏色與已計算出光學折射率的牙結石影像進行結合。 In order to achieve the above object, the dental calculus imaging method of the present invention comprises at least: (1) Tomography using optical coherence tomography (OCT); (2) defining the image area of the tooth surface; (3) finding the boundary position of the calculus image, then isolating the calculus image and marking the calculus isolation area (4) define the image area of the top and bottom of the calculus; (5) calculate the optical refractive index of the image area defining the calculus; (6) finally calculate the color of the calculus isolation area and the calculated optical refraction The rate of dental calculus images is combined.
每個物體都有獨一無二的光學折射率(refractive index)，因此計算待測物的光學折射率，將能大幅提昇特徵影像的辨識品質。 Each object has a unique refractive index, so calculating the optical refractive index of the object to be tested will greatly improve the recognition quality of the feature image.
對於本發明之技術特徵與實施範例，將配合圖示在如下的實施方式中詳細說明，讓本發明所屬技術領域中具有通常知識者，能瞭解其內容，並可據以實施。 The technical features and embodiments of the present invention will be described in detail in the following embodiments, and those skilled in the art to which the present invention pertains can understand the contents and implement them.
本發明的牙結石成像方法，其影像處理流程如下，如圖一所示。 The image processing procedure of the dental calculus imaging method of the present invention is as follows, as shown in FIG.
(a)先利用OCT進行牙齒的影像擷取。 (a) First use OCT for image capture of teeth.
(b)再將擷取後的影像進行非等方性延展濾波(anisotropic diffusion filtering)，以過濾掉影像的雜訊及斑點，進而知道影像的邊界位置。 (b) Anisotropic diffusion filtering is performed on the captured image to filter out the noise and spots of the image, thereby knowing the boundary position of the image.
(c)再將影像進行中值濾波(middle value filtering)，以濾除掉影像的斑點雜訊。 (c) Perform image middle value filtering to filter out the spot noise of the image.
(d)再將影像進行第一次的門檻值濾波(threshold filtering)，以進一步找出影像最外邊界的位置。 (d) Perform the first threshold filtering on the image to further find the position of the outermost boundary of the image.
(e)再進行牙齒表面線性收斂，定義出牙齒表面的影像區域。 (e) Perform a linear convergence of the tooth surface to define the image area of the tooth surface.
(f)另外，當步驟流程(d)完成後要進行步驟流程(e)之前，影像同時會傳送到另一條支線進行高斯濾波(Gaussian filtering)，以除去牙肉影像，純化牙結石影像。 (f) In addition, before the step (e) is completed, the image is simultaneously transferred to another branch for Gaussian filtering to remove the dental image and purify the dental image.
(g)再將影像進行第二次的門檻值濾波，以更進一步找出牙結石的邊界位置。 (g) The image is then subjected to a second threshold filtering to further find the boundary position of the calculus.
(h)確認是否已隔離出牙結石影像，如果尚未隔離，則再重覆步驟流程(g)，確認牙結石的邊界位置。 (h) Confirm whether the dental calculus image has been isolated. If it has not been isolated, repeat step (g) to confirm the boundary position of the calculus.
(i)當牙結石影像被隔離後，則更進一步確定牙結石影像的邊界位置。 (i) When the dental calculus image is isolated, the boundary position of the dental calculus image is further determined.
(j)進行牙結石頂線收斂，定義出牙結石頂端的影像區域。 (j) Convergence of the top line of the calculus to define the image area at the tip of the calculus.
(k)進行牙結石底線收斂，定義出牙結石底部的影像區域。 (k) Convergence of the bottom line of the calculus to define the image area at the bottom of the calculus.
(l)將定義出的牙結石頂端、牙齒表面及牙結石底部之影像區域進行光學折射率的計算，其公式為如下，並請參閱圖三。 (l) Calculate the optical refractive index of the defined image of the calculus tip, the tooth surface, and the bottom of the calculus. The formula is as follows, and see Figure 3.
z'：牙齒表面中心處到牙結石頂端之距離 z ': the distance from the center of the tooth surface to the top of the calculus
z：牙齒表面中心處到牙結石底部之距離 z : the distance from the center of the tooth surface to the bottom of the tooth stone
(m)另外，當影像處理流程(h)完成後要進行影像處理流程(i)之前，影像同時被傳送到另一條支線進行標示牙結石隔離區的顏色。 (m) In addition, before the image processing flow (i) is completed, the image is simultaneously transferred to another branch line to mark the color of the calculus isolation area.
(n)將牙結石隔離區的顏色與已算出光學折射率的牙結石影像進行結合收斂，然後完成整個影像處理。 (n) Combining the color of the calculus isolation zone with the calculus image of the calculated optical refractive index, and then completing the entire image processing.
從上述本案的影像處理程流可以了解，本案的牙結石成像方法，至少包括如下步驟，如圖二所示。 It can be understood from the image processing flow of the above case that the dental calculus imaging method of the present invention includes at least the following steps, as shown in FIG.
(1)利用光學同調斷層掃描術(OCT)進行牙齒成像。 (1) Tooth imaging using optical coherence tomography (OCT).
為了解OCT對其牙結石成像的實際狀況，本實施例使用一顆具有牙結石11的牙齒1，並且將接近人類牙齦肉之厚度0.8mm的豬牙齦肉2覆蓋在該牙齒1上，請參閱圖四A及圖四B。並將圖四B進行OCT的牙齒成像，該成像如圖四C所示，從圖四C可以觀察到，正常牙齒表面上另有一不規則形狀增生區域(如箭頭所示)，此影像符合牙結石堆積在牙齒表面之病理，並且也證實了OCT診斷牙齦下的牙結石能力。 In order to understand the actual condition of the OCT imaging of the dental calculus, this embodiment uses a tooth 1 having a calculus 11 and covers the tooth gingival meat 2 which is close to the thickness of the human gingival meat of 0.8 mm on the tooth 1, see Figure 4A and Figure 4B. Figure 4B is used to image the teeth of the OCT. The image is shown in Figure 4C. It can be observed from Figure 4C that there is another irregularly shaped hyperplasia on the surface of the normal tooth (as indicated by the arrow). The pathology of stones accumulating on the surface of the teeth and also confirmed the ability of OCT to diagnose calculus under the gums.
(2)定義牙齒表面(A)的影像區域，如圖四D所示。 (2) Define the image area of the tooth surface (A) as shown in Figure 4D.
(3)找出牙結石影像的邊界位置，如圖四G所示。再隔離牙結石影像，並標示牙結石隔離區的顏色，如圖四G的圓圈處所示； (3) Find the boundary position of the dental calculus image, as shown in Figure 4G. Re-separate the image of the dental calculus and mark the color of the calculus isolation zone, as shown in the circle at Figure 4G;
(4)定義牙結石的頂端(B)及底部(C)的影像區域，如圖四E及圖四F所示； (4) defining the image areas of the top (B) and bottom (C) of the calculus, as shown in Figure 4E and Figure 4F;
(5)計算定義出牙結石的影像區域之光學折射率，請參閱圖三所示。 (5) Calculate the optical refractive index of the image area defining the calculus, see Figure 3.
(6)最後將牙結石隔離區的顏色與已計算出光學折射率的牙結石影像進行結合，如圖四H所示。 (6) Finally, the color of the calculus isolation zone is combined with the dental calculus image in which the optical refractive index has been calculated, as shown in Fig. 4H.
本發明前述之實施例並非用以限定本發明，任何熟習相關技術者，在不脫離本發明之精神和範圍內所為之更動與潤飾，均屬於本發明之專利保護範圍。 The above-mentioned embodiments of the present invention are not intended to limit the present invention, and those skilled in the art can change and refine the invention without departing from the spirit and scope of the invention.
1‧‧‧牙齒 1‧‧‧ teeth
11‧‧‧牙結石 11‧‧‧calculus
2‧‧‧豬牙齦肉 2‧‧‧ pig tooth
圖一為本發明之影像處理流程圖。 FIG. 1 is a flow chart of image processing of the present invention.
圖二為本發明之成像步驟流程圖。 Figure 2 is a flow chart of the imaging steps of the present invention.
圖三為本發明之光學折射率的影像示意圖。 Figure 3 is a schematic view of the optical refractive index of the present invention.
圖四A為本發明實施例之具有牙結石的牙齒影像圖。 Figure 4A is a view of a dental image of a dental calculus according to an embodiment of the present invention.
圖四B為本發明實施例之豬牙齦肉覆蓋在牙齒上面的影像圖。 Figure 4B is an image view of the pig's gums covering the teeth of the embodiment of the present invention.
圖四C為將圖四B進行OCT的牙齒成像圖。 Figure 4C is a dental image of the OCT of Figure 4B.
圖四D為定義牙齒表面區域的影像圖。 Figure 4D is an image map defining the surface area of the tooth.
圖四E為定義牙結石頂端的影像圖。 Figure 4E is an image diagram defining the tip of the calculus.
圖四F為定義牙結石底部的影像圖。 Figure 4F is an image map defining the bottom of the calculus.
圖四G為牙結石區域的影像表示圖。 Figure 4G is an image representation of the calculus region.
圖四H為本發明完成後的影像圖。 Figure 4H is an image diagram after completion of the present invention.
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| CN102028555A (en) * | 2010-12-31 | 2011-04-27 | 中国科学院光电技术研究所 | Fluorescent tooth detector |
| TW201236635A (en) * | 2011-03-15 | 2012-09-16 | Crystalvue Medical Corp | Oral optical diagnosing apparatus and operating method thereof |
| US8351665B2 (en) * | 2005-04-28 | 2013-01-08 | The General Hospital Corporation | Systems, processes and software arrangements for evaluating information associated with an anatomical structure by an optical coherence ranging technique |
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| US8351665B2 (en) * | 2005-04-28 | 2013-01-08 | The General Hospital Corporation | Systems, processes and software arrangements for evaluating information associated with an anatomical structure by an optical coherence ranging technique |
| CN101911117A (en) * | 2008-01-18 | 2010-12-08 | 宝洁公司 | Methods and systems for analyzing hard tissues |
| CN102028555A (en) * | 2010-12-31 | 2011-04-27 | 中国科学院光电技术研究所 | Fluorescent tooth detector |
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