Multispectral Imaging for Differentiating Inflamed but Viable Pulp From Necrotic Pulp

Abstract

Pulp sensibility testing is a method used to evaluate the response of the pulpal nerve, not to directly assess the blood supply
and viability of the pulpal tissues, and therefore is not a good method to distinguish between inflamed but viable dental
pulp and necrotic pulp. Multispectral imaging may be a non-invasive way in which tissue responses at various wavelengths
can be used to detect optical patterns for pulpal oxygenation, perfusion, and structural changes. This article will review the
pathogenesis of pulpal inflammation and necrosis and discuss the possible use of multispectral imaging in improving the
diagnostic differentiation. It also takes into account the application of AI and ML for spectral data processing and feature
extraction and to help classify pulp conditions. A special focus is on diagnostic accuracy, sensitivity, specificity, reproducibility
and clinical feasibility. The imaging performance, however, may be compromised by problems of penetration, tooth structure,
restorations, heterogeneous inflammation and partial pulp necrosis. Thus, multispectral imaging must be assessed together
with the standard clinical evaluations and the use of suitable reference standards. Additional experimental and prospective
clinical studies are needed to define standard imaging protocols, to validate imaging diagnostic thresholds, and to determine
its utility in treatment planning. In the long term, this can contribute to better pulp diagnosis and maintain vitality in the pulp
tissue by biologically-driven endodontics.