Application of Thermography in Dental Wound Healing: An Overview

Introduction:

Retained or impacted teeth pose a potential risk for persistent dental soft tissue infections, leading to patient discomfort marked by pain, swelling, or overall discomfiture. Timely intervention, often in the form of tooth extraction, becomes essential to alleviate symptoms and prevent the continuation of infections. This process is significantly enhanced by the application of thermal imaging, which serves as a valuable tool for analyzing post-extraction wound healing dynamics and detecting any pathologic changes that may arise.

What Is the Principle of Infrared Thermography?

Infrared thermography is a scientific field focused on detecting infrared radiation. This principle applies to any object with a temperature above absolute zero. A detector captures the energy emitted, and this information is processed to generate a pixel map. In this map, temperature values are represented using a color scale.

Thermography finds extensive applications in oral and maxillofacial surgery (OMFS) and dentistry. It is also widely used in large-scale industries like power and construction. In the medical field, its applications are diverse and numerous, with its versatility in various settings.

What Are the Current Applications of Thermography in Dentistry?

In the field of healthcare, thermography has its used in various specialties such as dermatology, oncology, allergology, physiotherapy, and sports medicine.

Within dentistry, thermography is emerging as a promising technology with several futuristic applications. Here are some common uses:

• Evaluation of Thermal Effects: Measurement of thermal effects during procedures like light-cured fillings or filling lesions with light-cured materials, both in vivo and in vitro.

• Laser Dentistry: Application in various laser dentistry procedures.

• Diagnosis of Periodontal Infections: Utilization in diagnosing inflammatory infections related to the gums.

• Oral Inflammatory Conditions: Contribution to the diagnosis and assessment of various oral inflammatory conditions.

• Temporomandibular Joint Diseases: Detection and assessment of diseases affecting the temporomandibular joint.

What Are the Applications of Thermography in Dental Wound Healing?

Currently, thermography is increasingly being utilized to

• Assess temperature fluctuations within the oral cavity which is the key focus.

• Investigate soft tissue temperatures on the body's surface, especially in comparison to the condition of vital soft tissues like gums and oral mucosa.

• Anticipate outcomes of oral surgical procedures which makes it more feasible, offering a proactive approach to prevent post-operative complications in oral and dental surgeries.

• Infrared thermography emerges as a valuable tool for identifying changes in wound healing within the oral cavity, particularly after the removal or extraction of retained primary or permanently impacted teeth.

How Does Thermography Assist in Managing Impacted Teeth?

Dental surgery specializes in managing issues within the oral cavity, including the jaw bones and surrounding tissues. Specific procedures involve surgical extraction, dental implants, periodontal gum surgeries, alveolar process surgery, and apical resection.

A retained tooth refers to a fully developed tooth that does not naturally emerge within the oral cavity, remaining partially or fully retained in the jaw. Various factors contribute to this, such as oral cysts, jaw injuries, fractures, infections, neoplastic lesions, endocrine imbalances, or developmental jaw disturbances.

Impacted teeth often go unnoticed until they show clinical symptoms. Patients may not experience pain or swelling until a certain point. When such symptoms arise, dentists or oral surgeons diagnose the condition using radiographic methods like intraoral periapical X-rays, bite-wing X-rays, orthopantomogram (OPG), or advanced cone-beam computed tomography (CBCT).

Complications arising from retained teeth can include pain, swelling, and potential dental issues that require specialized attention and intervention in dental surgery.

How Does Thermal Imaging Help in Detecting the Wound Healing Process?

Thermal imaging, a powerful application of thermography, helps in monitoring the dynamic process of wound healing, particularly in cases of oral mucosal and soft tissue surfaces post-tooth extraction. By capturing thermal changes on the surface, this technique gives valuable insights into the metabolic activity and temperature fluctuations associated with the healing process.

• Detection of Healing Dynamics:

In the process of oral wound healing post-tooth extraction, the thermal map generated by thermography reveals areas of heightened metabolism, shown as elevated temperatures. Dental professionals can use these temperature readings and fluctuations to gain a comprehensive understanding of the complex dynamics involved in the formation and eventual healing of the soft tissue clot in the extracted tooth area.

• Primary Application:

The primary application of thermography in oral wound healing lies in its ability to identify abnormalities or variations from the standard socket healing process, which typically spans 10 to 14 days. This is particularly relevant in cases of inflammation, non-healing conditions, or localized risk factors that might impede the natural healing progression.

• Identification of Pathological Abnormalities:

Through the thermal map, thermography excels at detecting temperature irregularities associated with pathological abnormalities during the healing process. This includes cases where the extraction socket fails to follow the normal healing timeline, providing dental professionals with valuable insights for timely intervention.

What Are the Physiologic Changes That Are Observable Through Thermography?

The physiologic changes that are observed include:

• Clot Formation: Thermography captures the immediate post-extraction stage, showcasing clot or thrombus formation. This marks the initiation of phagocytosis and inflammatory cell activity, important for eliminating dead tissues and bacteria within the socket.

• Fiber and Extracellular Matrix Formation: The subsequent stage of oral tissue repair is characterized by fiber and extracellular matrix formation. Thermography effectively tracks the development of new blood vessels, osteons, and bone formation during this critical phase.

• Transformation into Lamellar Bone: Approximately two weeks post-extraction (14 days), the fibrous bone within the extraction socket transforms into woven and lamellar bone. By the eighth week, the woven bone is completely resorbed, leaving behind a resilient compact lamellar bone structure.

What Are the Advantages of Thermography in Dentistry?

Thermography offers several advantages in dentistry, including early disease detection, non-invasive examination, objective measurement via temperature mapping, real-time monitoring, improved patient comfort, support for preventive dentistry, enhanced diagnostic accuracy, customized treatment planning, screening for periodontal disease, and efficient follow-up assessments.

Conclusion:

Infrared thermography stands as a major innovation in oral surgical procedures, providing an advanced means of recording and interpreting thermal data. With this technology, dental professionals not only gain a deeper understanding of oral tissue healing dynamics but also proactively manage and reduce postoperative complications. The integration of infrared thermography into oral surgery practices represents a forward-looking approach, ensuring precision, early detection, and personalized care for improved patient outcomes.