Simulating Pulp Vitality Measurements via Digital Optical Twins: Influence of Dental Components on Spectral Transmission

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Abstract
Optical diagnostic techniques represent an attractive complement to conventional pulp vitality tests, as they can provide direct information about the vascular status of the pulp. However, the complex, multi-layered structure of a tooth significantly influences the detected signal and, ultimately, the diagnostic decision. Despite this, the impact of the various dental components on light propagation within the tooth, particularly in the context of diagnostic applications, remains insufficiently studied. To help bridge this gap and potentially enhance diagnostic accuracy, this study employs digital optical twins based on the Monte Carlo method. Using incisor and molar models as examples, the influence of tooth and pulp geometry, blood concentration, and pulp composition, such as the possible presence of pus, on spectrally resolved transmission signals is demonstrated. Furthermore, it is shown that gingival blood absorption can significantly overlay the pulpal measurement signal, posing a substantial risk of misdiagnosis. Strategies such as shifting the illumination and detection axes, as well as time-gated detection, are explored as potential approaches to suppress interfering signals, particularly those originating from the gingiva.

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