Artificial Intelligence in Diagnosis of Oral Diseases: A Systematic Review.

AIM: To understand the role of Artificial intelligence (AI) in oral radiology and its applications. BACKGROUND: Over the last two decades, the field of AI has undergone phenomenal progression and expansion. Artificial intelligence applications have taken up new roles in dentistry like digitized data acquisition and machine learning and diagnostic applications. MATERIALS AND METHODS: All research papers outlining the population, intervention, control, and outcomes (PICO) questions were searched for in PubMed, ERIC, Embase, CINAHL, database from the last 10 years on first January 2023. Two authors independently reviewed the titles and abstracts of the selected studies, and any discrepancy between the two review authors was handled by a third reviewer. Two independent investigators evaluated all the included studies for the quality assessment using the modified tool for the quality assessment of diagnostic accuracy studies (QUADAS- 2). REVIEW RESULTS: After the removal of duplicates and screening of titles and abstracts, 18 full texts were agreed upon for further evaluation, of which 14 that met the inclusion criteria were included in this review. The application of artificial intelligence models has primarily been reported on osteoporosis diagnosis, classification/segmentation of maxillofacial cysts and/or tumors, and alveolar bone resorption. Overall study quality was deemed to be high for two (14%) studies, moderate for six (43%) studies, and low for another six (43%) studies. CONCLUSION: The use of AI for patient diagnosis and clinical decision-making can be accomplished with relative ease, and the technology should be regarded as a reliable modality for potential future applications in oral diagnosis.

Assessing the Accuracy and Reliability of Cone-Beam Computed Tomography (CBCT) in Diagnosing Grade II and III Furcation Involvement Compared to Traditional Clinical Examination Methods.

Introduction Chronic periodontal diseases can lead to bone defects and tooth loss, making accurate diagnosis essential for treatment. Various methods are used for diagnosing furcation involvement, with clinical examination and cone-beam computed tomography (CBCT) being the most effective. CBCT produces reliable images with submillimeter resolution, revealing marginal bone contours and furcation defects. Limited studies show that CBCT is more precise than clinical detection for diagnosing furcation involvement. Therefore, CBCT technology can be considered as an adjunct method for furcation involvement detection. This study tests the accuracy and efficiency of CBCT and clinical examination in detecting furcation involvement. Material and methods The study included 25 patients (68 molars) with generalized periodontitis of stage II to IV, Grade B and C. Inclusion criteria required at least two intrabony defects with probing depth > 6mm in both jaws and criteria of periodontitis in at least 30% of the teeth present. Results The study compared clinical examination and CBCT readings for measuring maxillary and mandibular teeth furcation involvement. The results show significant differences between clinical and CBCT measurements of maxillary teeth furcation involvement, particularly in specific areas and types of furcation involvement. In contrast, there were significant differences between clinical and CBCT readings for only a few measurements of mandibular teeth furcation involvement. Therefore, the study suggests that CBCT imaging may be beneficial for accurate diagnosis and treatment planning in cases of furcation involvement in maxillary teeth. Conclusion CBCT imaging is a reliable adjunct method for detecting furcation involvement in maxillary teeth, while clinical examination alone may not be sufficient. Therefore, the use of CBCT technology should be considered in cases where accurate detection of furcation involvement is necessary for successful treatment outcomes. However, further studies with larger sample sizes are needed to confirm these findings.

The importance of cone-beam computed tomography in endodontic therapy: A review.

INTRODUCTION: Cone-beam computed tomography (CBCT) is a valuable tool in endodontics, particularly for assessing root morphology. AIM: To understand the importance of root morphology in endodontic treatment. METHODOLOGY: A comprehensive search of various databases was performed, and 804 studies were identified. After evaluating the studies using the inclusion criteria and eliminating duplicates, 12 articles were included in this review. RESULTS: CBCT assessment demonstrated a high prevalence of single canals in maxillary incisors, varying root configurations in maxillary first premolars, and diverse anatomical distributions in mandibular molars, such as C-shaped canals, more commonly observed in women. CONCLUSION: The findings from this review concluded that CBCT is a valuable tool for the diagnosis and treatment of root canal anomalies in endodontics.

Morphometric analysis of the hard palate using cone beam computed tomography in a Saudi population.

Background and objectives: Analyzing the anatomical and morphometric information of the hard palate is crucial in prosthodontics, orthodontics, maxillofacial surgery, implant dentistry, and forensic anthropology. No data exist in the literature regarding the morphometric analysis of the hard palate using 3D imaging techniques in Saudi Arabia. Therefore, this study aimed to evaluate the dimensions and types of hard palates using 3D geometric morphometrics and the existence of gender-related differences in a selected Saudi population. Material and methods: This cross-sectional study was performed by radiological evaluation of arbitrarily collected Cone Beam computed Tomography (CBCT) images includes 130 male and 45 female individuals from our department's archives, radiology department, Dental Hospital, Qassim University. The Galileos® Comfort Plus System (Sirona 3D, Germany) was used to obtain the CBCT images while standardizing the parameters. Images were linearly measured using Galileos software. Measurements of palatal length, palatal breadth, and palatal height, as well as the calculation of the palatine index and palatal height index, were noted and statistically analyzed. Results: The mean palatal length, breadth, height, palatine index, and height index were 48.8 ± 3.9 mm, 36.2 ± 3.8 mm, 11.6 ± 2.4 mm, 74.7 ± 8.9, and 32.4 ± 7.1, respectively. The mean palatal length, breadth, and height were greater in men than in women. The majority of the palatine index values corresponded to leptostaphyline (76.6%), followed by mesostaphylline (12%) and brachystaphylline (11.4%), distribution among males and females were not statistical significance (p > 0.05). Palatal height index analysis revealed that the majority were orthostaphyline (59.4%), followed by chamestaphyline (26.3%), and hypsistaphyline (14.3%) these distributions were not significant statistically among males and females(p > 0.05). Conclusion: The palatine index and palatine height index are useful in prosthodontics, orthodontics, and forensic anthropology for identifying races on the basis of the skull.

A Comparative Study of the Assessment of the Accuracy of Willems' and Demirjian's Methods in Dental Age Estimation of the Saudi Arabian Population.

BACKGROUND: The notion that "age is just a number" is sometimes expressed colloquially; however, within the domains of medicine and dentistry, age is not only a numerical value. Rather, it has significant importance in several facets of diagnosis and treatment planning. Demonstrating one's identity is necessary not only in the aftermath of natural calamities or mishaps but also in the context of forensic examination of living persons. Age assessment is a very important tool in forensic odontology and plays a vital role in various fields, including medico-legal matters. The primary focus of the current investigation is to assess the precision and correctness of the data and reliability of Demirjian's method (DM) and Willems' method (WM) for age estimation (AE) among the population of Saudi Arabia. METHODOLOGY: This research was conducted on 300 children from Saudi Arabia, aged seven to 13 years, including both males and females. The assessment of orthopantomography images involved the utilization of both Demirjian's and Willems' methodologies for ascertaining dental age. This determined dental age was then meticulously juxtaposed with the chronological age (CA) of every participant. The data collected underwent a comprehensive statistical analysis, which encompassed the application of the paired t-test. RESULTS: By using both methodologies, it was discovered that the estimated age (EA) exhibited higher values in both men and females compared to the CA. Both Willems' and Demirjian's approaches yielded significantly different results in terms of statistical significance (p = 0.000 and p = 0.000, respectively), as shown by the comparison. CONCLUSION: When comparing Willems' technique to Demirjian's method, it was found that the population under research showed somewhat greater accuracy levels for AE. However, it is important to note that the disparity between these two approaches was relatively small. Consequently, it is imperative to emphasize the necessity for additional research involving a larger sample size to establish the validation of a more region-specific AE method tailored specifically for the Saudi Arabian population.

Prevalence of palatogingival groove affecting maxillary anterior teeth in Saudi subpopulation: A cone-beam computed tomographic study with literature review.

Aim: To investigate the prevalence of palatogingival groove (PGG) affecting maxillary anterior teeth, bilateral occurrence, and distribution among sex in the Saudi subpopulation and to review the literature on the prevalence of PGG. Introduction: Palatogingival groove (PGG) primarily affects maxillary lateral incisors and, when present, may contribute to the pathogenesis of periodontal and endodontic lesions. Materials & methods: A total of 509 CBCT scans of Saudi patients with 2747 maxillary anterior teeth were included in the study. Patients' information, the tooth type, the presence/absence, the unilateral/bilateral distribution, and the type of PGG according to Gu's classification (type I, II, or III) were recorded. Results: The prevalence of the PGG in maxillary anterior teeth was 1.3%, affecting 32 (6.3%) patients. The PGGs were mostly detected in lateral incisors 25 (2.77%). The PGG was found to be unilateral in most patients (96.9%), with higher frequency in males than in females without significance for sex. Conclusion: PGG is not a rare anomaly in the Saudi population and is most frequently found in maxillary lateral incisors. Type I Gu's classification was mostly detected.

Burnout level in Pakistani dentists during COVID-19 pandemic: Cross-sectional national study.

Objective: This study aims to determine the prevalence and degree of Burnout during the COVID 19 pandemic in practicing Pakistani dentists. Introduction: The COVID-19 pandemic has significantly impacted dental practices worldwide, leading to increased stress and burnout among dental practitioners. Burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, can have detrimental effects on the quality of care and patient safety. Previous studies have shown high rates of burnout among healthcare workers, including dentists. The pandemic has added new challenges, such as financial losses and increased costs due to safety protocols. Recognizing and managing burnout is crucial to mitigate its severe consequences. By understanding the prevalence of burnout in this unique context, strategies can be developed to support dental practitioners and improve their well-being. Methods: A cross-sectional study was conducted using a 22-items based validated Maslach Burnout Inventory. The study was conducted between July and September 2021. Practicing dentists across Pakistan were approached via social media platforms. The questions were answered on a 7-point Likert scale. The sums of the scores were used as the evaluation criteria. Data analysis was done using SPSS version 24. Shapiro Wilk test was used to check normality of data. Mann Whitney U and Kruskal Wallis tests were utilized to analyze the differences in the prevalence of burnout amongst the different demographic groups. A P-value of <0.05 was considered as statistically significant. Results: Total of 282 dentists responded with 116 (41.1 %) male and 166 (58.9 %) female. Majority of the respondents were postgraduate residents (24.8 %), 47.9 % of the practitioners had 0-3 years of work experience, 48.6 % of the respondents were practicing in the Federal region, and 62.8 % of the subjects were between the age of 25-34. Emotional exhaustion was the major dimension of burnout identified in our study with 47.5 % of the population reporting high levels, while only 23 % of the population showed high levels of depersonalization and 29.4 % showed low sense of personal accomplishment. Conclusion: This study indicates a considerable percentage of burnout in the chosen sample. The mean scores of Emotional Exhaustion, Depersonalization and Diminished sense of personal accomplishment were all found to be in the moderate range, and that appropriate measures should be taken to manage it.

Age Estimation by Kvaal's Method Using Digital Panoramic Radiographs in the Saudi Population.

Introduction In forensic literature, estimating an individual's age has garnered a lot of attention. With increasing age, the size of the dental pulp cavity shrinks as a result of secondary dentin deposits. This could be used as a measure of age. Aside from morphological approaches, radiological approaches might be used to analyze this regression shift. Kvaal's method calculates the chronological age of individuals based on the age-pulp size relationship on periapical dental radiographs. Purpose This study aims to use Kvaal's method to estimate the chronological age of patients using digital panoramic radiographs and verify the validity of regression equations proposed by Kvaal et al. in the Saudi population. Material and methods A total of 74 digital orthopantomograms were randomly selected from Qassim University Dental Clinic in Saudi Arabia, ranging in age from 18 to 64 years (mean age 32 years). The radiographs were taken between 2018 and 2021 according to inclusion and exclusion criteria. Results When the Kvaal technique was applied to Saudi members, there was no statistically significant discrepancy between the estimated and chronological ages. The coefficient of determination R2 was highest when three mandibular teeth were evaluated together (0.752). Conclusion The most accurate indicator for age assessment was "M" (mean worth, all things considered) and "W L" (contrast among "Width" and "Length").

Non-Surgical Management of Lingual Hemangioma by Combined Sclerotherapy and Cryotherapy.

Hemangioma is frequently seen benign tumour of vascular origin, typed into capillary and cavernous hemangiomas based on the nature of vessels in the lesions. Capillary hemangioma is a collection of small capillary-size vessels and shows lobule formation. Cavernous hemangioma is formed by the large dilated vessels and it can reach a large size. The hemangioma can cause aesthetic and functional problems when it is located on the tongue. Several treatment modalities including sclerotherapy, embolisation, laser surgery, and cryosurgery have been described. Here, we are reporting a case of a 12-year boy diagnosed with a hemangioma on the left lateral border of the tongue using ultrasonography with color Doppler application and treated non-surgically with sclerotherapy and cryotherapy. Key Words: Color Doppler ultrasonography, Cryotherapy, Hemangioma, Sclerotherapy, tongue.

Insight of New Generation Dentists towards the Shifting Trends of Three-dimensional Printing for Patient Management in the Kingdom of Saudi Arabia.

Background: There is a lack of information in the few studies reporting on the use of three-dimensional (3D) Printing for Patient Management. However, few studies have been found about recent advances in 3D printing technology, and biomaterials are revolutionizing medicine. The purpose of this study is to evaluate the knowledge and attitude of new generation dentist towards 3D printing and its application in various aspects in the field of Prosthodontics. Materials and Methods: A cross-sectional study on dental practitioners/Prosthodontist throughout Saudi Arabia using a self-administered questionnaire, which had items to assess the knowledge attitude and practices of study participants toward the use of 3D printing in dental management. Results: It was observed 17.5% of our participants had complete information and 10.5% had no information about 3D printers in the field of dental medicine. When assessed, male dentists had complete information about 3D printers (17.5%) than females (0%). 43.9% of our participants "strongly agreed" for 3D printers to be implemented in dentistry, 40.4% had "no idea" regarding the experience of 3D prints. Conclusion: Very few dentists have knowledge of 3D printing application in dentistry. Hence we strongly recommend organizing continuing dental education programmed on 3D printing either with hand on workshops, conferences and regular updates on the use of this technology.

Impacted Third Molars, A Rare Occurrence of Identical Bilateral Impacted Mandibular Third Molars in Linguo-Buccal Location: A Case Report.

Symmetrical horizontal impacted bilateral mandibular third molar in lingo-buccal direction is a rare type of impacted teeth. When a tooth cannot erupt and fails to achieve a normal function and occlusion during its chronological age of eruption, it is called an impacted tooth. In this paper, a case of a male patient aged 20 years old who had bilateral horizontally impacted lower third molar which was noticed in a routine screening panoramic radiograph and confirmed with cone beam computed tomography (CBCT) imaging and referred to the oral maxillofacial surgical center for surgical removal of the impacted teeth in order to avoid late complications is discussed.

Arteriovenous Malformation of the Lip: A Rare Case Report.

Vascular malformation (VM) consists of a group of tumors that emerge from vascular origin caused by vascular angiovascular or lymphoproliferation. Arteriovenous malformations (AVMs) contribute high-flow, creating direct vein artery contact without regular capillary network. AVMs are present at birth or in congenital. Acquired AVMs occur later in life due to hormonal changes or trauma, and acquired AVMs in oral cavity are very rare. AVMs are persistent and progressive in nature when present, can represent a lethal, causing significant blood loss, and an incomplete resection frequently leads to a recurrence of the lesion. We present a rare case of a congenital AVM diagnosed on retinue dental checkup using color doppler ultrasonography (USG) in a 62-year-old man from South India.

Quality Assurance Audit of Digital Intraoral Periapical Radiographs at the Undergraduate Dental Clinics.

OBJECTIVE: To assess the quality of digital intraoral periapical radiographs by investigating the percentage of radiographic images that satisfied the good quality standards. STUDY DESIGN: An audit. PLACE AND DURATION OF STUDY: Undergraduate Dental Clinics, Qassim University College of Dentistry, Saudi Arabia, from April to September 2018. METHODOLOGY: This standard-based audit was conducted at the clinics of undergraduate dental school. A total of 506 intraoral periapical radiographs taken by dental students were graded, according to the standards set by Health Protection Agency, by two evaluators after the necessary calibration to reduce the inter-evaluator differences. In addition to the grading of radiographs, the documentation of errors like coning off, foreshortening/elongation, contact overlap, poor contrast, and image blurring was done. The data analysis was carried out with Microsoft excel software by utilising simple descriptive statistics. RESULTS: Out of the 506 digital periapical radiographs, 231 (45.7%) radiographs were categorised as Grade 1, 190 (37.6%) radiographs were categorised as Grade 2, and 85 (16.7%) radiographs were categorised as Grade 3, requiring a repeat radiograph; and were diagnostically unacceptable. Considering the aforementioned results, the findings of the first cycle fell short of the required standards. CONCLUSION: According to the results of the quality assurance audit, the radiographs were below the standards set by the Health Protection Agency. Recommendations were made for improvement measures in the radiology department, and re-audit was planned after one year. Key Words: Quality assurance, ALARA, Radiation protection, Audit, Digital dental radiography.

Supraorbital Rim Fracture Involving Frontal Sinus by Sports Injury.

Supraorbital rim fracture is a rare sports-related injury encountered by craniofacial specialty and great challenge to the surgeons because of their anatomical location and relation with vital structures in close relation. Currently, in the literature, no classification system or treatment protocol exists for the supraorbital rim fracture. Supraorbital rim fracture forms a small proportion of sports-related injuries. Here we present a case with supraorbital rim fracture by sports injury diagnosed by computed tomography and treated surgically by open reduction methods using mini plates.