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BACKGROUND AND AIM: To compare two cone beam computed tomography (CBCT) analysis techniques for measuring tertiary dentin (TD) volume, density, and root length increase, after indirect pulp therapy (IPT) in young permanent teeth with conventional periapical radiographs. DESIGN: Comparative study design: Sixty-nine CBCT scans were taken initially (T1) and after 1 year (T2) of IPT. New CBCT analysis technique A, standardization, segmentation, and registration of T1 and T2 scans were performed using ITK-SNAP and 3D Slicer CMF to measure TD volume (mm3), density (gray-level intensity), and root length increase (mm). In the traditional CBCT analysis technique B, analyses were conducted using the In-Vivo software to calculate TD thickness (mm), radiodensity (HU%), and root length increase (mm). Paired t-test and the intraclass correlation coefficient were calculated to compare and assess the reliability of all techniques. RESULTS: No significant difference between the two techniques existed in the measurement of TD mineral density (Mean [SD]:A = 22.4 [15.4]; B = 24.4 [15.4]; p = .47). Technique A resulted in significantly higher root length increase values (Mean [SD]: A = 1.3 [0.6]; B = 1.1 [0.5]; p = .03). The two techniques showed acceptable reliability levels (0.76-0.99). CONCLUSION: CBCT analysis techniques yielded similar findings for mineral density. The new CBCT volumetric analysis technique, although more laborious, produced higher values for root length increase, and allowed for measurement of dentin volume.
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OBJECTIVES: The purpose of this study was to compare student learning of cone beam computed tomography (CBCT) interpretation using immersive virtual reality (VR) and three-dimensional multiplanar (MP) reconstructions. METHODS: Sixty first-year dental students were randomly allocated to two groups, VR and MP, and underwent a one-on-one educational intervention to identify anatomic structures using CBCT data. All participants completed three multiple-choice questionnaires (MCQs) before (T1), immediately after (T2), and 2 weeks following (T3) the intervention. Additionally, pre-survey, post-survey, NASA Task Load Index (NASA-TLX), and presence questionnaires were completed. Analysis of objective measures of performance on MCQs and subjective data from the questionnaires was completed (α = 0.05). RESULTS: There was a significant increase in test performance and informational recall between T1-T2 and T1-T3 for VR and MP groups (p < 0.001). However, there were no significant differences in performance on MCQs between T2 and T3. Analysis of the Presence questionnaire indicated that the VR group felt decreased distraction (p = 0.013), increased realism (p = 0.035), and increased involvement (p = 0.047) during the educational intervention when compared with the MP group. Analysis of the NASA-TLX indicated that the VR group experienced more physical demand (p < 0.01) but similar cognitive demand when compared with the MP group. Qualitative responses indicated that the VR group had a more dynamic sense of visualization and manipulation compared to the MP group. CONCLUSION: Results from this study show that VR is as effective as traditional MP methods of CBCT interpretation learning. Further benefits of VR educational intervention include increased involvement, realism and less distraction.
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This study aimed to develop gelatin methacryloyl (GelMA)-injectable hydrogels incorporated with 58S bioactive glass/BG-doped with strontium for vital pulp therapy applications. GelMA hydrogels containing 0% (control), 5%, 10%, and 20% BG (w/v) were prepared. Their morphological and chemical properties were evaluated by scanning electron microscopy/SEM, energy dispersive spectroscopy/EDS, and Fourier transform infrared spectroscopy/FTIR (n = 3). Their swelling capacity and degradation ratio were also measured (n = 4). Cell viability (n = 8), mineralized matrix formation, cell adhesion, and spreading (n = 6) on DPSCs were evaluated. Data were analyzed using ANOVA/post hoc tests (α = 5%). SEM and EDS characterization confirmed the incorporation of BG particles into the hydrogel matrix, showing GelMA's (C, O) and BG's (Si, Cl, Na, Sr) chemical elements. FTIR revealed the main chemical groups of GelMA and BG, as ~1000 cm-1 corresponds to Si-O and ~1440 cm-1 to C-H. All the formulations were degraded by day 12, with a lower degradation ratio observed for GelMA+BG20%. Increasing the concentration of BG resulted in a lower mass swelling ratio. Biologically, all the groups were compatible with cells (p > 0.6196), and cell adhesion increased over time, irrespective of BG concentration, indicating great biocompatibility. GelMA+BG5% demonstrated a higher deposition of mineral nodules over 21 days (p < 0.0001), evidencing the osteogenic potential of hydrogels. GelMA hydrogels incorporated with BG present great cytocompatibility, support cell adhesion, and have a clinically relevant degradation profile and suitable mineralization potential, supporting their therapeutic potential as promising biomaterials for pulp capping.
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A 30-yr-old man developed right lower leg pain and a palpable solid mass. Radiographic imaging revealed a periosteal reaction with an exostotic mass arising from the right distal fibula. Generalized skeletal osteosclerosis with periosteal reaction was discovered on a radiographic skeletal survey. A biopsy of the right fibular mass revealed reactive woven bone. The patient was referred to a metabolic bone disease clinic, where laboratory values were consistent with secondary hyperparathyroidism and increased bone turnover. A DXA bone density scan revealed high bone density, with an L1-4 spine Z-score of +9.3, a left femoral neck Z-score of +8.5, and a total hip Z-score of +6.5. A dental exam revealed generalized gingival inflammation, teeth mobility, generalized horizontal alveolar bone loss and widening of the periodontal ligament space, increased bone density around the teeth, and thickening of the radicular lamina dura. An extensive evaluation was performed, with the result of a single test revealing the diagnosis. The differential diagnoses of osteosclerosis affecting the skeleton, teeth, and oral cavity are discussed.
A 30-yr-old man developed, over a short period, pain in his lower right leg accompanied by a hard mass. He also reported weight loss and night sweats for the past 6 months. After evaluation by his primary physician, an X-ray was ordered that reported a bony mass arising from the right fibula bone. A biopsy was performed of the mass, but no evidence of cancer or any other specific abnormality was found. The patient was then referred to a bone disease specialty clinic. Laboratory tests revealed a large increase in how quickly the patient's skeleton was remodeling, affecting the balance of bone formation and removal involved in maintaining a healthy skeleton. A bone density scan reported that the patient had very dense bones. Other unusual changes were also discovered in a dental exam, suggesting bone thickening. After an extensive evaluation, a single blood test revealed the cause of the fibular bone mass and dense bones.
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Osteosclerose , Humanos , Osteosclerose/diagnóstico por imagem , Osteosclerose/patologia , Osteosclerose/complicações , Masculino , Adulto , Densidade Óssea , Absorciometria de FótonRESUMO
BACKGROUND: The value of dental radiographs to oral health care decision making must be balanced with radiation safety to minimize patient exposure and occupational risk of oral health care providers. This review summarizes recommendations and regulatory guidance regarding dental radiography and cone-beam computed tomography. An expert panel presents recommendations on radiation safety, appropriate imaging practices, and reducing radiation exposure. TYPES OF STUDIES REVIEWED: A systematic search run in Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews identified relevant topical systematic reviews, organizational guidelines, and regulatory reviews published in the peer-reviewed literature since 2010. A supplemental search of the gray literature (eg, technical reports, standards, and regulations) identified topical nonindexed publications. Inclusion criteria required relevance to primary oral health care (ie, general or pediatric dentistry). RESULTS: A total of 95 articles, guidance documents, and regulations met the inclusion criteria. Resources were characterized as applicable to all modalities, operator and occupational protection, dose reduction and optimization, and quality assurance and control. PRACTICAL IMPLICATIONS: Understanding factors affecting imaging safety and applying fundamental principles of radiation protection consistent with federal, state, and local requirements are essential for limiting patient ionizing radiation exposure, in conjunction with implementing optimal imaging procedures to support prudent use of dental radiographs and cone-beam computed tomographic imaging. The regulatory guidance and best practice recommendations summarized in this article should be followed by dentists and other oral health care providers.
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Tomografia Computadorizada de Feixe Cônico , Proteção Radiológica , Radiografia Dentária , Humanos , Radiografia Dentária/normas , Proteção Radiológica/normas , Proteção Radiológica/legislação & jurisprudência , Doses de Radiação , Exposição à Radiação/prevenção & controle , Exposição à Radiação/efeitos adversos , Segurança do Paciente , Guias de Prática Clínica como AssuntoRESUMO
Temporomandibular joint osteoarthritis (TMJ OA) is a prevalent degenerative disease characterized by chronic pain and impaired jaw function. The complexity of TMJ OA has hindered the development of prognostic tools, posing a significant challenge in timely, patient-specific management. Addressing this gap, our research employs a comprehensive, multidimensional approach to advance TMJ OA prognostication. We conducted a prospective study with 106 subjects, 74 of whom were followed up after 2 to 3 y of conservative treatment. Central to our methodology is the development of an innovative, open-source predictive modeling framework, the Ensemble via Hierarchical Predictions through Nested cross-validation tool (EHPN). This framework synergistically integrates 18 feature selection, statistical, and machine learning methods to yield an accuracy of 0.87, with an area under the ROC curve of 0.72 and an F1 score of 0.82. Our study, beyond technical advancements, emphasizes the global impact of TMJ OA, recognizing its unique demographic occurrence. We highlight key factors influencing TMJ OA progression. Using SHAP analysis, we identified personalized prognostic predictors: lower values of headache, lower back pain, restless sleep, condyle high gray level-GL-run emphasis, articular fossa GL nonuniformity, and long-run low GL emphasis; and higher values of superior joint space, mouth opening, saliva Vascular-endothelium-growth-factor, Matrix-metalloproteinase-7, serum Epithelial-neutrophil-activating-peptide, and age indicate recovery likelihood. Our multidimensional and multimodal EHPN tool enhances clinicians' decision-making, offering a transformative translational infrastructure. The EHPN model stands as a significant contribution to precision medicine, offering a paradigm shift in the management of temporomandibular disorders and potentially influencing broader applications in personalized healthcare.
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Osteoartrite , Transtornos da Articulação Temporomandibular , Humanos , Estudos Prospectivos , Articulação Temporomandibular , Osteoartrite/terapia , Transtornos da Articulação Temporomandibular/terapia , Projetos de PesquisaRESUMO
INTRODUCTION: There is currently no consensus in the literature whether the aetiology of a Class II subdivision is dental, skeletal or both. The aim of this study was to identify and quantify skeletal and dental asymmetries in Class II subdivision malocclusions. METHODS: CBCTs from 33 Class II subdivision malocclusion patients were used to construct 3D volumetric label maps. Eighteen landmarks were identified. The original scan and associated 3D volumetric label map were mirrored. Registration of the original and mirrored images relative to the anterior cranial base, maxilla and mandible were performed. Surface models were generated, and 3D differences were quantified. Statistical analysis was performed. RESULTS: Anterior cranial base registration showed significant differences for fossa vertical difference, fossa roll, mandibular yaw, mandibular lateral displacement and lower midline displacement. Regional registrations showed significant differences for antero-posterior (A-P) mandibular length, maxillary roll, A-P maxillary first molar position, maxillary first molar yaw and maxillary first molar roll. Class II subdivision patients also show an asymmetric mandibular length as well as an asymmetric gonial angle. Moderate correlations were found between the A-P molar relationship and fossa A-P difference, mandibular first molar A-P difference, maxillary first molar A-P difference and maxillary first molar yaw. CONCLUSIONS: This study suggests that Class II subdivisions can result from both significant skeletal and dental factors. Skeletal factors include a shorter mandible as well as posterior and higher displacement of the fossa on the Class II side, resulting in mandibular yaw. Dental factors include maxillary and mandibular first molar antero-posterior asymmetry.
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Má Oclusão Classe II de Angle , Má Oclusão , Dente , Humanos , Arco Dental , Má Oclusão Classe II de Angle/diagnóstico por imagem , Mandíbula , Maxila , Cefalometria/métodosRESUMO
Treatment effects occurring during Class II malocclusion treatment with the clear aligner mandibular advancement protocol were evaluated in two growing patients: one male (12 years, 3 months) and one female (11 years, 9 months). Both patients presented with full cusp Class II molar and canine relationships. Intraoral scans and cone-beam computed tomography were acquired before treatment and after mandibular advancement. Three-dimensional skeletal and dental long-axis changes were quantiï¬ed, in which the dental long axis was determined by registering the dental crowns obtained from intraoral scans to the root canals in cone-beam computed tomography scans obtained at the same time points. Class II correction was achieved by a combination of mandibular skeletal and dental changes. A similar direction of skeletal and dental changes was observed in both patients, with downward and forward displacement of the mandible resulting from the growth of the mandibular condyle and ramus. Dental changes in both patients included mesialization of the mandibular posterior teeth with ï¬aring of mandibular anterior teeth. In these two patients, clear aligner mandibular advancement was an effective treatment modality for Class II malocclusion correction with skeletal and dental effects and facial proï¬le improvement.
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INTRODUCTION: This study aimed to quantify the outcomes of adolescent patients with Class II malocclusion treated with the Carriere Motion 3D Appliance (CMA) combined with full fixed appliances. METHODS: Cone-beam computed tomography scans of 22 patients were available before orthodontic treatment (T1), at removal of the CMA (T2), and posttreatment (T3). The average age of the patients was 13.5 ± 1.6 years at T1, 14.1 ± 0.2 years at T2, and 15.6 ± 0.5 years at T3. The 3-dimensional image analysis procedures were performed using ITK-SNAP (version 3.6.0; www.itksnap.org, Hatfield, Pa) and SlicerCMF (version 4.11.0; http://www.slicer.org, Cambridge, Mass); skeletal and dentoalveolar changes relative to cranial base, maxillary, and mandibular regional superimpositions were evaluated. RESULTS: Changes were analyzed with 1 sample t tests using the mean differences during the CMA phase (T1 to T2) and total treatment time (T1 to T3). Significant skeletal changes included a slight reduction of ANB from T1 to T3, mandibular growth (Co-Gn increment of 1.2 mm and 3.3 mm from T1 to T2 and T1 to T3, respectively), inferior displacement of point A, and anterior and inferior displacement of point B. The mandibular plane did not change significantly during treatment. During the CMA treatment, posterior tipping and distal rotation of the maxillary molars, tip back and inferior displacement of the maxillary canines, significant mesial rotation, and superior displacement of the mandibular molars were observed. These movements rebounded during the full fixed appliance phase except for the molar and canine vertical displacements. Clinically significant dental changes during treatment included a reduction in overjet and overbite, Class II correction of the molar and canine relationship, and proclination of the mandibular incisors. CONCLUSIONS: The CMA is an effective treatment modality for Class II correction in growing patients because of a combination of mesial movement of the mandibular molar, distal rotation of the maxillary molar, and anterior displacement of the mandible.
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Má Oclusão Classe II de Angle , Aparelhos Ortodônticos Funcionais , Sobremordida , Adolescente , Humanos , Criança , Cefalometria/métodos , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Sobremordida/terapia , Mandíbula/diagnóstico por imagem , Maxila , Desenho de Aparelho OrtodônticoRESUMO
BACKGROUND: The American Academy of Oral and Maxillofacial Radiology established an ad hoc committee to draft evidence-based recommendations and clinical guidance for the application of patient contact shielding during dentomaxillofacial imaging. TYPES OF STUDIES REVIEWED: The committee reviewed monographs and reports from radiation protection organizations and studies that reported radiation dose to gonads, breasts, and thyroid gland from dentomaxillofacial imaging. RESULTS: Considering the absence of radiation-induced heritable effects in humans and the negligible dose to the gonads and fetus from dentomaxillofacial imaging, the committee recommends discontinuing shielding of the gonads, pelvic structures, and fetuses during all dentomaxillofacial radiographic imaging procedures. On the basis of radiation doses from contemporaneous maxillofacial imaging, the committee considered that the risks from thyroid cancer are negligible and recommends that thyroid shielding not be used during intraoral, panoramic, cephalometric, and cone-beam computed tomographic imaging. PRACTICAL IMPLICATIONS: This position statement informs and educates the reader on evolving radiation protection practices and provides simple, unequivocal guidance to dental personnel to implement these guidelines. State and local authorities should be contacted to update regulations to reflect these recommendations.
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Radiografia Dentária , Radiologia , Humanos , Doses de Radiação , Radiografia Dentária/métodos , Radiografia Panorâmica/métodos , Tomografia Computadorizada de Feixe Cônico/métodosRESUMO
INTRODUCTION: This study aimed to develop a 3-dimensional (3D) characterization of the severity of maxillary impacted canines and to test the clinical performance of this characterization as a treatment decision support tool. METHODS: Cone-beam computed tomography images obtained from 83 patients with 120 impacted maxillary canines were included. Quantitative information on the canine 3D position and qualitative assessment of root damage of adjacent teeth were evaluated. A severity index was constructed on the basis of the quantitative findings. Clinical applicability was tested by comparing clinical diagnosis and treatment planning for conventional records vs the 3D characterization via a 2-part survey. RESULTS: The average quantitative assessments of impacted maxillary canine position were 6.4 ± 3.6 mm from the midsagittal plane, 11.6 ± 3.1 mm in height relative to the occlusal plane, 31.5° ± 18° of roll, and 48.8° ± 14.3° of pitch. The severity index ranged from 0-13 with a mean score of 4.5 ± 2.2. Overlap with adjacent teeth was the greatest contributor (33%) to the index. Bicortically impacted canines caused the most severe root damage. Cone-beam computed tomography was preferred for assessing root damage and overall severity, whereas conventional imaging was sufficient for height and angulation assessment. The 3D report was very important or important for evaluating root damage, canine position, overall severity, and overlap. The 3D report changed most of the decisions relating to biomechanics, patient education, and treatment time estimate. The decision of exposure and traction vs extraction was changed 22% of the time after the presentation of the 3D report. CONCLUSIONS: The overlap with adjacent teeth frequently contributes the most to the severity index. The 3D report provided relevant clinical information regarding the canine position, damage to adjacent teeth, and the severity index, with a profound impact on the decisions of the clinicians regarding biomechanics, patient education, and treatment time estimate.
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Reabsorção da Raiz , Dente Impactado , Humanos , Maxila , Tomografia Computadorizada de Feixe Cônico/métodos , Dente Impactado/diagnóstico por imagem , Dente Impactado/terapia , Dente Impactado/complicações , Dente Canino/diagnóstico por imagem , Tração/efeitos adversos , Reabsorção da Raiz/etiologiaRESUMO
OBJECTIVES: The purpose of this study was to evaluate the efficacy of student learning of anatomy and 3D imaging concepts using cone beam computed tomography (CBCT) and immersive virtual reality (VR) technology. METHODOLOGY: Ninety (n = 90) first year dental students with no previous experience in 3D imaging were recruited. All participants completed a 10-item, multiple-choice questionnaire (MCQ) and a pre-survey prior to the educational intervention. Following a brief video orientation on CBCT and anatomy, each participant underwent a one-on-one educational intervention using immersive VR with calibrated instructors to identify head and neck anatomic structures using a VR/CBCT educational tool. Immediately following the intervention, all participants completed a postsurvey, a second MCQ, NASA task load index and presence questionnaires. Participants completed a third MCQ 2 weeks following the intervention. Analysis of objective measures of performance on MCQ's (p < 0.05) and subjective data from the questionnaires was completed. RESULTS: The students doubled their mean test scores 2.45 ± 1.274 to 5.99 ± 1.576 on MCQ's immediately following the educational intervention (p < 0.05). The significant increase in the MCQ test scores was maintained after 2 weeks, 5.73 ± 1.721 (p < 0.05). There were no gender differences in student test performance. Students rated the immersive VR/CBCT educational intervention experience highly for control, sensory, and realism factors with minimal distraction and frustration factors. CONCLUSION: Results from this study show that immersive VR/CBCT educational intervention improved test performance and contributed to information recall in students. Further benefits reported by participants include the sense of presence and increased engagement using immersive VR.
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Estudantes , Realidade Virtual , Humanos , Imageamento Tridimensional , Tomografia Computadorizada de Feixe CônicoRESUMO
The aim of this study was to conduct a three-dimensional (3D) evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin-modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone-beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6- to 9-year-old children, were randomly allocated to one of 3 groups (n = 36) and treated with SDF+KI, SDF, and RMGIC as IPC materials. CBCT scans were taken at 0 and 12 months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes such as secondary caries, periapical radiolucency, internal resorption, and obliteration of the pulp. The 3D image analysis procedures were performed using ITK-SNAP and 3D Slicer CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p = 0.712) and grey level intensity (p = 0.660), increase in root length (p = 0.365), prevention of secondary caries (p = 0.63), and periapical radiolucency (p = 0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries, and other signs of failure as shown by CBCT. Clinical Significance: The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries, and other signs of failure) when using SDF+KI, SDF, and RMGIC in IPC. The results of this study can help guide treatment decision-making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
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Cárie Dentária , Iodeto de Potássio , Criança , Humanos , Iodeto de Potássio/farmacologia , Iodeto de Potássio/uso terapêutico , Capeamento da Polpa Dentária/métodos , Dentina/diagnóstico por imagem , Dentina/patologia , Fluoretos Tópicos/farmacologia , Fluoretos Tópicos/uso terapêutico , Cárie Dentária/diagnóstico por imagem , Cárie Dentária/prevenção & controle , Cárie Dentária/patologia , Compostos de Amônio Quaternário/farmacologia , Compostos de Amônio Quaternário/uso terapêutico , Cimentos de Ionômeros de Vidro/farmacologia , Cimentos de Ionômeros de Vidro/uso terapêuticoRESUMO
Temporomandibular joint osteoarthritis (TMJ OA) is a disease with a multifactorial etiology, involving many pathophysiological processes, and requiring comprehensive assessments to characterize progressive cartilage degradation, subchondral bone remodeling, and chronic pain. This study aimed to integrate quantitative biomarkers of bone texture and morphometry of the articular fossa and joint space to advance the role of imaging phenotypes for diagnosis of Temporomandibular Joint Osteoarthritis (TMJ OA) in early to moderate stages by improving the performance of machine-learning algorithms to detect TMJ OA status. Ninety-two patients were prospectively enrolled (184 h-CBCT scans of the right and left mandibular condyles), divided into two groups: 46 control and 46 TMJ OA subjects. No significant difference in the articular fossa radiomic biomarkers was found between TMJ OA and control patients. The superior condyle-to-fossa distance (p < 0.05) was significantly smaller in diseased patients. The interaction effects of the articular fossa radiomic biomarkers enhanced the performance of machine-learning algorithms to detect TMJ OA status. The LightGBM model achieved an AUC 0.842 to diagnose the TMJ OA status with Headaches and Range of Mouth Opening Without Pain ranked as top features, and top interactions of VE-cadherin in Serum and Angiogenin in Saliva, TGF-ß1 in Saliva and Headaches, Gender and Muscle Soreness, PA1 in Saliva and Range of Mouth Opening Without Pain, Lateral Condyle Grey Level Non-Uniformity and Lateral Fossa Short Run Emphasis, TGF-ß1 in Serum and Lateral Fossa Trabeculae number, MMP3 in Serum and VEGF in Serum, Headaches and Lateral Fossa Trabecular spacing, Headaches and PA1 in Saliva, and Headaches and BDNF in Saliva. Our preliminary results indicate that condyle imaging features may be more important in regards to main effects, but the fossa imaging features may have a larger contribution in terms of interaction effects. More studies are needed to optimize and further enhance machine-learning algorithms to detect early markers of disease, improve prediction of disease progression and severity to ultimately better serve clinical decision support systems in the treatment of patients with TMJ OA.
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The segmentation of medical and dental images is a fundamental step in automated clinical decision support systems. It supports the entire clinical workflow from diagnosis, therapy planning, intervention, and follow-up. In this paper, we propose a novel tool to accurately process a full-face segmentation in about 5 minutes that would otherwise require an average of 7h of manual work by experienced clinicians. This work focuses on the integration of the state-of-the-art UNEt TRansformers (UNETR) of the Medical Open Network for Artificial Intelligence (MONAI) framework. We trained and tested our models using 618 de-identified Cone-Beam Computed Tomography (CBCT) volumetric images of the head acquired with several parameters from different centers for a generalized clinical application. Our results on a 5-fold cross-validation showed high accuracy and robustness with a Dice score up to 0.962±0.02. Our code is available on our public GitHub repository.
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Inteligência Artificial , Tomografia Computadorizada de Feixe Cônico , Tomografia Computadorizada de Feixe Cônico/métodos , Cabeça , Processamento de Imagem Assistida por Computador/métodos , Cintilografia , Crânio/diagnóstico por imagemRESUMO
BACKGROUND: The objective of this study was to evaluate differences in number and type of radiographs used among 3 age groups (0-5, 6-12, 13-18 years) by general dentists, pediatric dentists, and other specialists, and to determine the association between number and type of radiographs and clinical need. METHODS: A retrospective analysis of insurance claims by age group and oral health care provider type included children aged 0 through 8 years in 2005 who had a minimum of 10 years of continuous eligibility. Indicator claim variables were calculated to identify high-risk, high-need patients. RESULTS: A total of 6,712,155 records from 105,010 patients and 34,406 providers were analyzed. There was a significant effect (P < .001) of age on the number of radiographs obtained per visit. The estimated rates of radiographs per visit for ages 0 through 5, 6 through 12, and 13 through 18 were 0.373, 0.492, and 0.393, respectively. There was a significant interaction effect between age and provider type. For patients younger than 13 years, general dentists had lower rates of obtaining radiographs than did pediatric dentists, with no significant difference between providers for the 13- through 18-year age group. Treatments received, except for extractions and prosthodontics, were significantly associated with rate of radiographs per visit, with "number of restorations" as an indicator of increased risk, need, or both showing an inverse association with radiograph use. CONCLUSIONS: Child age and provider type had an effect on number of radiographs obtained per visit. Lack of caries diagnostic codes and uncommon use of risk codes hindered interpretation of whether use, frequency, or both is associated with need. PRACTICAL IMPLICATIONS: Radiograph use should follow existing guidelines or recommendations based on clinical need.
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Cárie Dentária , Adolescente , Criança , Cárie Dentária/diagnóstico , Odontólogos , Humanos , Saúde Bucal , Estudos RetrospectivosRESUMO
Diagnosis of temporomandibular joint (TMJ) Osteoarthritis (OA) before serious degradation of cartilage and subchondral bone occurs can help prevent chronic pain and disability. Clinical, radiomic, and protein markers collected from TMJ OA patients have been shown to be predictive of OA onset. Since protein data can often be unavailable for clinical diagnosis, we harnessed the learning using privileged information (LUPI) paradigm to make use of protein markers only during classifier training. Three different LUPI algorithms are compared with traditional machine learning models on a dataset extracted from 92 unique OA patients and controls. The best classifier performance of 0.80 AUC and 75.6 accuracy was obtained from the KRVFL+ model using privileged protein features. Results show that LUPI-based algorithms using privileged protein data can improve final diagnostic performance of TMJ OA classifiers without needing protein microarray data during classifier diagnosis.