Assessing the Efficacy of AI Segmentation in Diagnostics of Nine Supernumerary Teeth in a Pediatric Patient.

We present a very rare case of a child with nine supernumerary teeth to analyze the potential, benefits, and limitations of artificial intelligence, as well as two commercial tools for tooth segmentation. Artificial intelligence (AI) is increasingly finding applications in dentistry today, particularly in radiography. Special attention is given to models based on convolutional neural networks (CNN) and their application in automatic segmentation of the oral cavity and tooth structures. The integration of AI is gaining increasing attention, and the automation of the detection and localization of supernumerary teeth can accelerate the treatment planning process. Despite advancements in 3D segmentation techniques, relying on trained professionals remains crucial. Therefore, human expertise should remain key, and AI should be seen as a support rather than a replacement. Generally, a comprehensive tool that can satisfy all clinical needs in terms of supernumerary teeth and their segmentation is not yet available, so it is necessary to incorporate multiple tools into practice.

Bifid Mandibular Canals: A Pediatric Case Series with Clinical Implications.

Aim: The aim of this case series is to provide a detailed account of pediatric cases with bifid mandibular canal (BMC) along with clinical implications. Background: The prevalence of BMC on panoramic radiographs has been reported to be 0.03-1.90% in adults. Only one study reported prevalence of BMC in children based on cone-beam computed tomography (CBCT) images. As CBCT images are not routinely prescribed in children, it is important to understand if panoramic radiographs provide a valuable tool to diagnose BMC in children. Case description: This case series provides a review of three cases of nonsyndromic, bilateral BMC, and associated radiculomegaly affecting mandibular permanent first molars in children during the mixed dentition stage. An overview of clinical implications of BMC in children is also discussed to help clinicians provide appropriate dental care and anticipatory guidance. Conclusion: Bifid mandibular canal (BMC) has never been reported in children during mixed dentition stage based on panoramic radiographs. This is the first case series reporting BMC and associated dental anomalies in children. Clinical significance: This case series will help clinicians in diagnosing BMC during mixed dentition stage and understand its clinical implications. Additionally, this case series will help define future cross-sectional studies evaluating BMC and associated dental anomalies in children. How to cite this article: Puranik CP, Chandki R, Mladenovic R, et al. Bifid Mandibular Canals: A Pediatric Case Series with Clinical Implications. Int J Clin Pediatr Dent 2023;16(3):547-549.

The Role of Artificial Intelligence in the Accurate Diagnosis and Treatment Planning of Non-Syndromic Supernumerary Teeth: A Case Report in a Six-Year-Old Boy.

Hyperdontia can cause numerous aesthetic and functional problems. The diagnosis is made radiologically, and the most commonly used radiological method is orthopantomography, while CBCT is also used. CBCT has the advantage of being three-dimensional. Artificial Intelligence is widely used in medicine and dentistry, and it can create a specific algorithm to aid in diagnosis and suggest therapeutic procedures. In a case report, a 6-year-old boy was diagnosed with a supernumerary tooth between the upper central incisors. Orthopantomography revealed another impacted supernumerary tooth, and the patient was referred for CBCT. A platform for analyzing dental images, based on artificial intelligence, Diagnocat (Diagnocat Inc., San Francisco, CA, USA), was used for analysis and the AI system identified the supernumerary teeth and provided a complete plan for treatment. The use of AI in dentistry allows for faster and more accurate diagnosis and treatment planning.

The Evaluation of Healing Properties of Galium verum-Based Oral Gel in Aphthous Stomatitis in Rats.

Although oral ulcers represent one of the most frequent oral mucosal diseases, the available treatment is not sufficient to provide complete ulcer recovery without side-effects. Therefore, the aim of our study was to prepare a mucoadhesive oral gel based on Galium verum ethanol extract (GVL gel) and reveal its healing effects in the model of aphthous stomatitis in rats. Rats with oral ulcers were divided into the following groups: control (untreated), gel base (ulcer was treated with the gel base, three times per day for 10 days), and GVL gel group (the ulcer was treated with GVL gel in the same way as the gel base). Animals from each group were sacrificed on days 0, 3, 6, and 10 for collecting blood and ulcer tissue samples. Healing properties of oral gel were determined by clinical evaluation, as well as biochemical and histopathological examinations. Our findings suggest a significant decrease in the ulcer size in GVL gel group, with healing effects achieved through the alleviation of oxidative stress, reduction in COX-2 immunopositivity, and increase in collagen content in buccal tissue. Significant ulcer repairing potential of GVL gel highlights this oral mucoadhesive gel as a promising tool for prevention and treatment of RAS.

The Importance of Correlation between CBCT Analysis of Bone Density and Primary Stability When Choosing the Design of Dental Implants-Ex Vivo Study.

This study aims to determine the correlation between the mean value of bone density measured on the CBCT device and the primary stability of dental implants determined by resonant frequency analysis. An experimental study was conducted on a material of animal origin: bovine femur and pig ribs. Two types of implants were used in this study: self-tapping and non-self-tapping of the same dimensions. Results of the experimental study showed a statistically significant correlation between bone density expressed in HU units and the primary stability of self-tapping and non-self- tapping dental implants expressed in ISQ units in bovine femur bones and self-tapping implants and pig rib bones. There was no statistically significant correlation between non-self-tapping dental implants in pig rib bones. Self-tapping and non-self-tapping implants did not show statistical significance in the primary stability in bones of different qualities. The analysis of bone density from CBCT images in the software of the apparatus expressed in HU units can be used to predict the degree of primary stability of self-tapping and non-self-tapping dental implants in bones of densities D1 and D2, and self-tapping dental implants in bones of the lower quality D4.

Application of the Kvaal Method in Age Estimation of the Serbian Population Based on Dental Radiographs.

This study aimed to evaluate the applicability of the Kvaal method in determining the age of a Serbian population. In this retrospective descriptive study, 170 dental patients (age range 16-77 years) were included. The measurements of six types of teeth were performed on digital orthopantomography radiographs according to the Kvaal method. Statistical inter-observer and intra-observer reliabilities were calculated to evaluate the reproducibility of the measurements, as well as to examine the correlation between chronological age and measured values. The evaluation revealed a substantial difference (over 12 years) between chronological and estimated age. The P ratio had the strongest correlation with chronological age for the maxillary central (r = ±0.293) and lateral incisors (r = ±0.240), whereas the pulp/root width ratio at level A had the strongest correlation for the mandibular first premolars (r = ±0.270). The lowest SD values, for measurements on teeth 15/25 (SD = 125,787), had the most accurate correlation with age. Thus, we can conclude that the original Kvaal method is not applicable in the age estimation of the Serbian population. For future research, we suggest using cone beam computer tomography as a precise technology to evaluate the applicability of Kvaal and other methods for age estimation.

Effectiveness of technology-enhanced teaching methods of undergraduate dental skills for local anaesthesia administration during COVID-19 era: students' perception.

BACKGROUND: Traditional face-to-face clinical learning became problematic for final year dental students during the COVID-19 pandemic. Distance-learning may help mitigate the immediate impact of dental school closures. Integrating e-learning technologies into the learning process helps bridge the gap between pre-clinical and clinical training. Simulation allows students to repeat procedures until they demonstrate acceptable levels of skill. This study aimed to determine the effectiveness of a serious game as an additional teaching tool during the COVID-19 era to improve dental students' local anaesthesia administration technique and confidence. METHODS: This study applied a simulation-based serious game as an additional learning tool for training and educating dental students in local anaesthesia. Students used a mobile simulator in Serbian for 10 days from their homes. To evaluate the learning process, the students completed a post-training questionnaire. RESULTS: All respondents felt comfortable using the simulator. Over 90% of respondents believed that the application facilitated the learning process and had advantages in terms of accessibility and ease of use. Also, students found augmented reality (AR) technology particularly interesting to use. The use of a mobile simulator designed as a 3D and AR environment allows for simpler localisation and identification of anatomical structures and reference points, which is a good base for clinical practice. CONCLUSION: Serious games of local anaesthesia procedures as an additional e-learning tool during the COVID-19 era could improve students' knowledge and skills.

AIRWAY MANAGEMENT IN LAPAROSCOPIC CHOLECYSTECTOMY - A COMPARATIVE ANALYSIS.

In this study, we aimed to compare supraglottic airway devices (Supreme and i-gel laryngeal mask) with tracheal tube with respect to airway control and efficiency in ventilation and oxygenation. The study included 325 patients of ASA I-II who underwent laparoscopic cholecystectomy. In group 1, the airway was secured using endotracheal intubation (115 patients). In group 2 (103 patients), LMA Supreme was applied, whereas i-gel mask was used for airway management in group 3 (107 patients). Monitoring parameters were recorded and compared using t-test, analysis of variance (ANOVA), Tukey's test and χ2-test. The following parameters were monitored: insertion time, number of attempts for device placement, oropharyngeal seal pressure, etc. Insertion time was longest in group 1 (14.7±1.65 s) as compared to group 2 (15.5±1.05 s) and group 3 (14.1±1.27 s); ANOVA test yielded a statistically significant difference (p<0.01). Insertion success rate was almost identical in all three groups (p=0.907, χ2-test). Comparison of oropharyngeal seal pressure between group 2 (35.95±2.92 cm H2O) and group 3 (36.47±1.43 cm H2O) yielded no statistical difference (p=0.314, t-test). Endotracheal tube, Supreme and i-gel laryngeal masks were shown to be equally efficient in airway management in laparoscopic cholecystectomy. All three devices enabled efficient ventilation and oxygenation despite certain pathophysiological changes associated with laparoscopy.

Analysis of the Impact of Oral Health on Adolescent Quality of Life Using Standard Statistical Methods and Artificial Intelligence Algorithms.

The aim of this study was to determine the impact of oral health on adolescent quality of life and to compare the results obtained using standard statistical methods and artificial intelligence algorithms. In order to measure the impact of oral health on adolescent quality of life, a validated Serbian version of the Oral Impacts on Daily Performance (OIDP) scale was used. The total sample comprised 374 respondents. The obtained results were processed using standard statistical methods and machine learning, i.e., artificial intelligence algorithms-singular value decomposition. OIDP score was dichotomized into two categories depending on whether the respondents had or did not have oral or teeth problems affecting their life quality. Human intuition and machine algorithms came to the same conclusion on how the respondents should be divided. As such, method quality and the need to perform analyses of this type in dentistry studies were demonstrated. Using artificial intelligence algorithms, the respondents can be clustered into characteristic groups that allow the discovery of details not possible with the intuitive division of respondents by gender.

The Outcomes of an Interventional Oral Health Program on Dental Students' Oral Hygiene.

Dental students are an interesting population because they are expected to have a higher level of knowledge of and to exhibit better oral hygiene habits, and thus have a greater impact on the environment, families, and society as a whole. The aim of this research was to determine the state of oral hygiene in dental students before and after the interventional health education program. The research sample consisted of 119 students of dentistry in their first and fourth years of study. The first research stage was conducted before health education intervention (for the evaluation of selected oral health parameters, the Decayed, Missing and Filled index, Greene-Vermillion index, Silness-Löe plaque index, Silness-Löe gingival index, and the Community Periodontal Index of Treatment Needs index were used). The second stage was conducted as a clinical measurement of oral health changes. The conducted health education intervention, to an extent, led to changes in the state of oral hygiene among the students, and thus healthier habits. There was a statistically significant difference in the examined population between the beginning of the study and after the health education intervention program. Although a significant improvement in oral hygiene and oral health was noticed after the health education intervention program, the state of oral hygiene was still not at a satisfactory level among the dental students, contrary to our expectations.

A Comparative Study of Antioxidative Activity of Saliva in Children and Young Teenagers with and without Gingivitis.

Objectives: The aim of this study was to compare the values of total antioxidant capacity (TAC), catalase (CAT) and glutathione peroxidase (GPX) in the saliva of children and young teenagers with and without gingivitis. Materials and Methods: A total of 120 children and young teenagers of the mean age of 12.2 participated in the research. Gingival condition was assessed using the Löe and Silness Gingival Index. The subjects were divided into groups of those without gingivitis and those with gingivitis. Samples of unstimulated saliva were collected, and TAC, CAT and GPX were determined spectrophotometrically. Results: By comparing the values of TAC, CAT and GPX in subjects with and without gingivitis, significantly lower values of TAC (p < 0.001) and CAT (p < 0.001) were observed in the group of subjects with gingivitis. The correlation analysis of these values showed a positive correlation in groups of subjects not suffering from gingival inflammation and those with gingival inflammation. Conclusions: The study showed significantly lower values of TAC and CAT in the saliva of subjects with gingivitis. This indicates their possible role as a potential biomarker in the early diagnosis and expression of periodontal disease in children and young teenagers.

Effectiveness of virtual reality as a distraction on anxiety and pain during impacted mandibular third molar surgery under local Anesthesia.

OBJECTIVE: The aim of this study was to assess the effectiveness of Virtual Reality (VR) in reducing anxiety and pain during impacted mandibular third molar extraction under local anesthesia. METHODS: The study was designed as a prospective clinical study covering 74 respondents over 20 years of age. Surgical extraction of both impacted mandibular third molars was performed in two phases, two weeks apart. In the first phase, surgical extraction of the tooth was performed following the standard procedure (Non VR), and in the second phase (VR), we used VR goggles as an auxiliary tool for distraction during the procedure. Face scale was used to assess the level of pain. Heart rate values were recorded by means of wristbands. After both procedures, the patients filled out a modified post-clinical satisfaction questionnaire. RESULTS: During the procedure with VR goggles, the respondents had significantly lower pain values during the application of anesthesia, as well as during the surgical extraction of the third molar. There was no statistically significant difference in the level of pain during both surgical procedures with regard to the gender and age. Heart rate values in both phases of the study were not significantly different before the application of anesthesia. When VR goggles were used, the respondents had significantly lower heart rate values before the procedure, as well as during the procedure. Analysis of answers to the post-clinical questionnaire measuring satisfaction with VR technology shows that over 90% of respondents did not experience any VR-related discomfort during the surgery. CONCLUSIONS: The VR distraction concept applied during impacted third molar surgery under local anesthesia can help reduce the patients' anxiety and acute pain levels.

Effectiveness of an intraoral thermoformed splint with magnet device in patients with xerostomia and hyposalivation: A pilot study.

AIM: The aim of the study was to examine the effectiveness of intraoral thermoformed splint with a magnet device over a period of 3 months, that is, to assess acceptability of this method of treatment using both objective and self-reported measures. MATERIALS AND METHODS: This study was designed as a prospective clinical pilot trial. 22 patients with xerostomia and hyposalivation were included. Xerostomia was assessed using a 4-question xerostomia questionnaire score and a test for unstimulated salivary flow rates. Evaluations were performed before the treatment and 3 months after the treatment using a thermoformed splint with a magnet device. RESULTS: There was a significant reduction in subjective symptoms after using a thermoformed splint with a magnet device for 3 months. For all 4 scored items, there was a statistically significant difference (P < .001) in median VAS scores before and 3 months after treatment. There was also a statistically significant difference in USFR before (0,15 ± 0,04 ml/min) and after treatment (0,24 ± 0,03 mL/min). CONCLUSION: Our findings indicate that the use of this device alleviated oral dryness and stimulated the function of the submandibular salivary gland. An intraoral thermoformed splint with a magnet device is safe, physiologically indifferent, useful, and effective in treating xerostomia and hyposalivation.

Effect of augmented reality simulation on administration of local anaesthesia in paediatric patients.

BACKGROUND: Augmented reality (AR) is a simulation of a three-dimensional environment created using hardware and software that provides the user with realistic experiences and ability to interact. The aim of the study was to evaluate the impact of AR simulator on the perception of learning and acute stress level in students administering local anaesthesia to paediatric patients relative to standard teaching methods. MATERIAL AND METHODS: The prospective study included 21 fourth- and fifth-year students enrolled in 5-year dental programme. In addition to conventional training, the students of the study group used the augmented reality simulator in a dental office 2 hours weekly in 2 weeks. The level of salivary cortisol was measured before and after the anaesthetic procedure as one of the indicators of acute stress. RESULTS: A statistically significant shorter time to perform infiltrative anaesthesia technique for the anterior superior alveolar nerve was observed in students using the AR technique (28.91 ± 9.06 seconds in the study group and 39.80 ± 9.29 seconds in the control group). The level of cortisol before and after anaesthesia was statistically significant in all subjects (cortisol concentration was 0.53 µg/dL before anaesthesia and 2.44 µg/dL after the procedure); however, there was no statistically significant difference between the groups. CONCLUSION: The AR concept may influence better manipulation and control of the syringe in students administering their first anaesthetic injection to paediatric patients, but may not reduce acute stress.

Primary hydatid disease of the transverse abdominal muscle A case report.

INTRODUCTION: Echinococcus is a parasitic disease that affects all organs and tissues. The most commonly affected are liver (70-80%) and lungs (10-25%), while very rarely, in about 5% of cases, it can be found in the spleen, kidneys, brain, heart, pancreas, muscles and skeleton. CASE REPORT: Although localization of hydatid cyst in muscle is rare, it is important to consideredPORT it in the differential diagnosis of a cystic mass in the muscle. Clinical diagnosis of cystic echinococcosis is based on general ultrasound imaging, CT, MRI, differentiation of Echinococcus-Ag, ELISA testing, immunoelectrophoresis (IEP), counterimmunoelectrophoresis (CIE). DISCUSSION: Surgery is the primary treatment for muscle hydatidosis. We present our experience in treating the case of an infected hydatid cyst on transverse abdominal muscle, with infection extending to the right diaphragm and subcutaneous tissue of abdomen and thorax between the transverse abdominal and internal sternal abdominal muscles. CONCLUSION: The goal of the surgical treatment is total evacuation of the parasite, "sterilization" of the residual cavity and handling of intraoperartive complications. The post-operative course was normal and the patient was discharged to home care ten days after surgery in good general and local condition. KEY WORDS: Abscess, Echinococcus, Infection, Muscle.