Comparing the accuracy of two machine learning models in detection and classification of periapical lesions using periapical radiographs.

BACKGROUND: Previous deep learning-based studies were mainly conducted on detecting periapical lesions; limited information in classification, such as the periapical index (PAI) scoring system, is available. The study aimed to apply two deep learning models, Faster R-CNN and YOLOv4, in detecting and classifying periapical lesions using the PAI score from periapical radiographs (PR) in three different regions of the dental arch: anterior teeth, premolars, and molars. METHODS: Out of 2658 PR selected for the study, 2122 PR were used for training, 268 PR were used for validation and 268 PR were used for testing. The diagnosis made by experienced dentists was used as the reference diagnosis. RESULTS: The Faster R-CNN and YOLOv4 models obtained great sensitivity, specificity, accuracy, and precision for detecting periapical lesions. No clear difference in the performance of both models among these three regions was found. The true prediction of Faster R-CNN was 89%, 83.01% and 91.84% for PAI 3, PAI 4 and PAI 5 lesions, respectively. The corresponding values of YOLOv4 were 68.06%, 50.94%, and 65.31%. CONCLUSIONS: Our study demonstrated the potential of YOLOv4 and Faster R-CNN models for detecting and classifying periapical lesions based on the PAI scoring system using periapical radiographs.

Lingual bracket transfer accuracy of double vacuum-formed indirect bonding tray using 3D-printed model: an in vivo study.

INTRODUCTION: This study aimed to assess the transfer accuracy of a digital indirect bonding method for lingual brackets using double vacuum-formed trays in vivo. METHODS: Twenty-five patients in need of lingual orthodontic treatment were consecutively recruited. Bracket placement was performed on ideal setups, followed by fabricating indirect bonding trays through vacuum-forming on 3-dimensional printed models. Transfer accuracy was measured at each bracket after superimpositions of postbonding scans and reference data. One-tailed t tests were used to determine whether bracket deviations were within the limit of 0.5 mm and 2° for linear and angular dimensions, respectively. RESULTS: A total of 611 lingual brackets were evaluated. Mean linear transfer errors were 0.06 mm, 0.09 mm, and 0.12 mm, with frequencies of deviations within the 0.5 mm limit of 99.7%, 99.8%, and 98.0% for mesiodistal, buccolingual, and occlusogingival dimensions, respectively. Regarding angular measurements, mean transfer errors were 1.28°, 1.73°, and 2.96°, with frequencies of deviations within the 2° limit of 81.0%, 68.9%, and 51.1% for rotation, tip, and torque, respectively. Mean errors fell within the clinically accepted limits for all linear dimensions and rotation but exceeded the limit for tip and torque. CONCLUSIONS: Lingual bracket indirect bonding using double vacuum-formed trays fabricated on 3-dimensional printed models has high transfer accuracy in the mesiodistal, buccolingual, and occlusogingival dimensions and rotation. However, the transfer of tip and torque is less accurate.

The Effectiveness of Early Childhood Caries Treatment with MI Varnish Fluor in Obese Subjects: A Study from Vietnam.

Objective: We conducted this work to evaluate the effectiveness of treatment for early childhood caries (ECC) using MI Varnish Fluor in obese children aged from 36 to 71 months. Methods: This study was conducted on 300 carious teeth of obese children and normal-weight children in Hanoi, Vietnam, over the period 2019-2020. Diagnodent KaVo 2190 laser equipment was used to diagnose ECC. The children in each group were selected on the basis of similarities in age, gender, and study location, and the teeth in the two groups were selected on the basis of similarities in damage level and jaw position. ECC treatment was performed once a week for four consecutive weeks with MI Varnish Fluor. The child, the child's family, and the child's teacher were consulted on diet and oral hygiene during the treatment. Children were examined and monitored throughout the treatment period. Children were re-examined after 3 and 6 months from the start time of treatment. The Mann-Whitney U test and Kruskal-Wallis tests were used, with statistical significance indicated at p < 0.05. Results: After six months of treatment with MI Varnish Fluor, the number of cases of code 0 damage recovery (D0) increased in both groups. The result showed that MI Varnish fluor was effective in ECC treatment. D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children were observed after six months of treatment, but there was no statistically significant difference between the two groups. Furthermore, there was no statistically significant difference between the two groups according to age, tooth position, or tooth surface position in D0 damage recovery. Conclusions: MI Varnish Fluor was effective in ECC treatment, with D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children after six months of treatment.

Early Childhood Caries in Obese Children: The Status and Associated Factors in the Suburban Areas in Hanoi, Vietnam.

Obesity and early childhood caries are two prominent health problems affecting the majority of children worldwide. Thus, early childhood caries in obese children must be studied. This study was conducted to investigate the status of early childhood caries in obese children in Hanoi, Vietnam, and its associated factors. A cross-sectional study was conducted on 234 obese children, 234 normal children (non-obese) aged 36 to 71 months, and their mothers at some kindergartens in Hanoi. Study subjects were randomly selected with similarities in age, gender, and study location. Decayed tooth of children was detected by clinical examination and Diagnodent Kavo 2190 machine of Germany. In addition, a questionnaire for their mothers was used to find out related factors. We found that, in the Obese Group, the rate of early childhood caries (ECC), severe-early childhood caries (S-ECC), dmft index (the number of decayed teeth, teeth lost due to cavities, filled decayed teeth or filled cavity), and dmfs index (the number of surfaces of the teeth decay, surfaces of teeth were lost due to cavities, surfaces of filled decayed teeth) were 82.91%, 59.83%, 6.84 ± 4.92, and 9.10 ± 7.48, respectively. In the Normal Group, these rates were smaller than in the Obese Group, but the difference was not statistically significant. Regarding related factors, the hobby of drinking soft drinks, the habits and frequency of drinking milk at night and eating sweet marshmallows were associated with ECC in the Obese Group with p < 0.05. In conclusion, the higher rates of ECC were seen in obese children, with eating hobbies and habits being the related factors. Therefore, it is necessary to have appropriate policies and effective communication strategies to minimize ECC in the future.

Skeletal Class III Malocclusion with Lateral Open Bite and Facial Asymmetry Treated with Asymmetric Lower Molar Extraction and Lingual Appliance: A Case Report.

A skeletal Class III malocclusion with open bite tendency is considered very difficult to treat orthodontically without surgery. This case report describes the lingual orthodontic treatment of an adult skeletal Class III patient with mandibular deviation to the left side, lateral open bite, unilateral posterior crossbite, zero overbite and negative overjet. The lower incisors were already retroclined to compensate with the skeletal discrepancy. The patient was treated by asymmetric molar extraction in the mandibular arch to retract the lower incisors and correct the dental midline, with the help of intermaxillary elastics. Lingual appliance was used with over-torqued lower anterior teeth's brackets to control the torque of mandibular incisors. After a 30-month treatment, satisfactory smile and facial esthetics and good occlusion was achieved. A 12-month follow-up confirmed that the outcome was stable. Asymmetric molar extraction could be a viable option to retract mandibular incisors in Class III malocclusion with lower dental midline deviation.

Diagnostic Value of Fluorescence Methods, Visual Inspection and Photographic Visual Examination in Initial Caries Lesion: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to investigate the efficacy of fluorescence-based methods, visual inspections, and photographic visual examinations in initial caries detection. A literature search was undertaken in the PubMed and Cochrane databases. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed, and eligible articles published from 1 January 2009 to 30 October 2019 were included if they met the following criteria: they (1) assessed the accuracy of methods of detecting initial tooth caries lesions on occlusal, proximal, or smooth surfaces in both primary and permanent teeth (in clinical); (2) used a reference standard; (3) reported data regarding the sample size, prevalence of initial tooth caries, and accuracy of the methods. Data collection and extraction, quality assessment, and data analysis were conducted according to Cochrane standards Quality Assessment of Diagnostic Accuracy Studies-2. Statistical analyses were performed using Review Manager 5.3 and STATA 14.0. A total of 12 eligible articles were included in the meta-analysis. The results showed that the sensitivity and specificity of fluorescence-based methods were 80% and 80%, respectively; visual inspection was measured at 80% and 75%, respectively; photographic visual examination was measured at 67% and 79%, respectively. We found that the visual method and the fluorescence method were reliable for laboratory use to detect early-stage caries with equivalent accuracy.

Bruxism, Related Factors and Oral Health-Related Quality of Life Among Vietnamese Medical Students.

Although bruxism is a common issue with a high prevalence, there has been a lack of epidemiological data about bruxism in Vietnam. This cross-sectional study aimed to determine the prevalence and associated factors of bruxism and its impact on oral health-related quality of life among Vietnamese medical students. Bruxism was assessed by the Bruxism Assessment Questionnaire. Temporomandibular disorders were clinically examined followed by the Diagnostic Criteria for Temporomandibular Disorders Axis I. Perceived stress, educational stress, and oral health-related quality of life were assessed using the Vietnamese version of Perceived Stress Scale 10, the Vietnamese version of the Educational Stress Scale for Adolescents, and the Vietnamese version of the 14-item Oral Health Impact Profile, respectively. The prevalence of bruxism, sleep bruxism, awake bruxism, and both conditions in Vietnamese medical students were 51.2%, 38.2%, 23.4%, and 10.4% respectively. Stress, temporomandibular joint pain, masticatory muscle pain, and tooth attrition were associated with the presence of bruxism. Vietnamese medical students were negatively affected by bruxism in terms of oral health-related quality of life.

The Combination of Adaptive Convolutional Neural Network and Bag of Visual Words in Automatic Diagnosis of Third Molar Complications on Dental X-Ray Images.

In dental diagnosis, recognizing tooth complications quickly from radiology (e.g., X-rays) takes highly experienced medical professionals. By using object detection models and algorithms, this work is much easier and needs less experienced medical practitioners to clear their doubts while diagnosing a medical case. In this paper, we propose a dental defect recognition model by the integration of Adaptive Convolution Neural Network and Bag of Visual Word (BoVW). In this model, BoVW is used to save the features extracted from images. After that, a designed Convolutional Neural Network (CNN) model is used to make quality prediction. To evaluate the proposed model, we collected a dataset of radiography images of 447 patients in Hanoi Medical Hospital, Vietnam, with third molar complications. The results of the model suggest accuracy of 84% ± 4%. This accuracy is comparable to that of experienced dentists and radiologists.

Perceptions of Dentists and Non-Professionals on Some Dental Factors Affecting Smile Aesthetics: A Study from Vietnam.

Aim: It is important to meet the aesthetic expectation regarding the smile concept of both dentists and non-professionals after treatment is complete. Therefore, the study aims to evaluate the effects of altered displays in incisors, gingival margin, and other smile-related-factors on dentists' vs. non-professionals' aesthetics perceptions. Materials and method: We altered the features of 42 digital smile photographs to generate the changed displays in incisors, gingival margin, and other smile-related-factors. Then, these altered photographs were presented to 51 dentists and 51 non-professionals, and each picture was rated by each participant with a visual analog scale ranging from 0 (very ugly) to 100 (very beautiful). Results: We found that the alterations in incisors, gingival margin, and other factors affected studied groups' aesthetic perception of smile. The ugly smile threshold rated by both groups for crown length of maxillary central incisors was 2.0 mm. This threshold was 2.5mm for dentists, with moving the gingival margin of maxillary lateral incisors to the incisal ridge. The ugly thresholds for other smile-related-factors were different between studied groups; for example, the ugly thresholds for gingival exposure levels were 3 and 4mm for dentists and non-professionals, respectively. Thus, our data indicate that altered displays in incisors, gingival margin, and other smile-related-factors affected perceptions of both studied groups on smile aesthetics, but dentists tended to feel more refined than non-professionals. Dentists and non-professionals had significantly different aesthetic perceptions of the alteration of the gingival exposure level. Conclusion: Both dentists and non-professionals' perceptions should be fully considered during orthodontic and prosthodontic treatment to achieve optimum aesthetic results.

An Update on the Progress of Isolation, Culture, Storage, and Clinical Application of Human Bone Marrow Mesenchymal Stem/Stromal Cells.

Bone marrow mesenchymal stem/stromal cells (BMSCs), which are known as multipotent cells, are widely used in the treatment of various diseases via their self-renewable, differentiation, and immunomodulatory properties. In-vitro and in-vivo studies have supported the understanding mechanisms, safety, and efficacy of BMSCs therapy in clinical applications. The number of clinical trials in phase I/II is accelerating; however, they are limited in the size of subjects, regulations, and standards for the preparation and transportation and administration of BMSCs, leading to inconsistency in the input and outcome of the therapy. Based on the International Society for Cellular Therapy guidelines, the characterization, isolation, cultivation, differentiation, and applications can be optimized and standardized, which are compliant with good manufacturing practice requirements to produce clinical-grade preparation of BMSCs. This review highlights and updates on the progress of production, as well as provides further challenges in the studies of BMSCs, for the approval of BMSCs widely in clinical application.

Author Correction: Evaluation of dental arch dimensions in 12 year-old Vietnamese children - A cross-sectional study of 4565 subjects.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The Effects of Adipocytes on the Regulation of Breast Cancer in the Tumor Microenvironment: An Update.

Obesity is a global pandemic and it is well evident that obesity is associated with the development of many disorders including many cancer types. Breast cancer is one of that associated with a high mortality rate. Adipocytes, a major cellular component in adipose tissue, are dysfunctional during obesity and also known to promote breast cancer development both in vitro and in vivo. Dysfunctional adipocytes can release metabolic substrates, adipokines, and cytokines, which promote proliferation, progression, invasion, and migration of breast cancer cells. The secretion of adipocytes can alter gene expression profile, induce inflammation and hypoxia, as well as inhibit apoptosis. It is known that excessive free fatty acids, cholesterol, triglycerides, hormones, leptin, interleukins, and chemokines upregulate breast cancer development. Interestingly, adiponectin is the only adipokine that has anti-tumor properties. Moreover, adipocytes are also related to chemotherapeutic resistance, resulting in the poorer outcome of treatment and advanced stages in breast cancer. Evaluation of the adipocyte secretion levels in the circulation can be useful for prognosis and evaluation of the effectiveness of cancer therapy in the patients. Therefore, understanding about functions of adipocytes as well as obesity in breast cancer may reveal novel targets that support the development of new anti-tumor therapy. In this systemic review, we summarize and update the effects of secreted factors by adipocytes on the regulation of breast cancer in the tumor microenvironment.

School education and childhood obesity: A systemic review.

Childhood obesity prevalence is shooting up at a phenomenal rate worldwide, leading to long-term devastating consequences. A great number of studies have investigated factors contributing to the increase in BMI of children and adolescents. School-based, home-based and clinic-based solutions have been suggested as possible viable strategies, among which school-based interventions is believed to produce a noticeable effect on a massive scale. However, the question of whether school interventions, especially school education exert significant impact on childhood obesity or not, is left with mixing results. This article aims to holistically review the relationship between school education and childhood obesity. Various factors are covered, including health education, nutrition education, school nutrition, physical education, teachers' awareness, teaching practice and school stress, In all, school education is not the answer to childhood obesity but just part of it. More attempts from other stakeholders (parents, community, policy makers, researchers, etc.) should be made in order to solve this complicated puzzle.

Reduced Need of Infiltration Anesthesia Accompanied With Other Positive Outcomes in Diode Laser Application for Frenectomy in Children.

Introduction: The abnormal maxillary labial frenum is common in children during the primary or mixed dentition stage. A conventional surgery for this abnormality usually requires infiltration anesthesia which leads to fear in children and consequent noncooperation during the surgery. The aim of present study was to evaluate the reduction in the need of infiltration anesthesia, intraoperative bleeding control and postoperative pain and wound healing in children when using the diode laser for abnormal labial frenum in the maxilla. Methods: The present study was carried out among 30 children attending the Hanoi Medical University, Vietnam. A Diode Laser with 810 nm wavelength and power of 0.8 W was used for frenectomy. Results: The proportion of procedures without any need of infiltration anesthesia was 70%, while 93.34% of children demonstrated positive and very positive behavior. Proportion of indolence on the first day after surgery was 83.3%. While 83.3% of children did not take any analgesics, not a single child complained of any pain 3 days after surgery. Conclusion: Our results indicated that the use of diode laser showed several benefits in maxillary labial frenectomy in children. These included reducing the need of infiltration anesthesia, increasing the children's cooperation as well as decreasing the postoperative pain.

Interventional Treatment of Lymphatic Leakage Post Appendectomy: Case Report.

BACKGROUND: Postoperative lymphatic complications are not common, and lymphatic leakage complication post appendectomy (LLCPC) is even rarer. However, the number of this operation is high so LLCPC can occur. CASE REPORT: Here, we report a female patient post appendectomy with severe chylous ascites. This patient underwent six operations. A leakage point at the right iliac-fossa, which was embolized successfully after two sessions, was spotted during intranodal lymphangiography. After 6 months, the ascites were significantly reduced while some lymphatic aneurysms still existed in the lumbar-retroperitoneal region. CONCLUSIONS: Basing the knowledge of this clinical case and literature, we have concluded that lymphatic leakage can be diagnosed and embolized by percutaneous intervention.

Zika virus in Vietnam, Laos, and Cambodia: are there health risks for travelers?

Vietnam, Laos, and Cambodia have reported first cases of Zika virus (ZIKV) infection since 2010 (Cambodia) and 2016 (Vietnam and Laos). One case of ZIKV-related microcephaly was recognized among a hundred infected cases in these areas, raising a great concern about the health risk related to this virus infection. At least 5 cases of ZIKV infection among travelers to Vietnam, Laos, and Cambodia were recorded. It is noticeable that ZIKV in these areas can cause birth defects. This work aims to discuss the current epidemics of ZIKV in Vietnam, Laos, and Cambodia and update the infection risk of ZIKV for travelers to these areas.

An Update on Anti-CD137 Antibodies in Immunotherapies for Cancer.

The selective expression of CD137 on cells of the immune system (e.g., T and DC cells) and oncogenic cells in several types of cancer leads this molecule to be an attractive target to discover cancer immunotherapy. Therefore, specific antibodies against CD137 are being studied and developed aiming to activate and enhance anti-cancer immune responses as well as suppress oncogenic cells. Accumulating evidence suggests that anti-CD137 antibodies can be used separately to prevent tumor in some cases, while in other cases, these antibodies need to be co-administered with other antibodies or drugs/vaccines/regents for a better performance. Thus, in this work, we aim to update and discuss current knowledge about anti-cancer effects of anti-CD137 antibodies as mono- and combined-immunotherapies.

On-site treatment of oral ulcers caused by cheek biting: A minimally invasive treatment approach in a pediatric patient.

In small children, it would be desirable for oral lesions, especially on the symmetrical sides, to be screened carefully, and for treatment to begin with minimal interventions including on-site medication and remedies to discontinue the bad routine. Minimal invasive approach and differential diagnosis are considered to be the main solutions for oral ulcers in pediatric patients.

Evaluation of dental arch dimensions in 12 year-old Vietnamese children - A cross-sectional study of 4565 subjects.

This study aimed to define the width and length of the dental arch in 12-year-old Vietnamese children, and to elucidate differences between genders and among ethnic groups. A cross-sectional study was conducted in 4565 12 years-old children from the 4 major ethnic groups in Vietnam (Kinh, Muong, Thai, and Tay), with a healthy and full set of 28 permanent teeth that had never had any orthodontic treatment and with no reconstructive materials at the measured points. The mean variables in all subjects were 36.39 mm for upper inter-canine width; 46.88 mm for upper inter-first molar width; 59.43 mm for upper inter-second molar width; 10.41 mm for upper anterior length; 32.15 mm for upper posterior length 1; 45.52 mm for upper posterior length 2; 28.31 mm for lower inter-canine width; 41.63 mm for lower inter-first molar width; 54.57 mm for lower inter-second molar width (LM2W); 7.06 mm for lower anterior length (LAL); 26.87 mm for lower posterior length 1 (LP1L); and 41.29 mm for lower posterior length 2. Significant differences in these parameters between genders were found in all ethnic groups, except for LAL in the Kinh and Thai groups, and LP1L in the Tay group. Significant ethnic differences were also found in almost all parameters except LM2W in both males and females. Taken together, the representative sizes of dental arches of 12-year-old Vietnamese children have been defined. Our data indicate that there are some variations in dental arch dimensions among ethnic groups and between genders.

Zoonotic diseases from birds to humans in Vietnam: possible diseases and their associated risk factors.

In recent decades, exceeding 60% of infectious cases in human beings are originated from pathogenic agents related to feral or companion animals. This figure continues to swiftly increase due to excessive exposure between human and contaminated hosts by means of applying unhygienic farming practices throughout society. In Asia countries-renowned for lax regulation towards animal-trading markets-have experienced tremendous outbreaks of zoonotic diseases every year. Meanwhile, various epidemic surges were first reported in the residential area of China-one of the largest distributor of all animal products on the planet. Some noticeable illnesses comprising of A/H5N1 or H7N9-known as avian influenza which transmitted from poultry and also wild birds-have caused inevitable disquiet among inhabitants. Indeed, poultry farming industry in China has witnessed dynamic evolution for the past two decades, both in quantity and degree of output per individual. Together with this pervasive expansion, zoonotic diseases from poultry have incessantly emerged as a latent threat to the surrounding residents in entire Asia and also European countries. Without strict exporting legislation, Vietnam is now facing the serious problem in terms of poultry distribution between the two countries' border. Even though several disease investigations have been conducted by many researchers, the disease epidemiology or transmission methods among people remained blurred and need to be further elucidated. In this paper, our aim is to provide a laconic review of common zoonotic diseases spread in Vietnam, outstanding cases and several factors predisposing to this alarming situation.