Assessing the performance of Bing Chat artificial intelligence: Dental exams, clinical guidelines, and patients' frequent questions.

OBJECTIVES: Bing Chat is a large language model artificial intelligence (AI) with online search and text generating capabilities. This study assessed its performance within the scope of dentistry in: (a) tackling exam questions for dental students, (ii) providing guidelines for dental practitioners, and (iii) answering patients' frequently asked questions. We discuss the potential of clinical tutoring, common patient communication and impact on academia. METHODS: With the aim of assessing AI's performance in dental exams, Bing Chat was presented with 532 multiple-choice questions and awarded scores based on its answers. In evaluating guidelines for clinicians, a further set of 15 questions, each with 2 follow-up questions on clinical protocols, was presented to the AI. The answers were assessed by 4 reviewers using electronic visual analog scale. In evaluating answers to patients' frequently asked questions, another list of 15 common questions was included in the session, with respective outputs assessed. RESULTS: Bing Chat correctly answered 383 out of 532 multiple-choice questions in dental exam part, achieving a score of 71.99 %. As for outlining clinical protocols for practitioners, the overall assessment score was 81.05 %. In answering patients' frequently asked questions, Bing Chat achieved an overall mean score of 83.8 %. The assessments demonstrated low inter-rater reliability. CONCLUSIONS: The overall performance of Bing Chat was above the regularly adopted passing scores, particularly in answering patient's frequently asked questions. The generated content may have biased sources. These results suggest the importance of raising clinicians' awareness of AI's benefits and risks, as well as timely adaptations of dental education curricula, and safeguarding its use in dentistry and healthcare in general. CLINICAL SIGNIFICANCE: Bing Chat AI performed above the passing threshold in three categories, and thus demonstrated potential for educational assistance, clinical tutoring, and answering patients' questions. We recommend popularizing its benefits and risks among students and clinicians, while maintaining awareness of possible false information.

Regeneration of Intrabony Defects Using a Novel Magnesium Membrane.

Background and Objectives: Due to their specific morphology, the regeneration of intrabony defects (IBDs) represents one of the greatest challenges for clinicians. Based on the specific properties of a magnesium membrane, a new approach for the surgical treatment of IBD was developed. The surgical procedure was described using a series of three cases. Materials and Methods: The patients were healthy individuals suffering from a severe form of periodontitis associated with IBD. Based on radiographic examination, the patients had interproximal bone loss of at least 4 mm. Due to its good mechanical properties, it was easy to cut and shape the magnesium membrane into three different shapes to treat the specific morphology of each IBD. In accordance with the principles of guided bone regeneration, a bovine xenograft was used to fill the IBD in all cases. Results: After a healing period of 4 to 6 months, successful bone regeneration was confirmed using radiological analysis. The periodontal probing depth (PPD) after healing showed a reduction of 1.66 ± 0.29 mm. Conclusions: Overall, the use of the different shapes of the magnesium membrane in the treatment of IBD resulted in a satisfactory functional and esthetic outcome.

Evaluation between Biodegradable Magnesium Metal GBR Membrane and Bovine Graft with or without Hyaluronate.

Bone substitutes and barrier membranes are widely used in dental regeneration procedures. New materials are constantly being developed to provide the most optimal surgical outcomes. One of these developments is the addition of hyaluronate (HA) to the bovine bone graft, which has beneficial wound healing and handling properties. However, an acidic environment that is potentially produced by the HA is known to increase the degradation of magnesium metal. The aim of this study was to evaluate the potential risk for the addition of HA to the bovine bone graft on the degradation rate and hence the efficacy of a new biodegradable magnesium metal GBR membrane. pH and conductivity measurements were made in vitro for samples placed in phosphate-buffered solutions. These in vitro tests showed that the combination of the bovine graft with HA resulted in an alkaline environment for the concentrations that were used. The combination was also tested in a clinical setting. The use of the magnesium metal membrane in combination with the tested grafting materials achieved successful treatment in these patients and no adverse effects were observed in vivo for regenerative treatments with or without HA. Magnesium based biodegradable GBR membranes can be safely used in combination with bovine graft with or without hyaluronate.

Guided Bone Regeneration Using a Novel Magnesium Membrane: A Literature Review and a Report of Two Cases in Humans.

Guided bone regeneration (GBR) is a common procedure used to rebuild dimensional changes in the alveolar ridge that occur after extraction. In GBR, membranes are used to separate the bone defect from the underlying soft tissue. To overcome the shortcomings of commonly used membranes in GBR, a new resorbable magnesium membrane has been developed. A literature search was performed via MEDLINE, Scopus, Web of Science and PubMed in February 2023 for research on magnesium barrier membranes. Of the 78 records reviewed, 16 studies met the inclusion criteria and were analyzed. In addition, this paper reports two cases where GBR was performed using a magnesium membrane and magnesium fixation system with immediate and delayed implant placement. No adverse reactions to the biomaterials were detected, and the membrane was completely resorbed after healing. The resorbable fixation screws used in both cases held the membranes in place during bone formation and were completely resorbed. Therefore, the pure magnesium membrane and magnesium fixation screws were found to be excellent biomaterials for GBR, which supports the findings of the literature review.

Osteogenic Potential of Autologous Dentin Graft Compared with Bovine Xenograft Mixed with Autologous Bone in the Esthetic Zone: Radiographic, Histologic and Immunohistochemical Evaluation.

This prospective, randomized, controlled clinical trial reports clinical, radiographic, histologic and immunohistochemical results of autologous dentin graft (ADG) and its comparison with a mixture of bovine xenograft with autologous bone (BX+AB). After tooth extraction in the esthetic zone of maxilla, the alveolar ridge of 20 patients in the test group was augmented with ADG, while 17 patients in the control group received the combination of BX+AB. Cone beam computed tomography (CBCT) was performed before tooth extraction and after 4 months when a total of 22 bone biopsies were harvested and subjected to histological and immunohistochemical analysis. Radiological analysis showed comparable results of bone dimension loss in both groups. Quantitative histologic analysis showed comparable results with no statistically significant differences between the groups. Immunohistochemical staining with TNF-α and BMP-4 antibodies revealed immunopositivity in both groups. A statistically significant difference between the groups was found in the intensity of TNF-α in the area of newly formed bone (p = 0.0003) and around remaining biomaterial particles (p = 0.0027), and in the intensity of BMP-4 in the area around biomaterial particles (p = 0.0001). Overall, ADG showed biocompatibility and achieved successful bone regeneration in the esthetic zone of the maxilla similar to BX+AB.

Regeneration of Horizontal Bone Defect in Edentulous Maxilla Using the Allogenic Bone-Plate Shell Technique and a Composite Bone Graft-A Case Report.

An insufficient volume of the alveolar bone may prevent implants from being placed in the prosthetically optimal position. Complex restoration of bony structures is required to achieve long-term peri-implant bone stability and represents an adequate prosthetic solution. Background and Objectives: The shell technique has become a widespread and important method for guided bone regeneration in dentistry. Allogeneic bone materials appear to be the most similar substitution for autogenous bone transplants. However, there are few studies using cortical bone allografts in combination with a mix of autogenous and xenograft materials for the augmentation of horizontal ridge defects. This combination offers the advantage of reduced patient morbidity while adding adequate volume and contour to the alveolar ridge. Case report: The present case study aimed to clinically and radiographically evaluate the efficacy of allogenic cortical bone lamina combined with a composite bone graft in the augmentation of a horizontal bone defect in the edentulous maxilla during a 6-year follow-up period. Three CB CT scans taken before treatment, 6 months after the augmentation period/before implant placement, and after a 6-year follow-up period, were analyzed using stable referent points. After the 6 -year follow-up period, the average resorption rate was 21.65% on the augmented buccal side, with no implant exposure being observed. Conclusions: The bone shell technique used in conjunction with allogenic bone plates combined with autogenous bone, xenografts, and collagen membranes is an effective technique to manage horizontal ridge defects.

Thermal Evaluation by Infrared Thermography Measurement of Osteotomies Performed with Er:YAG Laser, Piezosurgery and Surgical Drill-An Animal Study.

The bone healing process following osteotomy may vary according to the type of surgical instrumentation. The aim of the present in vivo study was to determine thermal changes of the bone tissue following osteotomies performed by Er:YAG laser ablation in contact and non-contact modes, piezoelectric surgery, and surgical drill using an infrared thermographic camera. For each measurement, the temperature before the osteotomy-baseline (Tbase) and the maximal temperature measured during osteotomy (Tmax) were determined. Mean temperature (ΔT) values were calculated for each osteotomy technique. The significance of the difference of the registered temperature between groups was assessed by the ANOVA test for repeated measures. Mean baseline temperature (Tbase) was 27.9 ± 0.3 °C for contact Er:YAG laser, 29.9 ± 0.3 °C for non-contact Er:YAG laser, 29.4 ± 0.3 °C for piezosurgery, and 28.3 ± 0.3 °C for surgical drill. Mean maximum temperature (Tmax) was 29.9 ± 0.5 °C (ΔT = 1.9 ± 0.3 °C) for contact Er:YAG laser, 79.1 ± 4.6 °C (ΔT = 49.1 ± 4.4 °C) for non-contact Er:YAG laser, 29.1 ± 0.2 °C (ΔT = -0.2 ± 0.3 °C) for piezosurgery, and 27.3 ± 0.4 °C (ΔT = -0.9 ± 0.4 °C) for surgical drill. Statistically significant temperature changes were observed for the non-contact laser. The results of the study showed beneficial effects of the osteotomy performed by the Er:YAG laser used in the contact mode of working as well as for piezosurgery, reducing the potential overheating of the bone tissue as determined by means of infrared thermography.

Bone Healing Following Different Types of Osteotomy: Scanning Electron Microscopy (SEM) and Three-Dimensional SEM Analyses.

The aim of the present study was to compare dynamics of the bone healing process after different types of osteotomies. In total, 24 Wistar rats were subjected to different types of osteotomy performed with standard steel bur, piezosurgery, contact, and non-contact Erbium:yttrium-aluminum-garnet (Er:YAG) laser ablation. The animals were randomly divided into four groups, to be euthanized immediately after the procedure, or at 1, 2, or 3 weeks after surgery. The obtained bone samples were analyzed by scanning electron microscopy (SEM). Immediately after surgery, there were significant differences in the appearance of the bone defects, with presence of bone fragments and debris after standard steel bur preparation, compared with the clean smooth walls and relatively sharp edges in all other groups. The initial bone formation in defects prepared by piezosurgery was observed to be the most rapid. After 3 weeks, all bone defects were completely restored; although, differences in the healing pattern were noted, with a modest initial delay in healing after laser preparation. The first stage of the bone healing process was delayed when contact and non-contact Er:YAG laser modes were used and accelerated by piezosurgery; however, the results after 3 weeks demonstrated similar restitution of defects in all tested groups.

Evaluation of Bone Healing After Osteotomies Prepared With Er:YAG Laser in Contact and Noncontact Modes and Piezosurgery--An Animal Study.

PURPOSE: To analyze the healing of bone tissue treated with Er:YAG laser contact and noncontact modes of and piezosurgery in a rat model using triangular laser profilometry. MATERIALS AND METHODS: Twenty-four 10-week-old adult male Wistar rats were used in the study. Three osteotomies on the medial part of tibia were performed in each animal, 1 in the right tibia and 2 in the left tibia. The osteotomies were performed with a piezoelectric device set at maximal power and the Er:YAG laser in contact mode (power, 7.5 W; pulse energy, 375 mJ; repetition rate, 20 Hz; MSP mode) and noncontact mode (power, 7.5 W; pulse energy, 750 mJ; repetition rate, 10 Hz; QSP mode) with a novel type of circular, digitally controlled handpiece (x-Runner). After surgery, 6 animals were immediately euthanized (group 1), and the others were euthanized after 1 week (group 2, n = 6), 2 weeks (group 3, n = 6), and 3 weeks (group 4, n = 6). Bone healing after osteotomy was analyzed using a 3-dimensional laser scanning technique (ie, laser triangulation profilometry). RESULTS: The volume reduction rates are similar for all 3 techniques (0.2 to 0.25 mm(3) per week). Greater volume reduction of 0.25 mm3 per week was observed for the Er:YAG laser in noncontact mode (x-Runner). After 3 weeks, almost complete healing of the prepared osteotomy was observed. CONCLUSION: Within the limitations of this study, the osteotomies performed by the Er:YAG laser in digitally controlled noncontact mode healed the fastest.

Surgical treatment of excessive gingival display using lip repositioning technique and laser gingivectomy as an alternative to orthognathic surgery.

Excessive gingival display (EGD) is a condition in which an overexposure of the maxillary gingiva (>3 mm) is present during smiling. The proper diagnosis and determination of its etiology are essential for the selection of the right treatment modality. Different techniques have been used in cases of hyperactive upper lip: botulinum toxin injections, lip elongations with rhinoplasties, lip muscle detachments, myotomies, and lip repositions. This report presents a case of a young woman with an EGD larger than 10 mm during smiling caused by altered passive eruption, vertical maxillary excess, and a hyperactive upper lip that was treated with a modified lip repositioning technique and laser gingivectomy because she strongly refused orthognathic surgical treatment. A novel addition to the technique is proposed, a reversible trial accomplished just by applying sutures on the borders of the future split-thickness flap, marked using diode laser, before starting the flap incision.