Artificial intelligence-based cephalometric landmark annotation and measurements according to Arnett's analysis: can we trust a bot to do that?

OBJECTIVE: To assess the reliability of CEFBOT, an artificial intelligence (AI)-based cephalometry software, for cephalometric landmark annotation and linear and angular measurements according to Arnett's analysis. METHODS: Thirty lateral cephalometric radiographs acquired with a Carestream CS 9000 3D unit (Carestream Health Inc., Rochester/NY) were used in this study. The 66 landmarks and the 10 selected linear and angular measurements of Arnett's analysis were identified on each radiograph by a trained human examiner (control) and by CEFBOT (RadioMemory Ltd., Belo Horizonte, Brazil). For both methods, landmark annotations and measurements were duplicated with an interval of 15 days between measurements and the intraclass correlation coefficient (ICC) was calculated to determine reliability. The numerical values obtained with the two methods were compared by a t-test for independent variables. RESULTS: CEFBOT was able to perform all but one of the 10 measurements. ICC values > 0.94 were found for the remaining eight measurements, while the Frankfurt horizontal plane - true horizontal line (THL) angular measurement showed the lowest reproducibility (human, ICC = 0.876; CEFBOT, ICC = 0.768). Measurements performed by the human examiner and by CEFBOT were not statistically different. CONCLUSION: Within the limitations of our methodology, we concluded that the AI contained in the CEFBOT software can be considered a promising tool for enhancing the capacities of human radiologists.

Topical application of tranexamic acid in anticoagulated patients undergoing minor oral surgery: A systematic review and meta-analysis of randomized clinical trials.

PURPOSE: To perform a systematic review and meta-analysis of randomized clinical trials (RCTs) investigating the efficacy and safety of topical tranexamic acid (TXA) to prevent postoperative bleeding in anticoagulated patients undergoing minor oral surgery. MATERIAL AND METHODS: We analyzed RCTs comparing the use of topical TXA versus other topical hemostatic agents or placebo solutions for minor oral surgeries. We assessed the risk of bias and strength of evidence according to the Cochrane guidelines and GRADE rating system, respectively. The pooled relative risk (RR) was calculated for the effect of topical application of TXA on postsurgical bleeding. RESULTS: Five RCTs were included in the study. The combined RR for the number of patients receiving TXA in comparison to the control group was 0.13 (95% CI 0.05-0.36; P = 0.01), indicating a protective effect of topical TXA on bleeding after minor oral surgeries. Subgroup analysis revealed that topical TXA was effective in preventing postsurgical bleeding compared to placebo and epsilon-aminocaproic acid. No cases of thromboembolic events were reported. CONCLUSIONS: Currently available evidence suggests that surgical site irrigation with TXA followed by mouthwash during the first postoperative week is safe and may reduce the risk of bleeding after minor oral surgeries in anticoagulated patients.

Digital radiographic evaluation of the midpalatal suture in patients submitted to rapid maxillary expansion.

AIMS: To analyze the density of the midpalatal suture by means of digital radiographs three months after retention to evaluate if this period of retention is really sufficient for bone repair. MATERIALS AND METHODS: This prospective study consisted of 31 patients (11 girls and 20 boys) in the mixed or permanent dentition stage, treated using a tooth-tissue borne expanders (Haas). Occlusal digital radiographs were taken at three stages: prior to rapid maxillary expansion (Stage I); immediately after desired maxillary expansion (Stage II); and after three months of retention (Stage III). Radiographs were taken on a dental X-ray machine, set at 70 kVp and 7 mA with an exposure time of 0.04 s. A phosphor storage plate system, imaging plate size n. 2 (35 × 45 × 1.6 mm), was used. Three regions (A, B and C) measured 0.02 mm² were selected for optical density analysis. The difference between the measurements was evaluated with the paired t-test. RESULTS: The optical density was reduced at Stages II and III compared with Stage I. Between-stage comparison showed statistically significant changes for all variables (P < 0.05), with the highest mean optical density at Stage I and the lowest at Stage II, in all groups. Actually, there was an increase in optical density between Stages II and III, but they are reduced compared with Stage I. CONCLUSION: The results strongly suggest that bone formation did not occur as expected, and that a longer retention period for bone repair may be necessary.

[Radioprotection in dentistry offices]. / Condições de radioproteção dos consultórios odontológicos.

In 1998, the Brazilian Ministry of Health established the Guidelines for Protection in Medical and Odontological Radiography, aimed at ensuring the quality of radiological procedures provided to the population as well as radiological protection for the health professionals. The purpose of this study was to verify the current situation in the dental offices with regard to the technical specifications and the adopted protective measures, using a questionnaire including questions about equipments, techniques and radiological protection. The investigated universe consisted of the surgeon dentists of the city of Aracaju using radiographic examination as a routine, resulting in a final sample of 103 professionals. The results showed that a high percentage of these professionals ignore the current norms (64.1%) as well as the technical specifications of their equipment (51.5% ignored the peak kilovoltage and 57.3% the milliamperage of their equipment), besides examining the radiographs visually (67%) As positive behaviors, the paralleling technique was preferred by 62.1% and the lead apron was used by 98.1%. We conclude that, despite the limited knowledge about the Guidelines, some measures are being correctly adopted but that the dentists have to be more aware of the necessary protective measures.