Artificial Intelligence in Adult and Pediatric Dentistry: A Narrative Review.

Artificial intelligence (AI) has been recently introduced into clinical dentistry, and it has assisted professionals in analyzing medical data with unprecedented speed and an accuracy level comparable to humans. With the help of AI, meaningful information can be extracted from dental databases, especially dental radiographs, to devise machine learning (a subset of AI) models. This study focuses on models that can diagnose and assist with clinical conditions such as oral cancers, early childhood caries, deciduous teeth numbering, periodontal bone loss, cysts, peri-implantitis, osteoporosis, locating minor apical foramen, orthodontic landmark identification, temporomandibular joint disorders, and more. The aim of the authors was to outline by means of a review the state-of-the-art applications of AI technologies in several dental subfields and to discuss the efficacy of machine learning algorithms, especially convolutional neural networks (CNNs), among different types of patients, such as pediatric cases, that were neglected by previous reviews. They performed an electronic search in PubMed, Google Scholar, Scopus, and Medline to locate relevant articles. They concluded that even though clinicians encounter challenges in implementing AI technologies, such as data management, limited processing capabilities, and biased outcomes, they have observed positive results, such as decreased diagnosis costs and time, as well as early cancer detection. Thus, further research and development should be considered to address the existing complications.

Antibacterial Properties of an Experimental Dental Resin Loaded with Gold Nanoshells for Photothermal Therapy Applications.

This study explored the chemical and antibacterial properties of a dental resin loaded with gold nanoshells (AuNPs) in conjunction with photothermal therapy (PTT) as a novel method against Streptococcus mutans (S. mutans) to prevent secondary caries. First, a 20-h minimum inhibitory concentration (MIC) assay was performed on solutions of AuNPs with planktonic S. mutans under an LED device and laser at 660 nm. Next, resin blends containing 0, 1 × 1010, or 2 × 1010 AuNPs/mL were fabricated, and the degree of conversion (DC) was measured using an FTIR spectroscopy. Lastly, a colony forming unit (CFU) count was performed following 24 h growth of S. mutans on 6 mm diameter resin disks with different light treatments of an LED device and a laser at 660 nm. The MIC results only showed a reduction in S. mutans at AuNP concentrations less than 3.12 µg/mL under a laser illumination level of 95.5 J/cm2 compared to the dark treatment (p < 0.010 for each). CFU and DC results showed no significant dependence on any light treatment studied. The AuNPs expressed antibacterial effects following PPT against planktonic S. mutans but not in a polymerized dental adhesive resin. Future studies should focus on different shapes, structure, and concentrations of AuNPs loaded in a resin blend.

Effects of Iron Salts on Demineralization and Discoloration of Primary Incisor Enamel Subjected to Artificial Cariogenic Challenge versus Saline Immersion.

AIM: This study aimed to assess the effects of iron salts on the demineralization and discoloration of primary incisor enamel subjected to artificial cariogenic challenge (ACC) versus saline immersion. METHODOLOGY: In this in vitro experimental study, 90 primary incisors were evaluated in 10 groups (n = 9). Five groups were subjected to ACC, and the other five were immersed in saline. Ferrous sulfate, ferrous fumarate, ferrous ammonium citrate, and ferrous gluconate were added to both saline and cariogenic solutions. The solutions were refreshed every 48 h. After 14 days, the teeth were removed from the media and their demineralization was inspected via scanning electron microscopy (SEM). Energy-dispersive X-ray spectroscopy (EDX) was also performed. The color of the specimens was measured at baseline and after the intervention using the Vita Shade Guide. RESULTS: Data were analyzed by the Kruskal-Wallis test, one-way ANOVA, and Tukey's test. The color change of specimens subjected to ACC was greater than the color change of those in saline (p = 0.083). The teeth subjected to ACC showed greater iron uptake than did those in saline (p = 0.023). SEM assessment revealed a regular pattern of enamel prisms, with some broken prisms and superficial cracks in the teeth immersed in saline. The teeth subjected to ACC showed numerous fractures and cracks, which were greater in the ferrous sulfate group. CONCLUSIONS: Immersion in ACC increased the structural porosities and led to greater iron uptake and, consequently, higher discoloration. The maximum structural changes and subsequent staining were noted in the ferrous sulfate group, followed by ferrous ammonium citrate, ferrous fumarate, and ferrous gluconate.

Polarography Can Successfully Quantify Heavy Metals in Dentistry.

Background and Objectives: Due to the nutritional and behavioral patterns of children, their teeth can be a good indicator of heavy metal uptake from over the years. To determine the amount of Zn, Cu, Cd, and Pb accumulated in the body, primary teeth of children in Zanjan, Iran, were examined with a polarography device. Materials and Methods: Samples were collected from dentistry clinics of Zanjan, Iran, and were prepared for acid digestion, and then were analyzed by a polarography device for determining the concentration of lead, copper, zinc, and cadmium. Results: Data were analyzed by a t-independent test to compare different groups (p < 0.05). Based on the results obtained from this study, the mean concentrations of zinc, lead, copper, and cadmium were 245, 7.66, 5.33, and 0.0879 µg/g, respectively, which shows that the amount of each of the four elements was more than the amounts that have been reported for different countries. The results showed no significant difference between age, tooth type, and jaw groups. Conclusions: We conclude that primary teeth are an important biological indicator to evaluate the concentration of heavy elements in the human body. The high concentrations of these elements in the primary teeth analyzed in this study could be attributed to the high concentrations of these elements in the environment of Zanjan.

Salivary Oxidative Stress Markers' Relation to Oral Diseases in Children and Adolescents.

Current evidence suggests that salivary markers of oxidative stress are indicative of clinical disease indices such as the papillary bleeding index (PBI) and the caries index (CI). The aim of this study was to assess the relation of oxidative stress markers with oral dental caries and periodontal problems in a pediatric population. In our case-control study, unstimulated whole saliva was collected from individuals aged 3-18 years (n = 177); 14 individuals were excluded. Study subjects were divided into those with caries (CI = 2, n = 78) and those who were caries-free (n = 85). These groups were then divided into another subset consisting of children (mean age 7.3 years, n = 121) and adolescents (mean age 16.1 years, n = 42). The PBI was determined in all groups. We then assessed salivary levels of oxidative stress markers. Our results showed that, the total antioxidant capacity (TAC) level increased in patients with more gingival bleeding (p < 0.05) in the study group aged 3-18 years. In addition, TAC showed a significant decrease in samples with caries when compared to the caries-free group in adolescents (p = 0.008). In conclusion, TAC levels may be a marker of both gingival bleeding and dental caries in young adult populations. We hope that in the near future, prophylaxis, control, follow up and even possible therapeutic use of oxidative stress markers in a chairside way will become possible as antioxidants have been shown to be effective against oral diseases.

Evaluation of inductive effects of different concentrations of cyclosporine A on MMP-1, MMP-2, MMP-3, TIMP-1, and TIMP-2 in fetal and adult human gingival fibroblasts.

Background The etiology of gingival overgrowth due to cyclosporine A (CsA) is still unknown. The aim of this study was to determine the possible role of matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) on extra-cellular matrix (ECM) homeostasis when treated with different levels of CsA and its difference between fetal and adult human gingival fibroblasts (HGFs). Methods Each group of cells (adult and fetal) was cultured in 40 wells that consisted of four different CsA treatment concentrations. Every 10 wells were treated with 0, 50, 100, and 150 ng/mL of CsA which makes a total of 80 wells. Supernatants of every well were used to determine the concentration of MMPs and TIMPs using the Elisa kits from Boster, CA, USA. Results MMP-1 level increased with the treatment of CsA when treated with 50 and 150 ng/mL of CsA (p = 0.02 and p = 0.04) as TIMP-1 decreased (p < 0.0001) in adult group; while in the fetal group, TIMP-1 level increased with treatment of 150 ng/mL (p < 0.0001). MMP-2 level increased in both adult and fetal groups (p < 0.0001). MMP-3 level decreased in adult group (p < 0.0001) but went up in fetal HGFs (p = 0.01) when treated with 150 ng/mL CsA. TIMP-2 level increased in all wells significantly when treated with CsA (p < 0.0001). The study showed that CsA affects secretion of MMPs and TIMPs. MMP-1 increment and TIMP-1 decrement were observed, which indicate more degradation of ECM. This may be due to single donor use in this study. TIMP-2 and MMP-2 were both more active when treated with CsA which may be due to the gelatinase activity of them and that in CsA gingival overgrowth. There was more inflammation rather than fibrosis.