Artificial intelligence in orthodontics: Where are we now? A scoping review.

OBJECTIVE: This scoping review aims to determine the applications of Artificial Intelligence (AI) that are extensively employed in the field of Orthodontics, to evaluate its benefits, and to discuss its potential implications in this speciality. Recent decades have witnessed enormous changes in our profession. The arrival of new and more aesthetic options in orthodontic treatment, the transition to a fully digital workflow, the emergence of temporary anchorage devices and new imaging methods all provide both patients and professionals with a new focus in orthodontic care. MATERIALS AND METHODS: This review was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The electronic literature search was performed through MEDLINE/PubMed, Scopus, Web of Science, Cochrane and IEEE Xplore databases with a 11-year time restriction: January 2010 till March 2021. No additional manual searches were performed. RESULTS: The electronic literature search initially returned 311 records, and 115 after removing duplicate references. Finally, the application of the inclusion criteria resulted in 17 eligible publications in the qualitative synthesis review. CONCLUSION: The analysed studies demonstrated that Convolution Neural Networks can be used for the automatic detection of anatomical reference points on radiological images. In the growth and development research area, the Cervical Vertebral Maturation stage can be determined using an Artificial Neural Network model and obtain the same results as expert human observers. AI technology can also improve the diagnostic accuracy for orthodontic treatments, thereby helping the orthodontist work more accurately and efficiently.

CBCT and CAD-CAM technology to design a minimally invasive maxillary expander.

BACKGROUND: A large number of articles in recent years studying the effects of non-surgically assisted tooth- versus bone-borne maxillary expanders in growing patients have found no significant differences in mid-palatal suture disjunction or even dentoalveolar changes. This suggests the need for new criteria and better use of current technology to make more effective devices and enhance the benefits of conventional treatments. This article describes a titanium grade V computer-aided design/computer-aided manufacturing (CAD/CAM) maxillary expander supported by two miniscrews, along with a 3D printed surgical guide. METHODS: The first step was to obtain a digitized model of the patient's upper maxilla. To simplify the process and ensure the placement of the device in a high-quality bone area, the patients' digital dental cast was superimposed with a cone beam computed tomography (CBCT) scan. Improved resistance to expansion forces was secured through the use of 2 mm-wide miniscrews, long enough for bicortical anchorage. Placement site and direction were assessed individually in order to achieve primary stability. We chose a site between the second premolars and first molars, while the inclination followed the natural contour of the palate vault. A 3D-printed, polyamide surgical guide was designed to ensure the correct placement of the device with a manual straight driver. RESULTS: Favorable clinical results were presented with 3D images. We confirmed a mid-palatal suture parallel separation of 3.63 mm, along with a higher palatal volume, as well as increased intercanine and intermolar distance. Segmentation of the facial soft tissue showed an expansion of nasal airways and changes in nasal morphology. CONCLUSIONS: Digital models, CBCT and CAD/CAM technology, are essential to accomplish the goals proposed in this article. Further studies are necessary to establish safer miniscrew placement sites and insertion angles so as to achieve greater in-treatment stability. Both the clinician and the patient can benefit from the use of current technology, creating new devices and updating traditional orthodontic procedures.

Association between sella turcica bridging and altered direction of dental eruption: A case-control study.

BACKGROUND: Calcification between the anterior and posterior clinoid processes, also the so-called sella turcica bridging, has been associated in some studies with skeletal anomalies as well as with dental and eruption disturbances. It was hypothesized that sella turcica bridging was associated with an altered direction of dental eruption. The aim of the study was to assess whether there was a relationship between the degree of calcification and the presence or absence of an alteration in the tooth eruption direction. MATERIAL AND METHODS: A case-control multicenter study was conducted. The study population consisted of 150 subjects (age 10-50 years), 30 of which presented some type of alteration of the direction canine eruption (impactation or transposition) (cases) and 120 selected at random who did not present altered direction of dental eruption (controls). Cases and controls were matched by age, sex, and approximate date of starting orthodontic treatment. Lateral cephalometric radiographies were obtained and the extent of the sella turcica bridging was measured using a Vernier caliper and scored as no calcification, partially calcified, and completely calcified. RESULTS: The frequency of a partially or completely calcified sella turcica bridge was significantly higher among cases with altered direction of dental eruption as compared with controls. There was a trend towards a shorter length of sella turcica in subjects with two or more canine eruption alterations. Sella turcica bridging was unrelated to sex, but it was significantly influenced by age. CONCLUSIONS: Sella turcica bridging is frequently detected in subjects with altered direction of dental eruption of canines. Key words:Dental eruption, sella turcica bridging, anterior clinoid process calcification, posterior clinoid process calcification, cephalometric radiographs.

Orthodontic camouflage in the case of a skeletal class III malocclusion.

AIM: To describe the clinical problem of a male patient, 15 years of age, who had a dolichofacial biotype and a Class III skeletal type at the beginning of treatment, manifesting itself at the dental level. METHODS: To resolve the dental problems, orthodontic camouflage (dentoalveolar compensation) with the extraction of two mandibular premolars was performed. RESULTS AND CONCLUSION: This procedure allowed a more harmonious occlusal relationship at the canine level and provided better occlusal stability of the final result. The procedure choice was based on the fact that some cephalometric values were favorable to attenuation of the skeletal Class III. For example, according to the analyses of Björk and Jarabak, these values are the total sum of 1, 2, 3 (sella angle, articular angle, and gonial angles) and the anterior/posterior facial height (S-Go/Na-Me). However, the same cephalometric data indicate a possible worsening of the existing open bite, which might be corrected with dental extractions and the use of intermaxillary elastics.