Craniofacial Cephalometric Morphology in Polish Adolescents with Cleft Palate Only.

Background: Cephalometric studies indicate that craniofacial morphology in patients with cleft palate only (CPO) differs from other forms of orofacial clefts and healthy patients. Planning orthodontic treatment for patients with different craniofacial deformities requires knowledge on the craniofacial complex. The aim of the present study was to describe the cephalometric craniofacial morphology in adolescents with cleft palate only compared to generally healthy orthodontic patients. Methods: The study comprised 100 lateral cephalograms (taken in the years 2003-2020) of Polish patients with cleft palate only aged from 11.1 to 14.2 (mean age 12.43 y) and a matched control group of 100 children without orofacial clefts aged 12-14 (mean age 12.25). All digital images were analyzed in specialized cephalometric software. Results: Statistically significantly lower values of both SNA (p < 0.001) and ANB (p < 0.001) were found in the study group versus the control group. Mandibular line to cranial base angle (ML-NSL) as well as maxillary base to cranial base (NL-NSL) were significantly higher in the CPO group. Both the maxilla and mandible were rotated distally in CPO. Moreover, the intermaxillary vertical angle (ML-NL) was reduced in CPO. Mandibular angle in CPO was significantly higher (p = 0.005), reflecting posterior mandibular rotation. Conclusions: In adolescents with CPO, maxillary deficiency is found, without a severe sagittal jaw discrepancy, with a slight compensatory lingual inclination of the lower incisors. Mandibular deficiency in CPO is concurrent with posterior rotation and an increased mandibular angle.

TLR2 and TLR4 Polymorphisms Are Not Associated with Dental Caries in Polish Children.

The aim of the present study was to analyze the association of the TLR2 (Toll-like receptor 2 gene) 2258G>A (rs5743708), TLR4 (Toll-like receptor 4 gene) 896A>G (rs4986790), and TLR4 1196C>T (rs4986791) polymorphisms with dental caries in Polish children. The participants, 261 15-year-old children, were divided into two groups: 82 cases (i.e., children with DMFT (Decayed, Missing, and Filled Teeth) index >5, having either moderate or high caries experience, assigned as the "higher" caries experience group) and 179 controls (i.e., children with DMFT ≤ 5, having either low or very low caries experience, assigned as the "lower" caries experience group). Genomic DNA was isolated from buccal swabs, and genotyping was determined by means of real-time PCR (polymerase chain reaction). There were no significant differences in the genotype or allele distributions in all tested SNPs (single nucleotide polymorphisms) between children with "higher" caries experience and those with "lower" caries experience. TLR4 haplotype frequencies did not differ significantly between cases and controls. In an additional analysis with another case definition applied (subjects with DMFT ≥ 1 were assigned as "cases", whereas children with DMFT = 0 were assigned as "controls"), no significant differences in the TLR2 and TLR4 genotype, allele frequencies, and TLR4 haplotype frequencies were found between the case and the control groups. The results of the present study broaden our knowledge on the potential genetic factors that might affect caries risk and suggest that TLR2 rs5743708 and TLR4 rs4986790 and rs4986791 SNPs are not associated with dental caries susceptibility in Polish children.

The Micromechanical Properties and Surface Roughness of Orthodontic Retainer Wires-An In Vitro Analysis.

BACKGROUND: Despite the large variety of retainer wires available, no studies could be found comparing the micromechanical properties and surface roughness of different retainer wires. Such characteristics affect the survival of the fixed retainer in terms of both fracture resistance and resistance to debonding from the tooth. Therefore, the aim of the present study was to examine and compare those characteristics in popular retainer wires. METHODS: six different popular orthodontic retainer wires were subjected to instrumental indentation based on the Oliver and Pharr method. The geometric surface structure was analysed using a non-contact profilometer. RESULTS: stainless steel wires had a higher hardness and a higher elastic modulus compared to titanium wires and white gold chain. The titanium wire and the white gold chain showed much more roughness than other wires. CONCLUSIONS: stainless steel wires are the most resistant, considering both the shape retention capacity and the ability to resist abrasive wear. The titanium wire showed the lowest hardness and, thus, the highest susceptibility to deformation. Bond-a-braid, Retainium and Orthoflex white gold are more resistant to fracture than other steel wires. Titanium wire and chain retainer wires have more roughness, which is a great advantage in terms of mechanical adhesion to composite materials.

Accuracy of Artificial Intelligence for Cervical Vertebral Maturation Assessment-A Systematic Review.

Background/Objectives: To systematically review and summarize the existing scientific evidence on the diagnostic performance of artificial intelligence (AI) in assessing cervical vertebral maturation (CVM). This review aimed to evaluate the accuracy and reliability of AI algorithms in comparison to those of experienced clinicians. Methods: Comprehensive searches were conducted across multiple databases, including PubMed, Scopus, Web of Science, and Embase, using a combination of Boolean operators and MeSH terms. The inclusion criteria were cross-sectional studies with neural network research, reporting diagnostic accuracy, and involving human subjects. Data extraction and quality assessment were performed independently by two reviewers, with a third reviewer resolving any disagreements. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool was used for bias assessment. Results: Eighteen studies met the inclusion criteria, predominantly employing supervised learning techniques, especially convolutional neural networks (CNNs). The diagnostic accuracy of AI models for CVM assessment varied widely, ranging from 57% to 95%. The factors influencing accuracy included the type of AI model, training data, and study methods. Geographic concentration and variability in the experience of radiograph readers also impacted the results. Conclusions: AI has considerable potential for enhancing the accuracy and reliability of CVM assessments in orthodontics. However, the variability in AI performance and the limited number of high-quality studies suggest the need for further research.

Comparison of Three Commercially Available, AI-Driven Cephalometric Analysis Tools in Orthodontics.

Background: Cephalometric analysis (CA) is an indispensable diagnostic tool in orthodontics for treatment planning and outcome assessment. Manual CA is time-consuming and prone to variability. Methods: This study aims to compare the accuracy and repeatability of CA results among three commercial AI-driven programs: CephX, WebCeph, and AudaxCeph. This study involved a retrospective analysis of lateral cephalograms from a single orthodontic center. Automated CA was performed using the AI programs, focusing on common parameters defined by Downs, Ricketts, and Steiner. Repeatability was tested through 50 randomly reanalyzed cases by each software. Statistical analyses included intraclass correlation coefficients (ICC3) for agreement and the Friedman test for concordance. Results: One hundred twenty-four cephalograms were analyzed. High agreement between the AI systems was noted for most parameters (ICC3 > 0.9). Notable differences were found in the measurements of angle convexity and the occlusal plane, where discrepancies suggested different methodologies among the programs. Some analyses presented high variability in the results, indicating errors. Repeatability analysis revealed perfect agreement within each program. Conclusions: AI-driven cephalometric analysis tools demonstrate a high potential for reliable and efficient orthodontic assessments, with substantial agreement in repeated analyses. Despite this, the observed discrepancies and high variability in part of analyses underscore the need for standardization across AI platforms and the critical evaluation of automated results by clinicians, particularly in parameters with significant treatment implications.

The Significance of Keratinized Mucosa in Implant Therapy: Narrative Literature Review and Case Report Presentation.

Background/Objectives: Implant treatment in patients who require teeth extraction due to periodontitis presents a significant challenge. The consideration of peri-implantitis is crucial when planning the placement of dental implants. The predictability of implant treatment relies on the suitability of both hard and soft tissue quality. The aim of this article is to present a case report demonstrating a secure treatment protocol for implant procedures in patients with periodontitis requiring the extraction of all teeth, soft tissue management targeted at increasing the keratinized mucosa zone, and the provision of a reliable prosthetic solution. The secondary objective is to review the relevant literature regarding the significance of keratinized mucosa surrounding dental implants and its association with the occurrence of peri-implantitis. Case presentation: A 65-year-old female with generalized periodontitis, stage IV grade C and very poor oral hygiene came for treatment and rehabilitation of the lower jaw. CBCT revealed periodontal lesions and labio-lingual ridge dimensions in the region of teeth 34-44 from 8.0 to 10.2 mm. The first surgery included teeth extraction and periodontal lesions enucleation with simultaneous placement of four implants in the positions of teeth 32, 34, 42, 44. The second-stage surgery involved increasing the keratinized mucosa using two free gingival grafts. Conclusions: The present case report described the treatment process of the patient with periodontitis, including immediate implantation in the infected region, soft tissue augmentation using free gingival grafts and the ultimate placement of a bar-retained overdenture for final restoration. After two years of observation, despite questionable hygiene, no symptoms of gingival inflammation were detected. Furthermore, there is limited information in the literature regarding the correlation between inadequate keratinized gingiva and the occurrence of peri-implantitis.

Periapical Lesions in Panoramic Radiography and CBCT Imaging-Assessment of AI's Diagnostic Accuracy.

Background/Objectives: Periapical lesions (PLs) are frequently detected in dental radiology. Accurate diagnosis of these lesions is essential for proper treatment planning. Imaging techniques such as orthopantomogram (OPG) and cone-beam CT (CBCT) imaging are used to identify PLs. The aim of this study was to assess the diagnostic accuracy of artificial intelligence (AI) software Diagnocat for PL detection in OPG and CBCT images. Methods: The study included 49 patients, totaling 1223 teeth. Both OPG and CBCT images were analyzed by AI software and by three experienced clinicians. All the images were obtained in one patient cohort, and findings were compared to the consensus of human readers using CBCT. The AI's diagnostic accuracy was compared to a reference method, calculating sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and F1 score. Results: The AI's sensitivity for OPG images was 33.33% with an F1 score of 32.73%. For CBCT images, the AI's sensitivity was 77.78% with an F1 score of 84.00%. The AI's specificity was over 98% for both OPG and CBCT images. Conclusions: The AI demonstrated high sensitivity and high specificity in detecting PLs in CBCT images but lower sensitivity in OPG images.

Tooth Colour and Facial Attractiveness: Study Protocol for Self-Perception with a Gender-Based Approach.

(1) Background. The aim of the present protocol is to assess whether self-perception of tooth colour and facial attractiveness correlates with gender and mood state. (2) Study protocol. The protocol foresees a cross-sectional clinical study, developed by Sapienza University of Rome, Italy, Department of Oral and MaxilloFacial Sciences, and 15 UNID (Unione Nazionale Igienisti Dentali-National Union of Dental Hygienists)-affiliated clinical centers in Italy. The protocol consists of a clinical visit, during which photographic documentation of the face and smile is collected with spectrophotometric evaluation of tooth colour. During the visit, two validated questionnaires are filled in. The first one is filled by the operator for the collection of data on: i) patient's face and smile colorimetric characteristics; ii) patient's and operator's evaluations of the dental colour and smile attractiveness. The second one is completed by the patient for the assessment of his/her mood state. (3) Conclusions. This protocol highlights the importance in aesthetic dentistry of a gender-specific approach and the limitations of gender-neutral models, revealing the existing gender differences in aesthetic self-perception. In addition, the colour-matching relationships between facial and dental colour characteristics will be explored. This approach improves the accuracy and personalization of aesthetic assessments in dentistry, by addressing personalized and gender-specific needs. A gender-inclusive methodology that takes a more nuanced and culturally aware approach to aesthetic dentistry is a useful adjunct to modern clinical practices.

Noise-Optimized CBCT Imaging of Temporomandibular Joints-The Impact of AI on Image Quality.

Background: Temporomandibular joint disorder (TMD) is a common medical condition. Cone beam computed tomography (CBCT) is effective in assessing TMD-related bone changes, but image noise may impair diagnosis. Emerging deep learning reconstruction algorithms (DLRs) could minimize noise and improve CBCT image clarity. This study compares standard and deep learning-enhanced CBCT images for image quality in detecting osteoarthritis-related degeneration in TMJs (temporomandibular joints). This study analyzed CBCT images of patients with suspected temporomandibular joint degenerative joint disease (TMJ DJD). Methods: The DLM reconstructions were performed with ClariCT.AI software. Image quality was evaluated objectively via CNR in target areas and subjectively by two experts using a five-point scale. Both readers also assessed TMJ DJD lesions. The study involved 50 patients with a mean age of 28.29 years. Results: Objective analysis revealed a significantly better image quality in DLM reconstructions (CNR levels; p < 0.001). Subjective assessment showed high inter-reader agreement (κ = 0.805) but no significant difference in image quality between the reconstruction types (p = 0.055). Lesion counts were not significantly correlated with the reconstruction type (p > 0.05). Conclusions: The analyzed DLM reconstruction notably enhanced the objective image quality in TMJ CBCT images but did not significantly alter the subjective quality or DJD lesion diagnosis. However, the readers favored DLM images, indicating the potential for better TMD diagnosis with CBCT, meriting more study.

Orthodontic treatment demand for fixed treatment and aligners among young adults in middle Europe and South America - a questionnaire study.

BACKGROUND: Patients experiencing any malocclusion, may desire for treatment. However, there is no scientific information orthodontic treatment demand and the knowledge of young adults about orthodontic treatment. The aim of the study was to assess orthodontic treatment demand in young adults from Poland and Chile, their previous orthodontic experience and their knowledge on fixed and aligner orthodontic treatment. METHODS: The target group comprised people aged 18-30. The sample size was estimated as above 400 for each country. The survey was carried out in Polish and Spanish within 3 months and consisted of 25 questions delivered via social media. Comparisons were made between countries, age subgroups and gender. RESULTS: The response rate was 1,99%, what stands for 1092 responses, 670 from Chile and 422 from Poland, respectively. The percentage of young adults who were already treated was 42,9% in Poland and 25,0% in Chile. The ones planning to have orthodontic treatment within a year counted for 11,8% in Poland and 5,3% in Chile. Most young adults who want to be treated (20,6%) rely on doctor's recommendation on type of appliance while 14,7% of all respondents are interested solely in aligners. Most respondents have heard about aligners (58%). Direct provider-to-customer service without a doctor is not acceptable, neither in Poland (85,1%) nor in Chile (64,8%). Most young adults provided incorrect answers referring various aspects of aligner treatment. CONCLUSIONS: In both countries, patients demand to be treated and monitored by the orthodontist. A high percentage of patients want to be treated exclusively with aligners. Direct-to-consumer orthodontics does not seem attractive to patients. Young adults do not have adequate knowledge referring to aligner treatment. Many people want to be treated despite a previous orthodontic treatment.