Artificial intelligence enabled smart phone app for real-time caries detection on bitewing radiographs.

Diagnosis of proximal caries is a difficult task. Artificial intelligence (AI) enabled diagnosis is gaining momentum. Therefore, it is of interest to evaluate the effectiveness of an artificial intelligence (AI) smart phone application for bitewing radiography towards real-time caries lesion detection. The Efficient Det-Lite1 artificial neural network was used after training 100 radiographic images obtained from the department of Oral Medicine. Trained model was then installed in a Google Pixel 6 (GP6) smartphone as artificial intelligence app. The back-facing mobile phone video camera of GP6 was utilised to detect caries lesions on 100 bitewing radiographs (BWR) with 80 carious lesion in real-time. Two different techniques such as scanning the static BWR on laptop with a moving mobile and scanning the moving radiograph on the laptop with stationery mobile were used. The average value of sensitivity/precision/F1 scores for both the techniques was 0.75/0.846 and 0.795 respectively. AI programme using the rear-facing mobile phone video camera was found to detect 75% of caries lesions in real time on 100 BWR with a precision of 84.6%. Thus, the use of AI with smart phone app is useful for caries diagnosis which is readily accessible, easy to use and fast.

Finite element analysis (FEA) of stress distribution in platform-switched short dental implants.

The distribution of stress on short platform switched dental implants is of interest. Hence, the mandibular posterior molar area was modelled using a three-dimensional finite element method (FEM) with a continuous 1.5 mm cortical bone thickness and an inner cancellous bone core. The implants used in the study were 5 mm long, 4.5 mm wide and 3.5 mm wide at the abutments. 120 N of force was applied in both the vertical and oblique (20° and 35°) directions to create a realistic simulation. ANSYS Workbench was generated for each model. Von Mises stress was assessed in the cortical and cancellous bones at varying depths. Ten noded tetrahedron elements with three degrees of freedom per node were employed to interpret translations on the x, y, and z axes. The stress-based biomechanical behaviour of platform switched short osseo-integrated implants varied across all 5 positions in FEM simulations, based on the depth of implant placement, the direction of applied force, and the shape of the bone. Data shows that opposite forces to the vertical forces caused more damage. Thus, the implantation of subcrestal implants resulted in reduced stress on the cortical and cancellous bone.

Estimation of Loss of Crestal Bone Around Dental Implants in Various Tissue Biotypes Using CBCT.

Objectives: To evaluate the loss of crestal bone height around dental implants placed in various tissue biotypes. Materials and Methods: 20 patients with single edentulous sites were allocated randomly, with 10 samples in each into Group I (implants were placed in thick tissue biotype) and Group II (implants were placed in thin tissue biotype). Baseline cone-beam computed tomography (CBCT) was performed after implant placement in both groups, and follow-up CBCT was taken at the time of cementation prior to occlusal loading to assess the crestal bone loss around the mesial and distal side of implants in both groups. Result: A significant loss of crestal bone at both the distal and mesial sides of the implants at the time of cementation was observed in both groups but Group II showed more crestal bone loss as compared to Group I. Conclusion: Mean crestal bone loss was more in Group II (thin tissue biotype) in comparison to Group I (thick tissue biotype). The thick biotype causes less crestal bone changes than the thin biotype, which evokes more loss of crestal bone during the period of peri-implant healing.

Assessment of Role of Bisphosphonates on Dental Implant Treatment in Post-menopausal Ladies.

Objectives: To examine the impact of bisphosphonates (BPs) on dental implant treatment and alveolar bone in post-menopausal ladies. Materials and Methods: Twenty post-menopausal ladies who had at least one dental implant within the previous 5 years participated in the current study. Ten subjects were categorized into two groups: Group A had BP medication for 1.5 years, and group B received parathyroid hormone (PTH). Both groups' bone thickness and bone mineral density (BMD) were measured. Result: Group A had 5%, and group B had 5% of dental implants failures. BMD of cortical bone was 1468 ± 136 mg/mL and 1008 ± 84 mg/mL in groups A and B, correspondingly. The cortical and cancellous bone densities in both the groups were statically significant. Cortical bone thickness was insignificant in comparison. Conclusion: Both cortical and cancellous bones' bone mineral density decreased in both groups. With continued usage of BPs, the cortical bone thickness increased.

Assessment of Platelet-Rich Plasma Alone and Platelet-Rich Plasma Combined with Bioactive Glass in the Management of Intrabony Defect.

Objectives: To assess the function of platelet-rich plasma (PRP) both only and in combination with bioactive glass in intrabony defects. Materials and Method: Twenty patients were split into two groups with 10 samples each: group I with PRP alone, whereas group II was done with PRP in addition to bioactive glass. Following local anesthesia, full-thickness mucoperiosteal flaps were elevated in the afflicted site, the defect was debrided, and root planning with curettes was performed. Irrigation was then used while in group II- PRP along with bone graft (BG) preservationwas done. Suturing in group I was contained. At day 0 (baseline) and 6 months after surgery, the clinical parameters for probing depth, clinical attachment stage, and radiographic assessment were noted for both groups. Result: When comparing both groups, there was no statistically considerable variation. However, the intragroup comparison for pocket depth and clinical attachment level between baseline and 6 months was significant. Radiographic bone level was not considerably dissimilar across groups; however, it was significantly different between groups. Conclusion: Reduced probing depth, higher clinical attachment level, and radiographic evidence of bone fill are clinical outcome measures that are associated with effective regenerative therapy.

Bio-ceramics application in Dentistry.

Bioceramics have gained significant attention in dentistry due to their unique properties, including biocompatibility, osseointegration, and tissue regeneration. Therefore, it is of interest to report the various applications of bioceramics in dentistry, their advantages, limitations, and future considerations. Bio-ceramics such as zirconia and hydroxyapatite offer high biocompatibility and durability for dental application. They support bone integration for implants, resist wear, and mimic natural tooth aesthetics. Used in crowns, bridges, and fillings, bio-ceramics enhance healing and are pivotal in restorative and reconstructive dental procedures.

Intrabony defect management with a bone graft (hydroxyapatite and ß-tricalcium phosphate) alone and in combination with a diode laser: A randomized control trial.

Objectives: The current research was conducted to evaluate the use of a diode laser and a bone graft (hydroxyapatite [HA] + ß-tricalcium phosphate [ß-TCP]) in healing of intrabony defects. Materials and Methods: In this split-mouth evaluation, 40 patients with bilateral intrabony defects were treated with, Group I (control) - bone graft alone (HA + ß-TCP) and Group II, (test) - bone graft with a diode laser. The clinical and radiologic parameters of all patients, such as plaque index (PI), probing depth (PD), gingival index (GI), gingival recession (GR), and relative clinical attachment level (RCAL) were recorded at baseline, after 3 months and after 6 months. Results: Reductions in PI, PD, GI, GR, and RCAL were found after 6 months. Furthermore, significant differences were displayed in the intra-group comparison while those of the inter-group evaluation (P > 0.05) were insignificant. Conclusion: In both groups, considerable decrease in intrabony pockets was discovered; however, the inter-group comparison was insignificant in relation to GR and RCAL.

Outcome of Implant Diameter and Length on the Distribution of Stress with Immediate Loaded Implants: A 3D Finite Element Analysis.

Objectives: To assess the outcome of implant diameter and length on THE distribution of stress using a three-dimensional (3D) finite elements (FE) analysis, with immediate loading implants. Materials and Methods: This study made use of a 3D FE model of an implant encased in a chunk of bone. The LEADER/ITALIA-Fix type implant was created specifically for immediate loading. To create a solid model of the implant and bone and to carry out the FE analysis, the ANSYS V.12 programme was used. Results: The findings indicated that the neck of dental implants is the area of highest stress for all implant diameters and lengths, with an increase in implant length from 10 mm to 12 mm resulting in a slight raise in stress at the interface of implant-bone, and an increase in diameter from 3.75 mm to 4.25 mm having no appreciable impact on the value of stresses around dental implants. Conclusion: It was concluded that an increase in length has a negative effect on stress, while a diameter increase has no discernible impact on stress values.

Retrospective Analysis of Dental Implant Failure Rates in Patients with Compromised Health.

Objectives: The goal of the current research was to compare the failure rate of dental implants in medically compromised patients to healthy individuals. Materials and Methods: In this seven years retrospective study, 50 patients from Group A who were medically compromised had 63 implants, while 50 patients from Group B who were healthy had 67 implants. Over 1 mm of bone loss around the implant in the first year and over 0.2 mm of bone loss per year after that were considered failure rates. Result: Two (2.9%) of the dental implants in Group B and 18 (28.6%) in Group A, both failed. The average bone loss around the implant in Group A during the first year was 1.21 mm, compared to 0.3 mm in Group B. Conclusion: Uncontrolled diabetes mellitus group had greater implant failure.

Clinical Assessment of Bone Quality at Implant Site using CBCT and Hounsfield Unit.

Objectives: The current research was done to assess the bone quality at implant site using CBCT. Materials and Methods: The present study was conducted on 50 partially edentulous patients of both genders. All subjects had their chests scanned using a Kodac machine set to 120 kVp, 12 mA, and a 17-second exposure time. Using Hounsfield units, bone quality was classified as D1, D2, D3, D4, and D5 (HU). Result: Out of 50 patients, 27 were males and 23 were females. The average HU was 786.1 at the anterior maxilla, 1174.3 at the anterior mandible, 332.1 at the posterior maxilla, and 742.4 at the posterior mandible. The variation was considerable (P-0.01). Conclusion: The anterior mandible, anterior maxilla, posterior mandible, and posterior maxilla were found to have the highest densities. Based on Hounsfield units, CBCT is helpful in determining the bone density at the implant site.

Evaluation of Bone Graft (Hydroxyapatite + Platelet-Rich Plasma) Alone and in Combination with Diode Laser in Management of Infrabony Defect.

Objective: The current study looked at how well bone graft (hydroxyapatite + platelet-rich plasma (PRP)) and a diode laser treated infrabony defects. Materials and Method: Twenty patients with bilateral infrabony deficiency were treated in a split-moth evaluation with bone graft (hydroxyapatite + PRP) alone (group I) (control) and bone graft combined with a diode laser (group II) (test). Clinical and radiologic measures such as the relative clinical attachment level (RCAL), probing depth (PD), gingival index (GI), and plaque index (PI) were recorded at baseline, 3 months later, and 6 months later in all patients. Result: At the 6-month follow-up, there was a decline in the plaque index, probing depth, gingival index, and relative clinical attachment level. Conclusion: When compared across groups, the intrabony pocket was significantly reduced with either the bone graft (hydroxyapatite + PRP) or in conjunction with the laser.

Comparative Evaluation of Two Implant Designs Based on Bone Loss and Stability with Early Loading Method.

The study evaluated the implant bone loss and stability of implant changes with diverse designs with early placement at eight weeks and eight months' time. The subjects for the current study had partial tooth loss in the posterior mandibular arch. A total of 30 samples were split into two groups of 15, one with a flared crest module and a buttress thread design, the other with a parallel crest module and a V-shaped thread design. Ostell assessed each subject's implant stability four times, at baseline, eight weeks, four months, and eight months. At intervals of eight weeks, four months, and eight months, intraoral periapical radiographs were examined using ImageJ software to measure crestal bone loss. When Group I and Group II's implant stability quotient (ISQ) values at baseline, eight weeks, four months, and eight months were compared; Group I's ISQ values at each of the four measured time periods were statistically significant. At eight weeks in Group I, the ISQ value was very considerable. At eight weeks, four months, and eight months, there was a statistically significant bone loss in Group II in comparison to Group I. At eight months, Group II's bone loss value was very considerable. In contrast to Group II implant designs, it was found that Group I implants demonstrated enhanced implant-less bone loss and stability.

Assessment of Bone Loss Around Dental Implant in Smokers.

Objectives: This research was done to assess how much bone is lost around dental implants in smokers. Material and Method: There were 80 participants total in the study, 40 of whom were smokers (Group I) and 40 of who were non-smokers (Group II). By evaluating the patients' clinical and radiographic data, the marginal bone-level measurements were determined. The acquired information underwent statistical analysis. Results: Smokers were found to have worse overall clinical parameters than non-smokers (P 0.05). Smokers experience more marginal bone loss around implants than non-smokers do. Conclusion: Smoking has a negative impact on the outcome rate of dental implants.

A Comparative Study of Mid-Crestal Incision and Diode Laser Shaped Incision to Assess Papilla Level in Second Stage Dental Implant Surgery.

Objectives: To assess papilla level using different techniques in a second stage dental implant surgery. Materials and Methods: Thirty patients who received 45 dental implants were equally divided into 3 groups of 10 each. Group I patients were operated with a scalpel with mid-crestal incision. In group II, dental implants were exposed with a gallium-aluminum-arsenide diode laser. In group III, dental implants were exposed with I shaped incision using a scalpel. Assessment of modified gingival index (mGI), modified plaque index (mPI), and Jemt index were performed at baseline, 3 months, and 6 months. The measurement of FAJI, FAJAdj, ST height, and CP Bone crest was performed. Results: A significant difference in crestal bone level of FAJ- I, FAJ- adj, ST height, and CP Bone crest was recorded at baseline, 3 months, and 6 months among groups I, II, and III (P < 0.05). At 6 months, both groups II and III exhibited >60% of papilla fill as compared to group I. Conclusion: Diode laser offers maximum papillary fill and resulted in less crestal bone loss as compared to mid-crestal and I shaped incision during a second stage surgery.

A cone-beam computed tomography evaluation of bone density for insertion of pterygoid implants in dentulous and edentulous patients.

OBJECTIVES: The bone quantity and quality determine the prosthetic success outcome. This research was performed to evaluate the bone density for insertion of pterygoid implants in edentulous and dentulous participants with cone-beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT evaluation was done for 66 dentate and edentulous patients for pterygoid implants at the pterygomaxillary region. The calculation of joint width, height, and volume of bone was done. Density of the bone was evaluated at the superior and inferior aspects of the pterygomaxillary column. RESULTS: It was observed that average pterygomaxillary joint height for dentulous (dentate) was -12.7 ± 7.2 mm, edentulous -12.4 ± 7.1 mm, the average pterygomaxillary joint width for dentulous was 8.15 ± 7.3 mm, and 8.13 ± 6.2 mm for edentulous. The average pterygomaxillary joint volume in dentulous participants was 279.4 ± 189.2 mm3 and for edentulous was 254.5 ± 176.4 mm3. There was expressively greater density of the bone in dentulous participants over edentulous participants (P < 0.05). CONCLUSION: There was better bone density found in dentate participants in comparison to edentulous participants. CBCT is a recent investigative device which measures pterygoid area efficiently. Pterygoid implants may be deliberated as an alternative method for resorbed (atrophic) maxilla.

Platelet-rich fibrin for root coverage: A plausible approach in periodontal plastic and esthetic surgery.

Predictable esthetic root coverage has evolved into conventional treatment modalities making cosmetic procedures an integral part of periodontal treatment. The advent of second-generation platelet concentrates, i.e., platelet-rich fibrin (PRF), has broad clinical application in medical as well as dental field with its recent use for recession defects. The simplicity of PRF procurement and its low cost makes it most suitable for use in daily clinical practice. This particular case report foregrounds the benefit of PRF membrane along with coronally repositioned flap for mucogingival surgery on the labial surface of an upper anterior tooth.

Résumé La couverture radiculaire esthétique prévisible a évolué vers des modalités de traitement conventionnelles faisant des procédures cosmétiques une partie intégrante du parodontal traitement. L'avènement des concentrés plaquettaires de deuxième génération, c'est-à-dire la fibrine riche en plaquettes (PRF), a une large application clinique en médecine comme ainsi que le domaine dentaire avec son utilisation récente pour les défauts de récession. La simplicité de l'approvisionnement en PRF et son faible coût le rendent particulièrement adapté utilisation dans la pratique clinique quotidienne. Ce rapport de cas particulier met en avant les avantages de la membrane PRF avec le volet repositionné coronairement pour chirurgie mucogingivale sur la surface labiale d'une dent antérieure supérieure.

Marginal bone loss around axial and straight implants supported with prefabricated SFI-Bar with mandibular overdentures.

To assess the role of prefabricated SFI-Bar in peri-implant bone loss around immediately axially loaded and straight implants. This study comprised of 40 complete denture wearer patients who received two axially parallel implants connected by SFI-Bars in group I and two 15° mesially tilted implants connected by SFI-Bars in group II. Peri- implant bone loss (PiBL) was measured at 1 year, 2 years and 3 years. The mean PiBL at 1 year in group I was 0.21 mm and I group II was 0.22, at 2 years in group I was 0.26 mm and in group II was 0.23 mm and at 3 years, in group I was 0.29 mm and in group II was 0.34 mm. The difference was significant at 3 years (P< 0.05). The mean mesial PIBL at 1 year in group I was 0.18 mm, in group II was 0.20 mm, at 2 years in group I was 0.19 mm and in group II was 0.07 mm and at 3 years, in group I was 0.25 mm and in group II was 0.29 mm. The difference found to be significant in each time duration in both groups (P< 0.05).The mean distal PIBL at 1 year in group I was 0.23 mm, in group II was 0.22 mm, at 2 years in group I was 0.33 mm and in group II was 0.39 mm and at 3 years, in group I was 0.34 mm and in group II was 0.39 mm. The difference found to be significant at 2 and 3 years in both groups (P< 0.05). Authors found that mandibular overdentures retained with Prefabricated SFI-Bar with axial and straight inserted implants may be useful in patients with reduced bone height.

Assessment of Levels of Plasma Oxidative Stress in Patient Having Aggressive Periodontitis before and after Full Mouth Disinfection.

AIM: The primary purpose of the study was to evaluate the levels of oxidative stress in plasma in patients with aggressive periodontitis (AgP) before and after full-mouth disinfection. MATERIALS AND METHODS: Twenty-five healthy controls and 25 participants with aggressive periodontal were assessed for plaque index, probing pocket depth, papillary bleeding index, and clinical attachment level. Periodontal bone support was assessed by taking full mouth periapical radiographs. Full-mouth disinfection of the patient was done within 24 h of clinical assessment of AgP. These parameters were assessed at the baseline and after 8 weeks of initial periodontal therapy. Plasma samples were taken and evaluated for various oxidative stress markers. RESULTS: Strong positive correlation was observed among periodontal parameters and levels of enzymatic/nonenzymatic biomarkers for oxidative stress (thiobarbituric acid-reactive substances [TBARS], glutathione peroxidase [GPX], and catalase [CAT]) (P < 0.05), before and after periodontal management. The patients with AgP had high levels of TBARS, GPX, and CAT levels in the plasma matched to the healthy individuals (P < 0.05). CONCLUSION: Enzymatic and nonenzymatic oxidative stress may have a role in the pathogenesis AP. Initial periodontal treatment can lead to the reduction of these stresses.

Oral Health-Related Quality of Life in Children and Adolescents of Indian population.

BACKGROUND: Kids and teenagers are more prone to oral diseases. Poor oral health has a significant impact on oral well-being-associated quality of life. Thus, we performed an investigation to examine the outcome of oral health status on the quality of life of children and adolescents in Indian population, by using the Oral Health Impact Profile-14 (OHIP-14). MATERIALS AND METHODS: A total of 100 children, ranging between 1 and 19 years of age who attended Indian hospitals from November 2016 to October 2019, were included in the study. The DMFT Index (Decayed, Missing, and Filled Teeth) and OHIP-14 were used as data collection tools. Association of the total OHIP-14 score and seven subscales associated with it was evaluated using Spearman's correlations. RESULTS: The results showed statistically noteworthy association between the toothbrushing regularity, number of dental appointments, history of oral trauma, smoking, and subdomains of OHIP-14 (P < 0.05). CONCLUSION: Dental and oral health of an individual has a great impact on their quality of life.

Evaluation of Microleakage and Microgap of Two Different Internal Implant-Abutment Connections: An In Vitro Study.

AIM: The higher success rate (>90%) of dental implants over 5 years has made this treatment option favorable for dental surgeons as well as for patients. The present in vitro study was conducted to assess microleakage and microgap of two dissimilar internal implant-abutment associations. MATERIALS AND METHODS: Forty dental implants were divided into two groups: trilobe internal connection fixtures in group I and internal hexagonal geometry fixtures in group II. For the immersion of implant abutment assemblies, sterilized tubes containing 4 mL of Staphylococcus aureus broth culture were incubated at 37°C for 2 weeks. Gram's stain and biochemical reactions were used for identification of colonies. RESULTS: The mean log10 colony-forming unit (CFU) in group I was 8.6 and was 9.3 in group II. The disparity among two groups was found to be significant (p < 0.05). The mean microgap in group I was 7.2 µm and was 10.4 µm in group II. The disparity among the two groups was found to be significant (p < 0.05). CONCLUSION: Authors found that microscopic space between implant and abutment may be the site of penetration of bacteria. There was significant higher log10 CFU in dental implant fixtures with an internal hexagonal geometry compared to the dental implant fixtures with a trilobe internal connection. CLINICAL SIGNIFICANCE: Microscopic space between implant and abutment may be the site of penetration of bacteria. This information will help to avoid microleakage to improve implant success rate.