An artificial intelligence study: automatic description of anatomic landmarks on panoramic radiographs in the pediatric population.

BACKGROUND: Panoramic radiographs, in which anatomic landmarks can be observed, are used to detect cases closely related to pediatric dentistry. The purpose of the study is to investigate the success and reliability of the detection of maxillary and mandibular anatomic structures observed on panoramic radiographs in children using artificial intelligence. METHODS: A total of 981 mixed images of pediatric patients for 9 different pediatric anatomic landmarks including maxillary sinus, orbita, mandibular canal, mental foramen, foramen mandible, incisura mandible, articular eminence, condylar and coronoid processes were labelled, the training was carried out using 2D convolutional neural networks (CNN) architectures, by giving 500 training epochs and Pytorch-implemented YOLO-v5 models were produced. The success rate of the AI model prediction was tested on a 10% test data set. RESULTS: A total of 14,804 labels including maxillary sinus (1922), orbita (1944), mandibular canal (1879), mental foramen (884), foramen mandible (1885), incisura mandible (1922), articular eminence (1645), condylar (1733) and coronoid (990) processes were made. The most successful F1 Scores were obtained from orbita (1), incisura mandible (0.99), maxillary sinus (0.98), and mandibular canal (0.97). The best sensitivity values were obtained from orbita, maxillary sinus, mandibular canal, incisura mandible, and condylar process. The worst sensitivity values were obtained from mental foramen (0.92) and articular eminence (0.92). CONCLUSIONS: The regular and standardized labelling, the relatively larger areas, and the success of the YOLO-v5 algorithm contributed to obtaining these successful results. Automatic segmentation of these structures will save time for physicians in clinical diagnosis and will increase the visibility of pathologies related to structures and the awareness of physicians.

Does the Modality of Dental Treatment Affect the Treatment Prognosis and the Necessity of Re-Treatments?

BACKGROUND: The utilization of evidence-based approaches is crucial to achieving long-term positive outcomes for treatment performed chairside or under general anesthesia. The study aimed to evaluate if treatment modality (at the chairside or under general anesthesia) affects prognosis and the need for re-treatment. METHODS: Oral-hygiene, gingival, and plaque indexes were recorded during the control appointment. The success of all treatments was evaluated according to the scoring of particular evaluation criteria. RESULTS: A total of 1066 dental procedures were performed on 92 children. Plaque index scores were higher for patients treated under general anesthesia. The success rate of restorative procedures was 82.5% under general anesthesia and 80.6% at the chairside. There was no statistically significant difference between the mean number of restorative treatments and the need for re-treatment between general anesthesia or chairside (p = 0.649, p = 0.311). The mean number of unsuccessful endodontic treatments performed under general anesthesia was higher than performed chairside. Only two out of thirty stainless-steel crowns were decemented, all performed under general anesthesia. CONCLUSIONS: The high volume of restoration failure due to secondary caries has highlighted the need for alternative approaches to caries management, especially given the risks associated with repeat general anesthetic.

Apical extrusion of bacteria following the use of reciprocating single-file and rotary multi-file instrumentation systems in oval root canals / Extrusão apical de bactérias após o uso de sistemas alternativos de instrumentação de arquivo único e rotativo de arquivo múltiplo em canais radiculares ovais

Objective: All instrumentation techniques and instruments are associated with apical extrusion during chemomechanical preparation, and this causes postoperative pain and flare-up. However, it is controversial whether reciprocal systems or rotary systems cause more apical extrusion. The objective of this in vitro study was to determine the differences in the amounts of apically extruded bacteria (AEB) associated with nickel-titanium rotary and reciprocating systems when used in oval-shaped root canals. Material and Methods: Seventy human mandibular premolar teeth with oval-shaped canals were randomly assigned to four experimental groups (15 teeth in each group) and one control group (10 teeth). The root canals were contaminated with Enterococcus faecalis and instrumented using two full-sequence rotary instruments (ProTaper Universal [PTU] and ProTaper Next [PTN]) and two reciprocating single-file instruments (Reciproc [R] and WaveOne [WO]). A 0.9% NaCl solution was used as an irrigant, and the bacterial extrusion was quantified as the number of colony-forming units for each sample. The results were statistically analyzed using the Kruskal-Wallis one-way analysis of variance and the Mann-Whitney U test, and the statistical significance level was set at p < 0.05. Results: The R system was associated with the highest amount of bacterial extrusion (p < 0.05). The PTU system caused more bacterial extrusion than the PTN and WO systems (p < 0.05). There was no significant difference between the PTN and WO systems (p > 0.05). Conclusions: All instrumentation techniques caused apical bacterial extrusion. The instrument design and preparation techniques affect the number of extruded bacteria (AU)

Objetivo: Todas as técnicas e instrumentos de instrumentação estão associados à extrusão apical durante o preparo quimomecânico, o que causa dor e surto no pós-operatório. No entanto, é controverso se sistemas recíprocos ou rotativos causam extrusão mais apical. O objetivo deste estudo in vitro foi determinar as diferenças na quantidade de bactérias apicalmente extrudadas (AEB) associadas aos sistemas rotativo e alternativo de níquel-titânio quando usadas em canais radiculares em forma oval. Material e Métodos: Setenta dentes pré-molares inferiores humanos com canais em forma oval foram divididos aleatoriamente em quatro grupos experimentais (15 dentes em cada grupo) e um grupo controle (10 dentes). Os canais radiculares foram contaminados com Enterococcus faecalise instrumentados usando dois instrumentos rotativos de seqüência completa (ProTaper Universal [PTU] e ProTaper Next [PTN]) e dois instrumentos alternativos de arquivo único (Reciproc [R] e WaveOne [WO]). Uma solução de NaCl a 0,9% foi usada como irrigante e a extrusão bacteriana foi quantificada como o número de unidades formadoras de colônias para cada amostra. Os resultados foram analisados estatisticamente usando a análise de variância unidirecional de Kruskal-Wallis e o teste U de Mann-Whitney, e o nível de significância estatística foi estabelecido em p < 0,05. Resultados: O sistema R foi associado à maior quantidade de extrusão bacteriana (p < 0,05). O sistema PTU causou mais extrusão bacteriana que os sistemas PTN e WO (p < 0,05). Não houve diferença significativa entre os sistemas PTN e WO (p > 0,05). Conclusões: Todas as técnicas de instrumentação causaram extrusão bacteriana apical. O desenho do instrumento e as técnica (AU)

Effect of avulsion storage media on periodontal ligament fibroblast differentiation.

BACKGROUND/AIM: An avulsed tooth must be stored in a solution which maintains periodontal ligament (PDL) cell viability. The aim of this study was to compare the effects of Hank's balanced salt solution (HBSS) and milk on the differentiation of PDL fibroblasts. MATERIALS AND METHODS: Eighteen extracted third molars, (n = 3 for each group), were immersed in HBSS, milk, and Dulbecco's modified Eagle medium-Ham's F12 (DMEM-F12) at 4°C for 30- to 60 minutes or 12 hours. The growth dynamics of PDL fibroblasts were evaluated with cell proliferation graphics and population doubling time (PDT) values. Runt-related transcription factor 2 (RUNX2), receptor activator of nuclear factor kappa-B ligand (RANKL), and collagen type XII (COL12) expression were used to evaluate the differentiation of PDL fibroblasts. RESULTS: The percentage of cell numbers and PDT values of groups were statistically insignificant. In the HBSS groups, RUNX2 expression increased showing a direction to osteogenic differentiation of PDL fibroblasts. In the DMEM-F12 groups, RANKL expression increased, indicating there was a tendency for osteoclastogenic differentiation. In the milk groups, RUNX2 expression decreased while other markers were stable showing PDL fibroblasts could protect fibroblast identity. CONCLUSIONS: In terms of protecting fibroblast identity and resistance to differentiation, milk was more effective than HBSS.