Development of Artificial Intelligence Models for Tooth Numbering and Detection: A Systematic Review.

Dental radiography is widely used in dental practices and offers a valuable resource for the development of AI technology. Consequently, many researchers have been drawn to explore its application in different areas. The current systematic review was undertaken to critically appraise developments and performance of artificial intelligence (AI) models designed for tooth numbering and detection using dento-maxillofacial radiographic images. In order to maintain the integrity of their methodology, the authors of this systematic review followed the diagnostic test accuracy criteria outlined in PRISMA-DTA. Electronic search was done by navigating through various databases such as PubMed, Scopus, Embase, Cochrane, Web of Science, Google Scholar, and the Saudi Digital Library for the articles published from 2018 to 2023. Sixteen articles that met the inclusion exclusion criteria were subjected to risk of bias assessment using QUADAS-2 and certainty of evidence was assessed using GRADE approach.AI technology has been mainly applied for automated tooth detection and numbering, to detect teeth in CBCT images, to identify dental treatment patterns and approaches. The AI models utilised in the studies included exhibited a highest precision of 99.4% for tooth detection and 98% for tooth numbering. The use of AI as a supplementary diagnostic tool in the field of dental radiology holds great potential.

Comparative Evaluation of Microleakage of Flowable Composite Resin Using Etch and Rinse, Self-Etch Adhesive Systems, and Self-Adhesive Flowable Composite Resin in Class V Cavities: Confocal Laser Microscopic Study.

The essential factor in determining the preservation of restoration is the marginal seal. Restoring cervical lesions with a resin composite has always been a challenge. Composite resins with various viscosities and different bonding systems are being researched to reduce the microleakage. Confocal laser scanning microscopy (CLSM) is the latest non-destructive technique for visualizing the microleakage. Objectives: To evaluate and compare the microleakage of Universal Flo composite resin (G-aenial) using etch and rinse adhesive system ER-2 steps (Adper Single Bond 2), self-etch adhesive system SE-1 step (G-Bond), and self-adhesive flowable composite resin (Constic) in Class V cavities using a confocal laser scanning microscope. Materials and Method: Class V cavities were prepared on 27 caries-free human extracted premolar teeth on the buccal and lingual surfaces with standardized dimensions of 2 mm height, width 4 mm, and a depth of 2 mm. After the cavity preparation, all teeth were randomly divided into three groups, namely Group-I: G-aenial Universal Flo with Single Bond 2 (n = 9 teeth); Group-II: G- aenial Universal Flo with G-Bond (n = 9 teeth), and Group-III: Constic (n = 9 teeth). The prepared and restored specimens were then subjected to thermocycling for 500 cycles in a water bath at 5 °C and 55 °C with a dwelling time of 30 s. The specimens were placed in 0.6% aqueous rhodamine dye for 48 h. Sectioning was carried out bucco-lingually and specimens were evaluated for microleakage under a confocal laser scanning microscope. Results: There was a significant difference (p = 0.009) in microleakage when comparing total etch and rinse, specifically between Adper Single Bond 2 ER-2 steps (fifth generation) and self-adhesive flowable composite resin, which is Constic. There was more microleakage in the self-etch bonding agent, particularly G-Bond, SE-1 step (seventh generation), when compared to ER-2 steps (fifth generation bonding agent); however, the results were not statistically significant (p = 0.468). The self-adhesive flowable composite resin showed more microleakage than SE-1 step and ER-2 steps. Conclusions: None of the adhesive systems tested were free from microleakage. However, less microleakage was observed in the total etch and rinse, especially Adper Single Bond 2 (ER-2 steps), than the self-etch adhesive system SE-1 step and self-adhesive flowable composite resin. Clinical significance: Constant research and technological advancements are taking place in dentin adhesives to improve the marginal seal. This has led to the evolution of total acid-etching dentin bonding agents termed as etch and rinse (ER)-2 steps (fifth generation dentin bonding agents) and self-etching (SE) 2 steps, and SE-1 step dentin bonding agents termed as the sixth and seventh generation bonding agents, respectively.

Evaluation of Fluoride Release in Chitosan-Modified Glass Ionomer Cements.

OBJECTIVE: This study assessed the influence of chitosan nanoparticles on the fluoride-releasing ability of 4 glass ionomer cement (GIC) through an in vitro analysis. METHODS: Four types of GIC (type II light cure universal restorative, type II universal restorative, GC Fuji VII, and type IX) were modified with nanochitosan particles; 10% chitosan was added to the glass ionomer liquid. Six specimens for each of the 4 groups were created, using expendable Teflon moulds. Discs of each type of GIC (n = 6) were immersed in deionised water at various time intervals. Electrodes selective for fluoride ions were employed to analyse the amount of released fluoride at 1, 7, 14, 21, and 28 days. RESULTS: Chitosan-modified GICs showed greater fluoride release than conventional GICs at all time points. All samples showed an initial high release of fluoride that tapered off with time. The total amount of fluoride released increased from the 1st day to the 28th day on adding chitosan to all the 4 types of GIC. Amongst those, type IX high-strength posterior extra with chitosan released a considerably higher quantity of fluoride at all time intervals. CONCLUSIONS: In all the experimental groups, adding chitosan to the glass ionomer liquid had an accelerating effect on its fluoride-releasing property.

Evaluation of Micro-Tensile Bond Strength of Fibre Post with Titanium Dioxide Nanoparticles as Fillers in Experimental Dental Composite Resin.

BACKGROUND: The clinical success of post-core restorations is determined by the composite utilized and the strength of the post-core adhesion. The effectiveness of titanium dioxide nanoparticles (TiO2 NPs) as a multifunctional material with photo-induced activities and better mechanical characteristics are observed as particle size is reduced to under 50 nm. AIM: The purpose of this study is to determine the bond strength of fibre-reinforced composite (FRC) posts with TiO2 NP as fillers and to compare it with conventional composite resin core material. MATERIALS AND METHODS: 30 single-rooted mandibular premolars were selected and routine root canal procedures were done. A quantity of 5% TiO2 NPs were synthesized and added as silanized filler to the experimental composite resin. Post space was prepared and fibre-reinforced composite (FRC) post luting was performed. The specimens were then grouped into the following groups: Group I consisted of the experimental composite resin containing 5% TiO2 fillers, Group II consisted of core X flow, and Group III consisted of Multicore Flow. All test groups were submitted for thermocycling. After this, the samples were tested for micro tensile bond strength. A stereomicroscope with a magnification of 20× was used to examine the fractured surfaces. The data were analysed using one-way ANOVA and Tukey HSD tests. RESULTS: Statistical analysis revealed that Group I showed the highest mean bond strength value of 35.6180 Mpa. The results obtained with Group III showed the lowest mean bond strength value of 19.4690 Mpa. Adhesive failures were identified by stereomicroscopy of the fractured surfaces. CONCLUSION: The experimental composite resin comprising 5% TiO2 NP had a greater bond to the FRC post than other materials tested.

Comparison of Dentinal Microleakage in Three Interim Dental Restorations: An In Vitro Study.

Aim: The aim of this study was to assess and compare the coronal microleakage of e-Temp (DiaDent, Korea), intermediate restorative material (IRM) (Dentsply, Sirona), and Systemp Inlay (Ivoclar Vivadent, Germany) temporary restorative materials used to seal the class I cavity preparations. Materials and Methods: In this in vitro experimental study, three temporary restorative materials were assessed for microleakage. A standardized class I access cavities (2 mm × 4 mm) were prepared in 30 freshly extracted intact human premolar teeth. Teeth were then divided randomly into three groups consisting of 10 samples each. Teeth were restored with e-Temp (n = 10), IRM (n = 10), and Systemp Inlay (n = 10), temporary restorations, and subjected to thermocycling 5000 times in a cold bath followed by a temperature of 55°C with a dwell time of 30 seconds. Teeth were painted with two layers of nail polish except for 1 mm around the restoration margin, soaked in 1% methylene blue dye solution (pH 7.4), and kept for 24 h. Sticky wax was used to seal the apical foramina. All the teeth were sectioned mesiodistally, and the specimens were examined for the amount of dye penetration (microleakage) through the restoration using Digital Microscope under 50× magnification. Data were analyzed using descriptive statistics, Mann-Whitney U, and Kruskal-Wallis tests. Results: e-Temp showed 1 (10%) specimen with dye penetration up to 1 mm (Score 1). The specimens restored with IRM showed a 1 (10%) and 9 (90%) of scores for 1 and 3 dye penetration. However, 2 (20%) teeth restored with Systemp Inlay showed a dye penetration up to 3 mm or more (Score 3). A comparison of mean microleakage values of e-Temp (0.03 ± 0.10), IRM (2.69 ± 0.77), and Systemp Inlay (0.78 ± 1.64) showed a statistically significant difference (P < 0.001). IRM specimens showed significantly higher microleakage values than e-Temp and Systemp Inlay specimens (P < 0.05). Conclusion: All the temporary restorative materials tested in this in vitro experiment showed a certain extent of microleakage. The temporary restorative material e-Temp showed the least microleakage values followed by Systemp Inlay and IRM.

Assessment of knowledge, attitude, and practice regarding Deep Margin Elevation (DME) among dental practitioners in Riyadh, Saudi Arabia.

OBJECTIVES: To evaluate Knowledge, Attitude, and Practice (KAP) regarding deep margin elevation (DME) among dental practitioners in Riyadh city. MATERIALS AND METHODOLOGY: A cross-sectional study that comprised a total number of 535 dental practitioners: 255 (47.7%) were males and 280 (52.3%) females. A self-constructed 21 close-ended self-administered questionnaire was utilized in the study. The data were entered and analyzed by Chi-square test and descriptive analysis using Statistical Package for the Social Sciences (SPSS) software. RESULTS: Although the majority of the respondents have heard about DME, only 30.4% have utilized this technique in their clinical practice by having general practitioners and specialists utilize this technique more often than consultants. Among the participants, 65.4% of them have agreed that adhesion by bonding to deep cervical dentin is predictable and related to the success of the final restoration. CONCLUSION: The knowledge level of DME among the study participants was adequate. The findings of this study revealed that the total number of dentists who utilize the technique in restoring large subgingival defects of posterior teeth with proximal caries is very minimal. Thus, it is recommended that dental practitioners have this technique introduced in their dental clinics as an alternative to surgical crown lengthening. Although years of experience and dentist rank may influence the clinical decision, in-depth factorial analysis with a greater sample size is necessary.

Taurine Augments Telomerase Activity and Promotes Chondrogenesis in Dental Pulp Stem Cells.

BACKGROUND: Stem cell therapy has become an advanced and state-of-the-art procedure to regenerate lost tissues of the human body. Cartilage repair is a challenging task in which stem cells find potential application. One of the important biologic modifiers that can cause chondrogenic differentiation of stem cells is taurine. However, taurine has not been investigated for its effects on dental pulp derived stem cell (DPSC) chondrogenic differentiation. OBJECTIVE: The objective of the study was to investigate if taurine administration to DPSCs heralds chondrogenic differentiation as ascertained by expression of SOX9, COL2A1, ACAN, ELN, and COMP. The study also investigated if the differentiated cells synthesized glycosaminoglycans, a marker of cartilage formation. The study also aimed to assess proliferative activity of the cells after taurine administration by measuring the hTERT gene and protein expression. MATERIALS AND METHODS: DPSCs were obtained from a molecular biology laboratory and characterization of stem cell markers was done by flow cytometry. The cells were subjected to a MTT assay using various concentrations of taurine. Following this, hTERT gene and protein estimation was done in the control, telomerase inhibitor treated DPSC (TI-III), 10 µM taurine treated DPSC, and TI-III + 10 µM taurine treated DPSCs. A polymerase chain reaction was done to assess gene expression of SOX9, COL2A1, ACAN, ELN, and COMP genes and glycosaminoglycans were estimated in control cells, Induced DPSCs, induced and TI-III treated DPSCs, and 10 µM taurine treated DPSCs. RESULTS: DPSCs expressed CD73, CD90, and CD105 and did not express CD34, CD45, and HLA-DR, which demonstrated that they were mesenchymal stem cells. The MTT assay revealed that various concentrations of taurine did not affect the cell viability of DPSCs. A concentration of 10 µM of taurine was used for further assays. With regard to the hTERT gene and protein expression, the taurine treated cells expressed the highest levels that were statistically significant compared to the other groups. Taurine was also found to restore hTERT expression in telomerase inhibitor treated cells. With regard to chondrogenesis related genes, taurine administration significantly increased the expression of SOX9, COL2A1, ACAN, and ELN genes in DPSCs and caused a significant increase in glycosaminoglycan production by the cells. CONCLUSIONS: Taurine can be regarded a biologic modifier that can significantly augment chondrogenic differentiation of DPSCs and can find potential applications in regenerative medicine in the area of cartilage regeneration.

Infection control awareness level among dental laboratory technicians, Riyadh, Saudi Arabia.

AIMS AND OBJECTIVES: Infection control is an essential part in dental practices. Potential disease transmission in the dental lab is well documented. Dental technicians should strictly adhere to the standard precautions in order to prevent potential risks of cross-contamination, thereby producing a safe environment for patients and staff. The aim of this study was to evaluate the knowledge, attitude, and practice among dental lab technicians toward infection control protocols at the dental laboratories of Riyadh. MATERIALS AND METHODS: A self-administered questionnaire will be distributed to dental lab technicians working at both private and governmental laboratories in Riyadh, Saudi Arabia. Data were collected from one hundred and twenty-one dental laboratory technicians. RESULTS: According to the findings, only 42.9% had an infection control manual display in the dental lab, 43.8% had received infection control training courses as part of their orientation, 40.4% of the technicians had a valid hepatitis B vaccination. Dental technicians are exposed to high risk of injuries, 72.7% of respondents answered Yes, when they were asked about reporting sharp injuries to laboratory administration. CONCLUSION: There was poor compliance to infection control procedures, dental techniques are at increased risk of cross-contamination and infection, they have limited orientation and knowledge on the infection control guideline and policy.

Evaluation of the effect of soft drinks on the surface roughness of dental enamel in natural human teeth.

Background: Exposing enamel to soft drinks and beverages causes changes in the microscopical morphology. Changes in the physical characteristics, like hardness and surface roughness, were studied with various parameters. Factors such as pH, exposed duration, and other content of the soft drinks have different effects on the enamel. Methods: Thirty-six human premolar teeth were randomly divided into three groups (n=12). Group 1 consisted of teeth which were immersed in artificial saliva (control), group 2 consisted of teeth which were immersed in Pepsi, and group 3 consisted of teeth which were immersed in Mirinda. After the preparation of samples and necessary measures, surface roughness was measured using the profilometer. Baseline measurements were taken. Reading two and reading three were taken after exposing the specimens for three days and 15 days, respectively. All of the collected data were compared statistically using SPSS and presented in tables and graphs. Results: At the baseline, the surface roughness value was the same for all three groups. On the 3 rd day, the Mirinda group showed more surface roughness compared to that of the test and Pepsi groups, which was statistically significant. On the 15 th day, both the Pepsi and Mirinda groups showed increased surface roughness compared to that of the control, which was statistically significant. Conclusions: Within the limitation of this study, it can be concluded that surface roughness increased when teeth were exposed to both soft drinks.

Awareness and compliance of dental students and interns toward infection control at Riyadh Elm University.

Aim: Dental students have increasing patient contact during their education and clinical years, putting them at high risk of cross-infection; therefore, the purpose of this study was to determine the level of infection control practices among dental students and interns at Riyadh Elm University, Riyadh, Saudi Arabia. Methods: Total of 400 questionnaires were distributed among interns and clinical students at Riyadh Elm University. The questionnaire comprised 32 items assessing infection control practices, and the data were tabulated and analyzed by SPSS to produce descriptive statistics. Results: Three hundred nine questionnaires were answered (response rate 77%).The implementation of different infection control measures was good to excellent, except for hepatitis B vaccination and wearing eye protection: only 76% of males and 83% of females were vaccinated against HBV, and only 30% of males and 26% of females always wore protective glasses. Conclusion: Compared to previous studies, an increased awareness regarding infection control practices among dental students and interns was noticeable. However, greater emphasis on the importance of infection control, especially compliance with HBV vaccination and wearing protective eyewear, is necessary.

Light intensity output of visible light communication units and clinicians' knowledge and attitude among Riyadh private clinics.

BACKGROUND: With the evolution of bonded restorations, visible light-curing units became inseparable from the practice of dentistry. This study was designed to evaluate light intensity output of light-emitting diode (LED) units used in private clinics in Riyadh, Saudi Arabia, and to investigate dentists' knowledge and attitude regarding the usage of light-curing units. METHODOLOGY: Two hundred randomly selected LED units' light intensity output was evaluated using Demetron ® LED Radiometer-Kerr among evenly distributed private clinics in Riyadh, Saudi Arabia. Three measurements of 20 s were taken, and average values were obtained. Furthermore, Output intensity measurements were subcategorized into three groups; <400 mW/cm2- inadequate intensity, 400-850 - marginal intensity, and more than 850 - adequate intensity. In addition, 100 questionnaires of ten close-ended questions, investigating demographics, knowledge, and attitude toward visible light communication (VLC) units, were filled by the same private clinics' dentists and data were collected and analyzed by SPSS. The investigation was started after official processing and agreement achieved between the investigators and the private clinics' administrators to get their full cooperation. RESULTS: Majority of dentists (78%) reported that they do not measure the light intensity output and 9% of the measured light intensity output of LED units was found of inadequate intensity, 40.5% of marginal intensity, and 50.5% of adequate intensity. Moreover, only 31% knew the minimum accepted wavelength of VLC units. CONCLUSION: Dentists among private clinics express poor knowledge, maintenance, and attitude toward VLC units. Educational programs are advisable, and routinely monitoring of VLC units is recommended.