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1.
BMC Oral Health ; 24(1): 426, 2024 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-38582843

RESUMEN

BACKGROUND: Dental development assessment is an important factor in dental age estimation and dental maturity evaluation. This study aimed to develop and evaluate the performance of an automated dental development staging system based on Demirjian's method using deep learning. METHODS: The study included 5133 anonymous panoramic radiographs obtained from the Department of Pediatric Dentistry database at Seoul National University Dental Hospital between 2020 and 2021. The proposed methodology involves a three-step procedure for dental staging: detection, segmentation, and classification. The panoramic data were randomly divided into training and validating sets (8:2), and YOLOv5, U-Net, and EfficientNet were trained and employed for each stage. The models' performance, along with the Grad-CAM analysis of EfficientNet, was evaluated. RESULTS: The mean average precision (mAP) was 0.995 for detection, and the segmentation achieved an accuracy of 0.978. The classification performance showed F1 scores of 69.23, 80.67, 84.97, and 90.81 for the Incisor, Canine, Premolar, and Molar models, respectively. In the Grad-CAM analysis, the classification model focused on the apical portion of the developing tooth, a crucial feature for staging according to Demirjian's method. CONCLUSIONS: These results indicate that the proposed deep learning approach for automated dental staging can serve as a supportive tool for dentists, facilitating rapid and objective dental age estimation and dental maturity evaluation.


Asunto(s)
Determinación de la Edad por los Dientes , Aprendizaje Profundo , Niño , Humanos , Radiografía Panorámica , Determinación de la Edad por los Dientes/métodos , Incisivo , Diente Molar
2.
J Indian Soc Pedod Prev Dent ; 42(1): 64-70, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38616429

RESUMEN

AIM: This study aimed to validate the accuracy of dental age (DA) based on the dental development of permanent teeth in children with special needs using Demirjian, Willems, and London Atlas methods and to correlate the dental and chronological age (CA) of children with special needs in Malaysia. MATERIALS AND METHODS: The panoramic radiographic images belonging to children with special needs from the two teaching dental hospitals in Malaysia aged between 5 and 16 years were included in the study. The evaluation was performed by two observers using three methods (London Atlas, Demirjian, and Willems methods) to estimate the accurate DA. The outcome was determined by comparing the mean of the DA and CA. RESULTS: A total of 52 panoramic radiographs were available for the analysis. The London Atlas and Demirjian methods overestimated the DA with a mean of 0.05 and 0.20 years, respectively, while the Willems method underestimated by 0.19 years. The London Atlas method was highly precise and accurate, while Demirjian and Willems methods were the least precise and accurate. CONCLUSION: The London Atlas method of DA estimation is highly accurate and valid for children with special needs in the Malaysian population, followed by the Willems and Demirjian methods.


Asunto(s)
Determinación de la Edad por los Dientes , Niños con Discapacidad , Niño , Humanos , Preescolar , Adolescente , Radiografía Panorámica
3.
Sci Rep ; 14(1): 7699, 2024 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-38565866

RESUMEN

Nasopalatine duct cysts are difficult to detect on panoramic radiographs due to obstructive shadows and are often overlooked. Therefore, sensitive detection using panoramic radiography is clinically important. This study aimed to create a trained model to detect nasopalatine duct cysts from panoramic radiographs in a graphical user interface-based environment. This study was conducted on panoramic radiographs and CT images of 115 patients with nasopalatine duct cysts. As controls, 230 age- and sex-matched patients without cysts were selected from the same database. The 345 pre-processed panoramic radiographs were divided into 216 training data sets, 54 validation data sets, and 75 test data sets. Deep learning was performed for 400 epochs using pretrained-LeNet and pretrained-VGG16 as the convolutional neural networks to classify the cysts. The deep learning system's accuracy, sensitivity, and specificity using LeNet and VGG16 were calculated. LeNet and VGG16 showed an accuracy rate of 85.3% and 88.0%, respectively. A simple deep learning method using a graphical user interface-based Windows machine was able to create a trained model to detect nasopalatine duct cysts from panoramic radiographs, and may be used to prevent such cysts being overlooked during imaging.


Asunto(s)
Quistes , Aprendizaje Profundo , Humanos , Radiografía Panorámica , Redes Neurales de la Computación , Quistes/diagnóstico por imagen , Bases de Datos Factuales
4.
BMC Pediatr ; 24(1): 248, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38600453

RESUMEN

AIM: Age estimation plays a critical role in personal identification, especially when determining compliance with the age of consent for adolescents. The age of consent refers to the minimum age at which an individual is legally considered capable of providing informed consent for sexual activities. The purpose of this study is to determine whether adolescents meet the age of 14 or 18 by using dental development combined with machine learning. METHODS: This study combines dental assessment and machine learning techniques to predict whether adolescents have reached the consent age of 14 or 18. Factors such as the staging of the third molar, the third molar index, and the visibility of the periodontal ligament of the second molar are evaluated. RESULTS: Differences in performance metrics indicate that the posterior probabilities achieved by machine learning exceed 93% for the age of 14 and slightly lower for the age of 18. CONCLUSION: This study provides valuable insights for forensic identification for adolescents in personal identification, emphasizing the potential to improve the accuracy of age determination within this population by combining traditional methods with machine learning. It underscores the importance of protecting and respecting the dignity of all individuals involved.


Asunto(s)
Determinación de la Edad por los Dientes , Humanos , Adolescente , Determinación de la Edad por los Dientes/métodos , Radiografía Panorámica , Tercer Molar , Ligamento Periodontal , Aprendizaje Automático
5.
BMC Oral Health ; 24(1): 456, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38622566

RESUMEN

PURPOSE: To assess the impact of endoscope-assisted fractured roots or fragments extraction within the mandibular canal, along with quantitative sensory testing (QST) alterations in the inferior alveolar nerve (IAN). METHODS: Six patients with lower lip numbness following mandibular third molar extraction were selected. All patients had broken roots or fragments within the mandibular canal that were extracted under real-time endoscopic assistance. Follow-up assessments were conducted on postoperative days 1, 7, and 35, including a standardized QST of the lower lip skin. RESULTS: The average surgical duration was 32.5 min, with the IAN exposed in all cases. Two of the patient exhibited complete recovery of lower lip numbness, three experienced symptom improvement, and one patient remained unaffected 35 days after the surgery. Preoperative QST results showed that the mechanical detection and pain thresholds on the affected side were significantly higher than those on the healthy side, but improved significantly by postoperative day 7 in five patients, and returned to baseline in two patients on day 35. There were no significant differences in the remaining QST parameters. CONCLUSIONS: All endoscopic surgical procedures were successfully completed without any additional postoperative complications. There were no cases of deterioration of IAN injury, and lower lip numbness recovered in the majority of cases. Endoscopy allowed direct visualization and examination of the affected nerve, facilitating a comprehensive analysis of the IAN.


Asunto(s)
Diente Impactado , Traumatismos del Nervio Trigémino , Humanos , Estudios Retrospectivos , Hipoestesia/complicaciones , Hipoestesia/cirugía , Canal Mandibular , Traumatismos del Nervio Trigémino/etiología , Mandíbula/cirugía , Nervio Mandibular , Extracción Dental/efectos adversos , Extracción Dental/métodos , Tercer Molar/cirugía , Diente Impactado/cirugía , Radiografía Panorámica/métodos
6.
Acta Odontol Scand ; 83: 174-179, 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38651519

RESUMEN

OBJECTIVE: We examined whether dental panoramic radiography (PAN) can be used to identify the clinical stage of eruption of mandibular third molars at the time of radiological examination. MATERIALS AND METHODS: Cross-sectional data included records from clinical oral examination and PANs of university students. In the retrospective analysis of 345 mandibular third molars in 189 participants (20% men, 80% women; mean age 20.7 years; standard deviation [SD] ± 0.6), clinical stages of eruption were compared with their radiographic depth in bone, inclination, and root development. Statistics included χ2, Mann-Whitney U tests, and logistic regression. RESULTS: Significant (p < 0.001) predictor variables for assessing the clinical stage of eruption were radiographic depth in bone and inclination. All teeth radiologically at a depth of the cementoenamel (CE) junction of the neighbouring second molar or deeper were clinically unerupted. Above the CE junction, 80% of vertical and 97% of distoangular teeth were connected to the oral cavity, and 82% of mesioangular and 69% of horizontal teeth were clinically unerupted. CONCLUSION: All teeth below or at the CE junction are clinically unerupted. Above the CE junction, stage of eruption should be assessed together with the inclination, but horizontally inclined teeth are recommended to be verified clinically.


Asunto(s)
Mandíbula , Tercer Molar , Radiografía Panorámica , Erupción Dental , Humanos , Tercer Molar/diagnóstico por imagen , Erupción Dental/fisiología , Masculino , Femenino , Estudios Transversales , Mandíbula/diagnóstico por imagen , Adulto Joven , Estudios Retrospectivos , Adulto
7.
Clin Oral Investig ; 28(5): 254, 2024 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-38630328

RESUMEN

OBJECTIVE: Dentinogenesis imperfecta (DI) is an inherited dentin defect and may be isolated or associated with disorders such as osteogenesis imperfecta, odontochondrodysplasia Ehler-Danlos and others. Isolated DI is caused mainly by pathogenic variants in DSPP gene and around 50 different variants have been described in this gene. Herein, we report on 19 patients from two unrelated Egyptian families with isolated DI. Additionally, we focused on genetic counselling of the two families. MATERIALS AND METHODS: The patients were examined clinically and dentally. Panoramic X-rays were done to some patients. Whole exome sequencing (WES) and Sanger sequencing were used. RESULTS: WES revealed two new nonsense variants in DSPP gene, c.288T > A (p.Tyr96Ter) and c.255G > A (p.Trp85Ter). Segregation analysis by Sanger sequencing confirmed the presence of the first variant in all affected members of Family 1 while the second variant was confirmed to be de novo in the patient of Family 2. CONCLUSIONS AND CLINICAL RELEVANCE: Our study extends the number of DSPP pathogenic variants and strengthens the fact that DSPP is the most common DI causative gene irrespective of patients' ethnicity. In addition, we provide insights on genetic counseling issues in patients with inherited DSPP variants taking into consideration the variable religion, culture and laws in our society.


Asunto(s)
Dentinogénesis Imperfecta , Osteocondrodisplasias , Humanos , Dentinogénesis Imperfecta/genética , Asesoramiento Genético , Etnicidad , Radiografía Panorámica
8.
Acta Odontol Scand ; 83: 197-203, 2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38661111

RESUMEN

OBJECTIVE: This study aimed to investigate the radiological features of the permanent canines and the treatment carried out to ensure their eruption relative to certain features involved in Dental Anomaly Patterns (DAP). MATERIAL AND METHODS: The cross-sectional part of this retrospective register--based study focused on 1,315 dental panoramic tomographs (DPTs) of children aged 8.5-10.5 years, while the longitudinal part involved information on the treatment provided for 1,269 canines after the DPTs and on their eruption into the oral cavity. RESULTS: The canines of the DAP children more often showed evidence of early treatment (p = 0.014), with girls having more frequently interceptive treatment (p = 0.004) and boys early headgear (p = 0.022). Delayed dental age was associated with early treatment (OR 3.29, 95% CI 1.08-9.99). Either no or clear overlapping of a canine with the lateral incisor occurred more often in the DAP children, whereas canine inclination did not differ between the groups. The root development stage of the canine was more often either beginning or well advanced in the DAP children. CONCLUSIONS: The children with dental developmental abnormalities more often showed evidence of early treatment for the canines. Monitoring of the erupting canines after the first mixed stage is important to enable timely early treatment.


Asunto(s)
Diente Canino , Maxilar , Radiografía Panorámica , Erupción Dental , Humanos , Niño , Diente Canino/diagnóstico por imagen , Diente Canino/anomalías , Masculino , Femenino , Estudios Retrospectivos , Erupción Dental/fisiología , Maxilar/diagnóstico por imagen , Estudios Transversales , Anomalías Dentarias/diagnóstico por imagen
9.
BMC Oral Health ; 24(1): 340, 2024 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-38493117

RESUMEN

BACKGROUND: Investigation is to utilize decision trees in conjunction with orthopantomography (OPT) and lateral panoramic graphy (LPG) to diagnose unilateral anterior disc displacement (ADD) of the temporomandibular joint. METHODS: In this study, 161 patients with images obtained through all three imaging methods, MRI, OPT, and LPG, were selected from the archives. The participants were categorized into two groups: the study group, comprising 89 patients with unilateral anterior disc displacement, and the control group, consisting of 72 healthy individuals. Measurements, including 2 angles (antero-posterior angle and superior-inferior angle) and 3 distance parameters (anterior joint space distance, superior joint space distance, and posterior joint space distance), were conducted on each imaging modality dataset. To assess the obtained measurement data within each patient, the differences from each measurement were calculated. Statistical analysis of the measurement differences between the control and study groups was carried out with independent t test, and decision trees were generated using the SPSS 25 decision tree module 5.0. RESULTS: In ADD patients, it was statistically significantly found that the APA increased while the SIA decreased for angle measurements. But for linear measurements, AS increased while the SS and PS decreased in MRI, OPT, and LPG. CONCLUSION: ADD can be diagnosed in OPT and LPG. The identification of the specific type of ADD that occurs in the temporomandibular joint is not feasible.


Asunto(s)
Luxaciones Articulares , Trastornos de la Articulación Temporomandibular , Humanos , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Cóndilo Mandibular , Radiografía Panorámica , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Luxaciones Articulares/diagnóstico por imagen , Articulación Temporomandibular , Imagen por Resonancia Magnética/métodos , Árboles de Decisión
10.
Can J Dent Hyg ; 58(1): 19-25, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38505315

RESUMEN

Background: The high demand for oral health care services among vulnerable individuals combined with limited available resources requires a rethinking of the provision of oral health services. This study aimed to determine the usefulness of the dental panoramic radiograph (DPR) as an imaging tool to assess oral health and prioritize dental interventions in vulnerable patients. Methods: This observational and retrospective study evaluated charts of patients who attended Public Health Dental Clinics (PHDC), Alberta Health Services (AHS), in Calgary, Canada, between January 2018 and December 2019. Data collected included sex and age at the time of image acquisition. The following radiographic findings were gathered: the number of missing, present, decayed, restored, and impacted teeth; periapical lesions; retained root; periodontal bone loss; odontogenic and non-odontogenic lesions in the jaws; carotid calcification; and incidental radiographic findings with clinical relevance. Results: Of the 526 DPRs evaluated, 57.4% were from male patients and 42.6% were from female patients, with a mean age of 38.5 years. The average number of present teeth in females and males was 23.7 and 22.6, respectively. The most prevalent dental-related finding was periodontal bone loss (81.5%), followed by periapical lesions (59.6%) and impacted teeth (27%). Among non-dental findings, osseous lesions of the jaws were found in 10.4% of the patients, and carotid atheroma had a frequency of 3.2%. Conclusion: The DPR is a useful adjunct to the clinical exam in this specific population. It provides an opportunistic overview of their oral health and necessary support to establish priorities in oral health care in a public health setting.


Contexte : La forte demande de services de santé buccodentaire chez les personnes vulnérables, combinée aux ressources limitées disponibles, nécessite de repenser la prestation des services de santé buccodentaire. Cette étude vise à déterminer l'utilité de la radiographie panoramique comme outil d'imagerie pour évaluer la santé buccodentaire et prioriser les interventions dentaires chez les patients vulnérables. Méthodes : Cette étude observationnelle et rétrospective a évalué les dossiers des patients qui ont fréquenté les cliniques dentaires de santé publique d'Alberta Health Services (AHS) à Calgary, au Canada, entre janvier 2018 et décembre 2019. Les données recueillies comprenaient le sexe et l'âge au moment de l'acquisition de l'image. Les résultats radiographiques suivants ont été recueillis : nombre de dents manquantes, présentes, cariées, réparées et incluses; lésions périapicales; racine résiduelle; perte osseuse parodontale; lésions odontogéniques et non odontogéniques dans les mâchoires; calcification carotidienne; et résultats radiographiques accessoires pertinents sur le plan clinique. Résultats : Parmi les 526 radiographies panoramiques évaluées, 57,4 % provenaient d'hommes et 42,6 % de femmes, avec un âge moyen de 38,5 ans. Le nombre moyen de dents présentes chez les femmes et les hommes était de 23,7 et 22,6, respectivement. La découverte la plus courante liée aux soins dentaires était la perte osseuse parodontale (81,5 %), suivie des lésions périapicales (59,6 %) et des dents incluses (27 %). En ce qui concerne les résultats non liés aux soins dentaires, des lésions osseuses des mâchoires ont été repérées chez 10,4 % des patients, et l'athérome carotidien avait une fréquence de 3,2 %. Conclusion : La radiographie panoramique est un complément utile à l'examen clinique dans cette population particulière. Elle donne un aperçu de leur santé buccodentaire et le soutien nécessaire pour établir les priorités en matière de soins buccodentaires dans un contexte de santé publique.


Asunto(s)
Pérdida de Hueso Alveolar , Diente Impactado , Humanos , Masculino , Femenino , Adulto , Radiografía Panorámica , Salud Bucal , Estudios Retrospectivos , Alberta/epidemiología
11.
BMC Oral Health ; 24(1): 387, 2024 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-38532414

RESUMEN

OBJECTIVE: Panoramic radiographs (PRs) provide a comprehensive view of the oral and maxillofacial region and are used routinely to assess dental and osseous pathologies. Artificial intelligence (AI) can be used to improve the diagnostic accuracy of PRs compared to bitewings and periapical radiographs. This study aimed to evaluate the advantages and challenges of using publicly available datasets in dental AI research, focusing on solving the novel task of predicting tooth segmentations, FDI numbers, and tooth diagnoses, simultaneously. MATERIALS AND METHODS: Datasets from the OdontoAI platform (tooth instance segmentations) and the DENTEX challenge (tooth bounding boxes with associated diagnoses) were combined to develop a two-stage AI model. The first stage implemented tooth instance segmentation with FDI numbering and extracted regions of interest around each tooth segmentation, whereafter the second stage implemented multi-label classification to detect dental caries, impacted teeth, and periapical lesions in PRs. The performance of the automated tooth segmentation algorithm was evaluated using a free-response receiver-operating-characteristics (FROC) curve and mean average precision (mAP) metrics. The diagnostic accuracy of detection and classification of dental pathology was evaluated with ROC curves and F1 and AUC metrics. RESULTS: The two-stage AI model achieved high accuracy in tooth segmentations with a FROC score of 0.988 and a mAP of 0.848. High accuracy was also achieved in the diagnostic classification of impacted teeth (F1 = 0.901, AUC = 0.996), whereas moderate accuracy was achieved in the diagnostic classification of deep caries (F1 = 0.683, AUC = 0.960), early caries (F1 = 0.662, AUC = 0.881), and periapical lesions (F1 = 0.603, AUC = 0.974). The model's performance correlated positively with the quality of annotations in the used public datasets. Selected samples from the DENTEX dataset revealed cases of missing (false-negative) and incorrect (false-positive) diagnoses, which negatively influenced the performance of the AI model. CONCLUSIONS: The use and pooling of public datasets in dental AI research can significantly accelerate the development of new AI models and enable fast exploration of novel tasks. However, standardized quality assurance is essential before using the datasets to ensure reliable outcomes and limit potential biases.


Asunto(s)
Caries Dental , Diente Impactado , Diente , Humanos , Inteligencia Artificial , Radiografía Panorámica , Huesos
12.
J Clin Pediatr Dent ; 48(2): 149-162, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38548645

RESUMEN

This retrospective study was conducted to evaluate different methods for dental age estimation in children and to examine the feasibility of using cone beam computed tomography (CBCT) data for age estimation. A total of 200 radiographic records (both digital panoramic radiographs and CBCTs) were acquired from 100 children aged 9 to 16 years, all taken on the same dates. Radiographic data was acquired from archived records and included both panoramic radiography and CBCT data belonging to the same individual. CBCT was used when panoramic radiographic data was insufficient. The pulp volume and pulp/tooth volume ratio of the left first molar teeth in the mandible were calculated from the CBCT data using MIMICS software. In addition, age was estimated by the Demirjian and Willems methods from data obtained from panoramic radiography images. Statistical analyses and linear regression analysis were performed as necessary. There was a statistically significant difference between the mean difference between the Demirjian method and chronological age, and between the Willems method and chronological age (p < 0.001). Statistically significance was achieved in a linear regression model created from pulp volume (R2 = 0.098) and pulp/tooth volume ratio (R2 = 0.395) data for the estimated dental age analysis (p < 0.001) and a negative correlation was observed with chronological age. When compared estimated dental age from CBCT data with chronological age, the pulp/tooth volume ratio method yielded results closer to chronological age than using only pulp volume data. When considering both panoramic radiographic age estimation methods and age estimation methods using CBCT data, we found that the results obtained with the Willems method, a panoramic radiographic age estimation technique, provided the closest results to the chronological age. More contributions should be made to the literature regarding the feasibility of age estimation using pulp and tooth volume as an alternative method.


Asunto(s)
Determinación de la Edad por los Dientes , Niño , Humanos , Radiografía Panorámica , Estudios Retrospectivos , Determinación de la Edad por los Dientes/métodos , Pulpa Dental/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico
13.
BMC Oral Health ; 24(1): 371, 2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38519914

RESUMEN

BACKGROUND: The most severe complication that can occur after mandibular third molar (MM3) surgery is inferior alveolar nerve (IAN) damage. It is crucial to have a comprehensive radiographic evaluation to reduce the possibility of nerve damage. The objective of this study is to assess the diagnostic accuracy of panoramic radiographs (PR) and posteroanterior (PA) radiographs in identifying the association between impacted MM3 roots and IAN. METHODS: This study included individuals who had PR, PA radiographs, and cone beam computed tomography (CBCT) and who had at least one impacted MM3. A total of 141 impacted MM3s were evaluated on CBCT images, and the findings were considered gold standard. The relationship between impacted MM3 roots and IAN was also evaluated on PR and PA radiographies. The data was analyzed using the McNemar and Chi-squared tests. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of PR and PA radiographies were determined. RESULTS: Considering CBCT the gold standard, the relationship between MM3 roots and IAN was found to be statistically significant between PR and CBCT (p = 0.00). However, there was no statistically significant relationship between PA radiography and CBCT (0.227). The study revealed that the most prevalent limitation of the PR in assessing the relationship between MM3 roots and IAN was the identification of false-positive relationship. CONCLUSIONS: PA radiography may be a good alternative in developing countries to find out if there is a contact between MM3 roots and IAN because it is easier to get to, cheaper, and uses less radiation.


Asunto(s)
Tercer Molar , Diente Impactado , Humanos , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Proyectos Piloto , Extracción Dental/métodos , Tomografía Computarizada de Haz Cónico/métodos , Nervio Mandibular/diagnóstico por imagen , Radiografía Panorámica/métodos , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía , Mandíbula/diagnóstico por imagen
14.
BMC Oral Health ; 24(1): 377, 2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38519919

RESUMEN

BACKGROUND: The correlation between dental maturity and skeletal maturity has been proposed, but its clinical application remains challenging. Moreover, the varying correlations observed in different studies indicate the necessity for research tailored to specific populations. AIM: To compare skeletal maturity in Korean children with advanced and delayed dental maturity using dental maturity percentile. DESIGN: Dental panoramic radiographs and cephalometric radiographs were obtained from 5133 and 395 healthy Korean children aged between 4 and 16 years old. Dental maturity was assessed with Demirjian's method, while skeletal maturity was assessed with the cervical vertebral maturation method. Standard percentile curves were developed through quantile regression. Advanced (93 boys and 110 girls) and delayed (92 boys and 100 girls) dental maturity groups were defined by the 50th percentile. RESULTS: The advanced group showed earlier skeletal maturity in multiple cervical stages (CS) in both boys (CS 1, 2, 3, 4, and 6) and girls (CS 1, 3, 4, 5, and 6). Significant differences, as determined by Mann-Whitney U tests, were observed in CS 1 for boys (p = 0.004) and in CS 4 for girls (p = 0.037). High Spearman correlation coefficients between dental maturity and cervical vertebral maturity exceeded 0.826 (p = 0.000) in all groups. CONCLUSION: A correlation between dental and skeletal maturity, as well as advanced skeletal maturity in the advanced dental maturity group, was observed. Using percentile curves to determine dental maturity may aid in assessing skeletal maturity, with potential applications in orthodontic diagnosis and treatment planning.


Asunto(s)
Determinación de la Edad por los Dientes , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Determinación de la Edad por los Dientes/métodos , Radiografía Panorámica , República de Corea , Estudios Retrospectivos , Pueblos del Este de Asia
15.
Clin Oral Investig ; 28(3): 204, 2024 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-38459362

RESUMEN

OBJECTIVES: To evaluate the performance of a commercially available Generative Pre-trained Transformer (GPT) in describing and establishing differential diagnoses for radiolucent lesions in panoramic radiographs. MATERIALS AND METHODS: Twenty-eight panoramic radiographs, each containing a single radiolucent lesion, were evaluated in consensus by three examiners and a commercially available ChatGPT-3.5 model. They provided descriptions regarding internal structure (radiodensity, loculation), periphery (margin type, cortication), shape, location (bone, side, region, teeth/structures), and effects on adjacent structures (effect, adjacent structure). Diagnostic impressions related to origin, behavior, and nature were also provided. The GPT program was additionally prompted to provide differential diagnoses. Keywords used by the GPT program were compared to those used by the examiners and scored as 0 (incorrect), 0.5 (partially correct), or 1 (correct). Mean score values and standard deviation were calculated for each description. Performance in establishing differential diagnoses was assessed using Rank-1, -2, and - 3. RESULTS: Descriptions of margination, affected bone, and origin received the highest scores: 0.93, 0.93, and 0.87, respectively. Shape, region, teeth/structures, effect, affected region, and nature received considerably lower scores ranging from 0.22 to 0.50. Rank-1, -2, and - 3 demonstrated accuracy in 25%, 57.14%, and 67.85% of cases, respectively. CONCLUSION: The performance of the GPT program in describing and providing differential diagnoses for radiolucent lesions in panoramic radiographs is variable and at this stage limited in its use for clinical application. CLINICAL RELEVANCE: Understanding the potential role of GPT systems as an auxiliary tool in image interpretation is imperative to validate their clinical applicability.


Asunto(s)
Diagnóstico Diferencial , Radiografía Panorámica , Consenso
16.
Clin Oral Investig ; 28(3): 198, 2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38448657

RESUMEN

OBJECTIVES: This study aimed to use all permanent teeth as the target and establish an automated dental age estimation method across all developmental stages of permanent teeth, accomplishing all the essential steps of tooth determination, tooth development staging, and dental age assessment. METHODS: A three-step framework for automatically estimating dental age was developed for children aged 3 to 15. First, a YOLOv3 network was employed to complete the tasks of tooth localization and numbering on a digital orthopantomogram. Second, a novel network named SOS-Net was established for accurate tooth development staging based on a modified Demirjian method. Finally, the dental age assessment procedure was carried out through a single-group meta-analysis utilizing the statistical data derived from our reference dataset. RESULTS: The performance tests showed that the one-stage YOLOv3 detection network attained an overall mean average precision 50 of 97.50 for tooth determination. The proposed SOS-Net method achieved an average tooth development staging accuracy of 82.97% for a full dentition. The dental age assessment validation test yielded an MAE of 0.72 years with a full dentition (excluding the third molars) as its input. CONCLUSIONS: The proposed automated framework enhances the dental age estimation process in a fast and standard manner, enabling the reference of any accessible population. CLINICAL RELEVANCE: The tooth development staging network can facilitate the precise identification of permanent teeth with abnormal growth, improving the effectiveness and comprehensiveness of dental diagnoses using pediatric orthopantomograms.


Asunto(s)
Aprendizaje Profundo , Humanos , Niño , Tercer Molar , Odontogénesis , Radiografía Panorámica
17.
Gen Dent ; 72(2): 48-54, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38411485

RESUMEN

The purpose of this research was to test the reliability of a modified magnification method for determining the position of an impacted canine from a single panoramic radiograph. This retrospective study evaluated 114 panoramic radiographs showing 136 impacted maxillary canines. The widths of the impacted canines, contralateral erupted canines, and ipsilateral maxillary incisors were measured, and ratios for the canine-incisor index (CII) and canine-canine index (CCI) were calculated. The impacted canines were also classified according to their location in the vertical plane (apical, middle, or coronal zone) relative to the contralateral central incisor. Continuous data were analyzed for normal distribution, and logistic and multivariate logistic regression models were conducted. The Benjamini-Hochberg procedure with a false discovery rate of 0.05 was used to account for multiple testing. The intrarater reliability was excellent for impacted canine, central incisor, and contralateral canine measurements (intraclass correlation coefficient > 0.9). The CII and vertical zone were strong predictors of an impacted canine position with clinically useful sensitivity and specificity values (0.69 and 0.74, respectively, based on an area under the curve concordance statistic of 0.75). A predictive range was evident for the CII of palatally (1.10-1.39) and buccally (0.90-1.19) impacted canines in the middle and coronal zones, respectively. The occurrence of palatal or buccal positioning was not significantly associated with the CCI (P = 0.2). The CII and vertical zone identified from a single panoramic radiograph can be used to determine the buccopalatal position of an impacted canine, with more reliability if the impacted canine crown is in the middle or coronal zone of the contralateral central incisor.


Asunto(s)
Diente Impactado , Humanos , Radiografía Panorámica , Reproducibilidad de los Resultados , Estudios Retrospectivos , Diente Impactado/diagnóstico por imagen , Diente Canino/diagnóstico por imagen
18.
Curr Med Imaging ; 20: 1-7, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38389337

RESUMEN

BACKGROUND: The lack of knowledge of the relation of the maxillary sinus with the apexes of maxillary posterior teeth can lead to important complications during common dental procedures. This can be avoided using different imaging techniques, such as orthopantomography (OPG) and cone beam computed tomography (CBCT). The present study aims to compare the performance of OPG with CBCT in measuring the vertical distance of the apexes of posterior-superior teeth to the maxillary sinus. METHODS: This study corresponded to a cross-sectional study. OPGs and CBCT scans were obtained from the same individuals, and the qualitative and quantitative vertical distance of the apexes in relation to the maxillary sinus was categorized and measured in mm. RESULTS: A total of 28 pairs of OPGs and CBCT scans from the same patients were obtained. About 381 roots were analysed, which included 89 upper first premolars, 51 upper second premolars, 115 upper first molars, and 126 upper second molars. Projection/protrusion was observed with more frequency in molars, specially 1º molars in both OPG (n= 75, 65.2%) and CBCT (n= 31, 27%); however, 106 more cases (27.9%) were classified as projected in the OPG compared to CBCT (p < 0.05). When comparing the performance of the OPG and CBTC for analysing all roots qualitatively, there was a 57.8% agreement between both techniques. This difference was statistically significant (p <0.0001). Statistically significant differences were also observed when comparing the millimetric differences. CONCLUSION: This study showed that OPG is not an accurate technique to observe the relationship between the maxillary sinus and the apexes of the upper posterior teeth. In those cases where precision is required when performing dental procedures in this area, CBCT should be used. When not available, the clinicians should be aware of the limitations of the OPG and add other complementary techniques.


Asunto(s)
Seno Maxilar , Raíz del Diente , Humanos , Estudios Transversales , Seno Maxilar/diagnóstico por imagen , Radiografía Panorámica , Tomografía Computarizada de Haz Cónico/métodos
19.
Medicine (Baltimore) ; 103(5): e36469, 2024 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-38306563

RESUMEN

To evaluate the feasibility of temporomandibular disorder (TMD) diagnosis with panoramic radiography, and provide standardized data for artificial intelligence-assisted diagnosis by measuring the differences in the condylar and mandibular ramus heights. A total of 500 panoramic radiographs (219 male and 281 female participants) of healthy individuals were examined. The panoramic machine compatible measurement software, SCANORA 5.2.6, was used to measure the bilateral condylar height and mandibular ramus height, and SPSS 27.0 was used to calculate the left- and right-side differences in condylar height and mandibular ramus height of healthy individuals. Magnetic resonance images of the temporomandibular joint region obtained from 46 outpatients in the Stomatology Department were selected along with their corresponding panoramic radiographs. The left- and right-sided differences were measured and compared with the magnetic resonance imaging results. The measurement data are expressed as mean ±â€…standard deviation (mm). t Tests were used to analyze data from healthy male and healthy female groups. The findings revealed that while there was no significant difference (P > .05) in the height of the condyle between men and women, there was a significant difference (P  < .05) in the height of the mandibular ramus. In healthy population, the difference in height between the left and right condyle was 1.09 ±â€…0.99 mm. The difference in height of mandibular ramus in men was 1.26 ±â€…0.85 mm and that in women was 1.19 ±â€…0.87 mm. For the diagnosis of TMD, the sensitivity of panoramic radiographs was 94.74% (36/38), specificity was 75.00% (6/8), and diagnostic accuracy was 91.30% (42/46). The height of the right and left lateral condyles was not identical in healthy individuals, resulting in a discernible height discrepancy. In addition, the height of the mandibular ramus varied. By considering the left-right lateral height differences identified in this study along with clinical examination, it is possible to employ this metric as a preliminary screening tool for patients with TMD. Further, the use of panoramic radiographs for initial TMD screening is both viable and significant.


Asunto(s)
Cóndilo Mandibular , Trastornos de la Articulación Temporomandibular , Humanos , Masculino , Femenino , Cóndilo Mandibular/patología , Radiografía Panorámica/métodos , Inteligencia Artificial , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/patología
20.
J Dent ; 144: 104891, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38367827

RESUMEN

OBJECTIVES: To evaluate the diagnostic performance of three versions of a deep-learning convolutional neural network in terms of object detection and segmentation using a multiclass panoramic radiograph dataset. METHODS: A total of 600 orthopantomographies were randomly selected for this study and manually annotated by a single operator using an image annotation tool (COCO Annotator v.11.0.1) to establish ground truth. The annotation classes included teeth, maxilla, mandible, inferior alveolar nerve, dento- and implant-supported crowns/pontics, endodontic treatment, resin-based restorations, metallic restorations, and implants. The dataset was then divided into training, validation, and testing subsets, which were used to train versions 5, 7, and 8 of You Only Look Once (YOLO) Neural Network. Results were stored, and a posterior performance analysis was carried out by calculating the precision (P), recall (R), F1 Score, Intersection over Union (IoU), and mean average precision (mAP) at 0.5 and 0.5-0.95 thresholds. The confusion matrix and recall precision graphs were also sketched. RESULTS: YOLOv5s showed an improvement in object detection results with an average R = 0.634, P = 0.781, mAP0.5 = 0.631, and mAP0.5-0.95 = 0.392. YOLOv7m achieved the best object detection results with average R = 0.793, P = 0.779, mAP0.5 = 0.740, and mAP0.5-0.95 = 0,481. For object segmentation, YOLOv8m obtained the best average results (R = 0.589, P = 0.755, mAP0.5 = 0.591, and mAP0.5-0.95 = 0.272). CONCLUSIONS: YOLOv7m was better suited for object detection, while YOLOv8m demonstrated superior performance in object segmentation. The most frequent error in object detection was related to background classification. Conversely, in object segmentation, there is a tendency to misclassify True Positives across different dental treatment categories. CLINICAL SIGNIFICANCE: General diagnostic and treatment decisions based on panoramic radiographs can be enhanced using new artificial intelligence-based tools. Nevertheless, the reliability of these neural networks should be subjected to training and validation to ensure their generalizability.


Asunto(s)
Redes Neurales de la Computación , Radiografía Panorámica , Humanos , Aprendizaje Profundo , Procesamiento de Imagen Asistido por Computador/métodos , Mandíbula/diagnóstico por imagen , Diente/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Implantes Dentales , Nervio Mandibular/diagnóstico por imagen
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