Simultaneous detection of dental caries and fissure sealant in intraoral photos by deep learning: a pilot study.

BACKGROUND: Deep learning, as an artificial intelligence method has been proved to be powerful in analyzing images. The purpose of this study is to construct a deep learning-based model (ToothNet) for the simultaneous detection of dental caries and fissure sealants in intraoral photos. METHODS: A total of 1020 intraoral photos were collected from 762 volunteers. Teeth, caries and sealants were annotated by two endodontists using the LabelMe tool. ToothNet was developed by modifying the YOLOX framework for simultaneous detection of caries and fissure sealants. The area under curve (AUC) in the receiver operating characteristic curve (ROC) and free-response ROC (FROC) curves were used to evaluate model performance in the following aspects: (i) classification accuracy of detecting dental caries and fissure sealants from a photograph (image-level); and (ii) localization accuracy of the locations of predicted dental caries and fissure sealants (tooth-level). The performance of ToothNet and dentist with 1year of experience (1-year dentist) were compared at tooth-level and image-level using Wilcoxon test and DeLong test. RESULTS: At the image level, ToothNet achieved an AUC of 0.925 (95% CI, 0.880-0.958) for caries detection and 0.902 (95% CI, 0.853-0.940) for sealant detection. At the tooth level, with a confidence threshold of 0.5, the sensitivity, precision, and F1-score for caries detection were 0.807, 0.814, and 0.810, respectively. For fissure sealant detection, the values were 0.714, 0.750, and 0.731. Compared with ToothNet, the 1-year dentist had a lower F1 value (0.599, p < 0.0001) and AUC (0.749, p < 0.0001) in caries detection, and a lower F1 value (0.727, p = 0.023) and similar AUC (0.829, p = 0.154) in sealant detection. CONCLUSIONS: The proposed deep learning model achieved multi-task simultaneous detection in intraoral photos and showed good performance in the detection of dental caries and fissure sealants. Compared with 1-year dentist, the model has advantages in caries detection and is equivalent in fissure sealants detection.

Inhibition of GSK3 Represses the Expression of Retinoic Acid Synthetic Enzyme ALDH1A2 via Wnt/ß-Catenin Signaling in WiT49 Cells.

Organogenesis, including renal development, requires an appropriate retinoic acid concentration, which is established by differential expression of aldehyde dehydrogenase 1 family member A2 (ALDH1A2) and cytochrome P450 family 26 subfamily A/B/C member 1 (CYP26A1/B1/C1). In the fetal kidney, ALDH1A2 expresses in the developing stroma and renal vesicle and its derivatives but does not present in the ureteric bud. It remains unclear what may contribute to this expression pattern. Here we show that the glycogen synthase kinase 3 alpha/beta (GSK3A/B) inhibitor CHIR99021 significantly represses ALDH1A2 expression in WiT49, which is a Wilms' tumor cell line that exhibits "triphasic" differential potential and is used as a fetal kidney cell model. CHIR99021 fails to suppress ALDH1A2 as ß-catenin is inhibited, suggesting that the downregulation of ALDH1A2 by CHIR99021 is through Wnt/ß-catenin signaling. Ectopic expression of mouse Wnt1, Wnt3a, Wnt4, and Wnt9b represses ALDH1A2 expression in WiT49 cells. Using immunohistochemistry, we show an inverse correlation of Aldh1a2 expression with ß-catenin in rat E18.5 kidney. ChIP demonstrated that ß-catenin is recruited to the ALDH1A2 promoter, the conserved intron1G, and another site within intron 1 of ALDH1A2. Using a luciferase assay, we further show that the ALDH1A2 promoter and the intron1G element are involved in the repression of ALDH1A2 expression by CHIR99021. Our work demonstrates that ALDH1A2 expression can be directly repressed by the Wnt/ß-catenin signaling in fetal kidney cells, suggesting that Wnt/ß-catenin may play a role in maintaining the expression pattern of ALDH1A2 in the fetal kidney, thus controlling the availability and localization of retinoic acid and regulating aspects of kidney development.

Ion-chelation based digital barcodes for multiplexing of a suspension array.

Ion-chelated microbeads (ICMs) for suspension arrays can be prepared by chelating metal ions (MIs), which are used as encoding materials. Stimulating the ICMs, laser induced breakdown spectra (LIBs) can be obtained and the atomic spectra of the chelated ions are chosen as the decoding signals. Our ICMs show digital characteristics with high stability due to the properties of LIBs. And, since there are many available coding materials and different kinds of coding materials can be easily combined, the coding capacity can be considerably enlarged. Further, the background interference in fluoroimmunoassay detection could be avoided, because the ICMs contain no fluorescence emission. In our studies, we achieved a total of 15 types of barcodes by taking full advantage of 4 kinds of ions, then a fluoroimmunoassay was performed to demonstrate the specificity and detection performance of our ICMs in multiplexing and the detection limit could reach 1.49 × 10-10 M, showing promising potential in applications.

Detection of Simulated Periradicular Lesions in Porcine Bone by Optical Coherence Tomography.

INTRODUCTION: The accurate detection of periradicular lesions located under a nonperforated cortical plate poses a challenge in endodontic microsurgery. Optical coherence tomography (OCT) is a noninvasive imaging method that has been successfully used in many dental applications. In this study, we investigated if spectral-domain OCT (SD-OCT) could be used to determine simulated periradicular lesions. METHODS: Twenty-eight cavities with different depths were prepared on bone plates obtained from 5 porcine mandibles. Both 3-dimensional SD-OCT imaging and micro-computed tomographic (micro-CT) imaging were used to image the bottom of the air-filled cavity and the cavity filled with soft tissue for comparison. The residual bone thickness under the cavity was measured by SD-OCT and micro-CT imaging and compared using the Pearson correlation. RESULTS: The air-filled lesions were readily detected; yet, filling of the cavity with soft tissue diminished the appearance of the lesion boundaries in the SD-OCT images. The optical values of residual bone thickness obtained from SD-OCT ranged from 0.14-2.11 mm, which corresponded to the range of 0.26-1.18 mm from micro-CT imaging. A strong correlation was found between the 2 imaging modalities (r = 0.96; range, 0.94-0.98). The slope (1.56) of the linear regression matched the bulk refractive index of bone tissues. CONCLUSIONS: SD-OCT allows for visualization of the lesion boundaries via intact bone surfaces and may be a promising, practical, and nonirradiating adjunct tool for chairside localization of periradicular lesions in bone.

[Heavy Metal Contamination in Farmland Soils at an E-waste Disassembling Site in Qingyuan, Guangdong, South China].

Crude e-waste dismantling activities have caused a series of environmental pollution problems, and the pollutants released from the dismantling activities would finally pose high risks to human health by means of the accumulation through food chains. To explore the contamination status of heavy metals to the surrounding farmland soils in Longtang and Shijiao Town, Qingyuan, Guangdong, China, 22 farmland soil samples were collected and analyzed for the contents, spatial distributions and chemical forms of 6 heavy metals (Pb, Cu, Cd, Zn, Cr and Ni). The results showed that the 6 heavy metals exhibited obvious accumulations when compared to the corresponding background values in Guangdong Province. According to farmland environmental quality evaluation standard for edible agricultural products HJ 332-2006, the pollution severity of heavy metals was evaluated by monomial pollution index and Nemerow synthetic pollution index methods, the results indicated that 72. 7% of the soil samples contained one or more kinds of heavy metals with higher concentrations than the corresponding standard values, Cd, Cu, Pb and Zn were the main metals in the polluted soils, and for the proportion of contaminated soil samples in all the 22 samples, Cd was the highest, followed by Cu, and finally Pb and Zn. Nemerow synthetic pollution index further revealed that 68. 2% of soil samples were contaminated, and among them 53. 3% of samples were heavily contaminated. Most of the heavy metals were well correlated with each other at the 0. 05 or 0. 01 level, which indicated that primitive e-waste recycling activities were an important source of the heavy metal contamination in Longtang and Shijiao Town. The contents of Cd, Pb, Cu and Zn in surface soils were higher than those of other soil layers, and the contents of these 4 metals in deep soils (20- 100 cm) did not show significant decreases with the increasing depths. The contents of Cr and Ni maintained constant, and exhibited no statistical differences with the sampling depths. Sequential leaching tests showed that the active fractions of Pb, Cu and Cd ranged from 36. 9% to 90. 6%, 39. 6% to 93. 9% and 43. 7% to 99. 6%, with mean values of 61. 3% 65. 3% and 80. 7%, respectively. The active fractions of these three metals in most samples accounted for more than half of their own total contents, which would cause a high ecological risk.

Effect of pretreatment on Er:YAG laser-irradiated dentin.

Erbium:yttrium-aluminum-garnet (Er:YAG) laser preparation of tooth cavities for restoration is an increasingly popular method, but its compatibility with existing composite material bonding protocols has not been fully defined. This study evaluated the effect of laser and etchant pretreatments on the performance of one-bottle self-etch adhesives in Er:YAG laser-prepared dentin. Eight groups of 20 extracted teeth were established to investigate bonding in tested dentin disks. Various combinations of laser preparation (with/without), pretreatment (none/acid-etch/low-fluence Er:YAG irradiation), and self-etching adhesive (G-Bond Plus or Xeno V) were tested. Samples were then restored with composite resin and subjected to a tensile bond strength (TBS) test. We also performed scanning electron microscopy (SEM) on dentin disks from some of these groups before and after adhesive application to evaluate their microscopic morphological appearance. Statistical analysis (Dunnett T3 test coupled with the general linear model at 5% significance level) revealed that the laser preparation of dentin did not impact on TBS (p = 0.914), whereas pretreatment with either phosphoric acid (p < 0.0001) or low-fluence Er:YAG laser irradiation (p < 0.0001) significantly increased TBS, although there was no difference between them in their respective elevation of TBS. SEM analysis demonstrated that both acid and laser pretreatments reduced irregularities and produced a more homogeneous surface. Er:YAG laser preparation does not compromise the efficacy of one-step self-etch dentin adhesives, and pretreatment with phosphoric acid or low-fluence Er:YAG laser can significantly increase the TBS of adhesion to this irradiated dentin.

Application of optical coherence tomography to identify pulp exposure during access cavity preparation using an Er:YAG laser.

OBJECTIVE: The study aimed to evaluate the ability of optical coherence tomography (OCT) to guide and identify pulp exposure using an erbium: yttrium-aluminum-garnet (Er:YAG) laser. BACKGROUND DATA: The Er:YAG laser has been proven to be effective in ablating dental hard tissue and offers advantages, as there is none of the vibration and noise you get with conventional methods, but it has limitations in relation to the tactile feedback that would aid in identification of entry into the pulp chamber. Based on depth-resolved optical reflectivity, OCT technology has been developed to provide high-resolution, cross-sectional images of the internal structure of biological tissues. MATERIALS AND METHODS: The pulp chambers of 20 human mandibular incisors were examined, and the average thickness of hard tissue covering the pulp chamber was assessed using micro-computed tomography (micro-CT) images. An Er:YAG laser was used to gradually penetrate the hard tissue over the pulp chamber under microscopic guidance. The preparation was constantly imaged using a swept-source OCT at 10 sec intervals until a pulp chamber exposure was identified using the technology. The pulp exposure was re-examined under the microscope and compared with micro-CT images for verification. RESULTS: The pulp exposures of 20 incisors were all verified microscopically and with micro-CT images. The thickness of hard tissue penetrated by the laser ranged from 0.44 to 1.69 mm. CONCLUSIONS: Swept-source OCT is a useful tool for identifying pulp exposure during access opening with the Er: YAG laser.

Comparison of tensile bond strengths of four one-bottle self-etching adhesive systems with Er:YAG laser-irradiated dentin.

This study aimed to investigate the interaction of current one-bottle self-etching adhesives and Er:YAG laser with dentin using a tensile bond strength (TBS) test and scanning electron microscopy (SEM) in vitro. Two hundred and thirteen dentin discs were randomly distributed to the Control Group using bur cutting and to the Laser Group using an Er:YAG laser (200 mJ, VSP, 20 Hz). The following adhesives were investigated: one two-step total-etch adhesive [Prime & Bond NT (Dentsply)] and four one-step self-etch adhesives [G-Bond plus (GC), XENO V (Dentsply), iBond Self Etch (Heraeus) and Adper Easy One (3 M ESPE)]. Samples were restored with composite resin, and after 24-hour storage in distilled water, subjected to the TBS test. For morphological analysis, 12 dentin specimens were prepared for SEM. No significant differences were found between the control group and laser group (p = 0.899); dentin subjected to Prime & Bond NT, XENOV and Adper Easy One produced higher TBS. In conclusion, this study indicates that Er:YAG laser-prepared dentin can perform as well as bur on TBS, and some of the one-step one-bottle adhesives are comparable to the total-etch adhesives in TBS on dentin.

Investigation of apex locators and related morphological factors.

INTRODUCTION: The purpose of this study was to investigate the ability of three electronic apex locators (EALs) to detect the minor foramen and morphological influencing factors relative to working length determination. METHODS: Three hundred fifty-six extracted teeth were decoronated, and the coronal portion of the canal was flared. The distance between the major foramen and the file tips (DMFF) was determined by different EALs. The relationship between the DMFFs determined by the EAL and the morphological features of the root apex was analyzed by linear regression analysis. RESULTS: The average DMFFs were 0.261 mm, 0.376 mm, and 0.383 mm for the Root ZX (J. Morita, Kyoto, Japan), Raypex 5 (VDW, Munich, Germany), and Elements Apex Locator (SybronEndo, Anaheim, CA), respectively. The file tips determined by EALs were much closer to the major foramen in teeth with a "lateral major foramen" (p < 0.001). The area and diameters of the minor foramen were significantly related to the variation of the DMFFs determined by EALs. CONCLUSION: When the "minor foramen" reading was given, the file tip connected to the Root ZX was much closer to the major foramen than the other two EALs. The minor foramen's morphology and the major foramen's location were both important influencing factors on the performance of EALs.