State of the art and prospects for artificial intelligence in orthognathic surgery: A systematic review with meta-analysis.

OBJECTIVE: To present a systematic review of the state of the art regarding clinical applications, main features, and outcomes of artificial intelligence (AI) in orthognathic surgery. METHODS: The PICOS strategy was performed on a systematic review (SR) to answer the following question: "What are the state of the art, characteristics and outcomes of applications with artificial intelligence for orthognathic surgery?" After registering in PROSPERO (CRD42021270789) a systematic search was performed in the databases: PubMed (including MedLine), Scopus, Embase, LILACS, MEDLINE EBSCOHOST and Cochrane Library. 195 studies were selected, after screening titles and abstracts, of which thirteen manuscripts were included in the qualitative analysis and six in the quantitative analysis. The treatment effects were plotted in a Forest-plot. JBI questionnaire for observational studies was used to asses the risk of bias. The quality of the SR evidence was assessed using the GRADE tool. RESULTS: AI studies on 2D cephalometry for orthognathic surgery, the Tau2 = 0.00, Chi2 = 3.78, p = 1.00 and I² of 0 %, indicating low heterogeneity, AI did not differ statistically from control (p = 0.79). AI studies in the diagnosis of the decision of whether or not to perform orthognathic surgery showed heterogeneity, and therefore meta-analysis was not peformed. CONCLUSION: The outcome of AI is similar to the control group, with a low degree of bias, highlighting its potential for use in various applications.

Could fluoride be considered a genotoxic chemical agent in vivo? A systematic review with meta-analysis.

The goal of this study was to perform systematic review (SR) to investigate the scientific literature regarding the genotoxicity effects of fluoride exposure (FE). The search of databases used for this study was PubMed/Medline, SCOPUS and Web of Science. The quality of included studies was assessed using the EPHPP (Effective Public Health Practice Project). A total of 20 potentially relevant studies were selected for evaluating the genotoxicity induced by fluoride. Few studies have revealed that FE induces genotoxicity. A total of 14 studies demonstrated negative results whereas 6 studies did not. After reviewing the twenty studies, 1 was classified as weak, 10 were considered moderate and 9 were considered strong, according to the EPHPP. Taken together, it has been established that genotoxicity of fluoride is limited.

Metaverse and oral and maxillofacial radiology: Where do they meet?

Since previous literatureregarding the application of the metaverse in educationis scarce, the present letter aimed to highlight possible applications, as a complementary tool for the classroom, in the oral and maxillofacial radiology academic experience.Thepotential risksof the metaverse are also discussed. The metaverse and its possible applications, especially related to enhanced teaching and learning, will become a hot topic in the near future, and therefore, there will be a challenging learning curve before the educator makes the most of these innovative educational tools empowered by deeply interactive virtual reality technology.

Comparison of different methods of analysis of maxillary sinus volume and validation of a new proposal using cone beam computed tomography.

PURPOSE: develop and validate a formula, through a discriminant analysis of sex estimation, evaluating maxillary sinus in cone beam computed tomography scans in a Brazilian population, comparing this formula with two other existing ones. METHODS: 190 cone beam CT scans of Brazilian adults were retrospectively evaluated by an independent examiner. Measurements were performed in the right and left MS region: height, width, length, distance between the breasts, distance between infraorbital foramina, and volume in the ITK software. The sample was divided into female and male. T test, ANOVA, Tukey test and the ROC Curve was performed (p > 0,05). RESULTS: statistically significant differences were found in relation to the maximum height of the MS both right (p = 0,001) and left (p = 0,026) between sexes and the maximum length in the right MS (p = 0,01). Regarding the comparison of MS volume according to the different analysis methods, statistically significant differences were found between sexes for the right MS when using the method by Bangi et al. (p = 0,012) and the volume of the left MS in females (p < 0,001). Comparing the three classification models, statistically significant differences were found between the proposed method and the classification by Bangi et al. (p < 0.007). The ROC curve showed greater accuracy in the classification proposed in this work. CONCLUSION: the new proposed formula obtained better predictions of sexual dimorphism, when compared to classifications already described in the literature.

The use of micronucleus assay in exfoliated oral cells in patients undergoing fixed orthodontic therapy: a systematic review with meta-analysis.

The aim of this systematic review was to evaluate published papers regarding the micronucleus assay in oral mucosal cells of patients undergoing orthodontic therapy (OT). A search of the scientific literature was made in the PubMed, Scopus, and Web of Science databases for all data published until November, 2021 using the combination of the following keywords: "fixed orthodontic therapy," "genetic damage", "DNA damage," "genotoxicity", "mutagenicity", "buccal cells", "oral mucosa cells," and "micronucleus assay". The systematic review was designed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Nine studies were retrieved. Some authors demonstrated that OT induces cytogenetic damage in oral mucosal cells. Out of the nine studies included, two were classified as strong, five as moderate, and two as weak, according to the quality assessment components of the Effective Public Health Practice Project (EPHPP). Meta-analysis data revealed no relationship between mutagenicity in oral cells and OT in different months of treatment. At one month, the SMD = 0.65 and p = 0.08; after three months of OT, the SMD = 1.21 and p = 0.07; and after six months of OT, the SMD = 0.56 and p = 0.11. In the analyzed months of OT, I2 values were >75%, indicating high heterogeneity. In summary, this review was not able to demonstrate that OT induces genetic damage in oral cells. The study is important for the protection of patients undergoing fixed OT, given that mutagenesis participates in the multi-step process of carcinogenesis.

Assessment of landmark detection in cephalometric radiographs with different conditions of brightness and contrast using the an artificial intelligence software.

OBJECTIVES: To evaluate the reliability and reproducibility of an artificial intelligence (AI) software in identifying cephalometric points on lateral cephalometric radiographs considering four settings of brightness and contrast. METHODS AND MATERIALS: Brightness and contrast of 30 lateral cephalometric radiographs were adjusted into four different settings. Then, the control examiner (ECont), the calibrated examiner (ECal), and the CEFBOT AI software (AIs) each marked 19 cephalometric points on all radiographs. Reliability was assessed with a second analysis of the radiographs 15 days after the first one. Statistical significance was set at p < 0.05. RESULTS: Reliability of landmark identification was excellent for the human examiners and the AIs regardless of the type of brightness and contrast setting (mean intraclass correlation coefficient >0.89). When ECont and ECal were compared for reproducibility, there were more cephalometric points with significant differences on the x-axis of the image with the highest contrast and the lowest brightness, namely N(p = 0.033), S(p = 0.030), Po(p < 0.001), and Pog'(p = 0.012). Between ECont and AIs, there were more cephalometric points with significant differences on the image with the highest contrast and the lowest brightness, namely N(p = 0.034), Or(p = 0.048), Po(p < 0.001), A(p = 0.042), Pog'(p = 0.004), Ll(p = 0.005), Ul(p < 0.001), and Sn(p = 0.001). CONCLUSIONS: While the reliability of the AIs for cephalometric landmark identification was rated as excellent, low brightness and high contrast seemed to affect its reproducibility. The experienced human examiner, on the other hand, did not show such faulty reproducibility; therefore, the AIs used in this study is an excellent auxiliary tool for cephalometric analysis, but still depends on human supervision to be clinically reliable.

ChatGPT: a tool for scientific writing or a threat to integrity?

The use of ChatGPT as a tool for writing and knowledge integration raises concerns about the potential for its use to replace critical thinking and academic writing skills. While ChatGPT can assist in generating text and suggesting appropriate language, it should not replace the human responsibility for creating innovative knowledge through experiential learning. The accuracy and quality of information provided by ChatGPT also require caution, as previous studies have reported inaccuracies in references used by chatbots. ChatGPT acknowledges certain limitations, including the potential for generating erroneous or biased content, and it is essential to exercise caution in interpreting its responses and recognize the indispensable role of human experience in the processes of information retrieval and knowledge creation. Furthermore, the challenge of distinguishing between papers written by humans or AI highlights the need for thorough review processes to prevent the spread of articles that could lead to the loss of confidence in the accuracy and integrity of scientific research. Overall, while the use of ChatGPT can be helpful, it is crucial to raise awareness of the potential issues associated with the use of ChatGPT, as well as to discuss boundaries so that AI can be used without compromising the quality of scientific articles and the integrity of evidence-based knowledge.

Comparative evaluation of mutagenic effects of two cone-beam computed tomography in oral mucosa cells.

BACKGROUND: This pilot study aimed to evaluate the mutagenic effects in cells of the oral mucosa after exposure to two different cone beam computed tomography (CBCT). METHODS: Eighteen adults were submitted to the different CBCT (Carestream CS8100 3D and I-CAT). The cells were collected immediately before the CBCT exposure and 10 days later, when the material was placed on a slide and stained using the Feulgen/Fast Green technique. Microscopic analysis counted micronuclei and other nuclear alterations, which are indicative of cytotoxicity such as pyknosis, karyolysis, karyorrhexis, and binucletion. 2000 cells were analyzed. The statistical analysis was performed with the Wilcoxon Signed-Rank test to compare the frequency of cellular alterations, and the Mann-Whitney U test to compare different CBCTs, both with a significance level of 5%. RESULTS: There was no statistically significant difference in the micronucleated cell count before and after the exposition to the ionizing radiation from I-CAT (p = .298) and CS8100 3D (p = .203) A significate increase of pyknosis (p < .001), karyolysis (p < .001), karyorrhexis (p < .001), and binucletion (p < .001) were noted on I-CAT CBCT. There was no statistically significant difference in cellular alterations in CS8100 3D CBCT. CONCLUSION: Despite the increase in micronuclei after exposure, this study indicates that there is no evidence of genotoxicity. On the other hand, the I-CAT CBCT produced cytotoxic effects.

Outcomes of the use of irrigating drains in severe odontogenic infection management.

OBJECTIVE: This study aimed to evaluate the outcomes of 2 types of drains for severe odontogenic infection management. STUDY DESIGN: Thirty-eight patients with severe odontogenic infections underwent drainage performed under general anesthesia. According to the type of drain used, they were randomized and separated into 2 groups: irrigating (n = 19) and non-irrigating drain (n = 19). Data such as age, ethnicity, sex, number of teeth, and fascial spaces were collected on admission through anamnesis. The clinical and laboratory parameters were checked every 24 hours until discharge. Symptom evolution was monitored daily using a visual analog scale. The Mann-Whitney U test was used for the primary outcome, and a P value < 0.05 was considered to indicate statistical significance. RESULTS: No statistically significant difference in the overall length of stay was observed. Statistically significant differences in parameters such as pain, odynophagia, and leukocyte and segmented neutrophil counts were observed. CONCLUSIONS: Non-irrigating drains may be as effective as irrigating drains in treating severe odontogenic infections.

Anatomical variations in the maxillary anterior region: a cone beam computed tomographic study of the canalis sinuosus and its accessory canals.

The objective of this study was to verify the frequency, diameter, and location of the canalis sinuosus (CS) and its accessory canals (ACs) using cone beam computed tomographic (CBCT) images and to correlate these findings with patient sex, age, and skeletal facial pattern. This observational retrospective study assessed the CBCT scans of 398 patients. The laterality, diameter, and location of the terminal portion of the canals were recorded. Linear measurements of the nasal cavity floor, buccal cortical bone, and alveolar ridge crest were also made. The χ2 and Fisher exact tests were used to verify the relationships between patient sex, age, and facial pattern and the presence of CS and ACs. The presence of CS and ACs was verified in 195 (48.99%) and 186 (46.73%) individuals, respectively, and showed no correlations with sex, age, or facial pattern. In 165 cases (84.61%), the CS emerged bilaterally. For ACs, most cases (n = 97; 52.14%) were unilateral. A total of 277 ACs were detected, and 161 (58.12%) of these were located in the palatal or incisive foramen region and 116 (41.88%) in the buccal region. Their terminal portions were located more frequently in the central incisor region (38.26%). The mean CS diameter was significantly larger in men than in women (P < 0.001). The linear measurements of the nasal cavity floor, buccal cortical bone, and alveolar ridge crest did not reveal statistically significant differences between the sexes. This knowledge is helpful for maxillary surgical planning to avoid damage to the neurovascular bundle and subsequent complications.

Is micronucleus assay a suitable method for biomonitoring children exposed to X-ray? A systematic review with meta-analysis.

PURPOSE: The aim of this study was to evaluate if the micronucleus test using oral epithelial cells is a suitable biomarker for biomonitoring children exposed to X-ray. MATERIAL AND METHODS: A search was performed through the electronic databases PubMed/Medline, Scopus, and Web of Science, all studies published up to February 2022 that examined the relationship between exposure of children to radiographic examinations and micronucleus. RESULTS: A total of 17 full-text manuscripts were screened for eligibility. Only two studies found a difference in micronucleus labeling. On the other hand, all studies showed that X-ray was able to induce cellular death in oral mucosa cells. Following the parameters of the Effective Practices in Public Health Project (EPHPP), five manuscripts reached moderate and strong scores, and four studies were categorized as weak at final rating. In the meta-analysis, statistically significant difference was detected in micronucleated cells in children before and after radiographic examinations (SMD = 0.96, 95% CI, 0.07-1.84, p = .04), with τ2=1.09; χ2=53.37, and p < .001. CONCLUSION: Radiographic examinations in children can cause genotoxic and cytotoxic damage in the oral epithelium with a large effect size.

The use of micronucleus assay in exfoliated oral cells in patients undergoing fixed orthodontic therapy: a systematic review with meta-analysis

Abstract The aim of this systematic review was to evaluate published papers regarding the micronucleus assay in oral mucosal cells of patients undergoing orthodontic therapy (OT). A search of the scientific literature was made in the PubMed, Scopus, and Web of Science databases for all data published until November, 2021 using the combination of the following keywords: "fixed orthodontic therapy," "genetic damage", "DNA damage," "genotoxicity", "mutagenicity", "buccal cells", "oral mucosa cells," and "micronucleus assay". The systematic review was designed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Nine studies were retrieved. Some authors demonstrated that OT induces cytogenetic damage in oral mucosal cells. Out of the nine studies included, two were classified as strong, five as moderate, and two as weak, according to the quality assessment components of the Effective Public Health Practice Project (EPHPP). Meta-analysis data revealed no relationship between mutagenicity in oral cells and OT in different months of treatment. At one month, the SMD = 0.65 and p = 0.08; after three months of OT, the SMD = 1.21 and p = 0.07; and after six months of OT, the SMD = 0.56 and p = 0.11. In the analyzed months of OT, I2 values were >75%, indicating high heterogeneity. In summary, this review was not able to demonstrate that OT induces genetic damage in oral cells. The study is important for the protection of patients undergoing fixed OT, given that mutagenesis participates in the multi-step process of carcinogenesis.

Rugosidade dos implantes dentários: análise comparativa da reutilização de ácidos no tratamento de superfície / Roughness of dental implants: comparative analysis of reuse of acids in surface treatment

Introdução: A importância da rugosidade para a osseointegração se dá pela correlação das interações das proteínas com a superfície do implante, a adsorção. Diferentes métodos são utilizados nos tratamentos de superfície, em que ocorre a remoção de partes da camada superficial, como o ataque ácido. Objetivo: Analisar as alterações de rugosidade na superfície dos implantes osseointegrados tratadas por duplo ataque ácido com uso único e até quatro reutilizações dos ácidos. Material e método As amostras de implantes dentários de liga de titânio (SINGULAR Implants ®) (n = 10) foram subdividas em cinco grupos: controle, tratamento 1, 2, 3 e 4, conforme as reutilizações dos ácidos. As capturas dos implantes no aumento de 500x, 1000x, 2000x e 4000x foram realizadas no microscópio eletrônico de varredura, para posterior análise de rugosidade pelo software ImageJ. Os valores de Ra e Rq foram analisados estatisticamente pelo teste ANOVA e o pós-teste de Tukey. Resultado: Os dados obtidos pelas imagens capturadas e pelos números de Ra e Rq adquiridos pelo ImageJ demonstraram que o tratamento com o duplo ataque ácido com cinco utilizações dos mesmos ácidos foi positivo para o tratamento de superfície do implante de liga de titânio. Conclusão: Pode-se concluir que até quatro reutilizações dos ácidos não interferiu estatisticamente nos valores de rugosidade em diferentes aumentos. São necessários mais estudos referentes à reutilização dos ácidos, contribuindo para a diminuição dos custos aos fabricantes, aumentando a sustentabilidade e mantendo-se a qualidade do produto.

Introduction: The importance of roughness for osseointegration is due to the configuration of proteins with the surface of the implant, and adsorption. Different methods are used in surface treatments, in which parts of the surface layer are removed, such as acid attack. Objective: To analyze changes in roughness on the surface of osseointegrated implants treated by double acid etching with single-use and up to 4 reuses of serums at a magnification of 500x, 1000x, 2000x, and 4000x in the scanning microscope (SEM). Method Samples of adherent implants (SINGULAR Implants ®) of lever alloy (n=10) were subdivided into 5 groups: control, treatment 1, 2, 3, and 4, according to the reuses. For the surface topography of the samples, SEM was used, followed by analysis by ImageJ software. Using the ANOVA test and Turkeys post-test, Ra and Rq values were statistically analyzed. Result: The data obtained both by the images captured in the SEM and by the Ra and Rq numbers acquired by the ImageJ illustrate that the treatment with the double acid attack with 5 uses of the same ones served, was positive for the surface treatment of the alloy implant of independent. Conclusion: It can be concluded that up to four reuses of food do not statistically interfere with roughness values. More studies are needed regarding the reuse of acids, certainly to reduce costs to manufacturers, increasing sustainability while maintaining product quality.

Comparison of the perception of orthodontists and general clinicians on the use of digital dental models in the city of Aracaju/Sergipe / Comparação da percepção de ortodontistas e clínicos gerais sobre o uso de modelos digitais odontológicos na cidade de Aracaju / Sergipe

ABSTRACT Context: Digital study models have become a safe and advantageous alternative for diagnosis and planning in dentistry. Despite the superior characteristics in comparison with traditional plaster models, professionals seem to resist the use of new technologies. Aims: To assess the level of knowledge and the use of digital models through a questionnaire applied to dental professionals. Methods: A questionnaire with 12 multiple-choice questions about plaster models, digital, and use of the 3Shape - 3D viewer software was answered by 76 orthodontists (42 women and 34 men; mean age =37.82 years (SD ± 7.60)) and 30 general dental surgeons (18 women and 12 men; mean age of 33.93 years (SD ± 8.45)) in Aracaju, Sergipe, Brazil. Data were tabulated in Excel spreadsheets and then analyzed using the SPSS statistical software version 20. An absolute analysis of frequency and percentage of responses was performed. Results: Most professionals reported using plaster models and claimed their low cost as justification for their use (P = 0.001). Aware of the benefits of digital models, professionals of both classes highlighted the facilitated storage and search for information as the main advantages, the cost and infrastructure as the main disadvantages. Regarding the use of the 3Shape - 3D viewer software, orthodontists showed better utilization of this resource than general dental surgeons (P = 0.0198). Conclusion: It verified that most professionals make use of plaster models. However, despite knowing the advantages of digital models, their cost is sees as a limiting factor for adherence to this technology.

RESUMO Contexto: Os modelos digitais de estudo têm se tornado uma alternativa segura e vantajosa para o diagnóstico e planejamento em odontologia. Apesar das características superiores em comparação aos modelos tradicionais de gesso, os profissionais parecem resistir ao uso de novas tecnologias. Objetivos: Avaliar o nível de conhecimento e a utilização de modelos digitais por meio de questionário aplicado a profissionais da área odontológica. Material e Métodos: Questionário com 12 questões de múltipla escolha sobre modelos de gesso, digitais e uso do software 3Shape - 3D viewer foi respondido por 76 ortodontistas (42 mulheres e 34 homens; idade média = 37,82 anos (DP = ± 7,60) ) e 30 cirurgiões-dentistas gerais (18 mulheres e 12 homens; média de idade de 33,93 anos (DP = ± 8,45)) em Aracaju, Sergipe, Brasil. Os dados foram tabulados em planilhas do Excel e posteriormente analisados no software estatístico SPSS versão 20. Foi realizada uma análise absoluta de frequência e percentual de respostas. Resultados: A maioria dos profissionais relatou utilizar modelos de gesso e alegou seu baixo custo como justificativa para seu uso (P = 0,001). Cientes dos benefícios dos modelos digitais, os profissionais de ambas as classes destacaram o armazenamento facilitado e a busca de informações como as principais vantagens, o custo e a infraestrutura como as principais desvantagens. Em relação à utilização do software 3Shape - 3D viewer, os ortodontistas apresentaram melhor aproveitamento desse recurso do que os cirurgiões-dentistas gerais (P = 0,0198). Conclusões: Verificou-se que a maioria dos profissionais faz uso de modelos de gesso. Porém, apesar de conhecer as vantagens dos modelos digitais, seu custo é visto como um fator limitante para a adesão a essa tecnologia.