Contemporary Clinical Dentistry最新文献

Background: The integration of artificial intelligence in dentistry has seen remarkable advancements, especially in diagnostic imaging. This study evaluates and compares the accuracy of deep learning models with that of dental postgraduate students in determining working length on intraoral periapical radiographs.

Materials and methods: One hundred anonymized radiographs of single-rooted teeth with files at working length were obtained. The images were preprocessed and used to train a deep learning model. Five dental postgraduates visually estimated the working length after receiving training. Pixel counting in image processing software provided the gold standard measurement. Accuracy comparisons were performed using a t-test.

Results: The deep learning model demonstrated significantly higher accuracy (85%) compared to human estimations (mean accuracy 75.4%). The t-test yielded P = 0.0374 (P < 0.05), rejecting the null hypothesis.

Conclusion: Deep learning models show great potential in enhancing precision and reliability for working length determination in endodontics. With further refinement, these models can effectively complement human expertise in dental radiographic interpretation.

Introduction: The use of tobacco products and alcohol consumption are two of the main risk factors for cancer of the oral cavity. The contribution of other factors such as diet, genetic predisposition, oral hygiene, and demographic variables to the occurrence of oral cancer has been debatable. This study explored the association between different risk factors and the risk of oral cancer using propensity score methods.

Methodology: A case-control study was conducted in Hyderabad, Telangana state, India in cancer hospitals between October 2022 and July 2023. Direct interviews with 238 cases and 450 controls were used to gather information about the different risk factors using structured data collection forms. Chi-square tests and multivariable logistic regression along with computation of propensity scores and inverse probability of treatment weighting for odds ratios (ORs) with weighted logistic regression were conducted using R version 4.3.2.

Results: Bivariate analysis found a significant difference in tobacco use, duration of use, frequency of alcohol consumption, and vegetable consumption between the cases and controls. Comparing cases of oral cancer to controls, the propensity weighed ORs were higher for those who had a habit of using smokeless tobacco (OR = 9.09, 95% confidence interval [CI]: 5.624-15.143) and smoking (OR = 8.96, 95% CI: 4.988-16.113) for more than 10 years. Oral cancer risk factors also included a history of chronic trauma in the mouth (OR = 3.00, 95% CI: 1.287-6.996) and daily alcohol consumption (OR = 5.69, 95% CI: 3.518-9.220).

Conclusion: This study establishes the role of tobacco use as a risk factor for oral cancer, with an emphasis on duration of use, and provides supporting evidence for the role of chronic oral trauma in oral cavity cancer.

Background: The assessment of three-dimensional (3D) Grummons analysis of cone-beam computed tomography (CBCT) and computed tomography (CT) using Dolphin Software in comparison to conventional manual tracing technique using two-dimensional (2D) postero-anterior (PA) cephalogram has been evaluated in this study.

Materials and methods: Pretreatment records of patients who underwent CBCT (n = 23) or CT (n = 23) scan were collected. 3D Grummons analysis of the CBCT and CT images were performed on Dolphin 11.9. In addition, PA cephalograms were reconstructed from these 3D data and Grummons 2D analysis was performed. The 2D PA cephalograms obtained were then printed on X-ray films for manual tracing. Intrarater correlation coefficient was calculated for assessing the reliability of the values obtained using 3D, 2D, and manual tracings and paired t test was used to test the significance of mean values.

Results: The results from the comparison of 3D and 2D data analysis indicated inconsistencies in anteroposterior parameters, particularly evident when CBCT and CT. The results from CBCT measurements showed the highest reliability when comparing 3D with 2D (both digital and manual tracings). Moderate-to-good reliability was found in CT measurements at Co-MSR (right and left), J-MSR right, mx/m and midline deviation, Me-deviation, Co-Ag (right and left) when comparing 3D and 2D methods. Paired t-test showed significant difference (P < 0.05) in the measurements comparing between Dolphin 3D and manual using CBCT at Ag-MSR left, Co-MSR (right and left), J-MSR (right and left). Among the CT measurements obtained, Dolphin 3D versus 2D and 2D manual tracing was found to show significant difference in parameters; Co-MSR right, Co-MSR left, J-MSR left, Co-MSR left, Ag-Me right, Ag-Me left Co-Ag right, and L6-MSR left.

Conclusions: The study results prove that the use of a single CBCT minimizes the radiation exposure as well as delivers a more accurate representation of 3D anatomical structures.

Modern dentistry increasingly relies on dental implants for single tooth replacements due to their superior benefits over conventional methods. Magnetic mallets, a recent development in the field of oral implantology, present a promising alternative to conventional manual or motor-driven instruments. This case report aims to document the successful placement of a dental implant in the mandibular posterior region using magnetic mallet technology highlighting its efficacy and advantages in implant dentistry. The use of magnetic mallet technology in this case demonstrated excellent clinical outcomes, including shortened operative times, reduced postoperative discomfort, and enhanced implant stability. Follow-up evaluations over 3 months showed stable healing and no significant bone loss, supporting the efficacy and reliability of magnetic mallets in implant dentistry.

Background: Children from marginalized backgrounds show higher susceptibility to early childhood caries which can have serious repercussions. Determining the ideal application frequency of 38% silver diamine fluoride (SDF) is crucial for those with limited access to dental care.

Objectives: This study aimed to evaluate the effectiveness of different frequencies of 38% SDF application in halting the progression of active dentin coronal carious lesions in primary teeth of children aged 2-6 years.

Methods: A randomized controlled trial with parallel arms was conducted at Amrita Kripa Hospital, Kalpetta, Wayanad, a region with a significant tribal population. Children with cavitated carious lesions were randomly assigned to three groups: (1) annual group (one application per year), (2) biannual group (two applications per year), and (3) four applications per year (at baseline, 2, 4, and 8 weeks). Carrie's arrest was assessed at 6 and 12 months.

Results: The study included 80 children and 440 teeth. The four-application group showed the highest caries arrest rate (80.5%), followed by the biannual group (78.2%) and the annual group (58.4%). Statistical analysis revealed significant differences between the groups (χ2 = 21.873, P < 0.001).

Conclusions: More frequent SDF applications (four times per year) were significantly more effective in halting caries progression compared to biannual or annual applications, particularly evident in tribal children; a high-risk population with limited access to dental care. The study supports the use of SDF as a noninvasive, cost-effective preventive treatment for young children, especially in resource-limited settings, and emphasizes the need for frequent SDF applications in community-based oral health programs with limited dental care access.

Being the intricate architecture of the maxillofacial region, rehabilitation of maxillofacial abnormalities is relatively hard for most maxillofacial surgeons. Orbital roof fractures are among the most uncommon craniofacial abnormalities. The fact that these fractures "grow" makes treatment challenging. An encephalocele can form as a result of a hemorrhage or swelling caused by a dural rupture. These "growing" fractures are prevalent in children. The etiology of these fractures is uncertain; however, a dural laceration usually occurs along the fracture line. After a latency period, clinical signs and symptoms of an expanding fracture of the orbital roof are observed. During this latent time, the fracture expands in size during the growth stage, causing the brain to herniate and cause ocular symptoms such as eyelid swelling or exophthalmos. Computed tomography scans are commonly used to diagnose this type of fracture, and computer-aided design and computer-aided manufacturing (CAD/CAM) can be used to render the three-dimensional model for treatment planning. Growing orbital roof fractures must be investigated as a differential diagnosis in patients with chronic ocular complaints. The case study that follows sheds light on the relevance of the use of CAD/CAM technology for such patients in treatment planning.

This case report describes the management of a misdiagnosed and maltreated extraoral draining sinus associated with a chronic odontogenic infection. Initially, the condition was misdiagnosed leading to conventional treatments, resulting in prolonged infectivity, inflammation, and delayed healing. The case highlights the clinical potential of Morinda citrifolia (Noni) as an adjunctive therapeutic agent in oral rehabilitation, particularly for its reported anti-inflammatory, antimicrobial, and wound-healing properties. Following the integration of M. citrifolia for endodontic therapy, the patient showed marked improvement in symptoms. This report focuses on the importance of thorough diagnostic evaluation and the possible role of alternative remedies in managing complex maxillofacial infections, providing insight into enhanced approaches for effective rehabilitation.

In dentistry, a tooth numbering system helps identify specific tooth positions in the mouth. This system includes quadrant types for primary and permanent teeth, making it easy to locate and document tooth positions. The tooth notation system is crucial for recording an individual's case history and efficient clinical record keeping and standardizing diagnostic makeover. However, existing tooth charting systems lack the denotation of dental anomalies. To address this issue, we have introduced a modification in the commonly used tooth nomenclature (Zsigmondy Palmer system) to incorporate details of both clinical and radiographically diagnosed tooth anomalies. Modified tooth numbering system can be a useful tool in interpreting clinical and radiographical information about dental abnormalities among clinicians.