Detection and diagnosis of dental caries using a deep learning-based convolutional neural network algorithm.

Dentistry for the child and adolescent

Background
Proximal dental lesions, limited to dentine, are traditionally treated by invasive (drill and fill) means. Non-invasive alternatives (e.g. fluoride varnish, flossing) might avoid substance loss but their effectiveness depends on patients' adherence. Recently, micro-invasive approaches for treating proximal caries lesions have been tried. These interventions install a barrier either on top (sealing) or within (infiltrating) the lesion. Different methods and materials are currently available for micro-invasive treatments, such as sealing via resin sealants, (polyurethane) patches/tapes, glass ionomer cements (GIC) or resin infiltration.

Objectives
To evaluate the effects of micro-invasive treatments for managing proximal caries lesions in primary and permanent dentition in children and adults.

Search methods
We searched the following databases to 31 December 2014: the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via OVID, EMBASE via OVID, LILACs via BIREME Virtual Health Library, Web of Science Conference Proceedings, ZETOC Conference Proceedings, Proquest Dissertations and Theses, ClinicalTrials.gov, OpenGrey and the World Health Organization (WHO) International Clinical Trials Registry Platform. We searched the metaRegister of Controlled Trials to 1 October 2014. There were no language or date restrictions in the searches of the electronic databases.

Selection criteria
We included randomised controlled trials of at least six months' duration that compared micro-invasive treatments for managing non-cavitated proximal dental decay in primary teeth, permanent teeth or both, versus non-invasive measures, invasive means, no intervention or placebo. We also included studies that compared different types of micro-invasive treatments.

Data collection and analysis
Two review authors independently screened search results, extracted data and assessed the risk of bias. We used standard methodological procedures expected by Cochrane to evaluate risk of bias and synthesise data. We conducted meta-analyses with the random-effects model, using the Becker-Balagtas method to calculate the odds ratio (OR) for lesion progression. We assessed the quality of the evidence using GRADE methods.

Main results
We included eight trials, which randomised 365 participants. The trials all used a split-mouth design, some with more than one pair of lesions treated within the same participant. Studies took place in university or dental public health clinics in Brazil, Colombia, Denmark, Germany, Thailand, Greenland and Chile. Six studies evaluated the effects of micro-invasive treatments in the permanent dentition and two studies on the primary dentition, with caries risk ranging from low to high. Investigators measured caries risk in different studies either by caries experience alone or by using the Cariogram programme, which combines eight contributing factors, including caries experience, diet, saliva and other factors related to caries. The follow-up period in the trials ranged from one to three years. All studies used lesion progression as the primary outcome, evaluating it by different methods of reading radiographs. Four studies received industry support to carry out the research, with one of them being carried out by inventors of the intervention.

We judged seven studies to be at high overall risk of bias, primarily due to lack of blinding of participants and personnel. We evaluated intervention effects for all micro-invasive therapies and analysed subgroups according to the different treatment methods reported in the included studies.

Our meta-analysis, which pooled the most sensitive set of data (in terms of measurement method) from studies presenting data in a format suitable for meta-analysis, showed that micro-invasive treatment significantly reduced the odds of lesion progression compared with non-invasive treatment (e.g fluoride varnish) or oral hygiene advice (e.g to floss) (OR 0.24, 95% CI 0.14 to 0.41; 602 lesions; seven studies; I2 = 32%). There was no evidence of subgroup differences (P = 0.36).

The four studies that measured adverse events reported no adverse events after micro-invasive treatment. Most studies did not report on any further outcomes.

We assessed the quality of evidence for micro-invasive treatments as moderate. It remains unclear which micro-invasive treatment is more advantageous, or if certain clinical conditions or patient characteristics are better suited for micro-invasive treatments than others.

Authors' conclusions
The available evidence shows that micro-invasive treatment of proximal caries lesions arrests non-cavitated enamel and initial dentinal lesions (limited to outer third of dentine, based on radiograph) and is significantly more effective than non-invasive professional treatment (e.g. fluoride varnish) or advice (e.g. to floss). We can be moderately confident that further research is unlikely to substantially change the estimate of effect. Due to the small number of studies, it does remain unclear which micro-invasive technique offers the greatest benefit, or whether the effects of micro-invasive treatment confer greater or lesser benefit according to different clinical or patient considerations.

Micro-invasive interventions for managing proximal dental decay in primary and permanent teeth.

Background and aim. Bioceramics are ceramic compounds obtained both in situ and in vivo, by various chemical processes.  Bioceramics exhibit excellent biocompatibility due to their similarity with biological materials, like hydroxyapatite. Bioceramics and multi-substituted hydroxyapatite or similar compounds have the ability to induce a regenerative response in the organism. The aim of this paper is to make a literature review on the main bioceramic materials currently used in endodontics and on their specific characteristics. Methods. We conducted a search in the international databases (PubMed), to identify publications in the last 10 years, using the following key words: "bioceramics endodontics", "bioceramic endodontic cement", "bioceramic sealer" and "direct pulp capping bioceramic". Results. Commonly used endodontic sealers (e.g., containing zinc oxide, calcium hydroxide and a resin) have a long tradition in scientific research and clinical use in endodontics. For specific cases, like root resorptions, perforations, apexification, and retrograde fillings, new biocompatible materials were developed in order to improve the clinical outcome: ProRooT MTA (Dentsply Company,Germany); Biodentine (Septodont, France); Endosequence BC sealer (Brassler, SUA); Bioaggregate (IBC, Canada); Generex A (Dentsply Tulsa Dental Specialties, USA). Conclusion. The studies are generally in favor of bioceramic materials even if there are not many products available on the market for endodontic use. As more products are launched and more research is performed regarding these materials, we will provide more reliable data on clinical outcome.

/pdf/the-use-of-bioceramics-in-endodontics-literature-review-57jr49rmo9.pdf

The use of bioceramics in endodontics - literature review

Age is one of the essential factors, which play an important role in every aspect of life. Person identification is an important aspect of forensic medicine and dentistry. Age, gender, race, and so on is used for identification of a person. Chronological age, as recorded by registration of birth date, is referred throughout an individual’s life. Age is an important factor in clinical practice; research and court of law. Major dental clues once neglected are increasingly used to solve the crime. Age is estimated on the basis of chronological age and bone age, dental age, mental age, and others. Dental age is considered to be vital as tooth development shows less variability than other developmental features and also low variability in relation to chronological age. Hence, dental age is considered to be vital in establishing the age of an individual. Different morphological stages of mineralization correlate with the different developmental stages. This paper reviews various aspects of age estimation like morphological, biochemical, and radiographical methods and its scope and limitation.

Dental age estimation methods-A review

Background Radiography plays an important role in the detection of interproximal caries. Objectives The aim of the present study was to determine diagnostic accuracy of chargecoupled devices (CCD), Photo Stimulable Phosphor (PSP) and film radiography in detecting non-cavitated caries. Patients and methods Seventy-two non-cavitated approximal surfaces of extracted human posterior teeth were radiographed under standardized conditions using three intraoral modalities: CCD Dixi3 (Planmeca, Finland), PSP Digora PCT (Soredex, Finland),and E-speed film (Kodak, USA). Radiographs were interpreted by four observers and caries lesions were classified as sound (R0), restricted to enamel (R1), reaching the dentinoenamel junction (DEJ) and the outer half of the dentin (R2) and the inner half of the dentin (R3). The teeth were subsequently sectioned for histological analysis which served as the gold standard for radiographic examination. Results Microscopic examinations showed that the distribution of caries were 63.9% sound, 18.1% enamel, 9.7% DEJ and outer half of the dentin and 8.3% into the inner half of the dentin. The sensitivity and specificity of film, CCD and PSP for the detection of enamel caries were 38% and 98%; 15% and 96 %; and 23% and 98%, respectively. The sensitivity and specificity of film, CCD and PSP for the detection of both dentin and enamel caries were 55% and 100%; 45% and 100% ; and 55% and 100%, respectively. Conclusions The results demonstrated that the diagnostic accuracy of digital images is similar to that of conventional film radiography in the detection of non-cavitated approximal caries.

/pdf/diagnostic-accuracy-of-digital-and-conventional-radiography-38rqshcmxt.pdf

Diagnostic accuracy of digital and conventional radiography in the detection of non-cavitated approximal dental caries.

Assessment of dental maturity of children aged 7-15 years using demirjian method in a selected Iranian population.

Background and aims. With availability of hydrophilic sealers, drying of the canals before endodontic obturation is still a matter of debate. The aim of this study was to compare the apical micro-leakage of AH26, Excite DSC, MTA Fillapex, and ZOE sealers in dry and moist root canals. Materials and methods. This experimental study was performed on 90 extracted maxillary central incisors. Rotary files were used for preparation of the canals. Root canals were filled with a single gutta percha cone, using one of the four sealers, under dry and moist root canal conditions (10 teeth in each group). Orifices were sealed with glue wax and all root surfaces were covered with nail polish except the positive control group. After ten days in 100% humidity, teeth were placed in methylene blue, and then were cut in longitudinal axis. Blue color permeability was measured by stereomicroscope in micrometers. Data were analyzed by t-test, ANOVA and Scheffe post hoc test using SPSS V.18 software at P 0.05). Apical micro-leakage was significantly higher in the Excite DSC groups (P < 0.001). Conclusion. AH26 provided the least apical micro-leakage under dry conditions while ZOE had the highest micro-leakage under moist conditions. MTA Fillapex provided acceptable apical seal regardless of moisture.

https://joddd.tbzmed.ac.ir/PDF/JODDD-8-125.pdf

Evaluation of Apical Micro-leakage of Different Endodontic Sealers in the Presence and Absence of Moisture.

Radiographic Evaluation of Dental Anomaly Prevalence in a Selected Iranian Population

Background and aim Given the importance of evaluating the maxillary sinus lateral wall thickness (LWT) to avoid complications during surgery, the aim of this study was to examine LWT as well as the effect of residual ridge height (RH), edentulous region, type of edentulism, age and gender on it. Methods In this cross-sectional study conducted in 2016, 150 samples of the CBCT imaging archives of the Oral and Maxillofacial Radiology Clinic in Babol, Iran, were evaluated retrospectively. In the coronal section, RH and LWT (at 3, 7, 10 and 15 mm from the lowest point of the sinus floor) were measured in NNT software in millimeters. Data were analyzed using the SPSS v22 software through independent-samples t-test, paired-samples t-test and ANOVA. Results In 150 assessed images, by increasing the wall distance from the floor, the mean sinus lateral wall thickness was increased (p=0.01). There was no relationship between gender and age with the sinus lateral wall thickness (p>0.05). RH showed a significant relationship with LWT so that the higher the RH, the greater the LWT (p<0.05). It was also observed that the mean LWT was 1.31±0.3 mm in the partial edentulism and 0.95±0.26 mm in the complete edentulism (p<0.05). The maximum thickness was found in the first molar and the minimum values were in the second premolar and the second molar. Conclusion Due to the impact of residual ridge height and type of edentulism on LWT and anatomical variations observed in the maxillary sinus, CBCT assessment is recommended before surgery such as sinus lifting in this area.

/pdf/radiographic-assessment-of-maxillary-sinus-lateral-wall-2fpngeorih.pdf

Farida Abesi

Papers

Diagnostic accuracy of digital and conventional radiography in the detection of non-cavitated approximal dental caries.

Assessment of dental maturity of children aged 7-15 years using demirjian method in a selected Iranian population.

Evaluation of Apical Micro-leakage of Different Endodontic Sealers in the Presence and Absence of Moisture.

Radiographic Evaluation of Dental Anomaly Prevalence in a Selected Iranian Population

Radiographic assessment of maxillary sinus lateral wall thickness in edentulous posterior maxilla.