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Diagnostics (Basel, Switzerland) Jun 2024This study aimed to assess the impact of artificial intelligence (AI)-driven noise reduction algorithms on metal artifacts and image quality parameters in cone-beam...
OBJECTIVE
This study aimed to assess the impact of artificial intelligence (AI)-driven noise reduction algorithms on metal artifacts and image quality parameters in cone-beam computed tomography (CBCT) images of the oral cavity.
MATERIALS AND METHODS
This retrospective study included 70 patients, 61 of whom were analyzed after excluding those with severe motion artifacts. CBCT scans, performed using a Hyperion X9 PRO 13 × 10 CBCT machine, included images with dental implants, amalgam fillings, orthodontic appliances, root canal fillings, and crowns. Images were processed with the ClariCT.AI deep learning model (DLM) for noise reduction. Objective image quality was assessed using metrics such as the differentiation between voxel values (ΔVVs), the artifact index (AIx), and the contrast-to-noise ratio (CNR). Subjective assessments were performed by two experienced readers, who rated overall image quality and artifact intensity on predefined scales.
RESULTS
Compared with native images, DLM reconstructions significantly reduced the AIx and increased the CNR ( < 0.001), indicating improved image clarity and artifact reduction. Subjective assessments also favored DLM images, with higher ratings for overall image quality and lower artifact intensity ( < 0.001). However, the ΔVV values were similar between the native and DLM images, indicating that while the DLM reduced noise, it maintained the overall density distribution. Orthodontic appliances produced the most pronounced artifacts, while implants generated the least.
CONCLUSIONS
AI-based noise reduction using ClariCT.AI significantly enhances CBCT image quality by reducing noise and metal artifacts, thereby improving diagnostic accuracy and treatment planning. Further research with larger, multicenter cohorts is recommended to validate these findings.
PubMed: 38928694
DOI: 10.3390/diagnostics14121280 -
Bioengineering (Basel, Switzerland) Jun 2024Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the...
Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the cavity left in the tooth, most commonly with amalgam or composite resin. The consequences of filling failure include repeating the filling or performing another treatment such as a root canal or extraction. Dental amalgam contains mercury, and there is a global effort to reduce its use. However, no consensus has been reached regarding whether amalgam or composite resin materials are more durable, and which is the best restorative material, when using randomized clinical trials. To determine which material is superior, we performed a retrospective cohort study using a large database where the members of 58 dental clinics with 440 dental units were treated. The number of failures of the amalgam compared to composite resin restorations between 2014 and 2021 were compared. Our data included information from over 650,000 patients. Between 2014-2021, 260,905 patients were treated. In total, 19,692 out of the first 113,281 amalgam restorations failed (17.49%), whereas significantly fewer composite restorations failed (11.98%) with 65,943 out of 555,671. This study indicates that composite is superior to amalgam and therefore it is reasonable to cease using mercury-containing amalgam.
PubMed: 38927815
DOI: 10.3390/bioengineering11060579 -
Frontiers in Dentistry 2024Teeth bleaching is an accepted and modern treatment in cosmetic dentistry. Bleaching agents may affect amalgam restorations and increase mercury release; therefore,...
Teeth bleaching is an accepted and modern treatment in cosmetic dentistry. Bleaching agents may affect amalgam restorations and increase mercury release; therefore, patients are at increased risk of mercury exposure in the body. The aim of this study was to investigate the effect of polishing and universal bonding application on mercury release from aged amalgams exposed to bleaching. In this in-vitro experimental study, 64 dental amalgam specimens with dimensions of 3×5×10 were prepared and divided into two experimental and control groups. Each group was further divided into 4 subgroups and received one of the following treatments: no intervention, surface bonding, polishing, or polishing and surface bonding. Subsequently, the samples were immersed in bleaching agent containing 7% hydrogen peroxide and the amount of mercury released after 96h was measured. The results were analyzed by two-way ANOVA and Tukey post hoc tests (α≤0.05). The results showed that the type of solution (P<0.05) and surface treatment (P<0.001) significantly affected the level of mercury release. However, there was no significant interaction between surface treatment methods in the bleaching group and those in the phosphate buffer group (P=0.621). Bleaching agents were found to enhance mercury release from dental amalgam. The application of polishing and universal bonding on amalgam surfaces exhibited significant effects on the reduction of the mercury release
PubMed: 38919769
DOI: 10.18502/fid.v21i14.15392 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Rubber dam isolation is crucial in dentistry, but its use varies among dental students. There is a need to assess their awareness, attitudes, and practices and find ways...
Rubber dam isolation is crucial in dentistry, but its use varies among dental students. There is a need to assess their awareness, attitudes, and practices and find ways to promote its usage. To evaluate dental students' knowledge and practices regarding rubber dam isolation and identify barriers to its use. The study employed a cross-sectional design to assess dental students' knowledge and practices regarding rubber dam isolation. Data were collected from dental students at Al-Qassim University during the period from January to March 2023. A convenience sampling method was used, involving students from the third, fourth, and fifth academic years, with a total of 62 questionnaires distributed. A pre-tested questionnaire consisting of 11 closed-ended questions was used to collect data, and the analysis was performed using SPSS version 21, with results presented through descriptive statistics. Only 21% always used rubber dam for amalgam restorations, while 53.2% used it for composite restorations. Over 70% believed their education on rubber dam was adequate. The main barriers were difficulty (40.3%) and time constraints (53.2%). About 68% felt rubber dam should be mandatory for composite treatments. Dental students need more education and training to bridge the gap between knowledge and practice concerning rubber dam isolation. Implementing it can enhance the quality of dental care.
PubMed: 38882844
DOI: 10.4103/jpbs.jpbs_1256_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024The stainless-steel crown (SSC) is a durable restoration and has several indications for use in primary teeth such as following a pulpotomy/pulpectomy, fractured teeth,...
The stainless-steel crown (SSC) is a durable restoration and has several indications for use in primary teeth such as following a pulpotomy/pulpectomy, fractured teeth, teeth with developmental defects, or large multi-surface caries lesions where amalgam is likely to fail. Due to its durability and a lifespan like the primary tooth, it could well be the gold standard in restorative care. SSCs protect the crown from fracture, reduce the possibility for leakage, and ensure a biological seal. However, the placement of the SSC should follow a meticulous technique. There are some clinical situations where the SSC may fail, leading to plaque accumulation and gingivitis. This could be secondary to improper crimping of crown margins, which lead to poorly adapted SSC. In some clinical situations, ledge formation under the crown or failure to clean excess cement can contact the gingiva and cause gingival inflammation. This study was carried out on 41 children between the ages of 4 and 10 in Al Qassim region to study the effects of SSCs on gingiva and oral hygiene. The study also aims to establish the correlation between SSC adaptation and post-insertion inflammation. The plaque and gingival index were recorded at 3 months' post SSC insertion. Clinical examination was undertaken, and gingival index (Loe and Silness 1967) and plaque index (Silness and Loe 1967) were used to record gingival health and plaque accumulation, respectively. The result for post-inflammation and SSC adaptation showed that there was no statistically significant difference in post-insertion inflammation and crown adaptation (P value = 0.216). The result for pre-operative inflammation and post-operative inflammation shows that there is no significant difference in post-inflammation and adaptation (P value = 0.47). We found that oral hygiene care had a heightening effect and oral hygiene maintenance plays a key role in preventing gingival inflammation irrespective of the SSC adaptation over short periods of time (3 months).
PubMed: 38882832
DOI: 10.4103/jpbs.jpbs_1208_23 -
Dental Materials : Official Publication... Jun 2024To compare the performance of Cention-N® with direct restorative materials used at the daily practice (e.g., resin-based composites/RBC, glass ionomer cements/GIC,... (Review)
Review
OBJECTIVES
To compare the performance of Cention-N® with direct restorative materials used at the daily practice (e.g., resin-based composites/RBC, glass ionomer cements/GIC, bioactive resins, silver amalgam) via a systematic review study.
METHODS
The review followed the PRISMA-NMA recommendations, and the protocol of the review was published at osf.io/ybde8. The search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, Lilacs, and SciELO databases, as well as in the grey literature (Open Grey, Proquest, and Periódicos CAPES). Studies with an in vitro experimental design evaluating the characteristics and properties of Cention-N in comparison to other restorative materials were included. The risk of bias of included studies was assessed using the RoBDEMAT tool, and meta-analyses were conducted using Review Manager 5.4 and MetaInsight V3 tools.
RESULTS
A total of 85 studies were included in the review, from which 79 were meta-analyzed. Several characteristics of direct restorative materials were analyzed, including physical (color change, degree of conversion, hardness, microleakage, polymerization rate, roughness, water solubility, water sorption), mechanical (bond strength to dentin, compressive strength, diametral tensile strength, flexural modulus, flexural strength, load-to-fracture, wear), and biological (alkalinizing effect, antibacterial activity, calcium and fluoride release) properties.
SIGNIFICANCE
Cention-N presented similar physico-mechanical properties compared to RBCs, but a stronger behavior than GICs. Despite the Alkasite nature of Cention-N, GICs may still demonstrate the greatest fluoride releasing ability from all direct restorative materials. This review confirmed the adequate behavior of Cention-N when compared to several other more traditionally used materials, confirming its applicability for the permanent restoration of decayed or fractured teeth.
PubMed: 38880724
DOI: 10.1016/j.dental.2024.06.014 -
Cureus May 2024Silver amalgam, glass ionomer, resin-modified glass ionomer, compomers, light polymerized hybrid composite resin, and hybrid glass ionomer are among the most frequent...
INTRODUCTION
Silver amalgam, glass ionomer, resin-modified glass ionomer, compomers, light polymerized hybrid composite resin, and hybrid glass ionomer are among the most frequent restorative materials used as cavity-based or post-endodontics. Thus, to meet the needs of both patients and dentists, Cention N reimagines the traditional filling by integrating bulk placement, ion release, and durability into a dual-curing, aesthetically pleasing solution. Hoewver, we do not have enough information from studies comparing this hybrid restorative material's shear bond strengths to dentin to draw any firm conclusions. Cention N, zirconomer, and Vitremer are three hybrid tooth-colored restorative materials that were evaluated for their shear bond strength to dentin. This research aimed to compare and evaluate these materials.
METHODOLOGY
The purpose of this research was to use a universal Instron machine to measure the shear bond stress of three distinct hybrid tooth-colored restorative materials in relation to dentin. The research samples consisted of 45 extracted lower first premolars from humans. The teeth were then assigned into three groups of 15 samples each according to different color acrylic resin blocks, namely, group A (pink acrylic blocks), which had Cention in cement; group B (white acrylic blocks), which has zirconomer cement; and group C (violet acrylic blocks), which had Vitremer cement.
RESULTS
There was no statistically significant difference between the three groups and the normal distribution, as shown by the negligible values in the tests involving the three groups. Put simply, each of the three categories exhibits data that follows a normal distribution. This allows for further data analysis to be conducted using the parametric test of significance.
CONCLUSION
The shear bond strength of hybrid glass ionomer restorative materials has to be further investigated in both laboratory and living organism settings.
PubMed: 38864074
DOI: 10.7759/cureus.60123 -
Journal of Dentistry May 2024When dental practitioners encounter a defective restoration, they are faced with a crucial decision whether to repair or replace it. This study aims to explore...
OBJECTIVES
When dental practitioners encounter a defective restoration, they are faced with a crucial decision whether to repair or replace it. This study aims to explore international preferences for repair procedures and the clinical steps taken during the repair process.
METHOD
An 11-question survey was distributed to dentists across 21 countries via different platforms. The survey comprised two sections: the first included five questions aimed at gathering demographic information, while the second consisted of six questions focusing on participants' practices related to the repair of composite or amalgam restorations A meta-analysis was employed to ascertain the pooled odds ratio of repairing versus replacement. The statistical analysis was carried out using the RevMan 5.3 program and forest plots were generated using the same program to visualize the results.
RESULTS
The survey was completed by 3680 dental practitioners. The results indicated a strong tendency to repair defective composite restorations (OR: 14.23; 95% CI: 7.40, 27.35, p<0.001). In terms of amalgam, there was a significant tendency to replace the restorations (OR: 0.19; 95% CI: 0.12, 0.30, p<0.001). When repairing restorations, the most common protocols were etching with orthophosphoric acid and creating an enamel bevel, regardless of the restorative material used.
CONCLUSION
The findings of this study indicate that there exists a knowledge gap among dental practitioners regarding restoration repair. It is imperative that dental practitioners receive proper education and training on restoration repair, to ensure the usage of adequate protocols and restoration survival.
PubMed: 38796090
DOI: 10.1016/j.jdent.2024.105096 -
BMC Oral Health May 2024The use of artificial intelligence in the field of health sciences is becoming widespread. It is known that patients benefit from artificial intelligence applications on...
Evaluating the accuracy of Chat Generative Pre-trained Transformer version 4 (ChatGPT-4) responses to United States Food and Drug Administration (FDA) frequently asked questions about dental amalgam.
BACKGROUND
The use of artificial intelligence in the field of health sciences is becoming widespread. It is known that patients benefit from artificial intelligence applications on various health issues, especially after the pandemic period. One of the most important issues in this regard is the accuracy of the information provided by artificial intelligence applications.
OBJECTIVE
The purpose of this study was to the frequently asked questions about dental amalgam, as determined by the United States Food and Drug Administration (FDA), which is one of these information resources, to Chat Generative Pre-trained Transformer version 4 (ChatGPT-4) and to compare the content of the answers given by the application with the answers of the FDA.
METHODS
The questions were directed to ChatGPT-4 on May 8th and May 16th, 2023, and the responses were recorded and compared at the word and meaning levels using ChatGPT. The answers from the FDA webpage were also recorded. The responses were compared for content similarity in "Main Idea", "Quality Analysis", "Common Ideas", and "Inconsistent Ideas" between ChatGPT-4's responses and FDA's responses.
RESULTS
ChatGPT-4 provided similar responses at one-week intervals. In comparison with FDA guidance, it provided answers with similar information content to frequently asked questions. However, although there were some similarities in the general aspects of the recommendation regarding amalgam removal in the question, the two texts are not the same, and they offered different perspectives on the replacement of fillings.
CONCLUSIONS
The findings of this study indicate that ChatGPT-4, an artificial intelligence based application, encompasses current and accurate information regarding dental amalgam and its removal, providing it to individuals seeking access to such information. Nevertheless, we believe that numerous studies are required to assess the validity and reliability of ChatGPT-4 across diverse subjects.
Topics: Dental Amalgam; United States; United States Food and Drug Administration; Humans; Artificial Intelligence; Surveys and Questionnaires
PubMed: 38789962
DOI: 10.1186/s12903-024-04358-8 -
Technology and Health Care : Official... Apr 2024Dental education is considered as a complex, challenging and often stressful educational procedure. Acquisition of psychomotor skills by undergraduate students is an...
BACKGROUND
Dental education is considered as a complex, challenging and often stressful educational procedure. Acquisition of psychomotor skills by undergraduate students is an important step in many health professions to become a successful professional. During under graduation, class II cavity preparation exercise is of utmost important in dentistry.
OBJECTIVE
To compare class II cavities prepared by students after hands-on live demonstration and pre-recorded video demonstration using well-organised evaluation rubrics.
METHOD
Preclinical dental students (n= 50) were divided into two groups. The students in group I (n= 25) attended a hands-on live demonstration performed by one faculty while students in group II (n= 25) watched a 15-minute pre-recorded procedural video on the projector. Both groups were appealed to prepare class II cavity for amalgam involving disto-occlusal surface of mandibular second molar articulated on jaw model (TRU LON study model, Jayna industries, Ghaziabad U.P., India). Following completion of the preparations, all teeth were collected, and labelled grades of prepared cavities were given according to prespecified rubrics. The data of scores were presented as means and standard deviation. Statistical analysis of data was executed using SPSS software. A paired t-test was used to compare scores between groups.
RESULTS
The study shows that the video-supported demonstration of a cavity preparation was better than the live hands-on demonstration. A higher mean response for the procedural video group was found compared to the live demonstration group (p= 0.000133).
CONCLUSION
Pre-recorded video-supported demonstration along with guidance by a tutor may be a viable alternative to hands-on live demonstration in cavity preparation procedures during undergraduate dental training. Moreover, rubric methods can be implemented in the teaching of various preclinical exercises for conservative dentistry and endodontics.
PubMed: 38788102
DOI: 10.3233/THC-231757