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NPJ Precision Oncology Jun 2024Oral epithelial dysplasia (OED) is a premalignant histopathological diagnosis given to lesions of the oral cavity. Its grading suffers from significant...
Oral epithelial dysplasia (OED) is a premalignant histopathological diagnosis given to lesions of the oral cavity. Its grading suffers from significant inter-/intra-observer variability, and does not reliably predict malignancy progression, potentially leading to suboptimal treatment decisions. To address this, we developed an artificial intelligence (AI) algorithm, that assigns an Oral Malignant Transformation (OMT) risk score based on the Haematoxylin and Eosin (H&E) stained whole slide images (WSIs). Our AI pipeline leverages an in-house segmentation model to detect and segment both nuclei and epithelium. Subsequently, a shallow neural network utilises interpretable morphological and spatial features, emulating histological markers, to predict progression. We conducted internal cross-validation on our development cohort (Sheffield; n = 193 cases) and independent validation on two external cohorts (Birmingham and Belfast; n = 89 cases). On external validation, the proposed OMTscore achieved an AUROC = 0.75 (Recall = 0.92) in predicting OED progression, outperforming other grading systems (Binary: AUROC = 0.72, Recall = 0.85). Survival analyses showed the prognostic value of our OMTscore (C-index = 0.60, p = 0.02), compared to WHO (C-index = 0.64, p = 0.003) and binary grades (C-index = 0.65, p < 0.001). Nuclear analyses elucidated the presence of peri-epithelial and intra-epithelial lymphocytes in highly predictive patches of transforming cases (p < 0.001). This is the first study to propose a completely automated, explainable, and externally validated algorithm for predicting OED transformation. Our algorithm shows comparable-to-human-level performance, offering a promising solution to the challenges of grading OED in routine clinical practice.
PubMed: 38942998
DOI: 10.1038/s41698-024-00624-8 -
Clinical Oral Investigations Jun 2024Increasing evidence indicates that the thickness of periodontal soft tissues plays an important role in various clinical scenarios, thus pointing to the need of further...
OBJECTIVES
Increasing evidence indicates that the thickness of periodontal soft tissues plays an important role in various clinical scenarios, thus pointing to the need of further clinical research in this area. Aim of the present study was to assess gingival thickness at the mandibular incisors by translucency judgement with two different probes and to validate if these methods are comparable and applicable as diagnostic tools.
MATERIALS AND METHODS
A total of 200 participants were included; gingival tissue thickness was measured by judging probe translucency at both central mandibular incisors, mid-facially on the buccal aspect of each tooth using a standard periodontal probe and a set of color-coded probe, each with a different color at the tip, i.e. Colorvue Biotype Probe (CBP). Frequencies and relative frequencies were calculated for probe visibility. Agreement between the standard periodontal probe and the CBP was evaluated via the kappa statistic.
RESULTS
When the periodontal probe was visible, the frequency of CBP being visible was very high. Kappa statistic for the agreement between the standard periodontal probe and the CBP was 0.198 (71.5% agreement; p-value < 0.001) for tooth 41 and 0.311 (74.0% agreement; p-value < 0.001) for tooth 31, indicating a positive association of the two methods.
CONCLUSIONS
An agreement that reached 74% was estimated between the standard periodontal probe and the color-coded probe at central mandibular incisors. CLINICAL RELEVANCE: In the context of the present study, the two methods of evaluating gingival thickness seem to produce comparable measurements with a substantial agreement. However, in the 1/4 of the cases, the visibility of the color-coded probe could not assist in the categorization of the gingival phenotype.
Topics: Humans; Incisor; Cross-Sectional Studies; Female; Gingiva; Male; Mandible; Adult; Middle Aged
PubMed: 38942966
DOI: 10.1007/s00784-024-05672-9 -
British Dental Journal Jun 2024Introduction Impacted mandibular third molars can be asymptomatic or cause some pathologies, such as distal caries and odontogenic cysts and tumours. This study...
Introduction Impacted mandibular third molars can be asymptomatic or cause some pathologies, such as distal caries and odontogenic cysts and tumours. This study investigates the prevalence of distal caries of the mandibular second molar adjacent to the mesioangular or horizontally partially erupted mandibular third molar and its relationship regarding decayed, missing and filled teeth (DMFT) risk group, age, side (left-right) and sex.Methods The study included patients who had an appointment for mesioangular or horizontally positioned and partially erupted mandibular third molar surgery. Before the surgery, the DMFT score, age, sex and side were recorded. After extraction, the second molar was clinically examined for distal caries. The prevalence of distal caries and the correlation between the DMFT risk group, age, sex and side were determined.Results The study was conducted on 514 patients and involved 639 teeth. Men and patients in the moderate- or high-risk group are significantly prone to developing distal caries of the second molar. No statistically significant relationship exists regarding age group, side and position.Conclusion Sex and DMFT risk groups affect the prevalence of distal caries in second molars adjacent to the mesioangular or horizontally partially erupted third molars. The prophylactic extraction should be considered in men and patients in the moderate- or high-risk group.
Topics: Humans; Male; Female; Dental Caries; Molar, Third; Cross-Sectional Studies; Risk Factors; Adult; Mandible; Molar; Prevalence; Young Adult; Adolescent; Middle Aged; Tooth, Impacted; DMF Index; Tooth Extraction; Sex Factors
PubMed: 38942867
DOI: 10.1038/s41415-024-7508-3 -
British Dental Journal Jun 2024
Topics: Humans; Mouth Diseases; United Kingdom; Oral Health
PubMed: 38942862
DOI: 10.1038/s41415-024-7555-9 -
British Dental Journal Jun 2024
Topics: Humans; Mouth Diseases; United Kingdom; Health Care Costs
PubMed: 38942861
DOI: 10.1038/s41415-024-7556-8 -
British Dental Journal Jun 2024
Topics: Humans; Oral Health; United Kingdom; Healthcare Disparities
PubMed: 38942860
DOI: 10.1038/s41415-024-7554-x -
British Dental Journal Jun 2024This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little...
This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little published literature.A 25-year-old woman was referred to a specialist centre by her general dental practitioner following an incidental finding of a radiographic radiolucency, suggestive of root resorption associated with tooth 21. A provisional diagnosis of external cervical resorption was made, and following cone beam computed tomography (CBCT), a definitive diagnosis of internal tunnelling root resorption given. Non-surgical endodontic treatment was completed using continuous wave compaction with a calcium-silicate based sealer. No further intervention has been required.A summary of the histology, aetiology, prevalence, diagnosis, management and prognosis of internal tunnelling root resorption is provided. The benefits of CBCT for diagnosing and managing internal tunnelling resorption defects and using continuous wave compaction with a calcium-silicate based sealer, compared to cold obturation techniques, are discussed.
Topics: Humans; Root Resorption; Female; Adult; Incisor; Cone-Beam Computed Tomography; Root Canal Filling Materials; Silicates; Calcium Compounds; Maxilla; Root Canal Therapy
PubMed: 38942857
DOI: 10.1038/s41415-024-7504-7 -
Journal of Stomatology, Oral and... Jun 2024To evaluate the clinical effectiveness and stability of open suture versus micro-screw anchored disc reduction and fixation in treating disc displacement without...
OBJECTIVE
To evaluate the clinical effectiveness and stability of open suture versus micro-screw anchored disc reduction and fixation in treating disc displacement without reduction in the anterior temporomandibular joint.
METHODS
A total of 38 patients (51 sides) with anterior disc displacement without reduction (ADDwR) of the TMJ treated in our hospital from August 2021 to January 2023 were selected, including 19 cases in group A (23 sides) treated with open temporomandibular joint disc reduction and anchorage, and 19 cases in group B (28 sides) treated with temporomandibular joint disc reduction and suture. The Magnetic Resonance Imaging (MRI) data of the two groups before and after operation were compared to evaluate the effective rate of articular disc reduction, the change of articular disc length, The Maximal Interincisal Opening (MIO) and Numeric Rating Scale (NRS) were measured before and after operation.
RESULTS
In group A, the MRI effective rate 6 months after disc reduction was 95.65% (22/23), the disc length gain was 1.74mm, MIO was 40.32±5.067mm, and NRS was 0.47±0.697. The MRI effective rate 6 months after disc reduction in group B was 100% (28/28). The disc length gain was 1.78mm, MIO was 41.58±3.746mm, and NRS was 0.00. There was no significant difference between the two groups (P>0.05).
CONCLUSIONS
TMJ disc reduction and suture and open TMJ disc anchorage can effectively reduce the TMJ disc. The TMJ disc stability is high at 6 months after operation, and the pain and mouth opening can be improved, which is worthy of further promotion in clinical practice.
PubMed: 38942235
DOI: 10.1016/j.jormas.2024.101956 -
Journal of Dentistry Jun 2024This study evaluated the clinical performance of Class II restorations made with flowable bulk-fill base versus conventional layering ORMOCER-based restorative material...
OBJECTIVE
This study evaluated the clinical performance of Class II restorations made with flowable bulk-fill base versus conventional layering ORMOCER-based restorative material in a split-mouth randomized clinical trial.
METHODS
Thirty patients received two class II restorations (n=60) performed with different strategies. All preparations received the application of the universal self-etching adhesive system according to the manufacturer's recommendation, followed by the placement of a sectional matrix, wooden wedge, and separation ring. The first restoration was performed using 4 mm of flowable bulk-fill material covered by 2 mm of conventional viscosity restorative material (Bulk-fill technique). The second restoration was performed only with the conventional viscosity material, with a maximum of 2 mm thick increments, up to fill the cavity (Layering technique). After occlusal adjustment, the same polishing system was used for all restorations. Evaluations using the FDI criteria were conducted after 7 days, 12, and 24 months. Data were analyzed with the Fisher's Exact test (α=0.05).
RESULTS
From 30 participants, 24 attended the 24-month recall, and 48 restorations were evaluated. All restorations received acceptable overall scores for esthetic and biological properties after this period, while only 6.66% of the restorations exhibited unacceptable overall scores for the functional properties in both groups. No significant differences between the tested restorative materials and techniques were found for each FDI criterion assessed. The success rate after 2 years was 93.33% for both groups.
CONCLUSION
Both restorative materials exhibited good clinical performance for the parameters analyzed with no differences between them after 24-month follow-up.
CLINICAL RELEVANCE
Flowable bulk-fill ORMOCER-based material is a suitable alternative for direct Class II restorations, providing good clinical outcomes and simplifying the restorative procedure.
CLINICAL TRIAL REGISTRATION NUMBER
RBR-6mvp9w.
PubMed: 38942111
DOI: 10.1016/j.jdent.2024.105154 -
European Journal of Dentistry Jun 2024The proper closure of the access cavity between appointments during endodontic treatment is paramount and relies on temporary fillings. This systematic review evaluates...
The proper closure of the access cavity between appointments during endodontic treatment is paramount and relies on temporary fillings. This systematic review evaluates the effectiveness of zinc oxide-based materials and glass-ionomer cement (GIC) as temporary coronal sealers after root canal treatment in extracted human teeth. Three databases were searched to identify randomized clinical trials that examined the sealing properties of various temporary sealing materials using dyes or stains as indicators. A total of seven studies that fulfilled the eligibility criteria were critically analyzed. These indicated significant variations in the relative sealing ability of the coronal breach of endodontically treated teeth, either by zinc oxide or GIC-based materials. While GIC-based material (e.g., Fuji IX and Fuji II) exhibited superior sealing of single-rooted teeth, zinc oxide-based material (e.g., Cavit, Coltosol, Caviton) also showed promising attributes. Resin-modified GIC formulations displayed enhanced physical properties, yet challenges related to adhesive failure and shrinkage during polymerization were observed. Zinc oxide-based materials have demonstrated superior coronal sealing effectiveness over certain GIC in controlled settings. Their premixed nature ensures consistent application and hygroscopic properties improve cavity sealing. However, the focus on dye penetration tests for microleakage may not fully represent the risk of bacterial infiltration. Thus, studies are crucial for validating these findings in clinical contexts.
PubMed: 38942056
DOI: 10.1055/s-0044-1782695