Evaluation of Prevalence and Positions of Mesiodens Using Cone-Beam Computed Tomography

Exploring the potential of artificial intelligence in paediatric dentistry: A systematic review on deep learning algorithms for dental anomaly detection

BACKGROUND

Artificial intelligence (AI) based on deep learning (DL) algorithms has shown promise in enhancing the speed and accuracy of dental anomaly detection in paediatric dentistry.

AIM

This systematic review aimed to investigate the performance of AI systems in identifying dental anomalies in paediatric dentistry and compare it with human performance.

DESIGN

A systematic search of Scopus, PubMed and Google Scholar was conducted from 2012 to 2022. Inclusion criteria were based on problem/patient/population, intervention/indicator, comparison and outcome scheme and specific keywords related to AI, DL, paediatric dentistry, dental anomalies, supernumerary and mesiodens. Six of 3918 initial pool articles were included, assessing nine DL sub-systems that used panoramic radiographs or cone-beam computed tomography. Article quality was assessed using QUADAS-2.

RESULTS

Artificial intelligence systems based on DL algorithms showed promising potential in enhancing the speed and accuracy of dental anomaly detection, with an average of 85.38% accuracy and 86.61% sensitivity. Human performance, however, outperformed AI systems, achieving 95% accuracy and 99% sensitivity. Limitations included a limited number of articles and data heterogeneity.

CONCLUSION

The potential of AI systems employing DL algorithms is highlighted in detecting dental anomalies in paediatric dentistry. Further research is needed to address limitations, explore additional anomalies and establish the broader applicability of AI in paediatric dentistry.

A New Surgical Assistance Aid for Mesiodens Extraction Based on the Ideal Approach

BACKGROUND

To date, the classification of mesiodens has been based on the location, crown orientation, and morphology; however, there is no assistance aid focusing on choosing surgical approach.

PURPOSE

This study aimed to introduce and evaluate a new surgical assistance aid for mesiodens extraction based on surgical approach.

STUDY DESIGN, SETTING, SAMPLE

For the retrospective trial part of this study, case data from mesiodens patients who had surgery at the Affiliated Stomatological Hospital was collected, and a new surgical assistance aid was developed. A prospective randomized controlled trial was conducted on mesiodens patients who were seen in our department (patients with one mesiodens were included).

PREDICTOR VARIABLE

The predictor variable was surgical approach either with or without the surgical assistance aid. Subjects were randomized to one of the two study groups. For subjects assigned to the group using the surgical assistance guide, the approach was selected according to the aid detailed in this study. For subjects assigned to the group without the surgical assistant aid, 2 residents chose an approach based on their judgment and review of relevant imaging and physical examination.

MAIN OUTCOME VARIABLES

The preoperative evaluation time, operative time, and complications associated with surgery were recorded separately for the two groups.

COVARIATES

The age and sex were also recorded.

ANALYSES

Variables were analyzed using the independent t-test and χ2 test. The level of statistical significance is P < .05.

RESULTS

In the retrospective trial part, a new surgical assistance aid for mesiodens extraction was developed based on the ideal surgical approach. In the prospective randomized controlled trial, the experimental group (n = 50) was statistically significant in preoperative evaluation time (4.51 ± 0.34 mins vs 5.43 ± 0.34 mins) and operative time (31.87 ± 5.57 mins vs 36.32 ± 5.28 mins) compared to the control group (n = 50) (P < .001). There was no significant intergroup difference in complications associated with surgery (P > .05).

CONCLUSION AND RELEVANCE

The new surgical assistance aid developed in this study guides surgeons to ease the selection of surgical approaches and shorten the operative time.

A Case of Supernumerary Incisors in a Young Male Child: A Rare Occurrence of Four Central Incisors in the Maxillary Anterior Region

Multiple supernumerary teeth in the central incisor region are an uncommon occurrence; the most frequently occurring type of supernumerary teeth are mesiodens. A 10-year-old male had reported to Sharad Pawar Dental College with the chief complaint of extra teeth. An intraoral examination revealed the presence of two labially placed incisors and two palatally placed incisors at a transitional phase of dentition. During a radiographic examination, the maxillary occlusal view revealed four incisors with similar morphology. Extraction of the palatally placed incisor was done under local anaesthesia which was followed by alignment of the anterior teeth and closure of space. Supernumeraries that have erupted should always be removed, unless the teeth next to them are absent, in which case they should be left in place. After alignment, closure of spaces was done since the permanent canines had not yet erupted; it was decided against trying to completely close any gaps between the teeth.

Deep learning-based identification of mesiodens using automatic maxillary anterior region estimation in panoramic radiography of children

OBJECTIVES

The purpose of this study is to develop and evaluate the performance of a model that automatically sets a region of interest (ROI) and diagnoses mesiodens in panoramic radiographs of growing children using deep learning technology.

METHODS

Out of 988 panoramic radiographs, 489 patients with mesiodens were classified as an experimental group, and 499 patients without mesiodens were classified as a control group. This study consists of two networks. The first network (DeeplabV3plus) is a segmentation model that uses the posterior molar space to set the ROI in the maxillary anterior region with the mesiodens in the panoramic radiograph. The second network (Inception-resnet-v2) is a classification model that uses cropped maxillary anterior teeth to determine the presence of mesiodens. The data were divided into five groups and cross-validated. Deep learning model were created and trained using Inception-ResNet-v2. The performance of the segmentation network was evaluated using accuracy, Intersection over Union (IoU), and MeanBFscore. The overall network performance was evaluated using accuracy, precision, recall, and F1-score.

RESULTS

Segmentation performance using posterior molar space in panoramic radiographs was 0.839, IoU 0.762, and MeanBFscore 0.907. The mean values of accuracy, precision, recall, F1-score, and area under the curve for the diagnosis of mesiodens using automatic segmentation were 0.971, 0.971, 0.971, 0.971, and 0.971, respectively.

CONCLUSIONS

The diagnostic performance of the deep learning system using posterior molar space on the panoramic radiograph was sufficiently useful. The results of the deep learning system confirmed the possibility of complete automation of the classification of mesiodens.

Bilateral Inverted Mesiodens: A Rare Case Evaluated by Cone-Beam Computed Tomography

Mesiodens is the most commonly occurring supernumerary tooth between the two maxillary central incisors. Mesiodens can be inverted, impacted, or placed buccally or palatally between the two maxillary central incisors. It mostly occurs unilaterally and rarely occurs bilaterally. We describe a rare occurrence of such a bilateral inverted mesiodens extended near the anterior nasal spine, evaluated by cone-beam computed tomography.

Nonsyndromic impacted triple supernumerary teeth in the maxilla, including single dens in dente malformation: A case report with a two-year follow-up

Introduction. A percutaneous transhepatic approach has been used to place tunneled catheters for hemodialysis in the inferior vena cava. This route through the suprahepatic vein could be used to place a tunnelled catheter for permanent hemodialysis without complications and with an excellent permeability rate. Case report. From 2011 to 2020 at the Military Medical Academy, we treated 4 patients with the transhepatic central venous catheter for hemodialysis. All of them had exhausted approaches during the period of hemodialysis. Arterio-venous fistulas thrombosed on the arms, subclavian vein thrombosis bilaterally or superior and inferior vena cava thrombosis, as well as bilateral iliac and femoral vein thrombosis were present as complications of longterm hemodialysis through femoral catheters. Peritoneal dialysis was not possible. One patient needed a scroll catheter since the hemodialysis did not have a good outcome, and one patient needed a thrombolysis of catheter due to its malfunction. The other two patients have been on hemodialysis without complications for 300 and 1,650 days, respectively. Conclusion. Transhepatic venous access under ultrasound and radioscopic guidance is a simple and safe method. It is an acceptable alternative for permanent hemodialysis catheters when other venous accesses are exhausted and when it is performed by a well-trained team.

Prevalence and presentation of hyperdontia in a non-syndromic, mixed Nigerian population

BACKGROUND

Although there have been studies on the prevalence and pattern of hyperdontia in sub-Saharan African subjects with similar cultural backgrounds, based on our search, none have been able to consider these epidemiological parameters in a multiethnic black population, which is expected to add substantial knowledge to what is available.

MATERIAL AND METHODS

This is a retrospective study on the panoramic radiographs of subjects who presented at two dental centres in Abuja, Nigeria between June 2013 and June 2018. Radiographic interpretations were carried out by three independent observers, trained on computer assisted radiographic image interpretation. Data were collected and analyzed using Statistical package for the Social sciences (SPSS) version 22 (IBM Corp, Armonk, USA).

RESULTS

One thousand eight hundred and thirty seven (1837) panoramic radiographs were studied. Subject comprised males and females between ages 12 - 95 years with an average of 35.0 years. The prevalence of unilateral hyperdontia was 1.47% while an occurrence rate of 0.27 was observed for bilateral and multiple hyperdontia. For maxillary hyperdontia, a prevalence of 1.09% was recorded which was significantly more common than the mandibular type (0.65). Of note is that all the supernumerary teeth types were commonly observed in the maxilla except the parapremolar type, with a mandibular occurrence rate of 76.9%.

CONCLUSIONS

From this study, we can conclude that the prevalence of hyperdontia (across different black ethnicities) is low. Although, follicular epithelium around the tooth and root resorption of the enlargement around the adjacent teeth was observed, most were asymptomatic (87.0%) and required no intervention. Key words:Hyperdontia, panoramic radiographs, Sub-Saharan Africa, supernumerary teeth.