Search Results (25)

Background/Objectives: Facial and intraoral parameters are important guidelines in prosthetic planning and rehabilitation. This study aimed to analyze and determine the relationship between facial parameters and measurements on the upper anterior teeth using digital photography of the participants. Methods: This cross-sectional observational study included 82 student participants. Digital images (front facial and dental view) were taken of each participant, and then standardized images were used to measure facial and dental parameters. Results: The width of the maxillary anterior teeth and facial parameters were greater in males than in females, except for the medial canthus of the eye, which was slightly larger in females. A significant positive correlation was found between all facial parameters and the widths of the central and lateral incisors, as well as their combined sum. The strongest correlation was observed between the lateral canthus of the eye and the total width of the maxillary anterior teeth (r = 0.546; p < 0.001). In regression analysis, it was shown that the bizygomatic width had a statistically significant contribution to the prediction of the central incisor width (p = 0.045). It was also shown that the intraoral parameters, such as the height of the interdental papilla and interpapillary angle, are shape-dependent. Interincisal angles between the central incisors in all participants are significantly lower (p < 0.05) than the angles between incisal edges in other anterior teeth. Conclusions: Facial parameters cannot be used independently to predict dental parameters; nevertheless, when integrated with basic esthetic principles, they provide complementary information relevant to analytical procedures in restorative and prosthetic dentistry. Full article

Background/Objectives: Accurate identification of dental malocclusions from routine clinical photographs can be time-consuming and subject to interobserver variability. A YOLOv11-based deep learning approach is presented and evaluated for automatic malocclusion detection on routine intraoral photographs, testing the hypothesis that training on a structured annotation protocol enables reliable detection of multiple clinically relevant malocclusions. Methods: An anonymized dataset of 5854 intraoral photographs (frontal occlusion; right/left buccal; maxillary/mandibular occlusal) was labeled according to standardized instructions derived from the Index of Orthodontic Treatment Need (IOTN) A total of 17 clinically relevant classes were annotated with bounding boxes. Due to an insufficient number of examples, two malocclusions (transposition and non-occlusion) were excluded from our quantitative analysis. A YOLOv11 model was trained with augmented data and evaluated on a held-out test set using mean average precision at IoU 0.5 (mAP50), macro precision (macro-P), and macro recall (macro-R). Results: Across 15 analyzed classes, the model achieved 87.8% mAP50, 76.9% macro-P, and 86.1% macro-R. The highest per-class AP₅₀ was observed for Deep bite (98.8%), Diastema (97.9%), Angle Class II canine (97.5%), Anterior open bite (92.8%), Midline shift (91.8%), Angle Class II molar (91.1%), Spacing (91%), and Crowding (90.1%). Moderate performance included Anterior crossbite (88.3%), Angle Class III molar (87.4%), Head bite (82.7%), and Posterior open bite (80.2%). Lower values were seen for Angle Class III canine (76%), Posterior crossbite (75.6%), and Big overjet (75.3%). Precision–recall trends indicate earlier precision drop-off for posterior/transverse classes and comparatively more missed detections in Posterior crossbite, whereas Big overjet exhibited more false positives at the chosen threshold. Conclusion: A YOLOv11-based deep learning system can accurately detect several clinically salient malocclusions on routine intraoral photographs, supporting efficient screening and standardized documentation. Performance gaps align with limited examples and visualization constraints in posterior regions. Larger, multi-center datasets, protocol standardization, quantitative metrics, and multimodal inputs may further improve robustness. Full article

Background/Objectives: Adolescents may experience psychosocial consequences from minor dentofacial variations. The relationship between objectively rated smile esthetics and self-reported psychosocial impact remains under-studied in Saudi adolescents. This study aimed to investigate the relationship between the objectively measured smile esthetics with the subjectively reported psychosocial impact of perceived smile esthetics. Methods: Cross-sectional, multistage cluster-stratified sample technique was used to study adolescents aged 15–20 years (n = 344) from Al-Ahsa schools. Standardized extra-/intraoral photography supported Dental Esthetic Screening Index (DESI) scoring and psychosocial impact using Arabic Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) were applied. Reliability was assessed through two-way mixed intraclass correlation coefficient (ICC), Bland–Altman analysis, standard error of measurement (SEM), and minimal detectable change at the 95% confidence level (MDC95). Associations were examined using correlations and regression models. Results: The distribution of DESI categories was excellent (6.4%), good (29.7%), satisfactory (42.2%), insufficient (18.9%), and poor (2.9%). The distribution of PIDAQ impact levels was minimal (37.8%), slight (41.6%), moderate (18.0%), and significant (2.6%) (age p = 0.052; sex p = 0.417). DESI and total PIDAQ were weakly correlated (Spearman ρ = 0.248, 95% CI 0.143–0.347; p < 0.001). In a multivariable linear regression model with continuous PIDAQ total score as the outcome (R² = 0.525; adjusted R² = 0.516; p < 0.001), self-perceived smile dissatisfaction (B = 7.789; β = 0.478; p < 0.001) and tooth-color dissatisfaction (B = 4.099; β = 0.306; p < 0.001) showed the strongest associations with higher PIDAQ scores, while DESI total score showed a smaller association (B = 0.310; β = 0.120; p = 0.002). Age and sex were not significant predictors after adjustment. Conclusions: Objective smile esthetics were modestly associated with psychosocial impact, whereas adolescents’ self-perceived smile and tooth-color dissatisfaction were strongly associated with worse psychosocial outcomes. Although the smile esthetics may be clinically acceptable, adolescents can still experience reduced oral health-related quality of life due to the psychosocial impact of perceived dental esthetics. These findings support incorporating brief subjective questions on smile and tooth-color perception alongside objective assessment during routine adolescent dental care. Full article

Objectives: There is a paucity of research evaluating the use of telehealth applications for preventive oral care, such as remote dental screening and oral health promotion. This study aimed to assess the efficacy of teledentistry in improving the oral health of school-aged children. Methods: In this cluster randomised controlled trial, a total of 175 children aged 4–15 years were enrolled from six schools across Western Australia. The schools were randomly assigned to either the teledentistry or the control group. The intervention consisted of dental screening and oral health promotion. Qualified oral health therapists (OHTs) performed in-person dental examinations on participants in the control group. Different OHTs conducted dental photography-based screenings for participants in the teledentistry group. Both groups received screening reports and educational leaflets. Nine months later, in-person examinations were conducted on all participants in both groups to assess their dental condition and adherence to the dental advice provided at baseline. The primary outcomes included decay experience (dft/DFT index) and the proportion of children converting from a ‘caries-free’ state to a ‘caries-active’ state at the follow-up. Results: A total of 164 children completed the follow-up (mean age, 7.7 ± 2.4 years). At baseline, the prevalence of dental caries in the control and teledentistry groups was 47% and 46%, respectively. The incidence of dental caries in the teledentistry (10%) and control (12%) groups at follow-up was not significantly different (p = 0.7). Conclusion: The findings suggest that teledentistry has comparable efficacy to traditional preventive oral care in maintaining oral health. Teledentistry may offer a viable solution for expanding access to preventive oral care, especially for disadvantaged communities. Full article

Background: Digital dental photography is increasingly essential for documentation and smile design. This study aimed to compare the linear measurement accuracy of various smartphones and a Digital Single-Lens Reflex (DSLR) camera against digital models obtained by intraoral and desktop scanners. Methods: Tooth height and width from six different casts were measured and compared using images acquired with a Canon EOS 250D DSLR, six smartphone models (iPhone 13, iPhone 15, Samsung Galaxy S22 Ultra, Samsung Galaxy S23 Ultra, Samsung Galaxy S24, and Vivo T2), and digital scans obtained from the Helios 500 intraoral scanner and the Ceramill Map 600 desktop scanner. All image measurements were performed using ImageJ software (National Institutes of Health, Bethesda, MD, USA), and statistical analysis was conducted using one-way analysis of variance (ANOVA) with Tukey’s post hoc test (α = 0.05). Results: The results showed no significant differences in measurements across most imaging methods (p > 0.05), except for the Vivo T2, which showed a significant deviation (p < 0.05). The other smartphones produced measurements comparable to those of the DSLR, even at distances as close as 16 cm. Conclusions: These findings preliminary support the clinical use of smartphones for accurate dental documentation and two-dimensional smile design, including the posterior areas, and challenge the previously recommended 24 cm minimum distance for mobile dental photography (MDP). This provides clinicians with a simplified and accessible alternative for high-accuracy dental imaging, advancing the everyday use of MDP in clinical practice. Full article

Background/Objectives: Clinical photography is an essential component of orthodontic records, alongside radiographs, dental scanners, and cone beam computed tomography. However, neither the American Association of Orthodontists nor the Spanish Society of Orthodontics provides a standardized protocol for dental photography. This study aimed to evaluate the current practices, challenges, and training needs related to clinical photography among orthodontists in Spain. Methods: A cross-sectional survey was designed using Google Forms^® and distributed to orthodontists practising in Spain. A sample size of 303 participants was calculated (95% confidence level; 0.1 precision). The questionnaire covered photographic practices, equipment usage, self-assessed skills, interest in training, and legal considerations. Descriptive and inferential analyses were performed using R software (significance level 0.05; version 4.4.1). Results: A total of 304 valid responses were analyzed, with a predominance of female participants (77.96%) and a mean age of 37.54 years (SD: 9.08). Digital single-lens reflex (DSLR) cameras with macro lenses and ring flashes were the most used equipment (68.09%). The primary software for cropping and editing images were Windows Photos (28.95%) and MacOS Photos (16.12%). Male participants rated their photography skills higher than female participants (p = 0.003), and those with full-time orthodontic training considered their skills better than those with other types of training (p = 0.014). Photography was most valued for diagnosis in the exclusive orthodontics group (p = 0.019). Additionally, 75.99% of respondents expressed interest in improving their photography skills through specialized courses. Conclusions: This study highlights significant variability in photographic practices among orthodontists in Spain. The findings emphasize the need for standardized photography protocols to enhance diagnostic accuracy, clinical documentation, and professional training. Full article

This study assessed the bleaching and abrasiveness levels of different kinds of toothpaste with various RDA values on nanohybrid and microhybrid composite samples using a novel Press-on Force-Guided brushing simulator. One hundred and forty disc-shaped samples were prepared using two nano-hybrid and three microhybrid composites and divided randomly into four subgroups (n = 7). The samples were immersed in a coffee solution for 144 h and then brushed using R.O.C.S. (Remineralizing Oral Care Systems) brand toothpaste with different RDA values [Sensitive Instant Relief (SIR), Sensation Whitening (SW), and their combination with PRO Polishing (PP) (once a week)] using a brushing simulator for 140, 280 and 560 strokes (140 strokes correspondence to one week of real-time brushing). The level of surface roughness and color change (ΔE) were measured before and after the simulated brushing. Color changes were evaluated in Photoshop CC software through ∆E₀₀* values generated from before and after L, a*, b* parameters on sample photographs taken by a mobile dental photography tool. The surface structure of samples was measured before and after the brushing using a profilometer. The measurements were analyzed in SPSS V23 software by Analysis of Variance and the Bonferroni Test, and the level of significance was set at <0.05. Regarding ΔE values comparisons, there were no significant differences between the toothpastes after 2 weeks of brushing. SW (2.82 ± 1.24), SIR + PP (2.78 ± 0.98), and SW + PP (2.84 ± 1.22) values were found to be similar after one month of brushing (p < 0.007). Regarding surface roughness comparisons between the toothpastes, two-week and one-month brushing values were found to be similar and statistically rougher than the initial values. Using R.O.C.S. PRO Polishing with low-abrasive toothpaste may increase the whitening effect by enhancing color recovery. Full article

Background/Objectives: The damage assessment of dental instruments, such as endodontic files, is crucial to ensure patient safety and treatment quality. Conventional scanning electron microscopy (SEM) has been the gold standard for this purpose; however, its limited accessibility and complex sample preparation protocols hinder its routine use in clinical settings. This study proposes a novel system that leverages digital photography and advanced image processing techniques as a viable alternative to SEM. Methods: Our system accurately detects early instrument damage by capitalizing on the high resolution of digital images. Its exceptionally user-friendly interface, portability, and key features make it highly suitable for daily clinical practice. Results: Our findings suggest that the proposed system provides image quality comparable to SEM. Conclusions: Image stacking provides a practical, efficient, and objective method for assessing endodontic instruments’ morphology. By detecting early damage, this system significantly improves the safety and quality of endodontic procedures, especially for reusable NiTi files, instilling confidence and security in its use. It offers a cost-effective and user-friendly alternative to traditional methods such as visual inspection and SEM, making it a comfortable and confident choice for both research and clinical settings. Full article

Three-dimensional technology using personal data records has been explored for human identification. The present study aimed to explore two methodologies, photography and orofacial scanning, for assessing orofacial records in forensic scenarios, highlighting their impact on human identification. A pilot and quasi-experimental study was performed using Canon 5D-Full Frame equipment (Tokyo, Japan) and an i700 scanner (Medit, Lusobionic, Portugal) (Seoul, Republic of Korea) with Medit Scan for Clinics (MSC) and Smile Design software (V3.3.2). The sample included living patients (n = 10) and individuals in forensic cases (n = 10). The study was divided into two complementary phases: (i) data collection using 2D and 3D technologies and (ii) visual comparison by superimposition procedures, 3D dental images with 3D facial records (3D–3D), and 2D photography with screen printing of 3D facial records (2D-3S). Statistical analyses were performed using descriptive procedures (Likert scale) and the Mann–Whitney U test. The Mann–Whitney U test comparing the data (n = 220 records) from living individuals and those in forensic cases identified statistically significant differences in the performance of the photographic methods for evaluating intraoral mineralisation (p = 0.004), intraoral soft tissues (p = 0.016), intraoral distortion (p = 0.005) and the scan methods for intraoral extra devices (p = 0.003) and extraoral soft tissues (p = 0.005). A visual comparison (n = 40) allowed 3D–3D superimposition. Additionally, 2D-3S superimposition qualitatively identified the middle third of the face as the corporal area within the anatomical features required for successful surgery. In conclusion, the present study presented evidence-based data suggesting that the IO scan method, as an emergent technology, should be explored as a valuable tool in forensic facial identification in real-world scenarios. Full article

Background: Dental Anomaly Pattern (DAP) is a collection of morphologic, numeric, and eruptive anomalies of teeth that are often observed together, suggesting a potential genetic relationship. Our objective was to assess the potential associations of Molar-Incisor Hypomineralization (MIH), a common developmental defect of enamel mineralization with a controversial etiology, with two specific components of DAP: (1) agenesis (AG) and (2) infraoccluded deciduous molars (IODM). Establishing such an association between MIH and one or both anomalies would provide evidence supporting a genetic link between MIH and DAP. Methods: We examined pretreatment intraoral standardized photographies and panoramic radiographs from 574 children aged 8–14 years, 287 having MIH and 287 without MIH, comparing the frequencies of AG and IODM in both groups. The subject samples were sourced from the databases of the orthodontic department at a university hospital. Results: The frequencies of AG in the MIH and non-MIH groups were 7% and 8%, respectively (p = 0.751). The corresponding frequencies of IODM were 27% and 19.2%, respectively (p = 0.082). That is, children with MIH did not exhibit an increased frequency of AG or IODM compared to those without MIH. Conclusions: These findings do not support the inclusion of MIH in DAP. Nevertheless, further analysis of possible associations is necessary to definitively validate or invalidate this hypothesis. Full article

The dental pulp has critical functions in tooth development as well as an ongoing role in promoting and maintaining the vitality of teeth. In particular, its regenerative ability allows dental tissues to be restored following damage caused by traumatic injury or caries. Regenerative endodontic procedures aim to utilise these processes to stimulate dental pulp repair in a minimally invasive manner and reduce the need for more invasive procedures such as root canal treatment. Dental pulp is a source of dental pulp cells (DPCs), which has a subpopulation of dental pulp stem cells (DPSCs), which are attractive for use in regenerative medicine due to their high proliferation rate, ability to differentiate into multiple cell types, and their preserved vitality following cryopreservation. The development of next-generation clinical therapeutics that maximise the potential of dental pulp relies on strong empirical evidence arising from in vitro experimentation. Here, we describe a modified method for the efficient isolation of primary human DPCs from sound third molar teeth for culture using an explant outgrowth method on basement membrane-coated flasks, as well as using high-resolution macro-photography to illustrate the methods. Critically, steps are taken to minimise potential physical and mechanical trauma to the cells and maximise yield. Human DPCs cultured using this method can be further expanded in cell culture flasks to facilitate their use in various in vitro experimental procedures. Full article

Dental imaging plays a crucial role in clinical dental practice. Conventional 2D dental imaging serves general-purpose tasks, such as patient documentation, while high-precision 3D dental scanning is tailored for specialized procedures, such as orthodontics and implant surgeries. In this study, we aimed to develop a cost-effective 3D imaging technique that could bridge the gap between conventional dental photography and high-precision 3D dental scanning, with the goal of improving patient dental care. We developed a 3D imaging technique based on close-range photogrammetry and termed it close-range photogrammetry-based dental imaging (CPDI). We evaluated this technique on both in vitro dental models and in vivo teeth. For dental models, we conducted a parametric study to examine the effects of the depth of field and specular reflection on reconstruction quality. We showed that the optimal results were achieved with an f/5.6 lens and without a circular polarizer for reflection suppression. This configuration generated 3D scans with 57.7 ± 3.2% and 82.4 ± 2.7% of reconstructed points falling within ±0.1 mm and ±0.2 mm error margins, respectively. With such accuracy, these 3D dental models can faithfully represent dental morphology and features. During in vivo imaging, we were able to reconstruct high-quality 3D models of the anterior arch, further demonstrating its clinical relevance. The reconstructed models carry both 3D shapes and detail full-color surface textures, which positions CPDI as a versatile imaging tool in different areas of clinical dental care. Full article

Background: Biological ageing and pathological changes of teeth impact the appearance and may hinder the effectiveness of facial aesthetic treatments. The present cross-sectional study in Caucasian dentate individuals aimed to measure facial features of the lower and middle parts of the face across different ages and to identify any significant impacts of age, sex and dental variables on facial aesthetics. Methods: Fifty-eight adults (ranging from 26 to 79 years of age) participated in the study. Facial measurements were collected via digital two-dimensional photography, and intraoral variables were recorded. The data were digitally analysed using ImageJ software and statistically analysed using SPSS Software. Results: The lower and middle third of the face revealed statistically significant changes across the age span tested, with the middle third presenting higher values in females and the lower appearing more prominent in males. A negative correlation with age was revealed for the distance between the pupil and the orbital point. Intraoral dental variables were also significantly related to facial measures. Conclusions: The study enriches the anthropometric data available for the Greek population, with age and sex significantly impacting facial aesthetics and oral variables. Considering such information during preoperative planning for full-arch dental restorations or facial surgery is essential. Full article

Aim: The aim of this paper is to describe the multidisciplinary management pathway for pediatric patients with suspected obstructive sleep apnea syndrome (OSAS) conducted by the Pediatric and Orthodontic Department of the Dental Clinic of Padua. Materials and methods: All pediatric subjects undergo a comprehensive medical history, including the completion of the Pediatric Sleep Questionnaire (PSQ), and a physical examination. Patients with suspected OSAS are placed on a waiting list for home respiratory polygraphy testing. The respiratory polygraphy examination is conducted over two consecutive nights and interpreted by a neurologist. Additionally, patients diagnosed with OSAS undergo a case study involving intraoral and extraoral photography, as well as radiographic evaluation. Results: Between September 2021 and May 2023, a total of 134 subjects (including 76 males), with an average age of 9.2 years, were identified as diagnostic suspects. Among these, 38 patients (28.3%) tested positive based on respiratory polygraphic results. Depending on the severity and etiopathogenetic characteristics of the disease, the positive cases were referred to various specialists. Conclusion: In the daily clinical practice of dentistry, particularly in orthodontics and pedodontics, the establishment of a defined management pathway for pediatric patients with OSAS is crucial. The collaboration of a multidisciplinary team with a shared objective of achieving accurate diagnosis and implementing targeted treatment in a timely manner is essential. Regular re-evaluation of patients through clinical and instrumental examinations is recommended. Full article