Search Results (109)

Background: Periodontitis is a multifactorial disease leading to the loss of clinical attachment and alveolar bone. The diagnosis of periodontitis involves a clinical examination and radiographic evaluation, including panoramic images. Panoramic radiographs are cost-effective methods widely used in periodontitis classification. The remaining bone height (RBH) is a parameter used to assess the alveolar bone level. Large language models are widely utilized in the medical sciences. ChatGPT, the leading conversational model, has recently been extended to process visual data. The aim of this study was to assess the effectiveness of the ChatGPT models 4.5, o1, o3 and o4-mini-high in RBH measurement and tooth counts in relation to dental professionals’ evaluations. Methods: The analysis was based on 10 panoramic images, from which 252, 251, 246 and 271 approximal sites were qualified for the RBH measurement (using the models 4.5, o1, o3 and o4-mini-high, respectively). Three examiners were asked to independently evaluate the RBH in approximal sites, while the tooth count was achieved by consensus. Subsequently, the results were compared with the ChatGPT outputs. Results: ChatGPT 4.5, ChatGPT o3 and ChatGPT o4-mini-high achieved substantial agreement with clinicians in the assessment of tooth counts (κ = 0.65, κ = 0.66, κ = 0.69, respectively), while ChatGPT o1 achieved moderate agreement (κ = 0.52). In the context of RBH values, the ChatGPT models consistently exhibited a positive mean bias compared with the clinicians. ChatGPT 4.5 was reported to provide the lowest bias (+12 percentage points (pp) for the distal surfaces, width of the 95% CI for limits of agreement (LoAs) ~60 pp; +11 pp for the mesial surfaces, LoA width ~54 pp). Conclusions: ChatGPT 4.5 and ChatGPT o3 show potential in the assessment of tooth counts on a panoramic radiograph; however, their present level of accuracy is insufficient for clinical use. In the current stage of development, the ChatGPT models substantially overestimated the RBH values; therefore, they are not applicable for classifying periodontal disease. Full article

Background and Clinical Significance: The retreatment of failed dental implants remains a challenging clinical scenario, particularly when complicated by peri-implantitis and as sociated bone loss. Successful management requires a comprehensive and predictable approach that addresses both hard and soft tissue deficiencies. Case Presentation: This case report illustrates a fully digital, prosthetically driven workflow for the rehabilitation of a posterior mandibular site following implant failure. A 44-year-old female patient underwent removal of a failing implant and adjacent tooth due to advanced peri-implantitis and periodontitis. After healing, a digital workflow—including intraoral scanning, cone-beam computed tomography (CBCT), and virtual planning—was employed to design and fabricate a customized CAD/CAM titanium mesh for vertical guided bone regeneration. The grafting procedure utilized a composite mixture of autogenous bone and anorganic bovine bone (A-Oss). After nine months of healing, two implants with a hydrophilic surface (SOI) were placed using a fully guided surgical protocol (OneGuide system). Subsequent soft tissue grafting and final prosthetic rehabilitation with monolithic zirconia restorations resulted in stable functional and aesthetic outcomes. Conclusions: This case highlights how the integration of modern digital technologies with advanced regenerative procedures and innovative implant surfaces can enhance the predictability and long-term success of implant retreatment in compromised posterior sites. Full article

Background: Dental erosion is the irreversible loss of tooth structure from acid exposure. Its prevalence is rising globally, making it an important oral health concern. However, longitudinal data from Eastern Europe are scarce, especially in Romania. This pilot study aimed to assess the 10-year incidence of dental erosion in Romanian young adults and to compare clinical index scoring with digital scanning. Methods: A 10-year prospective study followed 540 Romanian adults (aged 18–30) selected with no erosive lesions at baseline (Basic Erosive Wear Examination BEWE = 0). Erosive wear was assessed at the 10-year follow-up using BEWE, with 40 participants also undergoing digital intraoral scanning to measure enamel loss (μm). Gender differences were analyzed. Chi-square tests, relative risk, and correlation analyses were performed. Results: After 10 years, 23.2% of participants developed dental erosion. Males exhibited a higher incidence than females (29.9% vs. 17.2%; RR = 1.74, p < 0.001). Among the scanned subset (n = 40), the mean enamel loss was 137 ± 79 µm, with greater wear on palatal vs. buccal surfaces (p = 0.002). BEWE scores were moderately correlated with digital enamel loss (r = 0.58, p < 0.001). Conclusions: Erosion progressed over time in this cohort, with males at higher risk. Digital scanning detected subtle enamel loss not captured by BEWE, indicating greater sensitivity to early changes. BEWE and digital methods provided complementary information; their combined use offers a more comprehensive assessment. Full article

Background/Objectives: Avulsion is a major cause of tooth loss, and its treatment involves replantation. This study analyzed the repair process of incisive teeth subjected to delayed replantation after topical treatment with ampicillin and tetracycline. Methods: Forty male rats were equally divided into four groups: immediate replantation (IM), ampicillin (AM), tetracycline (TR), and dry medium (SE). In the IM group, replantation was performed 5 min after experimental avulsion, whereas in the SE group, the teeth were kept in a dry medium for 60 min. In the AM and TR groups, the teeth were stored in whole bovine milk for 60 min, and then immersed in their respective ampicillin and tetracycline solutions for 5 min. Euthanasia was performed 60 days after the experimental surgery. Histological slides were stained with Hematoxylin and Eosin for quantitative and qualitative analyses. Results: No statistically significant differences were observed among the IM, AM, and TR groups regarding the total resorption area, reattached periodontal ligament fibers, and ankylosis. However, when compared to the SE group, these groups exhibited a smaller total resorption area (IM: p = 0.005; AM: p = 0.0007; TR: p = 0.03), a larger area of periodontal ligament fibers reattachment (IM: p = 0.0002; AM: p = 0.0002; TR: p = 0.02), and a lower presence of ankylosis (IM: p = 0.005; AM: p = 0.0002; TR: p = 0.03). The AM group exhibited the smallest inflammatory resorption. Conclusions: It is concluded that, in an aseptic environment, the use of topical antibiotics such as ampicillin and tetracycline in the treatment of the root surface during replantation of teeth stored in milk is beneficial to the periodontal repair process and root resorption. Notably, ampicillin demonstrated superior efficacy in mitigating inflammatory root resorption and better periodontal ligament reattachment. Full article

This study proposes the use of Physics-Informed Neural Networks (PINNs) to further advance the curvature interference analysis method. The nonlinear equation system encountered in determining the curvature interference limit line is embedded into the PINN loss function, thereby enabling the solution of high-dimensional, nonlinear equations. Computational results demonstrate that the PINN model achieves a solution accuracy on the order of 10⁻¹³ when solving multidimensional nonlinear systems, which is comparable to the classical Fsolve algorithm. The curvature interference analysis reveals the presence of two curvature interference boundary lines, although they rarely extend to the worm gear tooth surface. A study on the influence of design parameters on the interference boundaries indicates that the axial installation distance has the greatest impact. Inadequate axial spacing causes the interference limit line to shift toward the inner end of the worm gear, significantly increasing the risk of interference in that region. The proposed curvature interference analysis method based on PINNs can be extended to other types of gear drives. It also lays the foundation for future work on establishing both forward and inverse mappings between design parameters and curvature interference using PINNs. Full article

The purpose of this narrative review is to identify and present clinical trials published in the last five years on local delivery agents used as adjuncts to subgingival instrumentation in the non-surgical management of periodontitis. Epidemiological studies have shown that periodontitis is highly prevalent in the general population. Treatment is usually based on mechanical removal of contaminants from the root surface followed by long-term supportive care, resulting in decreased occurrence of tooth loss. Clinical health is not always achieved at all sites, leading to research efforts by researchers to find adjunctive agents to help improve the periodontal condition. This review aims to present the most recent developments in local adjunctive agents for the non-surgical treatment of periodontitis. Therapies used included antimicrobial photodynamic therapy as well as antimicrobial and biomodulating compounds. A search in PubMed was conducted to identify the most recent randomized controlled trials relating to locally delivered adjunctive agents in periodontitis treatment beyond traditional therapies such as chlorhexidine, minocycline and doxycycline. Thirty-one articles published in the last five years were included. The most current evidence from human trials supports that, despite the high variability in experimental protocols, there may be a clinical benefit to antimicrobial photodynamic therapy and gels carrying sodium hypochlorite, melatonin, tea tree oil and Aloe vera. Most recently, advances in nanotechnology, including liposomes, present an avenue forward to potentially increase the effectiveness of current and future local delivery agents in the non-surgical treatment of periodontitis. Full article

Research on how a stratified oral epithelium gained the capability to create the hardest hydroxyapatite-based mineralized tissue produced biologically to protect the surfaces of teeth has been ongoing for at least 175 years. Many advances have been made in unraveling some of the key factors that allowed the innermost undifferentiated epithelial cells sitting on a skin-type basement membrane to transform into highly polarized cells capable of forming and controlling the mineralization of the extracellular organic matrix that becomes enamel. Genetic manipulation of mice has proven to be a useful approach for studying specific events in the amelogenesis developmental sequence but there have been pitfalls in interpreting loss of function data caused in part by conflicting literature, technical problems in tissue preservation, and the total amount of time spent on tooth development between different species that have led to equivocal conclusions. This critical review attempts to discuss some of these issues and highlight the challenges of characterizing amelogenesis in gene-targeted mouse models. Full article

(1) Background: The aim of this in vitro study was to evaluate the success of indirect pulp capping (IPC) procedures over a period of 40 years. (2) Methods: The investigation of 1412 dental records included 159 patients with 366 IPC teeth having been treated from 1969 to 1980. The teeth revealed caries within the inner third of dentin, were symptom-free, and showed no pulp exposure. The caries were excavated thoroughly and teeth with accidentally exposed pulp were excluded. Zinc–oxide–eugenol was used for the IPC procedures. The posterior teeth were restored with amalgam, and the anterior teeth received direct resin composite fillings. The gathered parameters with possible influences on survival rates were age, gender, tooth locations/positions, dates of vital therapy, the number of filled surfaces, types of primary restoration material, successional treatments on each tooth, and the last dates of surveillance. Data collection and statistical analysis were performed using Excel sheets and DataTab. Significant differences among groups were computed by cox regression analysis and the significance level was set at p = 0.05. Kaplan–Meier curves were utilized to illustrate the survival rates. (3) Results: Treatment success was measured by the maintenance of vitality beyond 365 days. The loss of vitality within 365 days was determined as treatment failure. Treatment outcomes were assessed after different time periods (1 and 6 months; 1, 2, 5, 10, 20, and 40 years). Pulp vitality dropped from 95% after 3 months to 32% after 40 years. Cavity size had a significant influence on the survival of pulp, but tooth position did not; however, third molars at least initially showed a better outcome. Beyond the 1-year recall, no differences for the evaluated parameters were present. (4) Conclusions: IPC showed excellent long-term success rates, revealing a 1.7% annual failure rate after 40 years of clinical service. Larger defects suffer more pulp damage in the long run. Full article

This paper proposes a two-dimensional (2D) generalized equivalent magnetic network (GEMN) model suitable for surface-mounted permanent magnet electric machines (SPEMs). The model divides the SPEM into eight types of regions: stator yoke, stator tooth body, stator tooth tips, stator slot body, stator slot openings, air gap, rotor permanent magnets, and rotor yoke. Each region is subdivided radially and tangentially into multiple 2D magnetic network units containing radial and tangential magnetic circuit parameters, forming a regular magnetic network covering all regions of the SPEM. The topology of this magnetic network remains unchanged during rotor rotation and can accommodate various surface-mounted permanent magnet structures including Halbach arrays, which enhances the generality of the model significantly. The proposed model can be used to calculate the 2D magnetic flux density distribution, winding electromotive force, electromagnetic torque, stator iron loss, and permanent magnet demagnetization in the influence of magnetic saturation, stator slotting, and current harmonic. Comparative analysis with the accurate subdomain method (ASDM) and finite element method (FEM) demonstrates that the GEMN model achieves a good balance between computational speed and accuracy, making it particularly suitable for efficient electromagnetic performance evaluation of SPEMs. Full article

Since tooth loss is a common problem in humans and is widespread worldwide, dental implants are an effective and optimal alternative to solve this problem. Thus, it is necessary to develop implants with improved surfaces that favor the osseointegration of the implant into the surrounding tissues and promote cell adhesion and proliferation while also preventing and inhibiting peri-implant infections that can lead to implant failure. In this regard, this review aims to provide new insights into nanotechnology and the use of nanoparticles in creating new coatings, the new trends for enhancing dental implant surfaces, and the current technologies used for this purpose. Although in vitro and in vivo tests attest to the possible use of the nanomaterials described in this review, further tests are needed to establish the optimal concentrations to be safe for clinical trials. Full article

To reduce harvest losses of a pepper harvester with a drum of elastic tooth type picking mechanism, this paper proposes an optimization method using AHP (Analytic Hierarchy Process) and RSM (Response Surface Methodology), thereby identifying the optimal harvesting parameters. Based on Hertz’s contact theory and projectile motion theory, dynamic and kinematic models were established for the picking and casting stage. Key parameters influencing harvest loss were identified as drum rotational speed, operating speed, and tooth spacing. A simulation model was constructed, and solved within LS-DYNA of ANSYS Workbench. A Box–Behnken design in RSM was employed to investigate the effects of drum rotational speed, operating speed, and tooth spacing on the picking rate, breakage rate, and loss rate. The optimal parameters, obtained through RSM optimization after AHP weighting, were determined to be a drum rotational speed of 182 r/min, an operating speed of 0.42 m/s, and a tooth spacing of 40 mm. A test bench was designed for validation, with simulation results deviating from experimental results by less than 5%. With optimized parameters, the picking rate increases from 89.73% to 95.13%, the breakage rate decreases from 3.21% to 2.66%, and the loss rate decreases from 5.16% to 3.95%. This study provides a theoretical foundation and practical reference for optimizing the drum with elastic tooth type picking mechanism in pepper harvesters. Full article

Background/Objective: Periodontal disease is a prevalent inflammatory condition affecting the supporting structures of teeth, with radiographic bone loss (RBL) being a critical diagnostic marker. The accurate and consistent evaluation of RBL is essential for the staging and grading of periodontitis, as outlined by the 2017 AAP/EFP Classification. Advanced tools such as deep learning (DL) technology, including Denti.AI, an FDA-cleared software utilizing convolutional neural networks (CNNs), offer the potential for enhancing diagnostic accuracy. This study evaluated the diagnostic accuracy of Denti.AI for detecting RBL in intraoral radiographs. Methods: A dataset of 39 intraoral radiographs (22 periapical and 17 bitewing), covering 316 tooth surfaces (123 periapical and 193 bitewing), was selected from a de-identified pool of 500 radiographs provided by Denti.AI. RBL was assessed using the 2017 AAP/EFP Classification. A consensus panel of three board-certified dental specialists served as the reference standard. Performance metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and mean absolute error (MAE), were calculated. Results: For periapical radiographs, Denti.AI achieved a sensitivity of 76%, specificity of 86%, PPV of 83%, NPV of 80%, and accuracy of 81%, with an MAE of 0.046%. For bitewing radiographs, sensitivity was 65%, specificity was 90%, PPV was 88%, NPV was 70%, and accuracy was 76%, with an MAE of 0.499 mm. Conclusions: Denti.AI demonstrated clinically acceptable performance in detecting RBL and shows potential as an adjunctive diagnostic tool, supporting clinical decision-making. While performance was robust for periapical radiographs, further optimization may enhance its accuracy for bitewing radiographs. Full article

Advancements in implant design, surface characteristics, and surgical protocols have made implant restorations safe and highly predictable procedures. Bone metabolism plays a central role in the success of implant therapy. Diabetes mellitus is a significant disease impacting bone metabolism, particularly during the initial stages of osseointegration and in long-term survival. Moreover, aging is linked to various systemic conditions, such as diabetes, which increase the susceptibility of the periodontium and teeth to disease, often resulting in tooth loss. Studies on the impact of glycemic control on the success and longevity of implant–prosthetic rehabilitation in diabetic patients highlight a significant association between hyperglycemia and complications in implant therapy. This review identified 18 relevant publications through Medline, and studies were screened against the aim and objectives of the review. A total of five articles were excluded because of lack of focus on the effect of glycemic control on dental implants. Diabetic patients with poorly controlled blood glucose levels may face a heightened risk of developing implant complications. Effective glycemic control plays a critical role in the long-term success of dental implants in these individuals. Marginal bone loss (MBL) is a critical indicator of implant health and success. Clinical studies generally show greater MBL in diabetic patients compared to non-diabetic individuals. Furthermore, controlled type 2 diabetes mellitus (T2DM) has been associated with significantly better maintenance. Full article

The natural aging process of the human organism leads to both physiological and pathological changes, including tooth loss. This requires dental prosthetic interventions aimed at restoring patients’ quality of life. The use of such prostheses necessitates selection of sufficiently strong, aesthetic and biocompatible materials, which also offer ease of shaping. The market for materials used in prosthetic applications offers a wide array of options; however, selection of the most suitable material for specific clinical scenarios can be challenging for dental professionals. This paper continues the comprehensive investigation of the physiochemical and mechanical/functional properties of two commonly used prosthetic—Biocetal and BioHPP—offering a comparative analysis of their characteristics to provide valuable insights for dentists and prosthodontists. The study focuses on in vitro analyses of physiochemical parameters, including density, water sorption, contact angle, and surface roughness. The structure of the materials was examined via scanning electron microscopy. Additionally, microbiological studies were performed using strains of Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa and Candida albicans. Statistical analysis was performed using Shapiro–Wilk test, Q-Q plot analysis, Grubbs test, and Student’s T-test (p < 0.05). The findings indicate that BioHPP demonstrates superior physiochemical and microbiological properties. However, Biocetal exhibit better surface characteristics. Despite its high performance, BioHPP presents certain drawbacks, which may influence dentists’ material choice in specific clinical cases, particularly for certain prosthetic restorations. Full article

To assess the biomechanical behaviors of endodontically treated molars (ETMs) restored with endocrowns composed of different materials, forty mandibular molars were assigned to five groups (n = 8 each). Untreated molars constituted the control group (group C); the rest of the teeth that underwent root canal therapy were restored with endocrowns composed of polycrystalline ceramics (ST zirconia^®, UPCERA) in group ZR, lithium disilicate glass ceramics (UP.CAD^®, UPCERA) in group LD, resin-based nanoceramics (Hyramic^®, UPCERA) in group NC, and feldspathic ceramics (CEREC Blocs^®, Sirona) in group FC. All teeth were axially loaded until fracture. The process was recorded using a high-speed camera system, and fractographic analysis was conducted. The results showed that fracture loads did not significantly differ among groups C, LD, and NC; the loads were significantly lower than the load in group ZR but higher than the load in group FC. The mean time from the initial crack to complete tooth fracture varied. Group C had the longest time, followed by group NC; groups ZR, LD, and FC had the shortest time. Similar failure patterns were observed in groups ZR and LD, which were more regular than the pattern in group NC; group FC exhibited the roughest fracture surfaces. Fracture resistance testing combined with a high-speed camera system and fractographic analysis provides a promising modality for studying the biomechanical behaviors of restored teeth. Endocrowns composed of lithium disilicate glass ceramics or resin-based nanoceramics offer alternative restorations for ETMs with extensive coronal loss. Full article