The Application of artificial intelligence in restorative Dentistry: A narrative review of current research.

This review explores the transformative impact of artificial intelligence (AI) on restorative dentistry. By discussing the diagnostic processes, treatment planning, image analysis, prosthodontics, and material/biomaterial research, this study highlights the role of AI in optimizing precision and efficiency. It emphasizes personalized material selection, accelerated biomaterial research, and AI-enabled clinical workflows for enhanced patient outcomes. The review concludes with insights into the challenges, ethical considerations, and future trends, emphasizing the collaborative efforts needed for continued innovation in AI-driven restorative dentistry.

Awareness about emergency management of avulsed tooth among intern dentists-a cross-sectional observational study.

Tooth avulsion is a frequently encountered dental emergency. Children are commonly reported group due to frequent sports activities, trauma, accidents and falls. Prompt emergency management is vital for long term success and to avoid morbidity. The study was aimed to assess the understanding of intern dentists about the emergency handling of avulsed teeth cases as mostly they are first responders among health care personnel. In this study a fourteen-item questionnaire with predefined responses was shared as online Google survey form with intern dentists of 5 different dental teaching hospitals of Islamabad, Pakistan. The duration of the study was 6 months (01 March 2022 to 31 August 2022). The questions were intended to collect personal information and to check level of knowledge and awareness about the management of avulsed tooth among the dental interns. The data was analyzed by statistical methods and is presented through tables and descriptive methods. In total, 152 participants completed the shared questionnaire. The vast majority (71%) of them were aware of the initial management of avulsed teeth, 49% were aware of the ideal transport medium for an avulsed tooth, (43%) were aware of the critical time for successful replantation, while (62%) had knowledge of the multiple factors responsible for the outcome of the tooth replantation. For majority of the statements, female participants had better knowledge as compared to their male counterparts. Statistically significant difference was noted for the statement "If you found the knocked-out tooth and it is dirty what will be your initial approach?" with female participants having better knowledge as compared to the male (p value = 0.005). Based on our study results, generally dental interns are well-informed but still lack expected level of awareness regarding the proper management protocol for avulsed tooth. Hence, improvement is needed regarding the effective handling of avulsed teeth cases.

Caries risk assessment by Caries Management by Risk Assessment (CAMBRA) Protocol among the general population of Pakistan-a multicenter analytical study.

Background: Caries risk (CR) assessment tools are used to properly identify individuals with caries risk and to improve preventive procedures and programs. A tool such as CAMBRA determines the precise protective factors of caries and identifies an individual's specific therapeutic intervention. The purpose of this study was to assess the caries risk using the CAMBRA protocol among the general population of Pakistan. Methods: This multicentre analytical study was conducted in ten dental hospitals in different provinces of Pakistan and the caries risk assessment was carried out using a questionnaire that was designed using the Caries Management by Risk Assessment (CAMBRA) protocol. All 521 participants were intra-orally examined to assess oral hygiene status and the presence of disease. Multiple logistic regression test was performed for analysis. Results: A higher number of participants (61.2%) were found to be in the moderate risk category of caries risk assessment. The males are 51% less likely to have caries compared to the females (AOR = 0.49, P = 0.081). The majority of participants (71.3%) had one or more disease indicators, with white spots and visible cavities. Those with visible, heavy plaque were 13.9 times more likely to have caries compared to those without (AOR = 13.92, P < 0.001). Those using calcium and phosphate during the last 6 months were 90% less likely to have caries compared to those not using them (AOR = 0.10, P < 0.001). There was no significant interaction between all eight risk factors retained in the final model (P > 0.05), the Hosmer and Lemeshow Test P < 0.001, classification accuracy = 87.1%, and AUC = 91.2%. Conclusion: The caries risk among the general population of Pakistan is moderate, with significant variation among age groups, education levels, and socioeconomic status.

The Association Between Economic Status and Religious Identity With Oral Health Disparities and Inequalities Around the World.

INTRODUCTION: The inequalities in oral health remain one of the current issues in the global public health agenda. The number of studies investigating health disparity by religious identity is limited and there is currently no such report relating to oral health. Similarly, there is compelling evidence for oral health disparities between socioeconomic statuses, education levels, and ethnic groups. This ecological study aimed to explore the disparity in oral health-related outcomes between Muslim and non-Muslim countries and country income status. METHODS: Publicly available data related to oral health measures, country income status, and membership in the Organization of Islamic countries were used. Five oral health-related measures were examined: caries experience (decayed, missing, and filled teeth (DMFT)), percentage of the population with no periodontal disease, and disability-adjusted life years (DALY) attributed to oral conditions, and mouth and oropharynx cancer. One-way analysis of variance (ANOVA) and Kruskal-Wallis tests were used to compare the oral health parameters by country income status and simple linear regression was used to compare the parameters between the non-member countries (n-MC) and member countries (MC). For the significant parameters, adjusted coefficients were obtained using multiple linear regression. RESULTS: From 170 countries included, 53 (31%) were MC and 117 (69%) were n-MC. Analysis showed that the mean DMFT in adults aged 35-44 years was significantly higher in the n-MC compared to MC after adjusting for country income status (p<0.05) but the latter was the stronger explanatory predictor of the outcome. The strength of the effect of country membership classification (standardized coefficient ß: DMFT35-44-year-old = -0.16) was smaller than country income status (ß = -0.60) in the multiple regression. CONCLUSION: There is significant but weak evidence from the available data to support the claim that economic status and religion contribute to oral health disparity.

Microleakage Assessment of Different Preparation Techniques and Pit and Fissure Sealants in Permanent Molars.

BACKGROUND: This study aimed to evaluate the predisposition of microleakage in permanent molar teeth following different preparation techniques for pits and fissure sealants. METHODS: In this cross-sectional analytical study, a dye penetration method was employed to evaluate microleakage in dental restorations. A total of 104 extracted molars were randomly assigned into two groups and further subdivided into two subgroups based on a class of sealant (filled/unfilled resin) containing 26 teeth each. Teeth in one group were prepared by a conventional method using pumice and acid etching with 37% phosphoric acid, and teeth in the other group were prepared with a 1/4-round carbide bur in a low-speed handpiece and then acid etched. In each group, 26 teeth were sealed with a filled sealant, and 26 teeth with an unfilled sealant. The chi-square test was used for the comparison of microleakage between the groups. RESULTS: Unfilled sealants prepared with bur preparation showed the lowest degree of microleakage. The greater number of teeth (17) showed no microleakage in the group of teeth prepared using the bur preparation technique. Furthermore, in dye penetration analysis, the subgroup of teeth that were filled with unfilled sealants showed a greater number of teeth (57.6%), with zero penetration, and the dye penetration scores were statistically significant among the groups with different preparation techniques (p=0.002). CONCLUSION: Teeth whose pits and fissures were prepared through 1/4 carbide bur and filled with unfilled pits and fissure sealants show less microleakage than those prepared with the conventional method and filled with filled sealants. Therefore, the choice of surface preparation technique for pit and fissure sealants can influence the effectiveness of the sealant in preventing microleakage.

Enhancement of Skill Competencies in Operative Dentistry Using Procedure-Specific Educational Videos (E-Learning Tools) Post-COVID-19 Era-A Randomized Controlled Trial.

E-learning has completely transformed how people teach and learn, particularly in the last three pandemic years. This study evaluated the effectiveness of additional procedure-specific video demonstrations through E-learning in improving the knowledge and practical preclinical skills acquisition of undergraduate dental students in comparison with live demonstration only. A randomized controlled trial was conducted for the second-year dental students in the College of Dentistry, Jouf University, to evaluate the impact of E-learning-assisted videos on preclinical skill competency levels in operative dentistry. After a brief introduction to this study, the second-year male and female students voluntarily participated in the survey through an official college email. Fifty participants were enrolled in the study after obtaining informed consent. The participants were randomly divided into two groups, twenty-five each. The control group (Group A) was taught using traditional methods, and the intervention group (Group B) used E-learning-assisted educational videos and traditional techniques. An objective structured practical examination (OSPE) was used to assess both groups. The faculty members prepared a structured, standardized form to evaluate students. After OSPE, statistical analysis was done to compare the grades of OSPE between Group A and Group B. Logistic regression analysis was done to express the effect of components of the OSPE on gender, cumulative gross point average (CGPA), Group A and Group B. The results showed a significant difference in the experimental groups after the intervention (p < 0.000). The simulator position parameter demonstrated that the participants had a significant competence level after the intervention by procedure-specific videos (p < 0.000) and an exponential value of 6.494. The participants taught by E-learning-assisted procedure-specific videos and traditional teaching strategies demonstrated an enhanced learning and skill competency level than participants who used only traditional teaching strategies.

Operators' Ease and Satisfaction in Restoring Class II Cavities With Sectional Matrix Versus Circumferential Matrix System at Qassim University Dental Clinics.

OBJECTIVES: This study aimed to investigate the operator's ease, satisfaction, and comfort of using a circumferential matrix system and sectional matrix system on the proximal contact points and contours when restoring class II cavities in posterior teeth. MATERIALS AND METHODS: This cross-sectional study was performed at the clinics in the Department of Conservative Dental Sciences, College of Dentistry, Qassim University. A total of 105 dental students randomly participated in this study to restore a class II cavity with direct composite resin restoration. Operators' comfort and satisfaction were evaluated according to their assessment of the contact points they reproduced and the emergence profiles of restorations, using a circumferential matrix system and sectional matrix system. RESULTS: Out of 105 operators, 57 were satisfied with using circumferential matrix bands for most of their cases while 78 of the operators were satisfied with sectional matrix bands. There were no significant differences between operator satisfaction and the use of circumferential matrix band system (P > 0.05) and sectional matrix band system (P = 0.134) but there was a significant difference between difficulty levels in the use of both matrix band systems (P < 0.05; P = 0.000). CONCLUSION:  Circumferential and sectional matrix band systems showed no significant differences with operators' satisfaction during restoring class II cavities in posterior teeth but using a sectional matrix band system was considered easier than using a circumferential matrix band system.

The Relationship of Orofacial Pain and Dental Health Status and Oral Health Behaviours in Facial Burn Patients.

This study aims to examine the association of orofacial pain and oral health status and oral health behaviours in facial burn patients. The participants in this cross-sectional study were randomly recruited from the Burn Care Center, Institute of Medical Sciences, Islamabad, Pakistan. An intraoral evaluation was carried out to record the DMFT and OHI-S. A self-administered questionnaire was used to collect information on sociodemographic status, brushing frequency, and dental visits. Orofacial pain during mandibular movement was assessed using the Visual Analogue Scale (VAS). Psychological status was assessed using the Generalized Anxiety Disorder Scale and Impact of Events Scale. ANOVA and simple and multiple linear regression tests were used to analyse the data. From the 90 facial burn patients included, the majority were below 34 years of age, female, single or divorced, and unemployed. The mean DMFT was 10.7, and 71% had poor oral hygiene. 56% of the participants had moderate-to-severe anxiety, and 68% had posttraumatic stress disorder. 53% of the participants had moderate-to-severe pain during mouth opening or moving the mandible with a mean score of 41.5. Analyses showed that orofacial pain was associated with less frequent brushing, irregular dental visits, greater DMFT score, and more plaque accumulation (OHI-S). It was also associated with employment status, the severity of a burn, anxiety, and stress. The treatment and management of dental and oral conditions in burn patients need judicious balance in controlling and accurate assessment of the pain and improving psychological problems in burn patients.

Shear Bond Strength and Bonding Properties of Orthodontic and nano Adhesives: A Comparative In-Vitro Study.

INTRODUCTION: Nano restorative composites have been successfully used in restorative dentistry and have high strength and wear resistance. Conventional orthodontic adhesives also possess optimal strength to withstand occlusal forces. This study was done to compare the shear bond strength (SBS) of orthodontic bracket after bonding with nanorestorative composite and orthodontic adhesives. MATERIALS AND METHODS: This in-vitro experimental study used sixty extracted teeth (divided into two groups). In Group A (n = 30), the brackets were bonded with Filtek Z350 (3M/Unitek, Monrovia, California, USA), a nano ceramic restorative composite, and in Group B (n = 30), the brackets were bonded with Transbond XT (3M/Unitek, Monrovia, California, USA), a conventional orthodontic adhesive. The SBS of the orthodontic brackets was measured using a universal testing machine. The modified 0-5-scale adhesive remnant index (ARI) was used to assess the amount of adhesive on enamel and bracket surfaces. The surface topography was observed to evaluate enamel damage. RESULTS: The mean (standard deviation [SD]) SBS of 11.07 (1.96) Mega Pascal (MPa) was observed with Filtek Z350, whereas the group bonded with Transbond XT showed the mean (SD) SBS of 12.18 (1.69) MPa. The results showed that Transbond light curing adhesive produced higher SBS than Filtek, but the difference was statistically insignificant (P = 0.088). The comparison of ARI score between the two groups also showed statistically insignificant difference (χ2 = 4.764, df = 5, P = 0.445), and most of the teeth in both groups exhibited score 3 (63%), showing the least damaging mode of bond failure to the enamel bracket interface. CONCLUSION: There was no significant difference in the mean SBS of Filtek Z and Transbond XT adhesives. Both materials showed optimum bond strength to withstand occlusal forces.

Comparison of two different matrix band systems in restoring two surface cavities in posterior teeth done by senior undergraduate students at Qassim University, Saudi Arabia: A randomized controlled clinical trial.

CONTEXT: Dental students commonly face the problem of overhanging proximal margins and unsatisfactory proximal contact points (PCPs) while restoring Class II cavities in posterior teeth. Various matrix band systems are used in dental clinics to avoid such problems. AIMS: The aim of this study is to compare the effects of two matrix band systems, circumferential matrix system and sectional matrix system on the PCPs and contours when restoring Class II cavities in posterior teeth. SETTINGS AND DESIGN: This was a randomized controlled clinical trial done at College of Dentistry, Qassim University, Saudi Arabia. SUBJECTS AND METHODS: Total 1200 Class II cavities in teeth were selected for this study. Treatment was done by senior undergraduate students. Cavities were randomly divided into two groups. Group 1: Total 600 cavities were restored using circumferential band system. Group 2: Total 600 cavities were restored using sectional band system. Teeth were restored either with the composite or the amalgam restoration. Contact points were evaluated. The presence or absence of proximal overhangs was assessed. Overhanging margins were categorized as positive overhangs, negative overhangs, and absent overhangs. STATISTICAL ANALYSIS USED: To identify the relationship between matrix band systems and other factors, Chi-square tests (χ2-tests) and Z-tests were used. Pearson correlation coefficient was computed and logistic regression analysis was carried out to assess variables that can affect proximal margins and contact points of final restorations. RESULTS: All optimum contacts 389 (100%) were found in restorations done using sectional band system. A highly significant association was found between open contact points and negative overhanging margins with the use of circumferential matrix band system (P < 0.00). CONCLUSION: Sectional matrix band system has been found superior to circumferential matrix band system.

Biphasic resection of a mandibular molar.

Teeth once designated obsolete for rehabilitation and deemed for extraction should be re-evaluated for salvaging two thirds or even one-third component of the individual teeth. In our part of the continent, financial restraints can effect the orthodox procedures of root amputation if the final restoration is not provided at an earlier date. This case report enlightens on a biphasic approach combining radisection and coronal resection of a tooth with an endodontic perforation, which is a procedure not normally executed for mandibular molars but was adopted after taking the socioeconomic status of the patient into consideration.

Nonsurgical endodontic management of cutaneously draining odontogenic sinus.

Odontogenic cutaneous sinus tract is a rare but well documented condition. It is usually misdiagnosed as a local skin lesion and maltreated by systemic antibiotics and/or surgical excision with eventual recurrence. This is because the primary etiology is incorrectly determined. We came across a 38 year old patient who presented with a cutaneous lesion on her left cheek with frequent purulent discharge and was not responding to systemic antibiotics. The case history, diagnosis and management of this condition is presented here.