Application of 4D printing in dentistry: A narrative review.

4D printing is an innovative digital manufacturing technology that originated by adding a fourth dimension, i.e., time, to pre-existing 3D technology or additive manufacturing (AM). AM is a fast-growing technology used in many fields, which develops accurate 3D objects based on models designed by computers. Dentistry is one such field in which 3D technology is used for manufacturing objects in periodontics (scaffolds, local drug-delivering agents, augmentation of ridges), implants, prosthodontics (partial and complete dentures, obturators), oral surgery for reconstructing jaw, and orthodontics. Dynamism is a vital property needed for the survival of materials used in the oral cavity since the oral cavity is constantly subjected to various insults. 4D printing technology has overcome the disadvantages of 3D printing technology, i.e., it cannot create dynamic objects. Therefore, constant knowledge of 4D technology is required. 3D printing technology has shortcomings, which are discussed in this review. This review summaries various printing technologies, materials used, stimuli, and potential applications of 4D technology in dentistry.

Quantitative and qualitative analysis of metallic ion release of orthodontic brackets in three different pH conditions - An invitro study.

Background: Fluoridated mouth rinses improve anti-cariogenic environment but decrease oral pH below critical value, affecting orthodontic bracket surface topography and causing corrosive changes over prolonged use. This invitro study aimed to quantitatively and qualitatively assess the surface topography and metallic ion release of the stainless steel (SS) brackets at varying acidic and alkaline pH. Materials and methods: Forty unused SS brackets were divided into four groups (Group A, B, C, D) and immersed for 48- hours in solutions of artificial saliva and sodium fluoride (0.2 %) mouth rinse at varying pH of 5.5,6.7,7 and 8. The surface morphologic changes were analyzed under scanning electron microscope (SEM) at 50×, 150×, and 500× magnification. The changes in slot area were scored using the customized scale. The Energy Dispersive Xray Spectroscopy Analysis (EDAX) was used to estimate the probed elements' atomic and weight percentage. Results: The mean score of the scale was 3.4 for the brackets immersed in the acidic solution which was statistically significant (p = 0.00)and for alkaline and neutral solutions (p = 0.00). Chromium was found to be significantly higher in the alkaline solution (p = 0.016) followed by the neutral solution. Carbon was found excess in acidic solution than the neutral and alkaline solution. Conclusion: Quantitative and qualitative analysis of the ion release in stainless steel brackets using SEM and EDAX revealed the corrosive effect of fluoride ion causing maximum surface changes in acidic medium and chromium release in alkaline pH.

Treatment outcomes of digital nasoalveolar moulding in infants with cleft lip and palate: A systematic review with meta-analysis.

The aim of this systematic review was to compare the treatment outcomes of digital nasoalveolar moulding (dNAM) technique with conventional nasoalveolar moulding (cNAM) or non-presurgical intervention protocol in infants with unilateral (UCLP) or bilateral (BCLP) cleft lip and palate. A bibliometric search by MEDLINE (via Ovid), Embase, Cochrane Library, grey literature and manual method was conducted without language restriction until November 2023. Literature screening and data extraction were undertaken in Covidence. The risk of bias was evaluated using the Newcastle-Ottawa Scale and RoB-2. Pooled effect sizes were determined through random-effects statistical model using R-Software, and the certainty of evidence was assessed using the GRADE approach. Among 775 retrieved articles, nine studies were included for qualitative synthesis (6-UCLP, 3-BCLP), with only three eligible UCLP studies for meta-analysis. In the UCLP group, very low certainty of evidence indicated no difference in alveolar cleft width (SMD, 0.13 mm; 95% CI, -0.31 to 0.57; I2, 0%), soft tissue (lip) cleft gap, nasal width, nasal height, and columellar deviation angle changes between dNAM and cNAM. In the BCLP group, qualitative synthesis suggested similar changes in alveolar, lip, and nasal dimensions with dNAM and cNAM. In both cleft groups (UCLP, BCLP), reduced alveolar cleft width was observed in the dNAM group compared to the non-presurgical intervention protocol, along with fewer clinical visits and reduced chairside time for dNAM compared to cNAM. It can be concluded that the treatment outcomes with dNAM were comparable to cNAM in reducing malformation severity and were advantageous in terms of chairside time and clinical visit frequency. However, the overall quality of evidence is very low and standardization is needed for the virtual workflow regarding the alveolar movements and growth factor algorithms. Registration: PROSPERO-database (CRD42020186452).

Does the use of platelet-rich fibrin enhance the rate of orthodontic tooth movement? A systematic review and meta-analysis.

Introduction: This review synthesizes the available evidence pertinent to the effect of platelet-rich fibrin on the rate of orthodontic tooth movement during comprehensive orthodontic treatment. Method: This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Nine electronic databases were searched until January 2024 without restrictions, followed by a hand search of the reference lists. Controlled randomized split-mouth human studies assessing the effect of platelet-rich fibrin on the rate of orthodontic tooth movement were included. All relevant data from the included studies were extracted and pooled for qualitative and quantitative analysis. Risk-of-Bias was assessed using the Cochrane Risk of Bias tool. The certainty of the evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation tool. Results: From 515 studies, eleven randomized clinical trials were included for qualitative analysis and nine for quantitative analysis. The certainty of the evidence for these studies was low to moderate. The overall risk of bias for most studies was of some concern. The pooled estimate of the data from ten studies has a mean revealed difference of 1.31 (0.13-2.48) at a 95 % confidence interval with significant heterogeneity. Conclusions: This systematic review suggest that platelet-rich fibrin enhances the orthodontic tooth movement rate, but the evidence quality was moderate. Further, based on the currently available evidence, the effectiveness of platelet-rich fibrin on the acceleration of orthodontic tooth movement could not be fully established. Trial registration: PROSPERO: (CRD42021261836).

Evaluation of scientific quality of YouTube video content related to orthodontic pain management.

INTRODUCTION: With the abundant use of the internet, patients undergoing or interested in orthodontic treatment try to use it to obtain information on pain during treatment. However, YouTube™ is unregulated and may potentially contain inaccurate information. OBJECTIVES: Thus, this study aimed to evaluate the scientific quality of the videos on YouTube™ related to orthodontic pain management. METHODS: A total of 62 videos related to orthodontic pain management were included in the study. All videos were evaluated by two experienced orthodontists. The video uploader, content, length, upload date, time since upload, number of views, comments, likes, dislikes, Interaction index, and Viewing rate of the videos were recorded and evaluated. The videos were scored using the Quality Criteria for Consumer Health Information (DISCERN), Global Quality Scale (GQS), and Audio-Visual Quality (AVQ), and divided into two groups: Doctors and Non-doctors. RESULTS: The mean DISCERN score was 2.56 ± 0.91, the GQS score was 2.56 ± 1.06, and AVQ was 2.48 ± 0.68. A statistically significant difference was found in DISCERN score of videos uploaded by Doctors compared to Non-doctors, but no statistically significant difference was found in GQS and AVQ scores between both groups (p> 0.05). CONCLUSIONS: The videos uploaded by Doctors were better in terms of quality and reliability, as compared to Non-doctors; and the AVQ of the videos uploaded by both groups was adequate. Despite that, both groups did not serve as a good source of information. YouTube™ cannot be considered a reliable source of information in terms of quality and reliability on videos related to orthodontic pain management.

Cervical Vertebral Maturation Assessment using various Machine Learning techniques on Lateral cephalogram: A systematic literature review.

Importance: For the assessment of optimum treatment timing in dentofacial orthopedics, understanding the growth process is of paramount importance. The evaluation of skeletal maturity based on study of the morphology of the cervical vertebrae has been devised to minimize radiation exposure of a patient due to hand wrist radiography. Cervical vertebral maturation assessment (CVMA) predictions have been examined in the state-of-the-art machine learning techniques in the recent past which require more attention and validation by clinicians and practitioners. Objectives: This paper aimed to answer the question "How are machine learning techniques being employed in studies concerning cervical vertebral maturation assessment using lateral cephalograms?" Method: A systematic search through the available literature was performed for this work based upon the Population, Intervention, Comparison and Outcome (PICO) framework. Data sources study selection data extraction and synthesis: The searches were performed in Ovid Medline, Embase, PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR). A search of the grey literature was also performed in Google Scholar and OpenGrey. We also did a hand-searching in the Angle Orthodontist, Journal of Orthodontics and Craniofacial Research, Progress in Orthodontics, and the American Journal of Orthodontics and Dentofacial Orthopedics. References from the included articles were also searched. Main outcomes and measures results: A total of 25 papers which were assessed for full text, and 13 papers were included for the systematic review. The machine learning methods used were scrutinized according to their performance and comparison to human observers/experts. The accuracy of the models ranged between 60 and 90% or above, and satisfactory agreement and correlation with the human observers. Conclusions and relevance: Machine learning models can be used for detection and classification of the cervical vertebrae maturation. In this systematic review (SR), the studies were summarized in terms of ML techniques applied, sample data, age range of sample and conventional method for CVMA, which showed that further studies with a uniform distribution of samples equally in stages of maturation and according to the gender is required for better training of the models in order to generalize the outputs for prolific use to target population.

Comparative evaluation of nasolabial appearance of unilateral cleft lip and palate patients by professional, patient and layperson using 2 aesthetic scoring systems: A cross sectional study.

OBJECTIVE: To compare the perspective of healthcare providers (orthodontists), cleft patients and laypersons in judging nasolabial aesthetics in patients with complete unilateral cleft lip, with or without cleft palate (UCL ± P) using 2 scoring systems. DESIGN: This cross-sectional study was conducted in a tertiary care government hospital. PATIENTS: Photographic records of 100 patients with complete UCL ± P from the age group of 5-18 years (mean age-12.2 ± 3.93 years) were included in this study. METHOD: Photographic records of 100 patients with complete UCL ± P from the age group of 5-18 years were included. A panel of 3 orthodontists, 3 laypersons and 3 cleft patients rated nasolabial aesthetics using 2 scoring systems i.e. Asher-McDade index (AMAI) and Cleft Aesthetic Rating Scale (CARS). Spearman's split-half reliability, Intra-class correlation coefficient and Cronbach's alpha were computed to measure internal consistency and reliability. Inter-panel agreement between pair of groups was determined by means of Spearman correlation coefficient. RESULTS: Estimated reliability of CARS for 3 raters in each panel was in moderate agreement for orthodontists and cleft patients (0.849 and 0.810). Good repeatability and agreement were recorded with moderate to high intra-panel reliability for all parameters of both AMAI and CARS. Overall inter-panel agreement was moderate for both AMAI and CARS. Pair-wise inter-panel agreement showed a moderately positive correlation in both scales (AMAI and CARS) by cleft patients and professionals. CONCLUSION: CARS index can be reliably used for assessment of nasolabial aesthetics by cleft patients, professionals and lay persons on 2D facial photographs. Patients were more critical than clinicians and laypersons using both indices (CARS and AMAI) as they are more self-aware and conscious. Thus, a clear communication between clinician and patient regarding expectations, perception and satisfaction with surgical results is strongly recommended.

Nasolabial appearance in unilateral cleft lip and palate patients: A comparison of aesthetics using two scoring systems: A cross-sectional study.

OBJECTIVE: The objective of the study was to assess nasolabial aesthetics in patients with complete unilateral cleft lip, with or without cleft palate (UCL ± P) using two scoring systems. DESIGN: A cross-sectional study conducted in a tertiary care government hospital. PATIENTS: Photographic records of 91 patients with complete UCL ± P from the age group of 5-18 years (mean age = 13.2 ± 3.14 years) were included. METHOD: A panel of three orthodontists with varying experience in cleft management rated nasolabial aesthetics using two scoring systems, that is Asher Mc-Dade index (AMAI) and Cleft Aesthetic Rating Scale (CARS). Intraclass correlation coefficient, Fleiss' kappa and Cronbach's alpha were used to measure the internal consistency amongst three raters and Spearman-Brown formula was used for measuring overall reliability. Time required for assessment of each photograph was compared with ANOVA. RESULTS: Overall, both AMAI and CARS showed high reliability and outcome assessment with good inter-rater reliability and internal consistency, when used independently by orthodontists having varied experience. Statistically significant difference was present in time taken for assessment of nasolabial aesthetics with CARS index (8.75 ± 1.65 seconds) as compared to AMAI (18.62 ± 3.49 seconds). CONCLUSION: Asher Mc-Dade index and CARS are equally reliable and consistent for the assessment of nasolabial aesthetics in patients with UCL ± P. However, considerably less time was taken for the assessment using CARS index as compared to AMAI. The use of CARS index is recommended for the initial assessment and screening of patients by orthodontists using two dimensional photographs.

Effects of RME on Hearing in UCLP Patients: A Pilot Study.

OBJECTIVE: To assess the changes in hearing after rapid maxillary expansion (RME) and at the end of 6 months retention period in complete unilateral cleft lip and palate (UCLP) patients using pure tone audiometry and tympanometry test. DESIGN: Prospective pilot study. SETTING: Tertiary health care teaching hospital in New Delhi. PATIENTS: This study was conducted on 6 UCLP patients in the age range of 6-14 years with normal ear anatomy. All 6 patients had undergone primary repair of cleft lip and palate and required no more than 5 mm expansion in the intermolar region. INTERVENTION: RME was done using a Hyrax expander with daily activation of one-quarter turn per day for a period of 15-20 days (0.25 mm per day). MAIN OUTCOME MEASURE: Audiometry and tympanometry readings at the baseline as compared to the post expansion and at the end of 6 months retention period. RESULTS: There were no significant changes in the hearing levels on the audiometry test after RME on the cleft side (p-value -0.51) and the noncleft side ear (p-value -0.26). No significant changes were observed in the middle ear volume on the tympanometry test after RME on the cleft side (p-value -0.09) and the noncleft side ear (p-value -0.28). CONCLUSION: There was no improvement or deterioration in the hearing levels after RME and at the end of 6 months retention period in UCLP patients as evaluated using pure tone audiometry and tympanometry test. Hence RME may be undertaken in UCLP patients safely in terms of hearing is concerned.

Evaluation of scientific quality of YouTube video content related to orthodontic pain management

ABSTRACT Introduction: With the abundant use of the internet, patients undergoing or interested in orthodontic treatment try to use it to obtain information on pain during treatment. However, YouTube™ is unregulated and may potentially contain inaccurate information. Objectives: Thus, this study aimed to evaluate the scientific quality of the videos on YouTube™ related to orthodontic pain management. Methods: A total of 62 videos related to orthodontic pain management were included in the study. All videos were evaluated by two experienced orthodontists. The video uploader, content, length, upload date, time since upload, number of views, comments, likes, dislikes, Interaction index, and Viewing rate of the videos were recorded and evaluated. The videos were scored using the Quality Criteria for Consumer Health Information (DISCERN), Global Quality Scale (GQS), and Audio-Visual Quality (AVQ), and divided into two groups: Doctors and Non-doctors. Results: The mean DISCERN score was 2.56 ± 0.91, the GQS score was 2.56 ± 1.06, and AVQ was 2.48 ± 0.68. A statistically significant difference was found in DISCERN score of videos uploaded by Doctors compared to Non-doctors, but no statistically significant difference was found in GQS and AVQ scores between both groups (p> 0.05). Conclusions: The videos uploaded by Doctors were better in terms of quality and reliability, as compared to Non-doctors; and the AVQ of the videos uploaded by both groups was adequate. Despite that, both groups did not serve as a good source of information. YouTube™ cannot be considered a reliable source of information in terms of quality and reliability on videos related to orthodontic pain management.

RESUMO Introdução: Com o uso abundante da Internet, os pacientes em tratamento ortodôntico, ou interessados em fazê-lo, tentam usá-la para obter informações sobre a dor durante o tratamento. Entretanto, o YouTube™ não é regulamentado e pode conter informações imprecisas. Objetivos: Esse estudo teve como objetivo avaliar a qualidade científica de vídeos no YouTube™ relacionados ao controle da dor ortodôntica. Métodos: No total, 62 vídeos relacionados ao controle da dor ortodôntica fora incluídos nesse estudo. Todos os vídeos foram avaliados por dois ortodontistas experientes. O responsável pela postagem do vídeo, seu conteúdo, sua duração, data de postagem, tempo decorrido desde a postagem, o número de visualizações, os comentários, os likes, os deslikes, o índice de interação e a taxa de visualização dos vídeos foram registrados e avaliados. Os vídeos foram pontuados usando os Critérios de Qualidade para Informações sobre Saúde do Consumidor (DISCERN), a Escala de Qualidade Global (GQS) e a Qualidade Audiovisual (AVQ), e divididos em dois grupos: Doutores e Não Doutores. Resultados: A pontuação DISCERN média foi de 2,56 ± 0,91, a pontuação GQS foi de 2,56 ± 1,06 e a AVQ foi de 2,48 ± 0,68. Foi encontrada uma diferença estatisticamente significativa na pontuação DISCERN dos vídeos postados por Doutores, em comparação com os Não Doutores, mas não foi encontrada diferença estatisticamente significativa nas pontuações GQS e AVQ entre os dois grupos (p> 0,05). Conclusões: Os vídeos postados pelos Doutores foram melhores em termos de qualidade e confiabilidade, em comparação com os Não Doutores, e o AVQ dos vídeos postados por ambos os grupos foi adequado. Apesar disso, ambos os grupos não serviram como uma boa fonte de informações. Em termos de qualidade e confiabilidade dos vídeos relativos ao manejo da dor ortodôntica, o YouTube™ não pode ser considerado uma fonte confiável de informações.

Efficacy of digital nasoalveolar molding in reducing severity of cleft lip or palate malformation in infants: a systematic review protocol.

OBJECTIVE: This review will compare the efficacy of nasoalveolar molding plates fabricated using a digital workflow to conventional fabrication methods or no intervention in infants with cleft lip or palate. INTRODUCTION: Nasoalveolar molding reduces the severity of orofacial defects in infants with cleft lip or palate using a series of adaptable plates for the maxillary arch. The conventional method needs multiple patient visits at short intervals for treatment. A digital workflow can be used to fabricate multiple plates in one appointment, which eliminates human error, reduces the number of appointments, and allocates more time for patient care for the orthodontic team than appliance fabrication. INCLUSION CRITERIA: This review will consider clinical studies that report the results of digital nasoalveolar molding in infants with cleft lip or palate and compare it to the conventional method or to no treatment. Outcomes of interest will be objective measures of craniofacial form, nasolabial measurements, or palatal form. METHODS: This review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases including PubMed, Embase, Cochrane Oral Health Group Trial Register, and ClinicalTrials.gov will be searched using appropriate keywords. Publications in English will be considered. Screening based on titles and abstracts will be done after de-duplication, followed by full-text reading for selection based on the inclusion criteria. Data extracted from the studies will be tabulated and assessed for risk of bias. If applicable, a meta-analysis of the pooled data will be conducted. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020186452.

Ectopic Eye Tooth Management: Photobiomodulation/Low-Level Laser Emission Role in Root Resorption after Fixed Orthodontic Treatment.

Aim: This study evaluates the role of low-level laser emission/photobiomodulation (LE/P) in quantitative measurements of root resorption (QRR). The application of LE/P performed after each orthodontic activation with four types of treatment intervention (TI) on the root resorption (RR) after fixed orthodontic treatment (FOT) of the upper arch with ectopic eye tooth/teeth [EET] was investigated. Materials and Methods: Thirty-two orthodontic patients scheduled for FOT were selected and assigned to the four groups. These were LE/P + Self ligating bracket (SLB), LE/P + Conventional bracket (CB), non-photobiomodulation (non-LE/P) + SLB and non-LE/P + CB. Standard management stages of FOT were followed in the maxilla. Each patient received a single application of LE/P labially/buccally and palatally, a total of five different points were used during each activation or appointment. The main outcome measure was QRR in maxillary anteriors before and after FOT, assessed via cone-beam computed tomography (CBCT) using 3D OnDemand software. Results: Insignificant QRR was found between before and after FOT in SLB, CLB, and LE/P, non-LE/P groups (p > 0.05). QRR in the SLB vs. CB and LE/P vs. non-LE/P group was significantly different in 11, 13, and 23 (p < 0.05). QRR in the LE/P + SLB group (p < 0.05) was significantly different in 11, 13, and 23 than that in the other groups. The most severe QRR was found on 13 (0.88 ± 0.28 mm and 0.87 ± 0.27 mm) and 23 (1.19 ± 0.14 mm and 1.16±0.13 mm) in the CB and non-LE/P group (p < 0.001). LE/P + SLB showed a highly significant superior outcome (p < 0.001) in relation to non-LE/P + CB, the QRR of 23 were 0.813 ± 0.114 mm and 1.156 ± 0.166 mm, respectively. Conclusion: Significantly higher amounts of QRR were found in EET patients after FOT treated with the CB, non-LE/P, and non-LE/P + CB system and warrant further investigation to explore potential specific causes.

Mucoadhesive silver nanoparticle-based local drug delivery system for peri-implantitis management in COVID-19 era. Part 1: antimicrobial and safety in-vitro analysis.

BACKGROUND: Pseudomonas aeruginosa, a major respiratory pathogen, has been isolated from peri-implant sites and is associated with dental implant failure. This in-vitro study (part 1) aimed to fabricate a novel mucoadhesive silver nanoparticle-based local drug delivery chip, evaluate its antimicrobial efficacy against P. aeruginosa, and its safety for the treatment of peri-implantitis. MATERIALS AND METHODS: Silver nanoparticles were synthesized and characterized using a transmission electron microscope (TEM). The local drug delivery chip was fabricated using gelatin, glycerol, silver nanoparticle solution (2.5 µg/ml, 5 µg/ml, 7.5 µg/ml, and 10 µg/ml), glutaraldehyde, and sodium alginate solution. These chips were evaluated for physical parameters, effect on viability of murine macrophage cell line J774A.1, and antimicrobial activity (using Kirby-Bauer disc diffusion method with 18 h incubation period) against P. aeruginosa ATCC 27853. RESULTS: Silver nanoparticle antimicrobial chip exhibited dimensions of 4 mm × 5 mm x 0.4 mm, 5.8 mg weight, pH 5-6, folding endurance 1.04, and one-year stability. P. aeruginosa was susceptible to ≥ 7.5 µg/ml concentration of silver nanoparticles (spherical shape with particle size ranging from 10 to 100 nm). Murine macrophage cells exhibited 93% viability after 24 h incubation with silver nanoparticle chips. CONCLUSION: The novel silver nanoparticle chip showed dimensional stability, minimal effect on murine macrophage cell viability, and significant antimicrobial activity against P. aeruginosa. With the further establishment of its effective dosage and safety, this chip could be used as an adjunct to mechanical debridement (as a non-aerosol generating procedure) in treating peri-implantitis, especially during the ongoing coronavirus disease 2019 (COVID-19) pandemic.

Does periodontal disease elevate the risk of Alzheimer's disease and mild cognitive impairment?

Data sources The electronic databases Medline, the Cochrane Central Register of Controlled Trials, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform, from inception to September 2020, were searched to identify the eligible studies measuring the association between periodontal disease and Alzheimer's disease or mild cognitive impairment.Study selection Cohort, cross-sectional and case-control studies, without any language restrictions, were selected by two reviewers independently.Data extraction and synthesis Data extraction and quality assessment were performed by two reviewers independently. Data was synthesised quantitatively with meta-analyses using a random or fixed-effects model, with P <0.1 considered statistically significant. Quality assessment of cohort and case-control studies was carried out using the Newcastle-Ottawa scale (NOS) and quality assessment of cross-sectional studies was undertaken using the Agency for Healthcare Research and Quality (AHRQ) tool. Heterogeneity of included studies was assessed with I2.Results Thirteen studies, including five cross-sectional studies, five case-control studies, two retrospective cohort studies and one prospective cohort study were found to be eligible. Meta-analyses showed elevated risk for Alzheimer's disease (odds ratio = 1.78; random-effects model; significant heterogeneity) and mild cognitive impairment (odds ratio = 1.60; fixed-effects model; low heterogeneity) in patients with periodontal disease. One case-control study and all cohort studies had high quality, while four case-control studies had medium quality, as evaluated by the NOS. Among the cross-sectional studies evaluated by the AHRQ tool, only one had high quality, whereas other studies had medium quality.Conclusions Within the limitations of the included studies, the authors concluded that periodontal disease is related to an elevated risk of Alzheimer's disease and mild cognitive impairment.

3D printing for fostering better dental education.

Aim This pilot study evaluated a novel method of teaching dental caries removal to overcome the drawbacks in using plastic teeth that neither simulate carious lesions nor emulate the hard tissues of the tooth.Methods This study evaluated the students' perception of a novel method of pre-clinical teaching of caries removal on 3D-printed teeth with a simulated carious lesion. The lesion was simulated by creating an area of low density within the printed tooth. The study also examined the variation in location and extent of cavity preparation by the participants using a heat map analysis. Students who were in their final year of graduation, in the same university of the researchers, prepared cavities on the 3D-printed teeth and answered a questionnaire on their perceived readiness for clinical practice with conventional teaching versus the 3D-printed teeth.Results Among the 14 participants, a majority stated that they had high levels of anxiety when treating their first carious lesion and that the 3D-printed teeth would have better prepared them to treat patients. More than half indicated that the 3D-printed teeth had a better haptic simulation of caries removal and would have reduced their stress/anxiety when treating their first caries patient. There was a wide variation in the perimeter and the surface area of the cavity preparations by the participants.Conclusion Teaching caries removal with 3D-printed teeth that emulate a carious lesion could help students gain confidence and make them feel better prepared to treat patients in clinics.

Current Applications of Artificial Intelligence in Cleft Care: A Scoping Review.

Objective: This scoping review aims to identify the various areas and current status of the application of artificial intelligence (AI) for aiding individuals with cleft lip and/or palate. Introduction: Cleft lip and/or palate contributes significantly toward the global burden on the healthcare system. Artificial intelligence is a technology that can help individuals with cleft lip and/or palate, especially those in areas with limited access to receive adequate care. Inclusion Criteria: Studies that used artificial intelligence to aid the diagnosis, treatment, or its planning in individuals with cleft lip and/or palate were included. Methodology: A search of the Pubmed, Embase, and IEEE Xplore databases was conducted using search terms artificial intelligence and cleft lip and/or palate. Gray literature was searched using Google Scholar. The study was conducted according to the PRISMA- ScR guidelines. Results: The initial search identified 458 results, which were screened based on title and abstracts. After the screening, removal of duplicates, and a full-text reading of selected articles, 26 publications were included. They explored the use of AI in cleft lip and/or palate to aid in decisions regarding diagnosis, treatment, especially speech therapy, and prediction. Conclusion: There is active interest and immense potential for the use of artificial intelligence in cleft lip and/or palate. Most studies currently focus on speech in cleft palate. Multi-center studies that include different populations, with collaboration amongst academicians and researchers, can further develop the technology.

Correlation between chronological age and skeletal maturity in different malocclusions: A retrospective study.

INTRODUCTION: The timing of initiation and duration of the pubertal peak is important in dentofacial orthopaedics as the mandible expresses maximum growth during the pubertal peak. The aim of the study was to compare the mean chronological age with skeletal age in three skeletal jaw relations. MATERIALS AND METHODS: The sample consisted of 787 cephalograms divided into class I, class II, and class III skeletal relationship, in which cervical vertebrae stages were assessed. Dunn test was used to compare different types of malocclusion. Pubertal peak duration was assessed by comparing the respective 95% CI. RESULTS: There was no statistically significant difference in the mean chronological age in all three malocclusion groups at CS2, CS3, CS4 and CS5. There was no significant difference in the mean age of boys and girls at each CVM stage, but class III boys have significantly delayed maturity during the pubertal spurt at CS4 (14.6 years±0.98) compared with girls (13.3 years±1.48) with P=0.02. The pubertal peak duration was 1.27 years (CI: 0.77-1.76) in the class I children, 0.96 (CI: 0.58-1.34) in the class II children and 1.15 years (CI: 0.26-2.0) in the class III children. In the class III children, the duration of the pubertal peak was higher for boys, 1.74 years (CI: 0.66-2.82) compared with girls, 0.8 years (CI: 0.42-2.82). CONCLUSIONS: There was positive correlation between chronological age and CVM stages in each skeletal jaw relation. Average time of attaining of a pubertal spurt is similar in class I, class II and class III children. Class III girls reach puberty slightly earlier than boys and puberty ends lately in class III boys. Class II boys have the shortest duration of the pubertal peak and class III boys have the longest duration of the pubertal peak.

Parental response to the feeding behavior problems in children with cleft lip and palate: A systematic review.

OBJECTIVE: To assess and analyze the global status of parental responses to feeding problems in patients with cleft lip and palate (CLP) and to provide recommendations for future research. DESIGN: A priori protocol was formulated according to PRISMA guidelines and registered. The predefined search strategy was used in established search engines up to July 27, 2020 without any restriction of language or year of publication. Studies evaluating the parental responses to feeding problems in patients with CLP were included. The data extraction was performed with a self-designed form, and risk of bias (ROB) was assessed. RESULTS: Out of 27 identified papers, eight studies could be included. Most were from Europe, conducted between 1994 and 2020, and had utilized valid and reliable questionnaires. The included studies showed moderate or low ROB. The majority of the studies reported parental dissatisfaction with the knowledge provided. The presence of anxiety and low self-esteem among parents was also highlighted. CONCLUSIONS: There was general consensus regarding lack of medical advice and support for CLP families, along with the presence of anxiety and low self-esteem among parents. Well-designed studies from different regions of the world must be conducted in the future for an accurate global picture to be presented.