Pulp Survival of Cracked Teeth with Reversible Pulpitis after Orthodontic Banding and Coronal Coverage - A Prospective Cohort Study with One Year Follow Up.

INTRODUCTION: The aim of this prospective study was to investigate the 1-year pulp survival of cracked teeth with reversible pulpitis managed with initial stabilization using orthodontic bands, followed by coronal coverage restorations. METHODS: One-hundred-and-twenty-five patients with a cracked tooth with reversible pulpitis each were recruited. Preoperative patient and tooth data were collected. After definitive pulp diagnoses were determined following an interim period of orthodontic banding, coronal coverage restorations were placed. Cox and logistic regression analyses were used to assess possible prognostic factors and to correlate initial time to pulp stabilization while in orthodontic bands with eventual outcome. Pulp survival was determined using both clinical and radiographic findings. RESULTS: One-hundred-and-six cracked teeth were followed up at 1 year. Pulp survival based on clinical and radiographic findings was found in 81 teeth (76.4%). Out of 25 failures, 11 (44%) required root canal treatment (RCT) in the orthodontic band stage and 10 (40%) required RCT during the process of or after coronal coverage restorations. Four teeth (16%) had incidental findings of periapical radiolucencies at the 1-year review without clinical symptoms. Teeth requiring RCT were found to have required longer periods in orthodontic bands prior to a definitive pulp diagnosis (P < .05). CONCLUSION: A step-by-step approach by using orthodontic banding to monitor pulp status may reduce the incidence of RCT required through definitive coronal coverage restorations for cracked teeth with reversible pulpitis.

The use of artificial intelligence to aid in oral hygiene education: A scoping review.

OBJECTIVES: Artificial intelligence (AI) has the potential to aid in constant, non-invasive monitoring of daily oral hygiene practices, potentially on behalf of a dentist or healthcare provider. This review summarises the evidence around the use of AI in the context of oral hygiene education. DATA & SOURCES: This scoping review was developed according to the Joanna Briggs Institute scoping review protocol guidelines and the PRISMA-ScR guidelines. Publications that involved the use of AI for oral hygiene education in any population and setting were included. A systematic electronic database search (MEDLINE via PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, and IEEE Xplore, arXiv, Proquest, Google Scholar, ClinicalTrials.gov, and PROSPERO) up to, and including 4 February 2023 was carried out. Citation searching from the full-text of included publications was also performed. RESULTS: Of the 3215 publications screened, 20 were selected for qualitative synthesis. These were broadly divided into two categories of AI-assisted feedback: (1) synchronous and (2) asynchronous monitoring. There is a lack of high-quality studies, scarce reflection on possible ethical concerns on AI, and of studies comparing qualitative feedback to quantitative clinical outcomes with a control. Barriers to adoption of AI technologies, patient privacy, and specific areas for improvement were identified. CONCLUSION: Within the limitations of this study, the use of AI to modify oral hygiene behaviour is promising. Further work is required in generating higher quality intra-oral images for dental biofilm detection, and in developing more personalised feedback for users. CLINICAL SIGNIFICANCE: This is the first review to map out the available literature on AI in providing oral hygiene education. It may be useful to dental researchers in appraising AI-assisted technologies in the context of oral health.

Validation of two clinical color measuring instruments for use in dental research.

OBJECTIVE: There are several shade matching instruments developed for clinical use, but the validity of their use in dental research has not been thoroughly investigated. The objective of this study is to evaluate the accuracy of using two clinical color measuring instruments, VitaEasyshade and Spectroshade, against a referent laboratory color measuring instrument (Spectroradiometer PR670). METHODS AND MATERIALS: The validity and repeatability of the referent laboratory color measuring instrument was assessed using standard color patches with certified CIE L*a*b* values. 10% of the 240 color patches were randomly selected and measured ten times in a random order to test for repeatability. 16 metal ceramic specimens, fabricated from base metal alloy veneered with porcelain of different Vita Classic shades, were measured for L*a*b* values using the PR670, Vita EasyShade and the Spectroshade. The CIE L*a*b* values obtained from the three color measuring instruments were compared using repeated measures ANOVA and post hoc using the Bonferroni test. The color difference, CIEDE2000 (∆E00), between the gold standard (PR670) and the two color measuring instruments were also determined and compared against the known perceptible color difference. RESULTS: L*a*b* values varied significantly between the three instruments. When comparing the mean ΔE00, the differences in values between PR670 and Spectroshade were not clinically significantly. However, the mean ΔE00 values between PR670 and Vita Easyshade were both clinically and statistically significant. CONCLUSION: The lack of clinical significance in values obtained from the SpectroShade when compared to those obtained by the PR670 suggests that the SpectroShade may be recommended for use in dental color research. CLINICAL SIGNIFICANCE: The SpectroShade instrument and PR670 spectroradiometer provided values that lacked clinical significance, suggesting that its use may be highly beneficial for clinical shade matching as well as color research.

Spectrophotometric and Visual Evaluation of Maxillary Anterior Implant Crowns and Peri-implant Soft Tissues: A Retrospective Study.

PURPOSE: To visually and spectrophotometrically determine the differences in the shades of maxillary anterior implant crowns and peri-implant soft tissues compared to a natural teeth control group. MATERIALS AND METHODS: A total of 44 patients restored with single implant-supported restorations were assessed after at least 6 months in function. Images of the implant crowns, peri-implant soft tissues, and their controls were captured using a spectrophotometer (SpectroShade Micro, Medical High Technologies). Visual assessment of shade differences between the implant crowns and peri-implant soft tissues and their controls were performed by the patients and four dental professionals using a visual analog scale (VAS). Analysis of variance was applied to detect differences between groups. RESULTS: The mean color differences (ΔE) between the implant crowns and peri-implant soft tissues and their respective controls were 4.8 ± 2.6 and 6.6 ± 2.7, respectively. A significant difference (P = .025) in mean ΔE values was observed only at the cervical third of the implant crowns. The patient group showed the highest mean VAS scores for shade matching of the implant crowns (8.4 ± 1.2) and peri-implant soft tissues (7.8 ± 1.6) with their respective controls. CONCLUSION: Spectrophotometric analysis showed significant shade differences at the cervical third of the implant crowns. The patients were more satisfied with the shade matching of their implant restorations than the dental professionals.