Deep learning for temporomandibular joint arthropathies: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: The accurate diagnosis of temporomandibular disorders continues to be a challenge, despite the existence of internationally agreed-upon diagnostic criteria. The purpose of this study is to review applications of deep learning models in the diagnosis of temporomandibular joint arthropathies. MATERIALS AND METHODS: An electronic search was conducted on PubMed, Scopus, Embase, Google Scholar, IEEE, arXiv, and medRxiv up to June 2023. Studies that reported the efficacy (outcome) of prediction, object detection or classification of TMJ arthropathies by deep learning models (intervention) of human joint-based or arthrogenous TMDs (population) in comparison to reference standard (comparison) were included. To evaluate the risk of bias, included studies were critically analysed using the quality assessment of diagnostic accuracy studies (QUADAS-2). Diagnostic odds ratios (DOR) were calculated. Forrest plot and funnel plot were created using STATA 17 and MetaDiSc. RESULTS: Full text review was performed on 46 out of the 1056 identified studies and 21 studies met the eligibility criteria and were included in the systematic review. Four studies were graded as having a low risk of bias for all domains of QUADAS-2. The accuracy of all included studies ranged from 74% to 100%. Sensitivity ranged from 54% to 100%, specificity: 85%-100%, Dice coefficient: 85%-98%, and AUC: 77%-99%. The datasets were then pooled based on the sensitivity, specificity, and dataset size of seven studies that qualified for meta-analysis. The pooled sensitivity was 95% (85%-99%), specificity: 92% (86%-96%), and AUC: 97% (96%-98%). DORs were 232 (74-729). According to Deek's funnel plot and statistical evaluation (p =.49), publication bias was not present. CONCLUSION: Deep learning models can detect TMJ arthropathies high sensitivity and specificity. Clinicians, and especially those not specialized in orofacial pain, may benefit from this methodology for assessing TMD as it facilitates a rigorous and evidence-based framework, objective measurements, and advanced analysis techniques, ultimately enhancing diagnostic accuracy.

The comparative evaluation of the effects of quercetin, α-tocopherol, and chlorhexidine dentin pretreatments on the durability of universal adhesives.

OBJECTIVE: The aim of this study was to evaluate and compare the effects of chlorhexidine, quercetin, and α-tocopherol on the shear bond strength of universal adhesives in the short (24h) and long term (6 months). MATERIAL AND METHODS: Ninety-six extracted sound molars were collected and divided randomly into four groups: control (no treatment), 2% chlorhexidine, 10% α-tocopherol, and 1% quercetin. The solutions were prepared and applied to the teeth for 60 s, followed by application of All-Bond universal adhesive and composite build-up. Half of the specimens in each group (n = 12) were tested for shear bond strength (SBS) after 24 h of storage and the other half were kept in distilled water for 6 months and then tested for shear bond strength. The shear bond strength test was performed and the failure modes were determined using a stereomicroscope. The data were analyzed using two-way analysis of variance and Tukey's post hoc tests with p ˂ .05 as the significance level. RESULTS: The results of the two-way analysis of variance test showed that there was no significant difference in immediate SBS, and after 6 months, α-tocopherol had the lowest SBS in comparison to the control and CHX subgroups (p < .05). The t-test showed that the shear bond strength in the α-tocopherol and quercetin groups was significantly decreased after 6 months. CONCLUSION: It can be concluded that the solutions used in this study had no adverse effect on immediate SBS. After 6 months, the CHX could preserve SBS in comparison to other groups.

Comparative evaluation of the postbleaching application of sodium ascorbate, alpha-tocopherol, and quercetin on shear bond strength of composite resin to enamel.

OBJECTIVE: This study aimed to evaluate and compare the impacts of the postbleaching application of sodium ascorbate, alpha-tocopherol, and quercetin on the shear bond strength (SBS) of composite resin. MATERIAL AND METHODS: 60 extracted intact maxillary first premolars were collected and were randomly divided into five experimental groups as follows (n=12): Group A (negative control): no bleaching, Group B (positive control): bleaching with 40% hydrogen peroxide (HP), Group C: HP±10% sodium ascorbate for 10min, Group D: HP±10% alpha-tocopherol for 10min, and Group E: HP±1% quercetin for 10min. Composite bonding was done immediately after bleaching for Groups B-E and without any treatment for Group A. After being stored in distilled water at room temperature for 24h, all specimens were tested for SBS in the universal testing machine. One-way analysis of variance and Tukey's post-hoc test were used to analyze the SBS values of all groups. RESULTS: The results showed that the bonding of composite to the unbleached group exhibited the highest mean value of SBS (22.68±2.91MPa). Among the antioxidant-treated groups, the highest SBS value was detected in quercetin-treated specimens (15.45±1.58MPa), which was significantly different from the positive control group (p<.05). CONCLUSION: It could be concluded that 10% quercetin applied for 10min increased the bond strength to bleached enamel, but it was not able to reverse it completely.