Early tooth loss in pediatric patients can lead to various complications, making quick and accurate diagnosis essential. This study aimed to develop a novel deep learning model for classification of ...missing teeth on panoramic radiographs in pediatric patients and to assess the accuracy. The study included patients aged 8-16 years who visited the Pusan National University Dental Hospital and underwent panoramic radiography. A total of 806 panoramic radiographs were retrospectively analyzed to determine the presence or absence of missing teeth for each tooth number. Moreover, each panoramic radiograph was divided into four quadrants, each of a smaller size, containing both primary and permanent teeth, generating 3224 data. Quadrants with missing teeth (n = 1457) were set as the experimental group, and quadrants without missing teeth (n = 1767) were set as the control group. The data were split into training and validation sets in a 4:1 ratio, and a 5-fold cross-validation was conducted. A gradient-weighted class activation map was used to visualize the deep learning model. The average values of sensitivity, specificity, accuracy, precision, recall and F1-score of this deep learning model were 0.635, 0.814, 0.738, 0.730, 0.732 and 0.731, respectively. In the experimental group, the accuracy was the highest for missing canines and premolars, and the lowest for molars. The deep learning model exhibited a moderate to good distinguishing power with a classification performance of 0.730. This deep learning model and the newly defined small sized region of interest proved adequate for classifying the presence of missing teeth.
Introduction: Hypo hyperdontia is a numeric mixed anomaly in which teeth may be supernumerary or absent, relative to the normal complement. The occurrence of this condition in the same individual is ...termed “Concomitant Hypo-Hyperdontia” (CHH). The presence of CHH in the same dental arch is uncommon, especially when it occurs in the front of the mandible in a Non-syndromic Concomitant Hypo-Hyperdontia (NCHH). Aim: To conduct a literature review of the published articles in the English language, regarding NCHH in the anterior region of the mandible covering the period from October 1977 to December 2021. Materials and Methods: An extensive electronic search was conducted in February 2022, from Google Scholar, PubMed, and Elton B. Stephens Company (EBSCO) databases, using keywords such as mandible, hypodontia, hyperdontia and non-syndromic. Manual sorting of the preselected literature, revealed only 19 published papers concerning NCHH in the frontal region of the mandible, spanning a period of 44 years. Results: The review analysed the data from 19 published studies, which presented 24 affected patients with a mean age of 12.36 years, with a male/female ratio of 1:1, involving a total of 41 missing teeth, including bilateral mandibular central incisors at 66.66%, followed by missing unilateral central incisor at 29.16% and 1 case (4.16%) displaying absence of both lateral incisors. Regarding 25 presented supernumerary teeth (ST), 72% of cases presented single midline ST, 20% were single unilateral ST, and one case presented double ST (8%) located bilaterally. The majority of ST (84%) were erupted conical-shaped. Conclusion: The study confirmed the exceptionally rare occurrence of NCHH in the anterior region of the mandible. Due to its interference with esthetics and function, the clinician should possess sufficient knowledge regarding NCHH diagnosis and management.
Background To evaluate the association of dental diseases and oral hygiene care with incidence of heart failure (HF) among patients with type 2 diabetes. Methods and Results This study included 173 ...927 patients with type 2 diabetes aged ≥40 years, who underwent Korean National Health Insurance Service health examinations in 2008 and were followed up until the end of 2017. Hazard ratios (HRs) and 95% CIs for HF were estimated using multivariable Cox proportional hazards regression analysis. During a median follow-up of 9.3 years, 1.94% of participants developed HF. An increased number of missing teeth was associated with a higher risk of HF (
<0.001). HRs of HF increased among individuals with ≥15 missing teeth (HR, 1.37 95% CI, 1.14-1.64) compared with those without missing teeth. Decreased risk of HF was observed in individuals with ≥1 time/year of professional dental cleaning (HR, 0.93 95% CI, 0.87-0.99) and in those with ≥2 times/d of toothbrushing (HR, 0.90 95% CI, 0.82-0.98) compared with those without these practices. While combined presence of missing teeth and periodontal disease (
=0.004) or dental caries (
=0.007) increased HF risk, combined oral hygiene care was associated with further HF risk reduction (
=0.024). Better oral hygiene care was associated with decreased HF risk, even as the number of missing teeth increased (
<0.001). Conclusions Among patients with type 2 diabetes, dental diseases and oral hygiene care are important determinants of HF development. Dental disease management and good oral care may prevent HF in patients with type 2 diabetes.
This clinical study evaluated the outcome and survival rate of resin-bonded fixed dental prostheses (RBFDPs) made of 3Y-TZP zirconia ceramic with a single-retainer design in the replacement of ...missing canines, premolars and molars.
Twenty-one patients that were provided with twenty-seven cantilevered zirconia ceramic RBFDPs replacing maxillary or mandibular missing canines or posterior teeth were recruited from the patients’ database at the University of Kiel, Germany. The preparation of the abutment teeth was minimal and limited to the enamel and consisted of a retainer wing and an occlusal rest on the abutment tooth. The restorations were observed over up to 12 years.
The patient age ranged from 16 to 72 years old with a mean age of 34 ± 21 years and 57% were females and 43% were males. The restorations were observed for a mean period of 53 ± 39 months with a minimum of 13 months and a maximum of 151 months of observation. No debonding for any of the restorations was detected, which amounts up to a survival rate of 100%. The development of treatable cervical caries on one abutment tooth of an elderly patient without extending to the retainer wing was the only recorded complication.
Zirconia ceramic single-retainer RBFDPs provide an esthetic, functional and minimally invasive treatment alternative to replace missing canines, premolar and molars with promising results due to excellent clinical outcome resulting from a survival rate of 100% and a success rate of 96.3% over a mean observation time of 53 ± 39 months.
Zirconia ceramic single-retainer RBFDPs might be a valid minimally-invasive option for replacing missing canines and missing teeth in the posterior area especially for young patients, in whom implants are contraindicated and conventional fixed dental prostheses are too invasive.
The aim of this study was to summarize the literature on the most frequently missing permanent teeth excluding the third molars.
A search was conducted to find all the available literature (in ...various scientific and general databases) regarding the most commonly missing teeth with respect to ethnicity and time, as well as factors biasing this outcome. Quality assessment was done to exclude studies with inconsistent information, poor designs, or data pertaining to syndromic cases or the third molars. The role of biasing factors was as well quantitatively assessed using statistical analyses Q-test, Egger regression, Spearman correlation coefficient, multiple linear regression, Welch t-test (α=0.05).
A total of 81 reports was included. The meta-sample was heterogeneous (P=0.000, Q-test). No significant publication bias was detected (P>0.1, Egger regression). The mandibular second premolar was reported as the most commonly missing tooth in most studies, followed by the maxillary lateral (the most commonly missing in the rest). In terms of the missing share of each tooth percent of all missing teeth, the mandibular second premolar and incisors are more likely to be absent, followed by the maxillary second premolar and lateral. The absence of different teeth can be affected by the ethnicity, sample types (epidemiological or dental patients), sample sizes (only in the case of bimaxillary second premolars), and the minimum ages of pooled subjects (only in the case of the maxillary lateral and the mandibular second premolar).
Since enrolling younger patients can bias the results, older patients should be sampled.
Objective
Single‐retainer resin‐bonded fixed dental prostheses (RBFDPs) are described as an excellent minimally invasive treatment modality for the replacement of a single missing incisor even in ...cases of congenitally missing teeth that are often associated with hard and soft tissue defects that need to be properly managed to optimize the esthetic outcome. The lack of a retentive form due to the minimally invasive preparation form makes the adhesive bonding procedure for RBFDPs relatively technique‐sensitive and might discourage practitioners from offering this treatment modality.
Clinical considerations
A patient with both maxillary lateral incisors congenitally missing was assessed for eligibility for treatment with RBFDPs. Bilateral horizontal ridge defects were present and treated through ridge augmentation to ensure an ovate pontic design and enhance the esthetic outcome. A minimally invasive preparation within enamel was conducted; the restorations were digitally designed and milled out of (3Y‐TZP) zirconia ceramic with labial veneering with feldspathic ceramic for enhanced esthetics. An improved design of positioning splints was used for the adhesive bonding procedure to ensure exact, secure, and flawless insertion of the restorations.
Conclusions
RBFDPs offer a highly esthetic treatment modality for missing teeth in the anterior area. Tissue defects could be overcome be means of a minor oral surgery, while using improved positioning splints might ensure flawless adhesive bonding and promote the usage of RBFDPs.
Clinical Significance
Hard and soft tissue defects can be remarkably optimized through a minor ridge augmentation. Improved positioning splints allow an easy and secure positioning as well as visual inspection of the seating in end‐position and complete removal of resin cement excess. Implementing the concept of insertion splints might promote RBFDPs for anterior tooth replacement as it helps preventing bonding errors.
Segmental odontomaxillary dysplasia (SOD) is a characteristic developmental abnormality that demonstrates posterior maxillary enlargement, dental abnormalities, altered bone trabeculation, and ...possible cutaneous findings. Only 62 cases have been reported in the English-language literature.
The authors described 3 newly diagnosed cases of SOD, all found in the left posterior maxilla in adolescent female patients; they reviewed the literature to elucidate this rare entity.
Because of the complexity and variety of associated dental and craniofacial features, patients with SOD may seek diagnosis from various dental and medical providers. The signs of SOD are characteristic, yet the condition is largely underrecognized among health care professionals, which may lead to unnecessary treatment.
The rapid development of artificial intelligence (AI) has led to the emergence of many new technologies in the healthcare industry. In dentistry, the patient's panoramic radiographic or cone beam ...computed tomography (CBCT) images are used for implant placement planning to find the correct implant position and eliminate surgical risks. This study aims to develop a deep learning-based model that detects missing teeth's position on a dataset segmented from CBCT images. Five hundred CBCT images were included in this study. After preprocessing, the datasets were randomized and divided into 70% training, 20% validation, and 10% test data. A total of six pretrained convolutional neural network (CNN) models were used in this study, which includes AlexNet, VGG16, VGG19, ResNet50, DenseNet169, and MobileNetV3. In addition, the proposed models were tested with/without applying the segmentation technique. Regarding the normal teeth class, the performance of the proposed pretrained DL models in terms of precision was above 0.90. Moreover, the experimental results showed the superiority of DenseNet169 with a precision of 0.98. In addition, other models such as MobileNetV3, VGG19, ResNet50, VGG16, and AlexNet obtained a precision of 0.95, 0.94, 0.94, 0.93, and 0.92, respectively. The DenseNet169 model performed well at the different stages of CBCT-based detection and classification with a segmentation accuracy of 93.3% and classification of missing tooth regions with an accuracy of 89%. As a result, the use of this model may represent a promising time-saving tool serving dental implantologists with a significant step toward automated dental implant planning.
Objective
Patients with oligodontia frequently show different types of malocclusions. However, how oligodontia affects the maxillofacial growth remains uncertain. This study aimed to investigate the ...maxillofacial morphological characteristics in growing patients with oligodontia.
Setting and Sample Population
The study subjects included 33 Japanese children with non‐syndromic oligodontia (14 boys and 19 girls; mean age: 10.2 years) who visited the orthodontic clinic of Fukuoka Dental College Medical and Dental Hospital from 1999 to 2019.
Materials and Methods
Cephalometric analyses were performed, and the variables measured in each subject were converted into Z scores in relation to the mean and standard deviation of the Japanese norms matched for growth stage. The one‐sample t‐test or Wilcoxon signed‐rank test was performed to compare the mean scores in the patients with oligodontia with those of the Japanese norms.
Results
Compared with the Japanese norms, patients with oligodontia showed a smaller convexity and larger A‐B plane and SNB angles. The Frankfort‐mandibular plane and gonial angles were smaller, whereas the height of the ramus was larger. The vertical height of the alveolar bone in the maxillary and mandibular incisors and molar areas was smaller in patients with oligodontia.
Conclusions
Patients with oligodontia showed Class III skeletal tendency with mandibular prognathism and flattened mandibular plane with a smaller gonial angle. These maxillofacial morphological features can be induced by a deficiency in the vertical growth of the alveolar bone in the maxillary and mandibular molar areas due to the lack of tooth germs.
Dental eruption is a very finely regulated process. A delay in tooth eruption may be due to a disturbance caused by local, systemic, or genetic abnormalities. Delayed eruption of multiple teeth in ...the absence of any etiology is very rare. Here, we report a case of delayed eruption in a 16-year-old female patient with multiple congenitally missing teeth and bilaterally ankylosed deciduous teeth with no underlying systemic or genetic disease.
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