Aim:The aim of this study was to develop and evaluate a deep learning-based model for the detection of occlusal caries in intraoral scans using YOLOv5. Materials and Methods:Intraoral scans were obtained from 117 patients, yielding 330 carious teeth (moderate and extensive lesions). Teeth were annotated using the International Caries Detection and Assessment System framework. YOLOv5 variants were trained with different preprocessing modules (single-channel, mixed channel, Ohta transformation). Performance was assessed using precision, recall, F1-score, mean average precision, and validated against expert annotations using Cohen's kappa and McNemar's test. Results:The best-performing YOLOv5 model achieved an accuracy of 90% in detecting moderate and extensive lesions. There was a significant amount of agreement with expert examiners (κ =0.77). No discernible difference (P = 1.0) between artificial intelligence (AI) predictions and human annotations according to McNemar's test was found. Conclusion:YOLOv5-based detection of occlusal caries in intraoral scans demonstrated strong diagnostic performance, comparable to expert annotations. Targeted preprocessing further enhanced model reliability, underscoring the potential of intraoral scan-based AI diagnostics in conservative dentistry.
Background: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, and increasing evidence suggests that periodontal dysbiosis may contribute to its development and progression. Periodontal pathogens may influence carcinogenesis through chronic inflammation, altered immune responses and microbial interactions within the tumour microenvironment. Aim: To evaluate the prevalence and burden of selected periodontal pathogens in OSCC tissue and to compare them with non-malignant oral tissue using polymerase chain reaction (PCR). Materials and Methods: This hospital-based case-control study included 40 participants at a tertiary care hospital, comprising 20 histopathologically confirmed OSCC patients and 20 non-malignant controls. Demographic characteristics, tobacco use, smoking, alcohol consumption and periodontal parameters including Plaque Index, Gingival Index, bleeding on probing, probing pocket depth and clinical attachment loss were recorded. Tissue samples were subjected to species-specific PCR for Porphyromonas gingivalis, Fusobacterium nucleatum, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans. Data were analysed using IBM SPSS Statistics version 27.0, with p<0.05 considered statistically significant. Results: Tobacco chewing was significantly more frequent among OSCC cases than controls (80.00% vs 35.00%; p=0.010). All periodontal parameters were significantly higher in OSCC patients (p<0.001). Porphyromonas gingivalis was detected in 75.00% of cases versus 35.00% of controls (p=0.025), Fusobacterium nucleatum in 80.00% versus 40.00% (p=0.022), and Treponema denticola in 55.00% versus 20.00% (p=0.048). At least one periodontal pathogen was identified in 95.00% of OSCC tissues compared with 60.00% of controls (p=0.020). Two or more pathogens were detected in 85.00% versus 40.00% (p=0.008). High pathogen burden was significantly associated with advanced TNM stage (p=0.019) and lymph-node positivity (p=0.020). Conclusion: OSCC tissues demonstrated significantly greater periodontal pathogen prevalence and polymicrobial burden than non-malignant tissues. The association of high pathogen burden with advanced stage and nodal involvement suggests that periodontal dysbiosis may be linked with OSCC severity.
Background: Immunofluorescence (IF) is a laboratory test used for antigen detection by using specific antibodies linked to a fluorescent tag. This review article aims to explore and explain the principles, methods, and patterns of diagnosis, as well as the clinical implications of direct and indirect IF (IIF) tests, especially in oral mucosal disorders. Methods: A PubMed search was independently conducted by two reviewers to identify articles published between 2002 and 2021 describing the role of IF in the diagnosis of oral mucosal disorders. Results: The analysis of the literature indicates that IF, including both direct and indirect techniques, is a robust adjunctive diagnostic modality in vesiculobullous lesions of the oral mucosa. Direct IF aids in detecting tissue-bound antibodies and complement deposition, whereas IIF identifies circulating autoantibodies. When integrated with clinical findings and histopathological examination, these techniques substantially enhance diagnostic accuracy, facilitate early detection, and assist in disease differentiation. Discussion: While histopathology remains the cornerstone for diagnosing oral mucosal lesions, IF is an indispensable complementary tool. It enhances diagnostic precision and provides critical insights into disease pathogenesis, particularly in vesiculobullous lesions. Incorporating these techniques into routine diagnostic protocols can significantly improve patient management and clinical outcomes.
INTRODUCTION:Accurate determination of the working length is critical for the success of root canal treatment, as it ensures effective cleaning, shaping, and obturation of the root canal system. Electronic apex locators are widely used for this purpose; however, their accuracy may be influenced by intracanal conditions, particularly the presence or absence of irrigation solutions. This study aimed to evaluate and compare the accuracy of a third-generation apex locator under dry, normal saline, and 3% sodium hypochlorite canal conditions. MATERIALS AND METHODS:This in vitro study was conducted on 45 extracted human single-rooted teeth randomly divided into three groups (n = 15 each) based on canal conditions: dry, normal saline, and 3% sodium hypochlorite. The actual working length (AWL) was determined visually and was used as the gold standard. The electronic working length (EWL) was measured using a Root ZX Mini. The difference between the EWL and AWL was calculated. Data were analyzed using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test, and categorical accuracy was assessed using the chi-square test, with significance set at p < 0.05. RESULTS:The normal saline group demonstrated the lowest mean deviation (0.21 ± 0.14 mm; 95% CI: 0.13-0.29), followed by the sodium hypochlorite group (0.34 ± 0.19 mm; 95% CI: 0.23-0.45), while the dry canal group showed the highest deviation (0.58 ± 0.22 mm; 95% CI: 0.46-0.70). A one-way ANOVA revealed a statistically significant difference between the groups (F = 18.74, p < 0.001). Post hoc analysis revealed significant differences between all groups (p < 0.05). The proportion of accurate measurements (±0.5 mm) was highest in the normal saline group, followed by the sodium hypochlorite and dry canal groups, although the chi-square test was not statistically significant (p = 0.071). CONCLUSIONS:Intracanal conditions significantly influenced the apex locator accuracy. Normal saline provided the most accurate measurements, whereas the dry conditions showed greater variability. Maintaining a moist canal environment may enhance clinical reliability.
Background: Long-term success of fixed prosthetic rehabilitation depends on prosthesis survival and maintenance of healthy periodontal and peri-implant tissues. Differences in supporting structures, prosthetic contours, plaque retention, and oral-hygiene accessibility may influence tissue response around implant-supported and tooth-supported fixed prostheses. Aim: To compare the periodontal and peri-implant status around implant-supported and tooth-supported fixed prostheses in patients at a tertiary care hospital. Materials and Methods: This hospital-based comparative observational study included 36 patients, divided equally into Group I with implant-supported fixed prostheses and Group II with tooth-supported fixed prostheses. Clinical assessment included plaque index, bleeding on probing, probing pocket depth, gingival/peri-implant mucosal recession, inflammation, suppuration, swelling or tenderness, and mobility. Prosthesis-related variables such as food impaction, marginal adaptation, oral-hygiene accessibility, and prosthetic contour were recorded. Marginal bone status was assessed radiographically. Data were analysed using IBM SPSS Statistics version 27.0, and p<0.05 was considered statistically significant. Results: Mean age was 46.78 ± 9.42 years in Group I and 48.61 ± 10.06 years in Group II (p=0.583). Implant-supported prostheses showed significantly lower plaque index (0.82 ± 0.31 vs 1.12 ± 0.36; p=0.011), bleeding on probing (21.70 ± 10.80% vs 34.60 ± 13.40%; p=0.003), probing pocket depth (2.74 ± 0.42 vs 3.18 ± 0.51 mm; p=0.008), recession (0.61 ± 0.29 vs 0.84 ± 0.36 mm; p=0.042), and marginal bone loss (0.78 ± 0.32 vs 1.08 ± 0.41 mm; p=0.020). Clinically evident inflammation was less frequent in Group I (22.22% vs 61.11%; p=0.041), as was food impaction (16.67% vs 55.56%; p=0.035). Marginal bone loss ≤1.00 mm was observed in 72.22% of Group I and 27.78% of Group II (p=0.026). Conclusion: Implant-supported fixed prostheses were associated with more favorable periodontal and peri-implant tissue conditions than tooth-supported fixed prostheses. Careful prosthetic design, effective plaque control, and regular maintenance remain essential for preserving supporting tissue health.
