Mercedes Gallas Torreira

Background/Objective: Preoperative prediction of third molar eruption with artificial intelligence (AI) has been a challenge in dentistry and oral surgery. Methods: In this investigation, we used machine learning (ML) algorithms to characterize M3 panoramic radiological images for the preoperative differential diagnosis of third nolar eruption/retention and compared them with clibical explorations to validate their performance. Results: We retrospectively collected data of patients with mandibular thid molar retention, where all eruption diagnoses were confirmed via clinical exploration. A total of 383 panoramic radiographies were selected to train the PDApp software for eruption diagnosis for the software validation. Conclusions: The PDApp software achieved the highest performance metrics for the prediction of mandibular third molar eruption

Background: Preoperative prediction of mandibular third molar (M3) eruption remains a major challenge in dentistry and oral surgery. Artificial intelligence (AI) offers new opportunities to improve diagnostic accuracy and reduce the subjectivity associated with manual assessment. Objective: This study aimed to develop and validate PDApp, a machine-learning-based software designed to predict third lower molar eruption status (erupted vs. retained) using panoramic radiographic images, and to compare its diagnostic performance with clinical exploration. Materials and Methods: A retrospective dataset of 383 mandibular third molars with clinically confirmed eruption status was collected. Panoramic radiographic images were processed and used to train multiple machine learning (ML) algorithms integrated into PDApp for eruption prediction. The software’s performance metrics were analyzed and validated against clinical exploration, considered the diagnostic reference standard. Results: PDApp achieved the highest performance metrics among the evaluated ML approaches, reaching an accuracy of up to 99.5% in predicting mandibular third molar eruption. The tool showed strong reliability in differentiating erupted from retained M3 using panoramic radiographs. Conclusions: PDApp represents a robust, accurate, and easy-to-use AI-based tool for predicting third molar eruption potential in adolescent and teenage patients. Its implementation may enhance diagnostic efficiency, reduce common errors associated with manual evaluation, and support clinical decision-making in the management of impacted mandibular third molars. Future work will focus on integrating automatic calculation of radiographic ratios to achieve a fully automated prediction workflow.

Background/Objectives: Chlorhexidine (CHX)-based mouthwashes are the most commonly used chemical methods as adjuvants for the treatment of peri-implant diseases, but there is a lack of information on their effect on the peri-implant microbiota. The objective of this study was to evaluate the impact of short-time (15 days) self-administered 0.05% and 0.12% commercial chlorhexidine mouthwashes on the peri-implant pocket microbiota of patients with peri-implantitis. Methods: In this pilot study, we analyzed the microbial composition of peri-implant lesions in 22 patients before and after a 15-day regimen of thrice-daily use of two commercial chlorhexidine mouthwashes containing 0.05% (n = 11) and 0.12% chlorhexidine (n = 11). Microbial samples were collected using paper points, and the taxonomic composition was determined through sequencing of 16S rRNA gene amplicons using Illumina MiSeq. Results: Although individual responses to chlorhexidine mouthwash treatment varied significantly, neither concentration produced a statistically significant change in the microbial diversity associated with peri-implantitis, suggesting limited treatment penetration into peri-implant lesions. Similarly, changes in the abundance of specific odontopathogens were not statistically significant. Conclusions: We found no significant differences in the effect of mouthwashes with different chlorhexidine concentrations on the peri-implant microbiota in short-period applications. Even though more extensive studies are required, the observed patient-dependent outcomes of both chlorhexidine mouthwashes on the peri-implant microbiota and their limited effect in controlling the abundance of oral pathogens indicate that prescription of chlorhexidine mouthwashes for the treatment of peri-implantitis should be carried out with caution. Novel presentations of chlorhexidine with better penetration capacities should be developed, as they could offer enhanced benefits in managing peri-implant diseases.

Objective: The purpose of this study is to analyze and compare the colors (A2, A3 and A3.5) of polymerized resin-based composites (RBCs) with respect to the shade numbers within each product line and the VITAPAN Classical^® shade guide they purported to represent. Methods: Three A-shades (A2, A3 and A3.5) from four RBC products (Harmonize^®, Empress^® Direct^®, Grandio^® and Filtek^® 500) were compared within the VITAPAN Classical^® shade guide and within their own commercial shade guide. Nine disk-shaped specimens, 6 mm in diameter and 2 mm thick, were prepared for each RBC color (three of each color). The color measurements were made according to the CIE L*a*b* color scale (quantifying L*c*h*a*b* values) using a Vita Easyshade Compact IV^® digital spectrophotometer. We calculated the CIEDE2000 color differences between polymerized composites and shade guides, as well as between composites. The values obtained from composites and samples of the color guides in the CIE L*a*b* space were represented by ICC3D software (Version 1.2.9) Results: The ANOVA test verified the existence of statistically significant differences between composites for the same shades (p < 0.05) except for shade A2. CIEDE2000 color differences between composites and the VITAPAN Classical^® shade guide ranged from 3.5 to 13.1 depending on the composite and the shade. Conclusions: There were color differences among the polymerized resin-based composites, between these and their own shade guides/manufacturer’s commercial guides, and between the former and the corresponding samples of the VITAPAN Classical^® shade guide. Clinical significance: Color selection when performing an aesthetic dental restoration is essential for the clinician and the patient to obtain an optimal result. Taking into account the color difference (∆E₀₀) for each composite with the VITAPAN Classical^® shade guide or with the manufacturers’ commercial guide allows for more precision with shade selection in aesthetic dentistry.

The decision-making process for third molar removal or maintenance remains controversial in dental practice. The most important variables to be analyzed in predicting the potential of third molar eruption are retromolar space and the direction of eruption. The various methods for prediction include linear measures: measurement of the available space, mandibular size and growth, size of the third molar, and third molar angulation. The available software is not suitable for predicting third molar eruption. The purpose of the present work was to develop a clinical tool that can automatically predict eruption of the third molars based on combined linear and angular measurements. In this paper, the development and validation analysis of Panoramic Dental Application (PDApp) software (registered by the University of Santiago de Compostela (USC)) is presented, which can automatically predict third molar eruption from panoramic radiographs. This prediction is performed using a machine learning classifier (a support vector machine with Gaussian kernel) trained on a set of 188 cases wherein third molar angulation and the radiological retention coefficient are used as input data. Operating in the daily practice of the School of Dentistry at USC, an accuracy of 97.96% in predicting the potential of third molar eruption is achieved for a set of 539 third molars belonging to 289 patients. The software was also rated as the best imaginable system by the system usability scale (SUS) questionnaire. In this study, we developed and analyzed a new, unique software tool with increased diagnostic accuracy that will facilitate and optimize dental care in routine clinical workflow.

Objectives: The main purpose of this study was to assess the response of oral leukoplakia to CO₂ laser vaporization treatment, as well as determining possible factors that may affect recurrence of lesions.Materials and methods: A retrospective study was conducted, in which the medical records of patients who had been clinically and histologically diagnosed with oral leukoplakia and treated with CO₂ laser between 1996 and 2019 at the Oral Medicine Teaching Unit of the Faculty of Dentistry of the University of Santiago de Compostela were reviewed.Results: Fifty‐eight patients were included: 36 female and 22 male subjects, with a mean age of 63.7 years old (SD ±13.1). The average follow‐up time was 57.5 months (SD ±57.9). A relapse rate of 52.6% was determined. Of all the studied variables, the margin was the only one for which a statistically significant association with recurrence of lesions was demonstrated (p < 0.05).Conclusion: The vaporization of lesions using CO₂ laser with a safety margin of at least 3 mm from the clinical limits of OL is a key factor in preventing recurrence.

The sentinel node biopsy (SNB) is highly protocolized in other cancers, however, this is not the case for oral squamous cell carcinoma patients, hence our objective was to evaluate the different protocols published. A specific study protocol was designed and subsequently registered on PROSPERO (Ref. CRD42021279217). Twenty‐three articles were included in the meta‐analysis. The grouped sensitivity of the SNB was 82% (95% CI: 0.74–0.88), and the grouped specificity was 100% (95% CI: 0.99–1.00). The use of other radiotracers other than pre‐operative lopamidol showed higher values of sensitivity of 82.80% (95% CI: 76.90%–87.50%; p < 0.001). The use of the blue dye stain showed higher sensitivity values of 85.60% (95% CI: 71.90%–93.20%), compared to sensitivity values of 77.50% when it was not used (95% CI: 69.10%–84.20%) (p < 0.001). Diagnostic rates are variable and they were significantly better when 99mTc was used in all its variations and accompanied by the blue dye staining.