scholarly journals Automating Periodontal bone loss measurement via dental landmark localisation

Author(s):  
Raymond P. Danks ◽  
Sophia Bano ◽  
Anastasiya Orishko ◽  
Hong Jin Tan ◽  
Federico Moreno Sancho ◽  
...  

Abstract Purpose Periodontitis is the sixth most prevalent disease worldwide and periodontal bone loss (PBL) detection is crucial for its early recognition and establishment of the correct diagnosis and prognosis. Current radiographic assessment by clinicians exhibits substantial interobserver variation. Computer-assisted radiographic assessment can calculate bone loss objectively and aid in early bone loss detection. Understanding the rate of disease progression can guide the choice of treatment and lead to early initiation of periodontal therapy. Methodology We propose an end-to-end system that includes a deep neural network with hourglass architecture to predict dental landmarks in single, double and triple rooted teeth using periapical radiographs. We then estimate the PBL and disease severity stage using the predicted landmarks. We also introduce a novel adaptation of MixUp data augmentation that improves the landmark localisation. Results We evaluate the proposed system using cross-validation on 340 radiographs from 63 patient cases containing 463, 115 and 56 single, double and triple rooted teeth. The landmark localisation achieved Percentage Correct Keypoints (PCK) of 88.9%, 73.9% and 74.4%, respectively, and a combined PCK of 83.3% across all root morphologies, outperforming the next best architecture by 1.7%. When compared to clinicians’ visual evaluations of full radiographs, the average PBL error was 10.69%, with a severity stage accuracy of 58%. This simulates current interobserver variation, implying that diverse data could improve accuracy. Conclusions The system showed a promising capability to localise landmarks and estimate periodontal bone loss on periapical radiographs. An agreement was found with other literature that non-CEJ (Cemento-Enamel Junction) landmarks are the hardest to localise. Honing the system’s clinical pipeline will allow for its use in intervention applications.

BDJ ◽  
1984 ◽  
Vol 157 (3) ◽  
pp. 91-93 ◽  
Author(s):  
Kufaishi Al ◽  
P N Hirschmann ◽  
M A Lennon

2014 ◽  
Vol 6 (2) ◽  
pp. 112-116
Author(s):  
VT Pramod ◽  
Shobhaprakash LNU ◽  
S Sadiya

Abstract Endodontic–periodontal lesions pose challenge to the clinician as far as diagnosis and prognosis of the involved teeth are concerned. The pathways for the spread of bacteria between pulpal and periodontal tissues are controversial. Treatment and prognosis of endodontic–periodontal diseases vary and depend on the cause and the correct diagnosis of specific condition. This case report describes a successful treatment of a 44 year old male patient who reported with a chief compliant of pain in the right upper and lower tooth back region of the jaw since 20 days. Clinical examination revealed deep pockets and furcation involvement between maxillary right first and second molars. Radiographic examination showed bone loss and furcation involvement. Non-vital root resection with maxillary first molar was planned. Prior to root resection, root canal treatment was performed and then rehabilitated with full metal crown. How to cite this article Pramod VT, Shobhaprakash, Sadiya S. Hopeless to hopeful: Management of an endo-perio lesion with an interdisciplinary approach - A case report: CODS J Dent 2014;6;112-116


2016 ◽  
Vol 12 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Katie Ekberg ◽  
Markus Reuber

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.


2021 ◽  
Vol 10 (13) ◽  
pp. 2849
Author(s):  
Piotr Kuligowski ◽  
Aleksandra Jaroń ◽  
Olga Preuss ◽  
Ewa Gabrysz-Trybek ◽  
Joanna Bladowska ◽  
...  

Odontogenic infections can directly trigger maxillary sinusitis. CBCT is an excellent choice for precise examination of maxillary sinuses and hard tissues within the oral cavity. The objective of this retrospective and the cross-sectional study was to analyze the influence of odontogenic conditions on the presence and intensity of maxillary sinus mucous membrane thickening using CBCT imaging. Moreover, periodontal bone loss and anatomic relationship between adjacent teeth and maxillary sinuses were assessed to evaluate its possible impact on creating maxillary thickening. The study sample consisted of 200 maxillary sinuses of 100 patients visible on CBCT examination with a field of view of 13 × 15 cm. The presented study revealed a significant influence of periapical lesions, inappropriate endodontic treatment, severe caries, and extracted teeth on the presence of increased thickening of maxillary sinus mucous membrane. In addition, an increase in the distance between root apices and maxillary sinus floor triggered a significant reduction of maxillary sinus mucous membrane thickening. The presence of periodontal bone loss significantly increases maxillary sinus mucous membrane thickening.


2021 ◽  
Vol 22 (2) ◽  
pp. 596
Author(s):  
Agnes Schröder ◽  
Joshua Gubernator ◽  
Alexandra Leikam ◽  
Ute Nazet ◽  
Fabian Cieplik ◽  
...  

Dietary salt uptake and inflammation promote sodium accumulation in tissues, thereby modulating cells like macrophages and fibroblasts. Previous studies showed salt effects on periodontal ligament fibroblasts and on bone metabolism by expression of nuclear factor of activated T-cells-5 (NFAT-5). Here, we investigated the impact of salt and NFAT-5 on osteoclast activity and orthodontic tooth movement (OTM). After treatment of osteoclasts without (NS) or with additional salt (HS), we analyzed gene expression and the release of tartrate-resistant acid phosphatase and calcium phosphate resorption. We kept wild-type mice and mice lacking NFAT-5 in myeloid cells either on a low, normal or high salt diet and inserted an elastic band between the first and second molar to induce OTM. We analyzed the expression of genes involved in bone metabolism, periodontal bone loss, OTM and bone density. Osteoclast activity was increased upon HS treatment. HS promoted periodontal bone loss and OTM and was associated with reduced bone density. Deletion of NFAT-5 led to increased osteoclast activity with NS, whereas we detected impaired OTM in mice. Dietary salt uptake seems to accelerate OTM and induce periodontal bone loss due to reduced bone density, which may be attributed to enhanced osteoclast activity. NFAT-5 influences this reaction to HS, as we detected impaired OTM and osteoclast activity upon deletion.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandrani Nirmala Wijekoon ◽  
Indika Wettasinghe ◽  
Dinithi Fernando ◽  
Arosha Sampath Dissanayake ◽  
Malinda Gunawardana ◽  
...  

Abstract Background Early recognition and the optimal management of anaphylaxis saves lives but studies from different countries have demonstrated gaps in knowledge and practices between healthcare workers. There is a paucity of such data from Sri Lanka. We assessed knowledge, perception and self-confidence in the diagnosis and management of anaphylaxis amongst pre-intern medical graduates who would soon become first-contact doctors attending emergencies. Methods This cross-sectional study included pre-interns who graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) degrees in 2019 from three Sri Lankan universities with differing undergraduate curricula. Using consecutive sampling data were collected within four months of the final-MBBS examinations with a self-administered questionnaire and the answers on case diagnosis and management were used as the basis of outcome scores. Results 385 participants responded (response rate: 91.5%). 16.4% correctly identified all anaphylaxis triggers. Only 7.3% correctly diagnosed all ten case scenarios and 34.5% all seven cases of anaphylaxis. 98.2 and 97.9% correctly identified 1:1000 adrenaline as the first-line treatment and the intramuscular route. 9.9% would preferentially but incorrectly use the intravenous route if access was available. Only 79.2 and 55.6% knew the correct adult and paediatric doses of adrenaline and 50% agreed that follow-up care was needed. The mean scores for case diagnosis and management of anaphylaxis were 7.7/10 ± 1.4 and 16.9/20 ± 1.9, respectively. Multiple linear regression indicated that the final MBBS results classification (class of degree or no class indicated) was a positive predictor of case diagnosis score [class vs no class: B = 0.662 (95% CI 0.347–0.978), p < 0.001] and being a graduate of University 2 [B = 1.568 (95% CI 1.182–1.953), p < 0.001] and passing with a class at final MBBS [B = 0.716 (95% CI 0.319–1.113), p < 0.001] were positive predictors of management score. Self confidence in diagnosing and managing anaphylaxis were rated as 79.7 and 62.1% and there was a positive correlation between knowledge and perception scores and self-confidence (case-diagnosis: rpb = 0.111, p = 0.03; management: rpb = 0.164, p = 0.001). Conclusions Knowledge, perception and self confidence in the diagnosis and management of anaphylaxis was sub optimal amongst pre-interns and we identified areas that need improvement. A higher MBBS qualification classification was a predictor for correct diagnosis and management and confidence in diagnosis and management positively correlated with knowledge and perception scores. Further and enhanced educational and training strategies are needed for this life threatening emergency condition.


2021 ◽  
Vol 17 ◽  
Author(s):  
Consuelo Romero-Sánchez ◽  
Sebastián Giraldo ◽  
Ana María Heredia-P ◽  
Juliette De Avila ◽  
Lorena Chila-Moreno ◽  
...  

Background: The aim of this study was to assess DKK-1 levels, in Gingival Crevicular Fluid (GCF) and serum, as a biomarker for bone loss and disease activity in periodontitis and early RA (eRA). Methods: In this cross-sectional study, we obtained serum and GCF from 10 interproximal sites (Distal Buccal I/S, Mesio Buccal I/S, Distal Palatal/Lingual, Mesio Palatal/Lingual) according to the highest degree of inflammation by a patient for 240 sites from eRA patients. Patients received a periodontal assessment, a radiographic evaluation, tomography of interproximal sites, and DKK1 levels were determined by ELISA. Comparisons were performed by the Mann–Whitney U test and analysis by Chi2 test, and a logistic regression model was applied. Results: The mean age was 46.33 ± 12.0 years, the Disease Activity Score (DAS-28-ESR) was 4.08 ± 1.4. Periodontitis was present in 65.2% of the patients, and 59.6% of these patients had bone loss in interproximal sites. Higher GCF-DKK1 levels were associated with serum-DKK1 (OR:2.41 IC95% 1.14–5.09, p=0.021) and were related with DAS28-ESR (p=0.001), Routine Assessment of Patient Index Data 3 (RAPID 3) (p=0.001), and tender joints (p=0.040). Foot bone erosion and juxta-articular osteopenia were associated with high levels of serum-DKK1 (p=0.009 and 0.001, respectively). Serum-DKK1 were associated with SDAI (OR: 2.38 IC95% 1.03–5.52, p=0.043), RAPID 3 (p=0.001), and rheumatoid factor (p=0.018). The GCF-DKK1 levels were associated with periodontal bone loss (p=0.011), periodontitis (p=0.070) and its severity (OR: 2.58 IC95% 2.28–7.28, p=0.001). Bone loss was more frequent in buccal sites (73.5%) and was associated with increased levels of DKK1 (p=0.033). Conclusion: In the early stages of the eRA disease, serum and GCF-DKK1 could be a biomarker for clinical disease activity and periodontal and articular bone erosion.


1981 ◽  
Vol 32 (1) ◽  
pp. 145-152 ◽  
Author(s):  
M A Taubman ◽  
J M Buckelew ◽  
J L Ebersole ◽  
D J Smith

1992 ◽  
Vol 27 (3) ◽  
pp. 184-190 ◽  
Author(s):  
W. Schulte ◽  
B. D'Hoedt ◽  
D. Lukas ◽  
M. Maunz ◽  
M. Steppeler

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