Here you will find everything related to cephalometric analysis, digital radiography, Dental imaging basically everything ceph-related.

ORCA Dental AI Recognized For Its Technology In A Recent Academic Paper

A recent paper by Dr. Yo-Wei Chen, DDS MSC, Dr. Kyle Stanley DDS, Prof Wael Att, DDS, and Dr. Med Dent, PHD, published by Quintessenze, review AI in dentistry – starting from its definition, through its potential roll, and reviewing currently active companies in this field. The paper reviews solution such as automatic caries detection, 3D anatomy segmentation, pathology detection, treatment plan suggestions and more – all based on machine learning and AI technologies. These are all applicable for general dentistry, as well Orthodontics, Prosthodontics and other.

ORCA Dental AI is being recognized as one of the market leaders, with its unique 2D and 3D technologies for image analysis, pathology recognition and anatomy segmentation.

Download the full paper from here

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Diagnosis and Treatment plan of Maxillary Impacted canines using CBCT DICOM data.

Dr. Laura Nicolas
Dr. Alberto Teramoto

Department of Orthodontics. Universidad Latinoamericana Mexico City, Mexico.

Introduction

There is no doubt that an adequate treatment plan of resolving impacted teeth could be very difficult when you don’t have all necessary information. It is mandatory to know the exact location and more importantly what the immediate relationships of the impacted teeth are to surrounding teeth, roots and even the mandibular nerve.

After the third molars, maxillary canines have the highest frequency of impacted localization, with a prevalence ranging from 1% to 3% (1-4), and it is more frequent in female patients to male with a ratio of 2:1 (5). And when surgical treatment is necessary it is not so easy and time consuming to treat when you don’t have enough information. That is why the accurate localization of impacted maxillary canines is very important, when you have to decide to treat orthodontically and especially if surgical intervention is required.

Most of the time in our daily practice the first radiographic image that is required to support the clinical examination is the panoramic radiograph and sometimes in order to have a better localization of impacted teeth we can improve diagnosis by using a combination of other two or more bi-dimensional images: occlusal and periapical, which allow the localization of impacted canines, treatment planning, and evaluation of the treatment result.

Importance of CBCT

It is well known that the diagnostic accuracy of these bidimensional radiographic techniques presents many limitations thus increasing the risk of mistake. Adding a third dimension to the radiographic information may result in another and better diagnostic approach and an improved treatment outcome – using Cone Beam Computed Tomography (CBCT), clinicians can take advantages from 3D information provided by a low radiation dose and with relatively low costs. CBCT provides information which is not revealed during traditional radiographic analysis and is therefore indicated in case of impacted teeth or craniofacial structural anomalies.

However sometimes even we have all this 3D images sometimes they are not enough, and it is because there is much more we can use of CBCT data, another use of DICOM data is using a process called segmentation, a process in which separation of structures of interest from the background and from each other, is an essential analysis function for which numerous algorithms have been developed in the field of image processing, segmentation of an object is achieved either by identifying all pixels or voxels that belong to the object or by locating those that form its boundary. Segmenting teeth from CBCT images is not an easy procedure, there are difficult problems like:

1) DICOM data is acquired in upper-lower jaw in occlusion, so it is hard to separate a tooth from its opposing teeth along their occlusal surface because of the lack of changes in gray values.

2) It is also hard to separate a tooth from alveolar bone by similar densities.

3) Most of the times all teeth possess similar shape and it is difficult to identifying different tooth instances.

There exist in the market some open source software for segmentation procedure, however even you solve those problems it takes a long learning curve and time to perform a good quality segmentation.

Recently, with use of Artificial Intelligence technology, Orca Dental AI created a unique system in a 3D controllable STL format which not only offers a teeth segmentation service but also cephalometric and airway volume analyses and videos of teeth segmentation, making this process much more complete, easy to use and completely informative in disclosing all the impacted relationships.

With data received and for a better diagnostic approach and an improved treatment outcome it is also possible to convert the Data Imaging and Communications in Medicine (DICOM) files of the CBCT to a model using a 3D printer (Zenith D DENTIS Co. LTD), that is a very useful tool to help visualize and have 3D feeling of conditions of impacted teeth, because this process allows to experience an extra dimension for diagnostic, this can help us to decide which is the best treatment plan, and decide for example if it is better to perform an orthodontic treatment to align an ectopic canine or definitively a surgical procedure because the difficult to align ectopic maxillary canines.

CASES

Case 1

Because the position of impacted canine root is close to vestibular side, with extraction of first premolar it is easy to move canine to its ideal position. (Fig.1 a-h)

 

Case 2

It is clear to observe especially how right impacted canine because horizontal position surgically option is the best choice for it. (Fig.2 a-f).

Conclusions

There exist clinical situations for which CBCT is a useful tool like impacted canines, craniofacial anomalies, TMJ assessment and upper airway analysis.

CBCT images in combination with and 3d segmentation impression and videos provide a better diagnosis and is useful to decide to treat these cases orthodontically or surgically.

Special thanks

Orca Dental AI  for segmentation process, video and airway , cephalometric analysis.

Ideas Dentales Mexico for printing  3D models.

References

  1. Mason C, Papadakou P, Roberts GJ. The radiographic localization of impacted maxillary canines: a comparison of methods. Eur J Orthod 2001;23:25-34.
  2. Preda L, La Fianza A, Di Maggio EM, Dore R, Schifino MR, Campani R, et al. The use of spiral computed tomography in the localization of impacted maxillary canines. Dentomaxillofacial Radiol 1997;26:236-41.
  3. Stewart JA, Heo G, Glover KE, Williamson PC, Lam EW, Major PW. Factors that relate to treatment duration for patients with palatally impacted maxillary canines. Am J Orthod Dentofac Orthop 2001;119:216-25.
  4. Walker L, Enciso R, Mah J. Three-dimansional localization of maxillary canines with cone-beam computed tomography. Am J Orthod Dentofac Orthop 2005;128:418-23.
  5. Peck S, Peck L, Kataja M. The palatally displaced canine as a dental anomaly of genetic origin. Angle Orthod. 1994;64:249-56.
  6. Ericson S, Kurol J. CT diagnosis of ectopically erupting maxillary canines – a case repost. European Juornal fo Orthodontics 1988;10:115-21.
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ORCA Dental AI Announces the Appointment of Mr. Chen Porat as VP Sales

ORCA Dental AI, the leading dental AI solutions provider, today announced the appointment of Mr. Chen Porat as VP Sales.

This after an extensive period of continuous growth and increasing market demand of its new AI software products.

Mr. Porat joins us with over 8 years in sales management in the dental market, and has extensive experience working with key players and opinion leaders in the field.

In his previous position, Mr. Porat was based in the USA, where he managed the US subsidiary of leading dental implant company. In this role, Mr. Porat  lead the company into a substantial player in the market while building the sales team, marketing strategy and infrastructure necessary to support rapid growth.

As VP of sales, Mr. Porat will take on ORCA Dental AI’s global sales management efforts, build a global network of resellers and agents and drive its continuous growth.

“Since the release of our latest dental AI software, we’ve been experiencing accelerated growth and increasing demand from potential resellers and agents that recognized the business potential we can deliver” said Shlomi Avigdor, Co-founder and CEO of ORCA Dental AI. “Chen’s proven experience in dental sales management will help Orca execute its ambitious growth plans for 2020 and we’re thrilled to have him join the team.

About ORCA Dental AI

ORCA is the leading provider of AI and deep learning solutions, bringing automated and accurate interpretations of the dental imagery. The company’s technology helps dental practitioners to improve office efficiency and productivity, to save time and effort and to reduce medico-legal risk.

ORCA envisions a world where it’s highly sophisticated capabilities, will immediately and seamlessly provide diagnostics, visual treatment suggestions and pathology findings. The solutions covers all types of dental imagery namely X-rays, CTs and intraoral scans.

ORCA aims to provide services to the entire dental ecosystem including Orthodontists, GPs and Prosthodontists. ORCA has partnered with the leading dental imaging manufacturers and top market players across the entire dental value chain, including Dentsply Sirona, Cefla and Planmeca. For more information about ORCA’s advanced solutions, visit http://www.orca-dental.ai.

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A Brilliant Way to Minimize Metal Artifacts in CBCT Scans

Artifacts in CBCT

CBCT technology is rapidly gaining popularity in the dental space, providing detailed and precise anatomical structure information and enabling advanced diagnostics and treatment planning for implantology, orthodontics, oral surgery, and endodontics.

CBCT technology has its limits, though, artifacts being a major one. Artifacts refer to variances between the reconstructed image and the actual content of the scanned subject. These variances usually make the results of scans diagnostically unusable as a result of their degraded quality. In addition to having degraded quality, structures that do not exist within the subject might appear in the images, creating a largely inaccurate scan result. These structures come about as a result of an imprecise image capture, reconstruction process or even patient motion. Artifacts make proper diagnosis very difficult and sometimes impossible to carry out. This article aims to highlight everything you need to know about artifacts and how to minimize them in CBCT scans.

Metal Artifacts

Metal streak artifacts are quite common in CBCT scans, often caused by patient-related objects such as implants, crowns, posts, fillings, and other radiopaque materials. These high-attenuation objects cause noise scattering and beam hardening, often resulting in bright and dark streaks that degrade the image quality.

Minimizing Artifacts in CBCT Scans

Minimizing metal artifacts produces a cleaner image, increasing diagnostics and improving treatment planning abilities. Other than the obvious, e.g. taking off metal objects (mainly jewelry), there’s another way to reduce artifacts – a brilliant one.

Deflection

Artifacts generated from metal or other radiopaque materials appear only in the plane horizontal to the patient positioning during the scan. By deflecting the artifact plane from the region of interest (ROI), you get a scan in which your ROI is cleaner, providing you with better diagnostics.

This deflection is executed by simply tilting the patient’s chin up or down when positioning for the scan.

For implant planning, the best patient positioning in most cases will be occlusal plane horizontal, leaving all crown and filling artifacts in the occlusal plane. In these cases, the bone will be as clean as possible.

It can still be affected by implants, deep posts, or gutta-percha.

When the ROI includes one or more teeth in the mandibular anterior region, position the patient with their chin tilted down. This way, artifacts generated in posterior areas will stay above the ROI.

ROI – mandibular posterior region: Place the patient with their chin tilted up. This will keep artifacts generated in the mandibular anterior region above the ROI.

ROI – maxillary anterior region: Place the patient with their chin tilted up. This will keep artifacts generated in the posterior area under the ROI.

ROI – maxillary posterior region: Place the patient with their chin tilted down. This will keep artifacts generated in the maxillary anterior region under the ROI.

ROI – premolars and first molars in either jaw: Place the patient with the occlusal plane horizontal. 

Make sure to help your patient place their heads in the various positions. Guide them in clear terms where to place their chin and change the machine height as needed.

In conclusion, it is easy to see that artifacts get in the way of carrying out proper diagnoses and treatment. Despite that, with careful planning and attention to detail, you can achieve good, usable results for your needs.

 

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5 Tools to Diagnose Impacted Teeth

5 Best Tools to Diagnose Impacted Teeth

Misdiagnosed impacted teeth may turn out to be risky to dentists just s they are to patients. Malpractice lawsuits are increasing in numbers, as patients claim for negligence- failure to timely recognize the need for eruption management, and failure to take timely action before risking the patients’ health.

The causes of an impacted tooth are often as a result of lack of space for the tooth in the mouth, due to orthodontic treatment or genetic factors. In other words, it may be caused by inherited factors or as a secondary effect to another oral condition.

This tooth condition can present with symptoms, i.e., symptomatic or even show no symptoms at all, i.e., asymptomatic. For those that present with symptoms, the common ones are:

  • Bad breath
  • Red swollen gum
  • Pain associated with mouth opening, biting, or chewing.
  • Bleeding gum etc.

The list of symptoms is not exclusive; some may experience one or more, while others none. And of course, these symptoms can serve as valid hallmarks to diagnosing the impacted tooth condition.

Here are some of the best methods of diagnosing impacted teeth:

  • Evaluation of the condition of tooth and gum: This is the conventional first diagnostic step taken by dentists. But this diagnosis is often not accurate, as there are many gums, teeth, or oral disease conditions that affect the gum, presenting almost the same symptoms as the “red- swollen- bleeding gum.” However, it can give a solid lead.
  • Intra-oral radiography – This type of radiography is said to more commonly used compared to the extra-oral radiography. The various Subtypes under it are indicative of the aspect of the teeth they show. Such Subtypes include:  Bite-wing x-rays, Periapical x-rays, Occlusal x-rays.

Known down-side for intra-oral radiography is their limited field-of-view, which can easily lead to missing out impacted teeth even when pointing the equipment to the right area.

  • Extraoral radiography – Referring primarily to Panoramic x-rays, this is a method preferred by most dentists. It enables effectively detecting teeth impaction within a region of the mouth. This implies that the specificity of location of impacted teeth may not be ascertained.
  • Cone-Beam Computed Tomography (CBCT):  Acquiring 3D scan is usually better, safer and more accurate than the radiography methods. For the safety of the patient it is often safer to take one exact CBCT in place of having to do repetitive radiography checks. The harmful effect of radiation is thus circumvented by this method of diagnosis. However many dentists find it hard to master 3D software, having to search through slices using different filters. Also, unlocking its full potential requires manual anatomy segmentation, before teeth and jaws can be moved, colored, removed etc, to allow diagnosis of impaction and other clinical condition, such as root absorption, bone thickness, nerve canal location and others.  
  • AI Driven 3D Segmentation: A 3D viewer that shows teeth and bone segmented by artificial-intelligence from a CBCT scan. This is an improvement over the conventional cone-beam computed tomography method of diagnosis, without adding any manual segmentation work or cost

Unlike the other methods of diagnosing impacted teeth, this newer method is better and more reliable. It gives a perfect 3D picture of the teeth segmented, making it very easy for the dentist/oral surgeon to accurately identify the impacted tooth/teeth. Dentists also have the option to share the case with patients, making them more connected and informed, to increase case acceptance.

CBCT 3D viewer helps the dentist to precisely identify the location of the impacted teeth; this is unlike the panoramic imaging that only helps to predict the teeth such as the maxillary canine. It reveals the location and shows the entire teeth in a three-dimensional manner, thus enabling accurate diagnosis.

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