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

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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What is Airway Volume Analysis?

Orthodontists have always had an interest in the upper airway, whether it’s the relationship between the airway and facial type, airway shape, or the airway volume. Most airway volume analysis is conducted using 2-dimensional (2D) cephalograms, which create a 2D airway analysis. This method provides limited data, like angular and linear measurements. A more sophisticated 3D airway analysis can be conducted by using 3D technology as the airway is part of a 3D structure. The most recent tool that can reveal the airway in 3D is cone-beam computed tomography (CBCT). The reason for orthodontists needing this information is so they can measure the airway volume for patients with obstructive sleep apnea, in relation to malocclusions, and also in those patients who have had orthodontic treatment.

2D lateral cephalograms

The older lateral cephalograms cost less than CBCT and are easy to use, but they are just limited to two-dimensional imaging, which doesn’t help to view structures in 3D. The use of CBCT has revealed that its reliability and accuracy of craniofacial measurements are far better than to 2D lateral cephalograms.

The use CBCT in the field of dentistry

This 3D diagnostic tool has in recent years become more accessible to the field of dentistry. It is now a reputable and well-acknowledged imaging technique for diagnosing oral and maxillofacial problems. It has in part become the preferred technique because it’s faster so it means the patient is subject to lower radiation doses. CBCT technology is so advanced that it can segment and visualise hollow structures in 3D such as airway volumes and surface areas.

Once the scan or digital image has been taken, the dentist, orthodontist or doctor needs to view the findings in a DICOM viewer, as DICOM is the file format accepted for a medical image. A DICOM viewer allows for a total analysis of any CBCT scan such as measuring airway volume and segmenting. When an image of an airway is segmented and structured this means delineating and removing any surrounding structures so that there is a clearer image which is easier to analyse.

Airway volume analysis and sleep apnea

The orthodontic community has a great interest in airway volume and respiratory function because studies have revealed airway problems are often related to different sorts of malocclusion and it’s been found that nasal obstruction is one of the main aetiological factors for dento-facial anomalies. Also, evaluation of airway volume is one of the diagnostic steps for patients who experience breathing disorders for example obstructive sleep apnoea (OSA) where the victims have marked craniofacial differences, like the position and size of the mandible, enlargement of the posterior airway space, and size of the soft palate and tongue. In these patients, airway volume analysis assessment has been performed, mostly using 2D lateral cephalograms, by identifying specific landmarks and measuring different areas and lengths in the airway region.

Airway volume analysis and malocclusion

Studies have shown that Class 11, division 1 malocclusion occurs because of an obstruction in the upper pharyngeal airway and mouth breathing. However, other research such as de Freitas et al. (2006), drew the conclusion that the width of the lower and upper pharyngeal airway width is not related to either Class I or Class II malocclusions. A further study by Kirjavainen and Kirjavainen in 2007 discovered that with Class II malocclusion, there is a definite association with the upper airway structure being narrower even in the absence of retrognathia.

Many of these studies to do with airway anatomy and its relationship to craniofacial development and growth face limitations because they have been using 2D frontal or lateral cephalograms which are not able to identify the contour of soft tissue in 3D which limits their ability to evaluate both volumes and areas in the upper airway. More and more practitioners take advantage of advances in computed tomography (CT) imaging and the 3D technology which allow them to better visualize the airway and volumetric analysis.

Clinicians are able to undertake the volumetric measurements and calculate the cross-sections of the airway in 3 planes of space, which are axial, coronal and sagittal. The axial plane, which can’t be seen on a lateral cephalogram, is considered to be the most relevant plane from a physiological perspective because it’s perpendicular to the airflow. CBCT systems have been specifically developed for the maxillofacial area.

Easy and accurate evaluation of the anatomy of the airway has been made possible using CBCT. Although there have been many studies published using CBCT to evaluate airways, not many have addressed its accuracy. Recent studies concentrated on evaluating both the reliability and accuracy of the airway volume which was measured on CBCTs digitally and at the most constricted part in the airway. This was compared to the manual measurements carried out on an airway model. They came up with varying results.

What we do at CephX

Our aim at CephX is to assist orthodontic practitioners worldwide to save valuable time by providing accurate analyses of dental imagery. The services we offer are automated, which is the highest quality analyses that helps you to improve the productivity and efficiency of your practice. Currently, we offer a cephalometric analysis service of 2D cephalometric x-rays or of CBCT scans, and 3D teeth segmentation. All the dental practitioner has to do is to upload the patient’s scan, and in no time at all he or she will be in receipt of the full analysis. Another key service we intend to add soon is automatic and instant 2D and 3D airway volume analysis using AI which will be available online.

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and How Artificial Intelligence Could Change the Face of Dentistry

The Use of AI in Dentistry is the Right Step Forward

Artificial intelligence (AI) isn’t actually a recent invention as it has been around since 1956, when intelligent machines were discussed at a conference for researchers. So, more than half a century later, AI has become part of our lives. It’s so pervasive that it is used in dentistry and for good reason, too. If as a dentist you are presented with a patient suffering from a toothache, first of all you are likely to quiz the patient on the exact location of the pain, take an x-ray and use the patient’s dental history and your experience to determine the actual site of the decay.  No dentist gets every diagnosis right. Caries can’t always be seen with the naked eye. However, AI is in the process of changing all that.

Machine learning and big data

Machines using big data inputted into them are getting closer and closer to obtaining a perfect score when confronted with having to give a diagnosis. But they do have to be fed a huge amount of data which provides them with sufficient information to come up with a useful diagnosis. Fortunately, the ability to store huge amounts of data has been mastered. In fact, just in the last 5 years, big data with cloud computing provides easy access to massive data sets and at little cost. The machine can sift through the data and select what it thinks is needed to solve a problem it’s been asked to do.

The new era of deep learning

This is considered to be the most cutting edge of AI in the machine learning field. Deep learning is more intelligent than early machine learning as it makes its own rules, even when additional data is included. This feature means it’s well suited for interpreting unstructured data, such as disease detection, earthquakes and for the diagnosis of medical issues. Dentists like you may already be accessing a deep-learning AI platform for diagnosing caries without even realising it.

AI on the dental horizon with deep learning

Artificial intelligence is of great use to the medical and dental fields because so often a diagnosis is dependent on what experience the dentist has had of a similar situation before.  IBM’s Watson can read upwards of 500,000 research papers in just 15 seconds. This sort of deep learning can delve into so much depth that it can recommend diagnoses and suggest the best treatment options. In a study published recently results were presented for detecting caries by a dentist and by a machine.

The AI machine outperformed dentists in sensitivity, which measures the percentage of caries predicted correctly. In the next year or two it’s expected that a reliable deep learning AI tool will be available to dentists. Not long after that, a tool for diagnosing periodontal disease and associated bone loss should be on the cards. So far ORCA Dental AI has developed ceph-tracing algorithms which can instantly offer a custom tracing and ceph analysis report. With cephalometric analysis, orthodontists are able to construct treatment plans for their easily and accurately so there is no delay in starting orthodontic treatment. ORCA’s cutting edge cephalometric analysis and tracing service assists practitioners like you to provide more efficient treatment. Your patients will see the immediate results from your state of the art treatment and they benefit while your revenue grows.

CephX and AI

In the last 4 years CephX discovered the growing importance of AI in the dental community. It hasn’t wasted any time and has responded by creating the first intelligent algorithm capable of automatic and instant cephalometric analysis on an x-ray scan. Most recently CephX introduced a new algorithm which is cephalometric tracing on a CBCT scan. Its AI teeth segmentation solution is no doubt the star of the show offering instant and automatic teeth segmentation. This allows far more accurate and faster treatment for your patients. 

What’s in it for your patients?

A lot more than one could imagine, as AI and big data score highly for the patient too. If one of your patients feels a debilitating jab of pain in a tooth they will soon be able to get their smart brush out, put it in the mouth and link it to a smart phone. In an instant it collects information about the painful tooth which is stored in cloud. Using big data and AI the data is analysed and a diagnosis is revealed, which ends up on your desktop. It’s then up to your practice to organise an appointment and go ahead with treatment.

Your dental practice and big data analytics

Big data analytics is a bit more than big data and it goes a step further in dental care. It has the ability to analyse vast amounts of data which includes a patient’s personal data and demographic data. This can give you an insight into likely dental problems that could affect your patients in the future because it discovers the common dental problems in a particular area. You can advise your patients of possible preventative measures they could use to halt the occurrence of one of these common dental problems.

As more and more AI and smart technology is added to dentistry the role of you as a dentist and your patient will ultimately change and it should lead to better oral health outcomes for your patients because they will be able to link with you in real time instead of waiting for a physical appointment. You will be able to offer state of the art AI diagnostic tools enabling you to come up with just the right diagnosis and treatment plan. You could even become the most sought after dentist in your area.

In the near future, it’s likely that tools for deep learning analysis for images will assist in diagnosing and suggesting treatment plans for periodontal disease because it will be able to far sooner early loss of bone and bone density changes. In orthodontics, it’s expected there will be far more sophisticated prediction models for movement of teeth tooth which will most likely improve drastically digital treatment plans. When applied to oral cancer a deep learning image analysis will improve earlier detection and offer more accurate diagnoses which will improve life’s outcome.

CephX works continuously on creating cutting edge solutions and services for orthodontic practitioners. To receive additional information regarding existing or new upcoming orthodontic services and solutions, please contact us at

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How Artificial Intelligence Could Change the Face of Dentistry

What is Artificial Intelligence?

Artificial intelligence (AI) isn’t a new concept. In fact, it was first mentioned in the 1950s by Minsky and McCarthy, who were considered to be pioneering experts in the field. They referred to AI as a task performed by a machine or programme that, if a human was to carry out exactly the same activity, the person would have to use intelligence to succeed in completing the task. The sorts of tasks could be anything to do with planning, reasoning, the sharing of knowledge and problem-solving.

Since those early days computers have increasingly taken over tasks normally associated with humans. This has enabled industries of all types to manufacture products more efficiently. AI is now so well developed that medicine is using it in a multitude of situations, enabling better outcomes for patients.  When a patient visits an emergency room, diagnosis is faster and more accurate. This means the right treatment is given, which means less delay than might happen if doctors have to discuss a case before deciding on a diagnosis.

AI is also being used to improve communication between medical personnel. In the long run, this all means that by patients getting the right treatment in the fastest time frame reduces time spent in hospital so reducing the stress levels of family and friends.

How the Watson platform uses AI to help the medical profession

The Watson platform was introduced by IBM into medical facilities to assist oncologists to come up with the most appropriate treatment for patients.  All the doctor has to do is input a patient’s diagnosis into Watson which at a touch of a button instantly recommends the best treatment suited to the data it has about the patient. It has already been fed with information provided by medical journals.  With this huge amount of accumulated knowledge, its AI allegedly comes up with the best treatment plan.

AI for dentistry makes its mark

AI is now being used to improve the efficiency of dentistry. Dr. John Kois has developed a similar AI model to IBM’s Watson called Evidentiae. It focuses more on using cloud-based dental software. It concentrates on information processing at the patient level, starting with an online patient history form and all the data relevant to the patient’s treatment.

Evidentiae’s algorithm has been designed to extract data from both medical and dental histories which have been inputted into it and charted examination findings. This enables the technology to generate a full overview of the dental health status of your patient. It has been so well developed that it is able to come up with a valuable diagnosis for periodontal issues and dento-facial alterations. It’s the best AI assistance yet invented for the dental profession.

A few years ago CephX understood the need for artificial intelligence in the dental industry. In response, they created the first cephalometric analysis intelligent algorithm. It enabled orthodontic practitioners to upload their patients’ cephalometric scan and to receive in a matter of seconds a full cephalometric tracing and analysis. This technology improved dramatically the way it was done, because now dentists could instantly receive a full and accurate analysis.

AI and Big Data in Dentistry

With AI and big data making inroads into dentistry soon algorithms will be diagnosing dental problems and the diagnosis will be sent directly to you. This is a step ahead of CephX and cephalometric analysis which is currently helping you with instantly tracing and analysing cephalometric scans. However, it is starting to move quickly as it is developing more intelligent algorithms for the orthodontic industry. One of them is the algorithm that can instantly segment all of your patient’s teeth.

Deep-learning in machine learning is becoming relevant to Dentistry

Advanced technologies that are disrupting all of our lives are also helping to revolutionize dentistry in numerous ways. Deep learning, which is an AI cutting-edge technique in machine learning, is using layered neural networks which are patterned on a human’s brain. Traditionally machine-learning relies on rules that have been handcrafted but defined by experts in human domain but do not improve with bigger datasets. Deep learning has the capacity to create its own unique rules that do improve when more data is added, making it particularly suited at interpreting unstructured data that’s required for more advanced applications like self-driving cars, the prediction of earthquakes, detection of disease and diagnosis and recommendations for treatment in medicine. Dentists do actually have some access to an AI deep learning platform for the detection of cavities today.

AI that can read CT scans for dentistry

Research and development of AI is progressing at such a fast rate that software are already able to read and interpret CT scans and other dental images. In the near future, it will suggest the best diagnosis and treatment which it has gleaned from its ability to review and analyse countless images that have been stored in numerous patients’ databases. What’s particularly important to dentistry is the speed and accuracy that emerges from the use of AI.

The medical profession is presently benefiting a lot from VisualDx, an AI technology that doctors can use to input patient symptoms and any relevant images and within a matter of seconds plausible diagnoses can be retrieved. This AI is soon likely to penetrate the dental industry.

The future of AI in the next decade

In the medical field at least AI is going to become increasingly relevant. This will result in administrative practices being far more streamlined. This, in turn, leads to a reduction in costs. It’s expected that there will be a far higher chance that any unnecessary medical procedures will be avoided, which should heighten patient satisfaction. This is all due to the way information is being inputted and the way humans are communicating with devices.

In the early stages of storing information, a human had to manually enter data. Graphical user interface (GUI) came next, followed by the development of the touch screen and the rapid evolution of mobile devices. All this, coupled with massive improvements in internet connectivity, has brought us to where we are today.

The dentist and a virtual assistant

Human voice recognition is increasingly being used to input information into an AI device. In a decade or so, dentists and others in the medical community will be communicating with AI devices using their own voices. AI will be able to assimilate and analyse data and recommend the best treatment options. This will be happening in the dentist’s chair, where communication with the dentist and the AI device will sound quite natural and not stilted.

It won’t be just a computer standing side by side with the dentist, but a virtual assistant using AI. It will be provided with so much data to analyse that it will come up with just the right treatment in orthodontics and other dental procedures and the future care requirements for the patient, dependent on data that it has been given to analyse. The virtual assistant will be able to make recommendations regarding future care requirements which will depend on the genetic data of the patient.


In the near future, AI will be able to help the dental practitioner spot a possible tumor, or other irregularities in teeth or gums, through an X-ray or CT scans. Artificial intelligence is already used in some medical centers to improve the efficiency of health care delivery. Software is being further developed to make surgery and imaging test timetabling more efficient by predicting how long each scheduled procedure will take. This and other innovative solutions can easily be adapted for use in a dental practice. CephX’s technologies which are all based on AI are trying to achieve exactly that.

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