The utility of 40 MHz periodontal ultrasonography in the assessment of gingival inflammation evolution following professional teeth cleaning

Abstract The aim of this study was to evaluate the usefulness of 40 MHz periodontal ultrasonography in the assessment of gingival inflammation, following professional teeth cleaning. Material and methods: The study was performed on 18 teeth without restorations having subgingival calculus (upper and lower premolars and frontal teeth). After the clinical exam the Gingival Index and the Sulcus Bleeding Index were calculated. Then a 40MHz transducer (ULTRASONIX SonoTouch device) was used to obtain longitudinal sections in the frontal plane. Three measurements were performed: alveolar crest -cementumenamel junction distance (ACJ), gingival height (GH), and gingival width (GW). Professional cleaning was performed by ultrasound scaling (SatelecP5 booster, France) and airflow (NSK, Japan). Two and seven days after the first evaluation, ultrasonographic and clinical examinations were repeated. Results: Two days after the treatment the median value of the ACJ, was 2.70 (2.38; 2.95) mm, whereas 7 days after treatment it was 2.55 (2.45; 3.01) mm. The intraclass correlation coefficient for ACJ measurement was 98.8 (p<0.001).The values obtained measuring GH [3.84(3.44; 4.27) mm vs. 3.52 (3.00; 3.76) mm] and GW [(1.81 (1.65; 1.95) mm vs.1.62 (1.40; 1.95) mm) had statistically significant differences between the 2nd and 7th day. Conclusions: Periodontal ultrasonography is a highly precise and reproducible imagistic method, with which bone resorption, gingival inflammation as well as the presence or absence of subgingival calculus can be assessed

Multi-Layer IoT Security Framework for Ambient Intelligence Environments

Ambient intelligence is a new paradigm in the Internet of Things (IoT) world that brings smartness to living environments to make them more sensitive; adaptive; and personalized to human needs. A critical area where ambient intelligence can be used is health and social care; where it can improve and sustain the quality of life without increasing financial costs. The adoption of this new paradigm for health and social care largely depends on the technology deployed (sensors and wireless networks), the software used for decision-making and the security, privacy and reliability of the information. IoT sensors and wearables collect sensitive data and must respond in a near real-time manner to input changes. An IoT security framework is meant to offer the versatility and modularization needed to sustain such applications. Our framework was designed to easily integrate with different health and social care applications, separating security tasks from functional ones and being designed with independent modules for each layer (Cloud, gateway and IoT device), that offer functionalities relative to that layer

Automatic Segmentation of Periodontal Tissue Ultrasound Images with Artificial Intelligence: A Novel Method for Improving Dataset Quality

This research aimed to evaluate Mask R-CNN and U-Net convolutional neural network models for pixel-level classification in order to perform the automatic segmentation of bi-dimensional images of US dental arches, identifying anatomical elements required for periodontal diagnosis. A secondary aim was to evaluate the efficiency of a correction method of the ground truth masks segmented by an operator, for improving the quality of the datasets used for training the neural network models, by 3D ultrasound reconstructions of the examined periodontal tissue. Methods: Ultrasound periodontal investigations were performed for 52 teeth of 11 patients using a 3D ultrasound scanner prototype. The original ultrasound images were segmented by a low experienced operator using region growing-based segmentation algorithms. Three-dimensional ultrasound reconstructions were used for the quality check and correction of the segmentation. Mask R-CNN and U-NET were trained and used for prediction of periodontal tissue’s elements identification. Results: The average Intersection over Union ranged between 10% for the periodontal pocket and 75.6% for gingiva. Even though the original dataset contained 3417 images from 11 patients, and the corrected dataset only 2135 images from 5 patients, the prediction’s accuracy is significantly better for the models trained with the corrected dataset. Conclusions: The proposed quality check and correction method by evaluating in the 3D space the operator’s ground truth segmentation had a positive impact on the quality of the datasets demonstrated through higher IoU after retraining the models using the corrected dataset

Accuracy Report on a Handheld 3D Ultrasound Scanner Prototype Based on a Standard Ultrasound Machine and a Spatial Pose Reading Sensor

The aim of this study was to develop and evaluate a 3D ultrasound scanning method. The main requirements were the freehand architecture of the scanner and high accuracy of the reconstructions. A quantitative evaluation of a freehand 3D ultrasound scanner prototype was performed, comparing the ultrasonographic reconstructions with the CAD (computer-aided design) model of the scanned object, to determine the accuracy of the result. For six consecutive scans, the 3D ultrasonographic reconstructions were scaled and aligned with the model. The mean distance between the 3D objects ranged between 0.019 and 0.05 mm and the standard deviation between 0.287 mm and 0.565 mm. Despite some inherent limitations of our study, the quantitative evaluation of the 3D ultrasonographic reconstructions showed comparable results to other studies performed on smaller areas of the scanned objects, demonstrating the future potential of the developed prototype

Photodynamic Therapy (PDT) in Prosthodontics: Disinfection of Human Teeth Exposed to <i>Streptococcus mutans</i> and the Effect on the Adhesion of Full Ceramic Veneers, Crowns, and Inlays: An In Vitro Study

The use of PDT in prosthodontics as a disinfection protocol can eradicate bacteria from tooth surfaces by causing the death of the microorganisms to which the photosensitizer binds, absorbing the energy of laser light during irradiation. The aim of the study was to investigate the capacity of PDT to increase the bond strength of full ceramic restorations. In this study, 45 extracted human teeth were prepared for veneers, crowns, and inlays and contaminated with Streptococcus mutans. Tooth surfaces decontamination was performed using a diode laser and methylene blue as a photosensitizer. The disinfection effect and the impact on tensile bond strength were evaluated by scanning electron microscopy (SEM) and pull-out tests of the cemented ceramic prosthesis. Results show that the number of bacteria was reduced from colonized prepared tooth surfaces, and the bond strength was increased when PDT was used. In conclusion, the present study indicates that using PDT as a protocol before the final adhesive cementation of ceramic restorations could be a promising approach, with outstanding advantages over conventional methods

An Evaluation of the Demineralizing Effects of Various Acidic Solutions

The purpose of this study was to evaluate which of the techniques and acids included in this in vitro research can induce artificial caries lesions in the most natural way. White spot lesions were created using six different demineralizing solutions in liquid form (lactic acid; orthophosphoric acid; formic acid; and an acid solution that contains calcium chloride, sodium phosphate and acetic acid) and gel form (hydrochloric acid and orthophosphoric acid). Radiographs, photographs and readings with a DIAGNODent™ pen, VITA Easyshade and a scanning electron microscope (SEM) were made in the initial situation, after 30 min, 1 h, 24 h and 96 h of demineralization. The total color change (ΔE) values in most cases presented statistically significant differences. SEM images showed different aspects of the enamel surface for each type of acid. Only in the case of exposed dentine did the DIAGNODent™ pen record significant differences. There was no noticeable radio-translucency of the teeth treated for a short period of time, but after 24 h, the absence of enamel and major demineralization of dentine were visible. Acids in the liquid state can penetrate and demineralize dental structures deeper than those that are more viscous. This study should be repeated with a protocol that includes remineralization. Using weaker acids would be another direction that could lead to more interesting findings