Applications of artificial intelligence in dentistry: A comprehensive review

This work was funded by the Spanish Ministry of Sciences, Innovation and Universities under Projects RTI2018-101674-B-I00 and PGC2018-101904-A-100, University of Granada project A.TEP. 280.UGR18, I+D+I Junta de Andalucia 2020 project P20-00200, and Fapergs/Capes do Brasil grant 19/25510000928-3. Funding for open-access charge: Universidad de Granada/CBUAObjective: To perform a comprehensive review of the use of artificial intelligence (AI) and machine learning (ML) in dentistry, providing the community with a broad insight on the different advances that these technologies and tools have produced, paying special attention to the area of esthetic dentistry and color research. Materials and methods: The comprehensive review was conducted in MEDLINE/ PubMed, Web of Science, and Scopus databases, for papers published in English language in the last 20 years. Results: Out of 3871 eligible papers, 120 were included for final appraisal. Study methodologies included deep learning (DL; n = 76), fuzzy logic (FL; n = 12), and other ML techniques (n = 32), which were mainly applied to disease identification, image segmentation, image correction, and biomimetic color analysis and modeling. Conclusions: The insight provided by the present work has reported outstanding results in the design of high-performance decision support systems for the aforementioned areas. The future of digital dentistry goes through the design of integrated approaches providing personalized treatments to patients. In addition, esthetic dentistry can benefit from those advances by developing models allowing a complete characterization of tooth color, enhancing the accuracy of dental restorations. Clinical significance: The use of AI and ML has an increasing impact on the dental profession and is complementing the development of digital technologies and tools, with a wide application in treatment planning and esthetic dentistry procedures.Spanish Ministry of Sciences, Innovation and Universities RTI2018-101674-B-I00 PGC2018-101904-A-100University of Granada project A.TEP. 280.UGR18Junta de Andalucia P20-00200Fapergs/Capes do Brasil grant 19/25510000928-3Universidad de Granada/CBU

Validation of a Hyperspectral Imaging System for Color Measurement of In-Vivo Dental Structures

A full comprehension of colorimetric relationships within and between teeth is key for aesthetic success of a dental restoration. In this sense, hyperspectral imaging can provide point-wise reliable measurements of the tooth surface, which can serve for this purpose. The aim of this study was to use a hyperspectral imaging system for the colorimetric characterization of 4 in-vivo maxillary anterior teeth and to cross-check the results with similar studies carried out with other measuring systems in order to validate the proposed capturing protocol. Hyperspectral reflectance images (Specim IQ), of the upper central (UCI) and lateral incisors (ULI), were captured on 30 participants. CIE-L*a*b* values were calculated for the incisal (I), middle (M) and cervical (C) third of each target tooth. Delta E-ab* and Delta E-00 total color differences were computed between different tooth areas and adjacent teeth, and evaluated according to the perceptibility (PT) and acceptability (AT) thresholds for dentistry. Non-perceptible color differences were found between UCIs and ULIs. Mean color differences between UCI and ULI exceeded AT (Delta E-ab* = 7.39-7.42; Delta E-00 = 5.71-5.74) in all cases. Large chromatic variations between I, M and C areas of the same tooth were registered (Delta E-ab* = 5.01-6.07 and Delta E-00 = 4.07-5.03; Delta E-ab* = 5.80-8.16 and Delta E-00 = 4.37-5.15; and Delta E-ab* = 5.42-5.92 and Delta E-00 = 3.87-4.16 between C and M, C and I and M and I, respectively). The use of a hyperspectral camera has proven to be a reliable and effective method for color evaluation of in-vivo natural teeth.MCIN/AEI/ERDF "Una manera de hacer Europa" PGC2018-101904-A-I00 PID2021128317OB-I00Junta de Andalucia RDI P20-00200OTRI 474

Evaluación de la fórmula de diferencia de color CIEDE2000(KL:KC:KH) y desarrollo de algoritmos predictivos de color: aplicación para materiales dentales

Tesis Univ. Granada. Departamento de Óptic

Colorimetric (CIEDE2000) comparison between two shade guides used for visual evaluation of tooth whitening efficacy

Introduction/Objective The objective of this study was to perform colorimetric comparison between two shade guides used for visual tooth whitening monitoring. Methods VITA Bleachedguide 3D-Master (BG) and value scale of VITA classical A1–D4 (VC) were evaluated (n = 3) using a non-contact spectroradiometer. Ranges, distribution, and correlation among color parameters were evaluated using CIEDE2000 color difference formula. In addition, optimized whiteness index for dentistry (WID), and Yellowness Index E313 (YI) were analyzed. ANOVA and Fisher’s PLSD test at a 0.05 level of significance were used in statistical analysis. Results The lightness (L’), chroma (C’), and hue (h’) ranges for BG were 20.4, 25.9, and 19.1, respectively. The corresponding ranges for VC were 15.3, 10.9, and 20.6. R2 values for individual color coordinate/tab arrangement were higher for BG than VC. The same is true for R2 values of pairs of color coordinates for BG/VC: L’C’ = 0.89/0.33, L’h’ = 0.88/0.53, and C’h’ = 0.70/0.51. BG also exhibited better agreement between the manufacturer’s tab arrangement with ΔE’, WID and YI. The ΔE’ between the lightest and the darkest BG and VC tab were 20.6 and 13.2, respectively. The average ΔE’ among the adjacent tabs were 1.9 (0.5) for BG (corresponding to two shade guide units, SGU) and 3.0 (1.0) for VC (1 SGU). Conclusion VITA Bleachedguide 3D-Master exhibited wider L’, C’, ΔE’, WID, and YI ranges compared to value scale of VITA classical A1–D4 shade guide and better distribution of evaluated color parameters. This, along with the presence of several shades lighter than B1 of VC, recommends the use of BG for visual evaluation of tooth whitening efficacy

Effect of White Light-Emitting Diode Illuminants Recommended by the CIE on Colors of Dental Ceramic Materials

The aim of this study was to evaluate color inconstancy of dental ceramics under the white light-emitting diode illuminants recently proposed by the CIE. From spectral reflectance factors of 18 dental ceramics (VST, NSP, and IEC; shades A1, A2, A3, A3.5, B2, and C2), the corresponding colors under illuminant D65 and CIE 1931 Standard Colorimetric Observer were computed for all samples, using the chromatic adaptation transform CIECAT16. CIEDE2000 color differences between dental ceramics illuminated by CIE D65 standard illuminant and different white LED illuminants were calculated. Perceptibility and acceptability thresholds (PT00 and AP00) in dental ceramics were used to analyze color changes. Color gamut size was within the same range for all illuminants and for all ceramics, since MCDM computed values were 4.1–4.4 for VST, 4.0–4.2 for NSP, and 4.3–4.6 for IEC. For all ceramics and shades, the color inconstancies were higher than 50:50% PT00 and, in general, lower than 50:50% AT00. The effect of CIE-proposed LED illuminants on dental ceramic is perceptible and slightly lower than on natural teeth. Dental clinicians should consider these lighting effects on the visual appearance of dental ceramics.Junta de Andalucia A-FQM-30-UGR20 P20-00200Spanish Government PGC2018-101904-A-10

Development of Thickness-Dependent Predictive Methods for the Estimation of the CIEL*a*b* Color Coordinates of Monolithic and Layered Dental Resin Composites

Usually, dentin and enamel shades are layered in dental restorations with the purpose of mimicking the natural appearance of teeth. The main objective of this study was to develop and assess accuracy of a color-prediction method for both monolithic and layered dental resin-based composites with varying shades and under different illuminants. A total of 15 different shades of VITAPAN Excell, VITAPAN Dentine and VITA Physiodens as well as VITA Enamel of five different thicknesses (0.5-2.5 mm range) were used to manufacture monolithic and layered samples. A non-contact spectroradiometer with CIE 45 degrees/0 degrees geometry was used to measure the color of all samples over a standard ceramic black background. Second-degree polynomial regression was used as predictive method for CIE-L*a*b* color coordinates. Performance of predictive models was tested using the CIEDE2000 total color difference formula (Delta E-00), while accuracy was evaluated by comparative assessment of Delta E-00 with corresponding 50:50% acceptability (AT(00)) and perceptibly (PT00) thresholds for dentistry. A mean color difference between measured (real) and predicted color of Delta E-00=1.71, with 62.86% of the color differences below AT(00) and 28.57% below PT00, was registered for monolithic samples. For bi-layered samples, the mean color difference was roughly Delta E-00=0.50, with generally 100% and more than 85% of the estimations below AT(00) and PT00, respectively. The predictive method allowed highly accurate color estimations for both monolithic and layered dental resin-based composites with varying thicknesses and under different illuminations. These results could be useful to maximize the clinical success of dental restorations.Ministry of Science and Innovation, Spain (MICINN) Spanish Government PGC2018-101904-A-100 PID2021-128317OB-I00Junta de AndaluciaUniversity of Granada RDI P20-00200 A.TEP.280.UGR1

Visual and instrumental coverage error of two dental shade guides: an in vivo study

Objectives This study aims to evaluate in vivo the color agreement between natural teeth and dental shade guides by means of visual and instrumental coverage error ( CE ) index. Materials and methods The color of the middle third of 735 incisors was visually determined by two evaluators using the Vita Classical (VC) and Vita 3D Master (V3DM) shade guides. The color match between the natural tooth and the shade tab was rated as poor (P), good (G), or optimum (O) by each observer. CIE color coordinates of the target teeth and shade tabs of VC and V3DM were instrumentally measured using a clinical spectrophotometer. Visual ( CE V ) and instrumental ( CE I ) coverage error indexes were computed using CIELAB and CIEDE2000 metrics for both shade guides. For CE V calculation, only the concordant inter-observer determination on tooth shade rated as O–O or O–G was used. The results were evaluated using perceptibility (PT, ΔE∗ ab = 1.2, ΔE 00 = 0.8) and acceptability (AT, ΔE∗ ab = 2.7, ΔE 00 = 1.8) color thresholds for dentistry. Results VC and V3DM exhibited CE I (2.5, 3.2, and 3.2, 2.7 CIELAB units; 1.9, 2.3, and 2.8, 2.4 CIEDE2000 units, respectively, for O–O and O–G match) and CE V (4.7, 4.8, and 4.1, 4.6 CIELAB units; 3.3, 3.4, and 3.4, 3.6 CIEDE2000 units, respectively, for O–O and O–G match) values greater than 50:50% AT for both color difference formulas. CE I contributes more than 50% (53.2–82.4% range) to the CE V value. This contribution depends on the shade guide used and the quality of the visual rating. Conclusions The evaluated shade guides exhibited visual coverage errors above acceptability thresholds, largely due to the contribution of the instrumental coverage error to the visual coverage error. Clinical relevance It necessary to further improve commercially available dental shade guides to facilitate achievement of satisfactory esthetics results in clinical practice.Universidad de Granada / CBUAJunta de Andalucia P20-00200 A.TEP.280.UGR18Spanish Government PGC2018101,904-A-I0