Robotics in Dentistry : A Narrative Review

Background: Robotics is progressing rapidly. The aim of this study was to provide a comprehensive overview of the basic and applied research status of robotics in dentistry and discusses its development and application prospects in several major professional fields of dentistry. Methods: A literature search was conducted on databases: MEDLINE, IEEE and Cochrane Library, using MeSH terms: [“robotics” and “dentistry”]. Result: Forty-nine articles were eventually selected according to certain inclusion criteria. There were 12 studies on prosthodontics, reaching 24%; 11 studies were on dental implantology, accounting for 23%. Scholars from China published the most articles, followed by Japan and the United States. The number of articles published between 2011 and 2015 was the largest. Conclusions: With the advancement of science and technology, the applications of robots in dental medicine has promoted the development of intelligent, precise, and minimally invasive dental treatments. Currently, robots are used in basic and applied research in various specialized fields of dentistry. Automatic tooth-crown-preparation robots, tooth-arrangement robots, drilling robots, and orthodontic archwire-bending robots that meet clinical requirements have been developed. We believe that in the near future, robots will change the existing dental treatment model and guide new directions for further development

求心性の歯周組織感覚入力により誘発された前頭前野の活動は咬合力を抑制する

The prefrontal cortex (PFC) plays an important role in several cognitive functions, such as planning, decision making, and social behavior. We previously reported that periodontal sensory input significantly increases PFC activity during the motor task of maintaining occlusal (biting) force. However, the relationships between periodontal sensation, PFC activity, and the performance of motor tasks, have not been evaluated in detail. Therefore, using functional near-infrared spectroscopy, we investigated PFC activity by monitoring changes in cerebral blood flow (CBF) to specific areas of the PFC that corresponded to changes in occlusal force generated during 4 different biting tasks: 1) occlusion with the central incisor with an interocclusal distance of 5 mm (BI-5 mm); or 2) 10 mm (BI-10 mm); 3) occlusion with the first molars with an interocclusal distance of 5 mm (BM-5 mm), or 4) 10 mm (BM-10 mm). Occlusion of molars generated increased PFC regional CBF as the interocclusal distance decreased (BM-10 mm vs BM-5 mm). No significant differences in CBF during occlusion of incisors were found when comparing 5 mm and 10 mm intercostal distances (BI-5 mm vs BI-10 mm). The mean occlusal force generated by BM-5 mm occlusion was significantly lower than that generated by BM-10 mm occlusion. Taken together, our results suggest that the PFC decreases efferent signaling to motor units, to reduce occlusal force generated when periodontal sensation, which is greater when the interocclusal distance is reduced, is primarily responsible for maintaining occlusal force in the absence of sensations from the temporomandibular joint and muscle spindles

Cascade between oral function and physical frailty

Background: No report has yet examined the impact of oral hypofunction on physical frailty in relation to intra‐relationships of physical frailty assessment items. The purpose of this study was to verify the potential of a clinical cascade between oral hypofunction and physical frailty, and especially to support the hypothesis that the influence of oral hypofunction on physical frailty is greater than the intra‐relationships among elements of physical frailty, and that sex differences significantly affect these relationships. Methods: The participants were 272 older adults (101 men and 171 women; mean age 75.1 ± 7.5 years). Maximum occlusal force (MOF) and oral dryness (OD), as indicators of oral hypofunction, and grip strength (GS) and walking speed (WS), as indicators of physical frailty, were measured. Mutual relationship of four variables was verified using covariance structure analysis. Results: In men, three paths from MOF to WS and GS and from WS to GS were confirmed, and those from MOF to WS and from WS to GS were found to be significant (p < 0.01). In women, three paths from MOF to WS and GS and from WS to GS were also confirmed, as with the men, and those from MOF to WS and from MOF to GS were found to be significant (p < 0.01). Model adaptability was shown to be good for both men and women. Conclusion: The results suggest our hypothesis was verified, and it is expected that the early detection of oral hypofunction, that is, MOF, may be important for assessing physical frailty, especially in women

Investigating Eating Behaviors and Symptoms of Oral Frailty Using Questionnaires

A questionnaire survey was conducted to investigate eating behavior and the subjective symptoms of oral frailty, and to examine the relationship between them. A total of 744 subjects with ages over 65 years were included. The questionnaire comprised 18 question items indicating eating behavior and seven question items indicating oral frailty. All items were assessed according to 4 grades on a scale of 1 (not applicable) to 4 (applicable). The total score of oral frailty gradually increased with age. Regarding the scores for “eating recognition” and “eating habits”, no changes were observed, however the scores for “eating action” demonstrated a decreasing tendency with age and the scores of ≥ 85 years age group was significantly lower than the 65–69, 70–74, and 75–79 years age groups. As a result of multiple regression analysis, among the significant independent variable, the scores of “I do not chew foods well” under the category of “eating action” showed the highest standard partial regression coefficients for dependent variable of symptoms of oral frailty. The significant association was found between the eating behavior and subjective symptoms of oral frailty, and this study suggests that the good chewing habit might be an important criterion for the prevention of oral frailty

Does Masticatory Ability Contribute to Nutritional Status in Older Individuals?

Mastication plays a primary role in the process of eating. Hence, compromised masticatory ability may affect the nutrition and quality of life, which are particularly important concerns among older individuals. It remains unclear how is the masticatory ability assessed regarding the nutritional status. We examined the effect of various oral factors on three masticatory ability tests conducted among older individuals. A total of 100 older individuals were enrolled in this study. Body mass index (BMI) as an indicator of nutritional status; and age, sex, and the number of occlusal and molar occlusal supports as clinical attributes were recorded. Three masticatory ability tests (masticatory efficiency, masticatory score, and satisfaction with mastication) were conducted, and tongue pressure, cheek pressure, and occlusal force were assessed as oral functions. A significant but weak correlation was found between masticatory efficiency and the masticatory score, but not between masticatory efficiency and satisfaction score. Objective masticatory efficiency was strongly associated with objective oral factors, whereas subjective assessments of masticatory ability (masticatory score and satisfaction score) were not. Furthermore, BMI was significantly associated with subjective assessments of masticatory ability but not with objective masticatory efficiency. Both subjective and objective assessments of masticatory ability, along with considerations of nutritional formulations, are required for the maintenance and improvement of nutritional status in older individuals

Expectation Management in a Global Collaboration Project Using a Deterministic Design Approach

Expectation management in product engineering design aims at setting achievable goals for both customers and designers, while leaving room for creativity and passion. This is especially challenging in the global workplace. Using an example of a design project, the Dental Headrest project (DHR), this paper reviews how expectations were managed in a successful, collaborative project between the University of Tokushima (UT) and Massachusetts Institute of Technology (MIT). The goal of the project was to design an innovative mechanism for the positioning a dental chair headrest so satisfy both the needs of a patient for comfort and a clinician for flexibility and access. The design team was formed with six students from the MIT MechE’s Precision Machine Design class, while the challenge proposed by a UT team of dentists and design engineers. The team followed a deterministic design procedure inducing understating the challenge and reviewing prior art, strategy and concept generation, detailed module design and fabrication and testing, culminating in presentation and documentation. Through the process was coordinated by online communication and collaborative working spaces which ensured real-time information transfer between the continents. The conclusion was a face-to-face meeting between the two institutions. This DHR project resulted in an innovative design of headrest adjusting mechanism that was implemented in a prototype. Moreover, the students, faculty and clinicians benefitted from the experience of innovative design collaboration in a multidisciplinary, global team.CIMIT: Center for Integration of Medicine and Innovative TechnologyJ. Morita Corporatio

Application of artificial intelligence in the dental field : A literature review

Purpose: The purpose of this study was to comprehensively review the literature regarding the application of artificial intelligence (AI) in the dental field, focusing on the evaluation criteria and architecture types. Study selection: Electronic databases (PubMed, Cochrane Library, Scopus) were searched. Full-text articles describing the clinical application of AI for the detection, diagnosis, and treatment of lesions and the AI method/architecture were included. Results: The primary search presented 422 studies from 1996 to 2019, and 58 studies were finally selected. Regarding the year of publication, the oldest study, which was reported in 1996, focused on “oral and maxillofacial surgery.” Machine-learning architectures were employed in the selected studies, while approximately half of them (29/58) employed neural networks. Regarding the evaluation criteria, eight studies compared the results obtained by AI with the diagnoses formulated by dentists, while several studies compared two or more architectures in terms of performance. The following parameters were employed for evaluating the AI performance: accuracy, sensitivity, specificity, mean absolute error, root mean squared error, and area under the receiver operating characteristic curve. Conclusion: Application of AI in the dental field has progressed; however, the criteria for evaluating the efficacy of AI have not been clarified. It is necessary to obtain better quality data for machine learning to achieve the effective diagnosis of lesions and suitable treatment planning

Does Periodontal Tactile Input Uniquely Increase Cerebral Blood Flow in the Prefrontal Cortex?

We previously studied the effect of peripheral sensory information from sensory periodontal ligament receptors on prefrontal cortex (PFC) activity. In the dental field, an alternative dental implant without periodontal sensation can be applied for missing teeth. In this study, we examine whether periodontal tactile input could increase cerebral blood flow (CBF) in the PFC against elderly patients with dental implants lacking periodontal tactile (implant group), elderly individuals with natural teeth (elderly group), and young individuals with natural teeth (young group). The experimental task of maintaining occlusal force as closed-loop stimulation was performed. Compared with the young group, the elderly group showed significantly lower CBF. Contrastingly, compared with the young group, the implant group showed significantly lower CBF. There were no significant differences between the elderly and implant groups. Regarding the mean occlusal force value, compared with the young group and the elderly group, the implant group had a numerically, but not significantly, larger occlusal force exceeding the directed range. In conclusion, the periodontal tactile input does not uniquely increase PFC activity. However, increased CBF in the PFC due to the periodontal tactile input in the posterior region requires existing attention behavior function in the PFC