Background: Every single field preferred artificial intelligence with great passion and thereby the discipline of dental science is no exemption. Aims: To evaluate the awareness and perception of dentists regarding artificial intelligence among dentists working in Karachi Methods: The current online cross-sectional survey conducted in Karachi during july 2021 . The survey included house officers, post-graduate trainees, and general dental practitioner and specialist consultant dental surgeons of either gender. A questionnaire was adopted from an existing similar study and modifications were made according to our settings. The link of survey was created using Google Docs and disseminated through various open social media groups of dental practitioner in Karachi. Results: Total 118 complete responses were received with almost equal responses from males (n=56, 47.5%) and females (n=52.5%). The mean age of study participants was 30.3±5.9 years. 83(70.3%) had awareness of the artificial intelligence driven tools in dentistry. 75.9%, 77.1%, 10.8%, 28.9%, 39.8%, 2.4% and 10.8% reported the use of digital intraoral radiographs, CAD-CAM, CBCT, digital dental records, clinical decision support system and none of the tool in their practice respectively. All of the participants had opinion that AI applications should be part of dental trainings. Conclusion: The present survey showed that the majority had awareness of AI applications in dentistry and had positive perception regarding its future role but there was lacking in the utilization rate of AI tools in their practice. Therefore, it is recommended to attend AI trainings to bring and adapt the AI related changes in local settings. Keywords: Artificial intelligence, dentistry, online survey, perception, awareness, Karachi
Introduction
The most important factor determining survival in patients with head and neck squamous cell carcinoma (HNSCC) is a disease recurrence. A high rate of recurrence was noted in previous studies conducted in Pakistan; however, these studies did not consider margin status as inadequate margin clearance leads to disease recurrence. In this study, we determined cancer recurrence in patients with HNSCC after nullifying this factor.
Methods
This cross-sectional observational study was conducted in Liaquat National Hospital (LNH) for a duration of three years. Data collection period was from January 2015 to December 2017. A total of 150 patients that underwent surgery at LNH for HNSCC with margin-free frozen sections were included in the study. Pathological tumor characteristics such as tumor type, size, depth of invasion and nodal status were determined.
Results
The mean age of the patients was 50.31±12.90 with mean tumor size of 3.38±1.76. Nodal metastases were present in 45.3% cases with 17.3% showing extranodal extension. Recurrence was observed in 66% of cases with median disease-free survival of 12 months and perineural invasion was noted in 12% cases. We found a significant association of disease recurrence with larger tumor size, depth of invasion and extranodal extension. Moreover, younger age (<30 years) and older age (>50 years) groups showed higher rates of recurrence than the middle age group (30-50 years). Similarly, univariate and multivariate analyses revealed that tumors with ≥1 cm depth of invasion and the presence of extranodal extension were more likely to have disease recurrence than tumors with <1 cm depth of invasion and without extranodal extension. Survival analysis using the Kaplan-Meier method for HNSCC revealed a significant difference in disease-free survival in patients with more than 2 cm tumor size and ≥1 cm depth of invasion than cases with ≤ 2cm tumor size and <1 cm depth of invasion.
Conclusion
A high rate of disease recurrence for HNSSC was noted in our study, despite margin-free primary tumor resection. Apart from tumor size and depth of invasion, extranodal extension was significantly associated with disease recurrence in HNSCC. This signifies a need for margin evaluation of neck dissection specimen in cases with extranodal extension.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.