Objectives: The aim of this study was to assess the attitude of dentists and dental students in Brazil regarding the impact of artificial intelligence (AI) in oral radiology, and to evaluate the effect of an introductory AI lecture on their attitude. Methods: A questionnaire was prepared, comprising statements regarding the future role of AI in oral radiology and dentistry. A lecture of approx. 1 h was prepared, comprising the basic principles of AI and a non-exhaustive overview of AI research in medicine and dentistry. Participants filled in the questionnaire prior to the lecture. After the lecture, the questionnaire was repeated. Results: Throughout 7 sessions at 6 locations, 293 questionnaires were collected. The majority of participants were undergraduate dental students (57%). Prior to the lecture, there was a strong agreement regarding the various future roles and expected impact of AI in oral radiology. Approximately, one-third of participants was concerned about AI. After the lecture, agreement regarding the different roles of AI in oral radiology increased, overall excitement regarding AI increased, and concerns regarding the potential replacement of oral radiologists decreased. Conclusions: A generally positive attitude towards AI was found; an introductory lecture was beneficial towards this attitude and alleviated concerns regarding the effect of AI on the oral radiology profession. Given the unprecedented, ongoing revolution of AI-augmented radiology, it is pivotal to incorporate AI topics in dental training curricula.

Aim: To develop a simple and reproducible method for semi-automated planimetric quantification of dental plaque.Materials and Methods: Plaque from 20 healthy volunteers was disclosed using erythrosine, and fluorescence images of the first incisors, first premolars, and first molars were recorded after 1, 7, and 14 days of de novo plaque formation. The planimetric plaque index (PPI) was determined using a semi-automated threshold-based image segmentation algorithm and compared with manually determined PPI and the Turesky modification of the Quigley-Hein plaque index (TM-QHPI). The decrease of tooth autofluorescence in plaque-covered areas was quantified as an index of plaque thickness (TI). Data were analysed by analysis of variance (ANOVA) and Pearson correlations. Results:The high contrast between teeth, disclosed plaque, and soft tissues in fluorescence images allowed for a fast threshold-based image segmentation. Semi-automated PPI is strongly correlated with manual planimetry (r = 0.92; p < .001) and TM-QHPI recordings (r = 0.88; p < .001), and may exhibit a higher discriminatory power than TM-QHPI due to its continuous scale. TI values corresponded to optically perceived plaque thickness, and no differences were observed over time (p > .05, ANOVA). Conclusions:The proposed semi-automated planimetric analysis based on fluorescence images is a simple and efficient method for dental plaque quantification in multiple images with reduced human input.

A considerable body of work has studied the involvement of osteopontin (OPN) in human physiology and pathology, but comparably little is known about the interaction of OPN with prokaryotic cells. Recently, bovine milk OPN has been proposed as a therapeutic agent to prevent the build-up of dental biofilms, which are responsible for the development of caries lesions. Bioactive milk proteins are among the most exciting resources for caries control, as they hamper bacterial attachment to teeth without affecting microbial homeostasis in the mouth. The present work investigated the ability of OPN to prevent the adhesion of three dental biofilm-forming bacteria to saliva-coated surfaces under shear-controlled flow conditions in comparison with the major milk proteins α-lactalbumin, β-lactoglobulin, αs1-casein, β-casein and κ-casein, as well as crude milk protein. OPN was the most effective single protein to reduce the adhesion of Actinomyces naeslundii, Lactobacillus paracasei subsp. paracasei and Streptococcus mitis. β-casein and crude milk protein also had a pronounced effect on all three species, which suggests binding to different microbial surface structures rather than the blocking of a specific bacterial adhesin. Bioactive milk proteins show potential to delay harmful biofilm formation on teeth and hence the onset of biofilm-related oral disease.

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Carbohydrate components, such as glycoconjugates and polysaccharides, are constituents of the dental biofilm matrix that play an important role in biofilm stability and virulence. Exopolysaccharides in Streptococcus mutans biofilms have been characterized extensively, but comparably little is known about the matrix carbohydrates in complex, in situ-grown dental biofilms. The present study employed fluorescence lectin binding analysis (FLBA) to investigate the abundance and spatial distribution of glycoconjugates/polysaccharides in biofilms (n = 306) from 10 participants, grown in situ with (SUC) and without (H2O) exposure to sucrose. Biofilms were stained with 10 fluorescently labeled lectins with different carbohydrate specificities (AAL, ABA, ASA, HPA, LEA, MNA-G, MPA, PSA, VGA and WGA) and analyzed by confocal microscopy and digital image analysis. Microbial composition was determined by 16S rRNA gene sequencing. With the exception of ABA, all lectins targeted considerable matrix biovolumes, ranging from 19.3% to 194.0% of the microbial biovolume in the biofilms, which illustrates a remarkable variety of carbohydrate compounds in in situ-grown dental biofilms. MNA-G, AAL, and ASA, specific for galactose, fucose, and mannose, respectively, stained the largest biovolumes. AAL and ASA biovolumes were increased in SUC biofilms, but the difference was not significant due to considerable biological variation. SUC biofilms were enriched in streptococci and showed reduced abundances of Neisseria and Haemophilus spp., but no significant correlations between lectin-stained biovolumes and bacterial abundance were observed. In conclusion, FLBA demonstrates the presence of a voluminous biofilm matrix comprising a variety of different carbohydrate components in complex, in situ-grown dental biofilms.

Background Shifts in microbial communities are common over time, but they may disturb the host‐microbiome homeostasis and result in inflammation of the peri‐implant issues if a dysbiotic biofilm is established. Purpose Considering that different oral substrate surfaces may have a relevant impact on the microbial adhesion and colonization, the aim of this study was to investigate the microbial communities of the biofilm formed on single‐implant restorations using titanium or zirconia abutments and how they correlate with clinical parameters after 3‐years of implant loading. Materials and methods MiSeq sequencing of 16S rRNA amplicons was used to characterize the oral biofilms of individuals (n = 20) who were sampled longitudinally during 3 years of masticatory loading. Bioinformatics analysis and multivariate statistical analysis were used to evaluate the microbial diversity and clinical outcomes. Results Microbiomes of both abutment materials presented high alpha‐diversity indices during all the experimental period, irrespective of the time of sampling. Microbial communities of titanium and zirconia were quite different over time, differing about 30% after 3 years of functional loading. Similarity of microbiomes between tested abutments and contralateral teeth was also low, ranging between 45% and 50% after 3 years of investigation. Periodontal pathogens commonly associated with peri‐implantitis were found in both groups. Furthermore, both abutment materials presented strong correlations of diversity indices and microbial taxa with clinical outcomes. Conclusions The type of abutment substrate significantly influenced diversity and clustering of communities during 3 years of functional loading. The time of sampling had no effect on the variables. Large correlations were found between microbial findings and clinical outcomes.

Dental plaque accumulation is quantified using clinical indices or, otherwise, the planimetric plaque index (PPI), which measures the relative area of a tooth that is covered by plaque deposits. Compared to clinical indices, the PPI has a higher discriminatory power, but traditional planimetry is a time-consuming analysis, as the plaque-covered and clean tooth areas have to be determined manually for each image using image-processing software. Here, we present a method for the semi-automated planimetric quantification of dental plaque, which allows for the rapid processing of up to 1,000 images simultaneously. The method exploits the enhanced contrast between disclosed plaque, sound tooth surfaces, and soft tissues in fluorescence images acquired with an intraoral camera. Careful execution of the clinical procedures and accurate image acquisition are crucial steps for the successful semi-automated identification of the plaque-covered areas. The method is suitable for planimetry on sound facial and oral tooth surfaces, on most composite resin restorations, and on teeth with orthodontic brackets, but not on metallic restorations. Compared to traditional PPI recordings, semi-automated planimetry considerably reduces the amount of time spent on the analysis, as well as the subjective human input, thus increasing the reproducibility of planimetric measurements.

Proanthocyanidin (PA) is a promising dentin biomodifier due to its ability to stabilize collagen fibrils against degradation by matrix metalloproteinases (MMPs); however, the most effective protocol to incorporate PA into bonding procedures is still unclear. This study evaluated the effect of dentin biomodification with a PA acid etchant on MMP activity, adhesive interface morphology and resin-dentin microtensile bond strength. Sound extracted human molars were flattened to expose dentin and acid-etched for 15 s according to the groups: EXP - experimental phosphoric acid; EXP+PA - experimental phosphoric acid 10% PA; TE - total-etching system; SE - self-etching system. Samples were restored with composite resin and stored in distilled water (37ºC). MMP activity and interface morphology were analyzed after 24 h by in situ zymography (n=6) and scanning electron microscopy (n=3), respectively. The resin-dentin microtensile bond strength (μTBS) was evaluated after 24 h and 6 months storage (n=6). Significantly higher MMP activity was detected in etched dentin compared with untreated dentin (p<0.05), but no difference among acid groups was found. Resin tags and microtags, indicative of proper adhesive system penetration in dentinal tubules and microtubules, were observed along the hybrid layer in all groups. There was no difference in μTBS between 24 h and 6 months for EXP+PA; moreover, it showed higher long-term μTBS compared with TE and EXP (p<0.05). The results suggest that 15 s of biomodification was not sufficient to significantly reduce MMP activity; nonetheless, EXP+PA was still able to improve resin-dentin bond stability compared with total- and self-etching commercial systems.