Search Results (4)

Background/Objective: This study aimed to develop an AI-supported clinical tool to evaluate the difficulty of mandibular third molar extractions based on panoramic radiographs. Methods: A dataset of 2000 panoramic radiographs collected between 2023 and 2024 was annotated by an oral radiologist using bounding boxes. YOLO11 sub-models were trained and tested for three basic scenarios according to the Pederson Index criteria, taking into account Winter (angulation) and Pell and Gregory (ramus relationship and depth). For each scenario, the YOLO11 sub-models were trained using 80% of the data for training, 10% for validation, and 10% for testing. Model performance was assessed using precision, recall, F1 score, and mean Average Precision (mAP) metrics, and different graphs. Results: YOLO11 sub-models (nano, small, medium, large, extra-large) showed high accuracy and similar behavior in all scenarios. For the calculation of the Pederson index, nano for Winter (average training mAP@0.50 = 0.963; testing mAP@0.50 = 0.975), nano for class (average training mAP@0.50 = 0.979; testing mAP@0.50 = 0.965), and medium for level (average training mAP@0.50 = 0.977; testing mAP@0.50 = 0.989) from the Pell and Gregory categories were selected as optimal sub-models. Three scenarios were run consecutively on panoramic images, and slightly difficult, moderately difficult, and very difficult Pederson indexes were obtained according to the scores. The results were evaluated by an oral radiologist, and the AI system performed successfully in terms of Pederson index determination with 97.00% precision, 94.55% recall, and 95.76% F1 score. Conclusions: The YOLO11-supported clinical tool demonstrated high accuracy and reliability in assessing mandibular third molar extraction difficulty on panoramic radiographs. These models were integrated into a GUI for clinical use, offering dentists a simple tool for estimating extraction difficulty, and improving decision-making and patient management. Full article

Dental injury to the second molar (SM) caused by the surgical extraction of the impacted third molar tends to be underestimated. The necessity of assessment of the impact of the removal of the wisdom tooth in the mandible on the second molar arose. The study group (n = 60) was the one with the second molar on the surgical side, and the control group (n = 60) was the one with the tooth on the opposite side of the alveolar arch. Before the surgery, the difficulty level was assessed according to the Pederson scale. The periodontal status of the SM was assessed by probing depth (PD), gingival index (GI), tooth mobility (TM) examination by the percussion method and resonance frequency. Measurements were taken before and after the surgery, 7 days and 8 weeks after the surgery. The study demonstrated the significant impact of the surgical removal of the wisdom tooth on the PD, GI and TM of the SM. The predicted degree of difficulty of the very difficult surgery had an influence on the increase in PD on the distal buccal and lingual surface of the SM, and on the GI in the proximity of the examined tooth. The results of the presented research confirm the necessity of the clinical assessment of the lower SM before and after the surgical removal of the impacted wisdom tooth in the mandible. Full article

The aim of this study was to evaluate the levels of vitamin D (25OHD) and other bone biomarkers in patients with third molar impaction (TMI). Thirty males and 30 females with unilateral or bilateral impacted mandibular third molar, and 15 males and 15 females as a control group (CG) were recruited. Rx-OPT was used to evaluate dental position and Pederson index to measure the difficulty of the intervention. Bone biomarkers were measured through blood venous sample in TMI group and CG. Mann-Whitney test, Pearson’s correlation coefficient, linear regression model were used to compare the different parameters in the two groups. 25OHD showed lower values in TMI group than in CG (p < 0.05) with values significantly lower in bilateral impaction (p < 0.05). Pearson’s coefficient for 25OHD presented a negative correlation with the Pederson index (ρ = −0.75). Bone alkaline phosphatase (BALP) showed significantly lower dosage in TMI group than CG (p = 0.02), Pearson’s coefficient for BALP presented a negative correlation with the Pederson index. Serum calcium, serum phosphorus, ionized calcium levels in TMI and CG groups were similar and Mann-Whitney test did not significantly differ between TMI and CG. TMI could be a sign of vitamin D deficiency and of low BALP levels that should be investigated. Full article

Classifications of impacted teeth allow defining the type and degree of retention, as well as assessing the degree of difficulty of the procedure. The aim of this study was to conduct retrospective analysis of the degree of retention and difficulty in the surgical removal of impacted mandibular third molars in the clinical material of the Department of Oral Surgery in 2013–2018. This study included 1585 dental panoramic radiographs of patients of the Department of Oral Surgery, who reported in 2013–2018, in order to perform surgical removal of the impacted mandibular third molar. Based on dental panoramic radiographs, the degree of retention was determined based on classifications according to Winter, according to Pell and Gregory, according to Tetsch and Wagner, and according to Asanami and Kasazaki. The difficulty of the procedure was also assessed based on the Pederson index. The most common types of lower wisdom tooth impaction are as follows: in Winter’s classification, mesial-angular impaction; in Tetsch and Wagner’s classification, oblique medial-angular impaction; in Pell and Gregory’s classification, impaction grade 2A; and in Asanami and Kasazaki’s classification, 3A and anterior inclination. In most cases of surgical removal of an impacted tooth, the anticipated difficulty of the procedure was rated as very difficult. Full article