The aim of this study was to assess the reliability of the artificial intelligence (AI) automatic evaluation of panoramic radiographs (PRs). Thirty PRs, covering at least six teeth with the possibility of assessing the marginal and apical periodontium, were uploaded to the Diagnocat (LLC Diagnocat, Moscow, Russia) account, and the radiologic report of each was generated as the basis of automatic evaluation. The same PRs were manually evaluated by three independent evaluators with 12, 15, and 28 years of experience in dentistry, respectively. The data were collected in such a way as to allow statistical analysis with SPSS Statistics software (IBM, Armonk, NY, USA). A total of 90 reports were created for 30 PRs. The AI protocol showed very high specificity (above 0.9) in all assessments compared to ground truth except from periodontal bone loss. Statistical analysis showed a high interclass correlation coefficient (ICC > 0.75) for all interevaluator assessments, proving the good credibility of the ground truth and the reproducibility of the reports. Unacceptable reliability was obtained for caries assessment (ICC = 0.681) and periapical lesions assessment (ICC = 0.619). The tested AI system can be helpful as an initial evaluation of screening PRs, giving appropriate credibility reports and suggesting additional diagnostic methods for more accurate evaluation if needed.

Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions especially with immediate loading protocols. When the implant placement is planned immediately after extraction with irregular bone topography or there is an un-leveled alveolar ridge topography for any other reason, bone reduction may be required to level the alveolar crest in order to create the desired bone architecture allowing for sufficient bone width for implant placement and to insure adequate inter-arch restorative space. Bone reduction protocols exist in analog and digitally planned methodologies, with or without surgical guides to achieve the desired bone level based upon the desired position of the implants with regard to the restorative outcome. The objective of this paper was to scrutinize the literature regarding the practice of bone reduction in conjunction with implant placement, and to review different types of bone reduction surgical guides. Results: The literature reveals different protocols that provide for bone reduction with a variety of bone reduction methods. The digitally-planned surgical guide based on Cone-Beam computerized tomography (CBCT) scan reconstructed data can improve accuracy, reduce surgical time, and deliver the desired bone level for the implant placement with fewer surgical and restorative complications. The clinician’s choice is based on personal experience, training, and comfort with a specific guide type. Conclusions: Bone reduction, when required, is an indispensable step in the surgical procedure to attain suitable width of bone in anticipation of implant placement ideally determined by the desired tooth position and required restorative space based on material selection for the chosen framework design, i.e., hybrid, monolithic zirconia. Additionally, bone reduction and implant placement can be accomplished in the same surgical procedure, minimizing trauma and the need for two separate interventions.