Access to high-quality dental healthcare remains a challenge in many countries due to limited resources, lack of trained professionals, and time-consuming report generation tasks. An intelligent clinical decision support system (ICDSS), which can make informed decisions based on past data, is an innovative solution to address these shortcomings while improving continuous patient support in dental healthcare. This study proposes a viable solution with the aid of multimodal artificial intelligence (AI) and large language models (LLMs), focusing on their application for generating orthopantomography radiology reports and answering questions in the dental domain. This work also discusses efficient adaptation methods of LLMs for specific language and application domains. The proposed system primarily consists of a Blip-2-based caption generator tuned on DPT images followed by a Llama 3 8B based LLM for radiology report generation. The performance of the entire system is evaluated in two ways. The diagnostic performance of the system achieved an overall accuracy of 81.3%, with specific detection rates of 87.9% for dental caries, 89.7% for impacted teeth, 88% for bone loss, and 81.8% for periapical lesions. Subjective evaluation of AI-generated radiology reports by certified dental professionals demonstrates an overall accuracy score of 7.5 out of 10. In addition, the proposed solution includes a question-answering platform in the native Sinhala language, alongside the English language, designed to function as a chatbot for dental-related queries. We hope that this platform will eventually bridge the gap between dental services and patients, created due to a lack of human resources. Overall, our proposed solution creates new opportunities for LLMs in healthcare by introducing a robust end-to-end system for the automated generation of dental radiology reports and enhancing patient interaction and awareness.

We assessed perceived satisfaction of patients and related factors for treatment provided by the oral surgery student dental clinic of the only Sri Lankan dental school. A descriptive cross-sectional study was conducted among 288 consenting patients who received oral surgery treatment at the student dental clinic of Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. A self-administered, validated questionnaire and a 19-item multidimensional patient satisfaction scale were used for data collection. Patients of all ages were represented, but were dominated by females, aged 30 to 44 years, possessing educational attainment up to General Certificate of Education ordinary or advanced level of which 54.9% were unemployed. They had travelled distances of less than 10 and 10 to 20 km (28.1% and 27.5%, respectively) predominantly to receive tooth extractions exacerbated by symptoms. Overall, 90% of responding patients were highly satisfied with the items of many dimensions of dental treatment. Despite high levels of perceived satisfaction expressed, further improvements were warranted for waiting time, optimal pain control with more kind, and courteous staff.

Introduction: Malignancies in the oral cavity poses significant health burden in Sri Lanka and demonstrate an increasing trend. The aim of this study was to analyze the characteristics of patients with oral cavity malignancies presenting to a tertiary care center during 2020-2022.Methodology: Hospital records of patients diagnosed with primary oral cavity malignancies presenting to the Dental Teaching Hospital Peradeniya were entered by two investigators to Microsoft Excel spreadsheet according to the National Cancer Control Program format. Descriptive data analysis was conducted using Microsoft Excel software.Results: A total of 193 patients were reported during this period, approximately 9 patients per month. Mean age and standard deviation of the cohort were 61±13 years. The male to female ratio was 2.8:1. There were a total of 17 histological types of malignancies, the commonest being squamous cell carcinoma 74.1%. From the total, 50.8% were diagnosed at advanced clinical stages. The commonest anatomical locations of malignancies were buccal mucosa 36.5% followed by border of the tongue 18.8%. Surgical resection was offered for 163 (84.4%) patients, while 5 (2.6%) received surgery and radiotherapy, and one (0.5%) received surgery and chemotherapy.Conclusions: Male gender, older age group and low socio-economic status were common among patients with oral cavity malignancies in Sri Lanka. The commonest location was buccal mucosa while commonest histological type was squamous cell carcinoma. Late diagnosis remains a major barrier in managing oral malignancies in the country.

The palato-gingival groove (PGG) is a developmental anomaly that predisposes maxillary anterior teeth to localized periodontal and endodontic complications. Cone-beam computed tomography (CBCT) enables precise three-dimensional visualization of these grooves and their associated bone changes, overcoming the diagnostic limitations of conventional imaging. This study aimed to determine the prevalence, morphological characteristics, and periodontal bone loss associated with PGGs in maxillary anterior teeth using CBCT imaging in a Sri Lankan cohort. A retrospective review of 676 CBCT scans encompassing 4,021 maxillary anterior teeth was conducted, and each tooth was examined for the presence, location, and extent of PGGs as well as for associated periodontal and endodontic changes. Statistical analysis was performed using the Chi-square test with a significance level of p < .05. PGGs were identified in 11 teeth from nine individuals, corresponding to a prevalence of 1.33% at the patient level and 0.27% at the tooth level. Lateral incisors were most frequently affected (81.8%), predominantly on the mesial surface (72.7%). All grooves were of mild or moderate extent, with no complex types observed. Periodontal bone loss was evident in 81.8% of affected teeth, and one case showed combined endodontic involvement. A significant association was found between PGG presence and tooth type (p = 0.03), but not with sex or groove extent. Although uncommon, PGGs were strongly associated with localized periodontal bone loss detectable on CBCT. The mesial predominance and low prevalence observed suggest possible population-specific morphological patterns. These findings highlight CBCT as a valuable diagnostic tool for early identification of PGG-related bone defects and prevention of progressive periodontal destruction.

Accessory mental nerve is defined as an additional branch of the mental nerve arising from the mental foramen. The current case report describes an accidental finding of an accessory mental nerve during mandibular fracture reduction. Also reviews literature encompassing this area.