Artificial intelligence (AI) is a branch of science concerned with developing programs and computers that can gather data, reason about it, and then translate it into intelligent actions. AI is a broad area that includes reasoning, typical linguistic dispensation, machine learning, and planning. In the area of medicine and dentistry, machine learning is currently the most widely used AI application. This narrative review is aimed at giving an outline of cephalometric analysis in orthodontics using AI. Latest algorithms are developing rapidly, and computational resources are increasing, resulting in increased efficiency, accuracy, and reliability. Current techniques for completely automatic identification of cephalometric landmarks have considerably improved efficiency and growth prospects for their regular use. The primary considerations for effective orthodontic treatment are an accurate diagnosis, exceptional treatment planning, and good prognosis estimation. The main objective of the AI technique is to make dentists’ work more precise and accurate. AI is increasingly being used in the area of orthodontic treatment. It has been evidenced to be a time‐saving and reliable tool in many ways. AI is a promising tool for facilitating cephalometric tracing in routine clinical practice and analyzing large databases for research purposes.

Background: Artificial Intelligence has created a huge impact in different areas of dentistry. Automated cephalometric analysis is one of the major applications of artificial intelligence in the field of orthodontics. Various automated cephalometric software have been developed which utilizes artificial intelligence and claim to be reliable. The purpose of this study was to compare the linear and angular cephalometric measurements obtained from web-based fully automated Artificial Intelligence (AI) driven platform “WebCeph”™ with that from manual tracing and evaluate the validity and reliability of automated cephalometric measurements obtained from “WebCeph”™. Methods: Thirty pre-treatment lateral cephalograms of patients were randomly selected. For manual tracing, digital images of same cephalograms were printed using compatible X-ray printer. After calibration, a total of 18 landmarks was plotted and 12 measurements (8 angular and 4 linear) were obtained using standard protocols. The digital images of each cephalogram were uploaded to “WebCeph”™ server. After image calibration, the automated cephalometric measurements obtained through AI digitization were downloaded for each image. Intraclass correlation coefficient (ICC) was used to determine agreement between the measurements obtained from two methods. ICC value < 0.75 was considered as poor to moderate agreement while an ICC value between 0.75 and 0.90 was considered as good agreement. Agreement was rated as excellent when ICC value > 0.90 was obtained. Results: All the measurements had ICC value above 0.75. A higher ICC value > 0.9 was obtained for seven parameters i.e. ANB, FMA, IMPA/L1 to MP (°), LL to E-line, L1 to NB (mm), L1 to NB (°), S-N to Go-Gn whereas five parameters i.e. UL to E-line, U1 to NA (mm), SNA, SNB, U1 to NA (°) showed ICC value between 0.75 and 0.90. Conclusion: A good agreement was found between the cephalometric measurements obtained from “WebCeph”™ and manual tracing.

Objective: Endodontic treatment should be both conservative and effective. Endodontic instruments with a greater taper are used for coronal flaring, for proper debridement with efficient irrigation. However, increased taper of an instrument can remove a larger amount of pericervical dentin, compromising the strength of the tooth. The aim of this study was to determine the effect of hand files, ProTaper Universal, ProTaper Next, and V Taper rotary instrument systems on the fracture resistance of teeth. Materials and Methods: In total, 60 extracted human maxillary first premolars were divided into four groups—Group I (Hand Files; HF), Group II (ProTaper Universal; PT), group III (ProTaper Next; PTN) and Group IV (V Taper; VT) (N = 15). Each group was instrumented with the respective instrument system, irrigated, obturated, restored, and mounted in cold cure acrylic. A universal load-testing machine (Shimadzu, Japan) was used to apply a vertical compressive load. The maximum force was recorded in Newton. Analysis of variance (ANOVA) and Independent t-tests were applied to compare the maximum mean force required to fracture the tooth. Results: There was a statistically significant difference in fracture resistance between Group I (HF) and Group II (PT) and between Group II (PT) and Group IV (VT) (p < 0.001). Similarly, a significant difference was observed between Group II (PT) and Group III (PTN) (p < 0.01). Furthermore, a significant difference was observed between Group I (HF) and Group III (PTN), and between Group III (PTN) and Group IV (VT) (p < 0.05), too. However, there was no statistically significant difference between Group I (HF) and group IV (VT) (p > 0.05). Conclusion: Rotary files with more taper seem to remove more pericervical dentin than traditional manual and rotary files with less taper, thus altering the strength of the tooth.

Objective. Bonding failure is a problem in orthodontic therapy and has been associated with orthodontic emergencies and delayed treatment time. The aim of this study is to determine the bracket failure rate among patients undergoing orthodontic therapy. Materials and Methods. From the archives of posttreatment records, 200 total cases were selected, out of which 122 cases had detailed treatment records. Cases with incomplete records, large restorations, or enamel aberrations were excluded from the study. Descriptive statistics were applied to obtain sample characteristics, and a chi-square test was applied to compare the bracket failure between different categories. Result. Out of the 122 samples enrolled in the study, female and male patients comprised 71% and 29%, respectively. Class I malocclusions were the most common problem (56%), followed by Class II (41%) and Class III (3%). The bracket failure rate was 3.43%, and 32% of the patients had an incidence of bracket failure. There was no significant difference in bracket failure among genders ( ), malocclusion types ( ), or operators ( ). The maxillary left quadrant was the most common site of bracket failure, followed by the mandibular right quadrant. Conclusion. Bracket failure is relatively uncommon. It is not affected by the gender or age of the patient or by malocclusion type. The maxillary left and mandibular right quadrants are the most common sites of bracket failure.

Background Orthodontic treatment is taken as a painful procedure by most of the patients. The pain can be experienced during different procedures like separator placement, banding, bonding, extraction as well as arch wire activation and debonding. There are very few studies done on the anticipated pain and pain experienced among mentioned orthodontic procedures. Objectives To compare the anticipated pain and pain experience among the patients going for comprehensive orthodontic treatment. Methods Total 45 patients going for comprehensive orthodontic therapy are enrolled into the study. They are given a 100mm Visual Analogue Scale (VAS) for pain. The anticipated pain as well as perceived pain after different orthodontic procedures are recorded on the VAS by patients and returned back to orthodontic office. The data are analyzed by SPSS 16.00 software by paired and independent t-test for the statistical significance. Results The result showed that there is significant difference between the anticipated pain before orthodontic treatment and the pain experienced following orthodontic treatment. It also showed that perception of pain between two sexes is significantly different. The comparison of anticipated pain among male and female does not show any significant difference, however the pain felt after separator placement as well as after orthodontic bonding is significantly different in two sexes. Conclusion The level of anticipated pain before orthodontic treatment is higher than the real pain experienced after orthodontic procedures. So it is better to counsel and explain the patients about the orthodontic treatment and procedures. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 71-73 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7348

Introduction: Orthodontic treatment is usually perceived as a lengthy treatment as average treatment time usually last more than a year and may go up to even five years. So, in orthodontic practice the optimum treatment result with minimal treatment time should be the goal of clinicians. Treatment duration varies based on different clinico-environmental factors. Materials & Method: Total 200 cases were randomly selected from the archives of debonded treatment records from the department of orthodontics, Dhulikhel Hospital, Kathmandu University Teaching Hospital. Out of the 200 records, 103 records were fit for the study based on previously set inclusion and exclusion criteria. The selected cases were divided into three different groups: extraction n= 28 (extraction of 4 premolars), partial extraction= 19, (extraction of 1-3 teeth) and non-extraction n=56. Furthermore, the cases were also divided into Class I, II and III malocclusion patterns. After doing the test of normality, descriptive statistics, independent samples t test and ANOVA test were performed to compare the treatment duration with respect to gender, malocclusion pattern and treatment modalities. Result: Out of the 103 selected cases, maximum number of cases were of Class I(60) followed by Class II(37) and Class III(6). There was no statistical significance on treatment duration among male and female subjects (p= 0.933) as well as among different malocclusion pattern ( p= 0.255). On the contrary, there was statistical difference on treatment duration among non extraction, partial extraction and extraction groups ( p=0.0004). The average treatment duration for non extraction, partial extraction and extraction group were 22, 28 and 29 months respectively. Conclusion: Orthodontic treatment duration is shorter for therapies done by non extraction than extraction. The average treatment duration for non extraction and extraction therapy is 22 and 29 months respectively. The treatment duration is not affected by gender and type of malocclusion.