Chairs:
christina lindh
louise hauge matzen

55: ASSOCIATION BETWEEN CAROTID ARTERY CALCIFICATIONS ON PANORAMIC RADIOGRAPHS, PERIODONTITIS, AND SIGNS OF VASCULAR DISEASE IN ULTRASOUND EXAMINATION

M. Bladh1, N. Gustafsson1, D. Jönsson2, E. Levring Jäghagen1 (alt presenter: Eva Levring Jäghagen)

1Umeå University, Oral and Maxillofacial Radiology, Department of Odontology, Umeå, Sweden, 2Lund University, Department of Clinical Sciences, Lund, Sweden

Background: Cardiovascular diseases (CVD) and periodontitis are highly prevalent global diseases. Panoramic radiographs (PR) are often used in dentistry. Carotid artery calcification (CAC) is a sign of CVD and can be detected in PR as an incidental finding. The aim of the study was to investigate if CAC on PR combined with periodontitis were associated with different characteristics in ultrasound (US) examinations, pointing at CVD.

Material and Methods: In total, 346 participants examined with PRs and for periodontal status in the Malmö Offspring Dental Study (MODS), were assessed for CAC on PR. The participants were stratified into four categories: 1) No CAC or periodontitis, 2) No CAC, but periodontitis 3) CAC, no periodontitis 4) combined CAC and periodontitis. All participants within MODS were examined with carotid US. Three characteristics of carotid plaque were determined by US; i) largest area of a plaque, ii) number of plaques, iii) lumen reduction. Comparisons were made between CAC with and without periodontitis and US findings.

Preliminary results: CAC category 3-4 on PR were significantly associated with a higher degree of findings in US, when compared to participants without CAC (category 1-2) (P ≤0.045; Kruksal-Wallis-test after adjustment). The association was most pronounced for CAC on PR combined with periodontitis (category 4) (P<0.001; dito).

Conclusion: The association was strong between CAC on PR and signs of CVD on US and increased when the patient had both periodontitis and CAC on PR. This new knowledge could be a future tool to identify patients at unknown cardiovascular risk.

102: PERFORMANCE OF A NOVEL PHOTON COUNTING INTRAORAL SENSOR IN THE ASSESSMENT OF CARIES-LIKE LESIONS

P. Badawi1, J. Melo da Fonte2, D. Pita de Melo3, A.P. Fugolin1, S. Sousa Melo1

1Oregon Health & Science University, Portland, United States, 2University of Connecticut, Farmington, United States, 3State University of Paraiba, Campina Grande, Brazil

Aim: To compare the diagnostic performance of a photon-counting (PC) sensor in comparison to 2 CMOS sensors in the assessment of caries-like lesions.

Material and Methods: Sixty extracted teeth (30 premolars, 30 molars) were selected. A demineralizing solution was used to induce caries-like defects on the distal surface of 15 premolars (dPM) and mesial surface of 15 molars (dM). The remaining sound teeth (sPM, sM) were kept caries-free. Phantoms were mounted in 4 different combinations: dPM-dM, dPM-sM, sPM-dM, and sPM-sM. Standardized radiographs were obtained with one PC (XpectVision-XVD2530) and two CMOS (RVG-6200, Dexis-IXS) sensors. All images were coded and scored by three calibrated dentists using a 5-point scale. Observers’ agreement, sensitivity, specificity, accuracy and area under curve (AUC) were calculated and verified through Kappa, ANOVA and Tukey test.

Results: The intra- and interobserver agreements varied from fair to perfect agreement. The tested sensors presented values of specificity (70.57-83.35), accuracy (64.98-71.10), and AUC (72.63-78.00) with no statistically significant differences (p>0.05). PC sensor presented higher sensitivity when compared to RVG-6200 (p=0.017). When comparing different teeth (dPM, dM) within the same sensor, sensitivity was higher for dPM on all sensors and AUC was higher for dPM on Dexis-IXS and PC sensors.

Conclusion: The performance of the PC sensor was similar to that of the more commonly used sensors. The PC sensor presented slightly superior sensitivity in diagnosing caries-like lesions when those were truly present.

Acknowledgment: We thank Shenzhen Xpectvision Technology Co. as the source of the photon-counting sensor (XVD2530) used for the study.

145: ASSESSING THE ACCURACY OF A DEEP LEARNING-BASED APPLICATION IN THE DIAGNOSIS OF DENTAL CARIES ON INTRAORAL RADIOGRAPHS

V. Szabó1, B.T. Szabó1, D.S. Veres2, D. Manulis3, M. Ezhov3, A. Sanders3, K. Orhan4,1

1Semmelweis University, Faculty of Dentistry, Department of Oral Diagnostics, Budapest, Hungary, 2Semmelweis University, Department of Biophysics and Radiation Biology, Budapest, Hungary, 3Diagnocat Inc, San Francisco, United States, 4Ankara University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara, Turkey

Aim: The objective of this study was to evaluate the performance of the Diagnocat (DC) system, which employs deep convolutional neural network (CNN), in detecting caries on intraoral radiographs.

Materials and Methods: The proximal surfaces of the 323 selected teeth on intraoral radiographs were evaluated by two independent observers using the deep learning-based DC system. The presence or absence of carious lesions was recorded (Phase 1). After 4 months, the AI-aided human observers evaluated the same radiographs (Phase 2), and the advanced CNN reassessed the radiographic data (Phase 3). Subsequently, the data reflecting human disagreements were excluded (Phase 4). For each phase, the Cohen and Fleiss kappa values, as well as the sensitivity, specificity and correctly classified proportion values of DC were calculated.

Results: The following Cohen kappa values of the two human and AI observers were determined during the phases: κ=0.66-1, κ=0.58-0.7, and κ=0.49-0.7, respectively. The Fleiss kappa values were ranged between the values of κ=0.57-0.8.

Conclusions: According to our findings, the assessed DC system can support the evaluation of intraoral radiographs for the diagnosis of dental caries, as determined by the agreement between human and AI observers.

155: TYPE AND SUFFICIENCY OF RADIOGRAPHIC IMAGES BEFORE REMOVAL OF MANDIBULAR THIRD MOLARS WITH A PERMANENT NEUROSENSORY DISTURBANCE

L.B. Petersen1, L.H. Matzen2, L. Schropp3

1Lars Bo Petersen, Colosseumklinikken, KopenhageC, Denmark, 2Aarhus Denmark, Radiological, Aarhus, Denmark, 3Aarhus, Radiological, Aarhus, Denmark

Aim: To evaluate the type and sufficiency of radiographic images performed before removal of a mandibular third molar (M3) in a population with permanent post-operative neurosensory disturbances of the inferior alveolar nerve (IAN).

Material and Methods: Over a period of six years, 189 patients received compensation from the Danish Dental Compensation due to permanent neurosensory disturbance of the IAN following removal of M3. By consensus, two observers with access to a secure database registered type of radiographic image (intraoral/panoramic/CBCT) available before surgery. Furthermore, it was registered, if the image sufficiently displayed the whole M3 and surrounding structures including the mandibular canal (MC), overprojection/no-bony separation between M3 and MC in 2D and 3D, respectively.

Results: 104(55%) M3 were removed based on an intraoral and 54(29%) based on a panoramic. 15(8%) had both 2D modalities available. 14(7%) M3 had a CBCT. Two (1%) had no images. 22(21%) of intraorals were insufficient and no other examination was performed. Two CBCT(14%) were insufficient. 151 of M3 overprojected the MC in 2D/3D.

Conclusion: The majority of M3 was removed based on an intraoral. 12% of M3 were removed based on an insufficient intraoral. All panoramics were sufficient. Few M3 was examined with CBCT. The majority of M3 were observed overprojecting MC in 2D or with no-bony separation in 3D. It must be born in mind that the incidence of a permanent sensory disturbance is very low when interpreting the results.

165: IMPACT OF LITHIUM THERAPY ON JAW BONE DENSITY AND SOFT TISSUE CALCIFICATION IN BIPOLAR DISORDER: A PRELIMINARY STUDY

A. Çukurluoğlu1, F. Dilek1

1Erciyes University Faculty of Dentistry, Oral and Maxillofacial Radiology Department, Kayseri, Turkey

Aim: Bipolar disorder is a debilitating mental illness affecting a significant portion of the global population. Lithium, a cornerstone in the treatment of bipolar disorder, raises concerns regarding its impact on secondary hyperparathyroidism and bone health in cases of long-term use. While there is conflicting evidence regarding the detrimental effects of lithium-induced hyperparathyroidism on bone integrity, a potential osteoprotective role of lithium has also been reported. This study aims to elucidate potential differences in trabecular and cortical bone density of the mandible, along with soft tissue calcification, in lithium-treated patients with bipolar disorder compared to a matched control group.

Materials and Methods: A retrospective analysis of panoramic radiographs obtained from 50 lithium-treated patients with bipolar disorder and 50 age- and gender-matched controls was conducted. Assessment parameters included the Klemetti Index for cortical bone analysis, trabecular bone pattern analysis, and identification of soft tissue calcification. All the assessments were carried out by two researchers.

Results: There was no statistically significant difference in terms of the prevalence of soft tissue calcification and Klemetti Index between the lithium-treated bipolar disorder group and the control group (p= 0.291 and p=0.688, respectively). However, a significant difference was found for trabecular bone pattern analysis, indicating a denser trabecular bone structure in the mandible of lithium-treated bipolar disorder patients compared to controls (p=0.001).

Conclusion: This study underscores a denser trabecular bone microarchitecture in lithium-treated patients with bipolar disorder compared to the control cohort. These findings advocate for further exploration of lithium›s potential bone-preserving effects in the jawbones.