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Objectives: To validate a novel artificial intelligence (AI)-based tool for automated tooth modelling by fusing cone beam computed tomography (CBCT)-derived roots with corresponding intraoral scanner (IOS)-derived crowns., Methods: A retrospective dataset of 30 patients, comprising 30 CBCT scans and 55 IOS dental arches, was used to evaluate the fusion model at full arch and single tooth levels. AI-fused models were compared with CBCT tooth segmentation using point-to-point surface distances-reported as median surface distance (MSD), root mean square distance (RMSD), and Hausdorff distance (HD)- alongside visual assessments. Qualitative assessment included visual inspection of CBCT multiplanar views. The automated fused model was also compared to expert-manual fusions for single tooth analysis in terms of accuracy, time efficiency, and consistency., Results: AI-based fusion evaluation showed mean values of MSD, RMSD, and HD of 4 μm, 114 μm, and 940 μm for full arch; 5 μm, 104 μm, and 503 μm for single tooth analysis. Qualitative assessment showed discrepancies between fused tooth outline and CBCT tooth margin lower than 1 voxel for 59% of cases. AI-based fusion showed high similarity with expert-manual fusions with median MSD, RMSD, and HD values of 28 μm, 104 μm, and 576 μm, respectively. However, AI-based fusion was 32 times faster than manual fusion. Considering the time required for manual fusion, intra-observer agreement was high (ICC 0.93), while inter-observer agreement was moderate (ICC 0.48)., Conclusion: The AI-based CBCT/IOS fusion demonstrated clinically acceptable accuracy, efficiency, and consistency, offering substantial time savings and robust performance across different patients and imaging devices., Clinical Significance: Manual CBCT/IOS fusion performed by experts is effective but labor-intensive and time-consuming. AI algorithms show a remarkable ability to minimize human variability, resulting in more reliable and efficient fusion. This capability demonstrates the potential to provide a more personalized, precise and standardized approach for treatment planning and dental procedures., Competing Interests: Declaration of competing interest The authors declare that there are no known conflicts of interest that could have influenced the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: Does a complex intervention of oral hygiene advice (OHA) delivered with intra-oral scanner images, anti-gingivitis toothpaste and motivational reminders, improve oral health more than a standard of care control arm of fluoride toothpaste, with OHA without scanner images?, Methods: Adult participants with pre-existing gingivitis were randomised to intervention or control. Following enrolment, baseline and each subsequent visit (V) (3-weeks, V2; 3-months, V3; 6-months, V4) followed the same schedule. Bleeding on Probing (BOP) was assessed and Intra Oral Scan IOS(1) recorded. Plaque was disclosed, scored and re-scanned (IOS(2)). The intervention group received OHA with IOS images, control group receiving OHA without IOS images. Participants brushed with their allocated toothpaste (fluoride, control; anti-gingivitis, intervention), IOS(3) was recorded. Between visits participants brushed with their allocated toothpaste, intervention group received motivational reminders., Results: BOP scores from baseline were significantly improved in the intervention group compared to control at all visits for all surfaces (p<0.001); differences at V4 were 0.292 (all), 0.211 (buccal/labial) and 0.375 (lingual/palatal). Plaque scores from baseline pre-brushing to each visit pre- and post-brushing also favoured the intervention group, the difference always significant on lingual/palatal surfaces (p<0.05), significant for all but pre-brushing-V4 (p<0.05) on all surfaces, but only significant for pre-brushing-V3 (p<0.05) buccally/labially. Differences from baseline to post-brushing at V4 were: 0.200 (all), 0.098 (buccal/labial) and 0.291 (lingual/palatal)., Conclusion: A complex intervention comprising OHA delivered with IOS-images, anti-gingivitis toothpaste and motivational reminders improved gingival health more than existing standard of care-OHA together with a standard fluoride toothpaste over a 6-month period., Clinical Significance Statement: Intra-oral scans (IOS) are now frequently used in general dental practice for a variety of purposes. IOS use, in combination with motivational texts and an anti-gingivitis toothpaste, could be further deployed to promote oral hygiene behaviour change in patients and improve gingival health, in a cost-effective manner., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: This study was carried out by the Clinical Trials Unit at Bristol Dental Hospital. This study was Supported by Haleon Consumer Healthcare, UK. CP is an employee of Haleon and Haleon contributed to the design of the study and the manuscript. NW, NC and JS contributed to the design of the study. The study was carried out, analysed and prepared for publication by SD, JS, NC, RN and NW., (Copyright © 2023. Published by Elsevier Ltd.)

Aims: To determine whether personalised Oral Hygiene Advice (OHA) using an intra-oral-camera (IOC) combined with standard OHA as provided in general dental practice reduces plaque levels after 4 weeks more than the provision of standard OHA., Materials and Methods: 22 healthy adult participants diagnosed with gingivitis took part in this pilot parallel-designed, randomised, examiner-blind, 2x-treatment, study regarding their home-care oral hygiene habits and attitudes to oral health. An IOC-image was taken and plaque, gingival and bleeding scores were recorded. Test group participants received standard OHA with IOC-images to indicate areas for improvement, control group participants received standard OHA. Questionnaires and plaque, gingival and bleeding scores were repeated after 4 weeks. Plaque was scored from the IOC-images and scores compared to clinical plaque scores., Results: Lifestyle habits, attitudes to oral health, plaque (0.63vs0.61, control vs test) and bleeding scores (1.17vs0.96, control vs test) were similar at baseline. After 4-weeks, plaque scores improved more in test as compared to control group (39.4vs20.6%, p<0.05, while gingival and bleeding scores approached significance. There was no difference in lifestyle habits between groups, but the test group reported significantly greater confidence in adhering to their bespoke oral health plan. Agreement between the clinical and IOC plaque scores was good., Conclusions: Use of IOC further personalises the prevailing standard of oral hygiene advice and generates great patient engagement with pictorial reports to facilitate a more in-depth patient explanation of their gingival health, resulting in significant plaque reduction and improved gingival health compared to the standard OHA alone., (Copyright © 2022. Published by Elsevier Ltd.)

Objectives: To compare gingival inflammation scores obtained chairside using the non-invasive modified gingival index (MGI) with MGI scores from an intraoral scan (IOS) captured at the clinical visit but viewed 10 days later., Methods: Single visit, anterior teeth, observational, proof of concept study in healthy adult participants with a spectrum of gingival inflammation. One investigator performed both clinical and intraoral scan MGI assessments, a second repeated the MGI evaluation from the IOS., Results: 23 participants aged 18-72 yielded data for 552 gingival sites. There was agreement at 90 % of sites comparing clinical with IOS MGI scores. The commonest disagreements were MGI grade 0 read as 1 and 2 read as 3, the highest single probability of error occurring where a clinical score of 0 was scored 1 from the IOS: 0.118 and 0.129 for examiners 1 and 2 respectively. The second most common probability of error occurred where an IOS score of 3 was scored clinically as 2: 0.089 and 0.097 for examiners 1 and 2 respectively. MGI scores from the scans were similar for both examiners (91 % agreement), with no discrepancies of greater than 1 scale point. There was very close agreement between clinical MGI and IOS colour/texture scores., Conclusion: This study conclusively demonstrated that the MGI score from the scanned image was very similar to the MGI scored clinically. This study confirms that a digital IOS accurately captures gingival contour images allowing a clinician to determine health or degree of gingival inflammation from it using MGI scores., Clinical Significance Statement: This study confirms that IOS images of teeth and soft tissues are sufficiently accurate to allow the clinical evaluation of health or inflammatory gingival status using non-invasive indices. IOS has great potential for efficient and accurate data capture, for general practice and research facilitating remote evaluation and data verification., (Copyright © 2021 Elsevier Ltd. All rights reserved.)