Improved detection accuracy of red lesions in retinal fundus images with superlearning approach

BackgroundDiabetic Retinopathy (DR) is a serious consequence of diabetes that can result to permanent vision loss for a person. Diabetes-related vision impairment can be significantly avoided with timely screening and treatment in its initial phase. The earliest and the most noticeable indications on the surface of the retina are micro-aneurysm and haemorrhage, which appear as dark patches. Therefore, the automatic detection of retinopathy begins with the identification of all these dark lesions.MethodIn our study, we have developed a clinical knowledge based segmentation built on Early Treatment DR Study (ETDRS). ETDRS is a gold standard for identifying all red lesions using adaptive-thresholding approach followed by different pre-processing steps. The lesions are classified using super-learning approach to improve multi-class detection accuracy. Ensemble based super-learning approach finds optimal weights of base learners by minimizing the cross validated risk-function and it pledges the improved performance compared to base-learners predictions. For multi-class classification, a well informative feature-set based on colour, intensity, shape, size and texture, is developed. In this work, we have handled the data imbalance problem and compared the final accuracy with different synthetic data creation ratios.ResultThe suggested approach uses publicly available resources to perform quantitative assessments at lesions-level. The overall accuracy of red lesion segregation is 93.5%, which has increased to 97.88% when data imbalance problem is taken care-off.ConclusionThe results of our system have achieved competitive performance compared with other modern approaches and handling of data imbalance further increases the performance of it.     

Interdisciplinary management of an adult patient with significant tooth wear

Adult patients may present with compromised dentitions which require extensive oral rehabilitation. This case report shows the fulfilment of both functional and aesthetic treatment objectives for a patient with significant tooth wear through carefully planned interdisciplinary management. © 2022 Australian Dental Association.     

Effect of full pulpotomy using a calcium silicate–based bioactive ceramic in adult permanent teeth with symptoms indicative of irreversible pulpitis: A retrospective study

BackgroundThe authors studied the treatment effect of full pulpotomy using a calcium silicate–based bioactive ceramic in adult permanent teeth with symptoms indicative of irreversible pulpitis.MethodsEighty-one adult permanent teeth with symptoms indicative of irreversible pulpitis in 78 patients aged 18 through 72 years were evaluated for inclusion in the study. After caries excavation, the pulp was amputated to the level of the canal orifices. After hemostasis was achieved, calcium silicate–based bioactive ceramic was placed as the capping agent. The cavity was sealed temporarily with a glass ionomer cement and then restored with flowable resin and composite resin after 2 weeks if no positive symptoms were reported or detected. Postoperative evaluation was performed by means of clinical and radiographic examination at 2 weeks and 3, 6, and 12 months.ResultsOverall success rates of the procedure were 96.3% (78 of 81), 93.8% (76 of 81), 92.6% (75 of 81), and 92.6% (75 of 81) at the 2-week, 3-month, 6-month, and 12-month recall visits, respectively. Six of the 81 teeth failed and required root canal therapy. In these 6 teeth, 3 exhibited severe cold stimuli pain and spontaneous pain at the 2-week follow-up, 2 had no response to electric pulp testing with apical percussion pain and periapical rarefaction at the 3-month follow-up, and 1 tooth exhibited periapical rarefaction and labial mucosal fistula at the 6-month follow-up.ConclusionsUnder the conditions of this study, full pulpotomy using a calcium silicate–based bioactive ceramic was a successful option for the treatment of adult permanent teeth with carious originated symptoms indicative of irreversible pulpitis.Practical ImplicationsVital pulp therapy is no longer impossible for adult permanent teeth with carious originated symptoms indicative of irreversible pulpitis.