1) The document discusses the use of artificial intelligence in orthodontics, including applications like automated cephalometric analysis, skeletal classification, predicting orthodontic treatment needs, and 3D tooth segmentation. 2) AI technologies like convolutional neural networks, artificial neural networks, and deep learning are being used in these orthodontic applications. 3) While AI is proving accurate and can help practitioners make decisions faster, limitations include cost, data protection concerns, and ensuring AI systems do not replace human clinicians for serious medical decisions.

1. ARTIFICIAL INTELLIGENCE IN ORTHODONTICS
M.Z. Theodoridou1, I. Christopoulou2, O.E. Kolokitha3
1 Postgraduate student, Department of Public Health, Faculty of Medicine, European University Cyprus,
Nicosia, Cyprus
2 Postgraduate student, Department of Metabolic Bone Diseases, School of Medicine, National and
Kapodistrian University of Athens
3 Associate Professor Department of Orthodontics, Faculty of Dentistry, School of Health Sciences,
Aristotle University of Thessaloniki, Thessaloniki, Greece

2. Artificial intelligence in orthodontics
 Introduction: Artificial intelligence (AI) has made deep inroads into the field of orthodontics the last years. John McCarthy, a mathematician coined the
term artificial intelligence in 1955, and widely recognized as the father of artificial intelligence. The definition of AI technology, in the modern day world,
refers to any machine or technology that is able to mimic human intelligence, so as to be self-ruling. The most universally subfields of AI are machine
learning (ML), artificial neural networks (ANNs), convolutional neural networks (CNNs) and deep learning (DL) (1,2).
 Objective: The objective of this presentation is to review the existing evidence on the use of artificial intelligence in orthodontics, and to justify any
restrictions, currently limiting the use of AI.
 Methods: Three databases (MEDLINE, PubMed, Cochrane Library) were searched from inception and hand searching till October 2021. The keywords
and phrases used were ”orthodontics”, “artificial intelligence”, “A.I.” Initially 834 articles were identified, and finally, after duplication removal and
application of the inclusion/exclusion criteria, 21 articles were considered eligible for inclusion. A data extraction table was made and the study
characteristics, as well as the assessed outcomes, were summarized and analyzed.
 Results: AI has revolutionized the field of orthodontics. The current applications of AI in orthodontics are:
1) Identification of cephalometric landmarks and automated cephalometric analysis due to CNN and a custom-made CNN deep learning algorithm, which
is training with current data or new ones, and with equal precision to human analysts (3,4).
2) Skeletal classification with the aid of a CNN model, which carries lateral cephalograms and patient demographic information, and shows potential for
skeletal orthodontic diagnosis, with greater accuracy in vertical assessment (5).
3) Assessing the need for orthodontic extractions (6), where an ANN shows impressive accuracy, helping the clinician to proceed into a decision with
promising stable orthodontic results.
4) Determining the cervical vertebral maturation. An ANNs based model shows considerable success on predicting the current and remaining growth stage
and development (7).
5) 3D Tooth Segmentation and Labeling, by using a deep CNN that is extremely accurate even with foreign matters on models’ surfaces (8).
6) Predicting the need for orthodontic treatment and proposing a treatment planning. Studies based on ANN based model, demonstrate great
effectiveness on orthodontic treatment with encouraging results, giving valuable aid to the orthodontist (9,10).
7) Prediction of the estimated facial appearance after orthognathic surgery and orthodontic treatment (11), using landmark-based geometrical
morphometric methods, in combination with deep learning.

3. Limitations:
Despite the continuous rise of AI in the field of orthodontics, there are several limitations currently leading to its restricted use, arising from the high cost of
the necessary equipment (computers, AI-based machines), the concern about patients’ data protection, and the potential of these systems to make serious,
reliable medical decisions. It still remains to be seen whether, humans can or not be replaced, and up to which point.
 Conclusions: It is indisputable that AI technology promises a bright future ahead in the field of orthodontics, involving various applications and modernizing
both diagnostics and clinical practice. AI proves to be as effective and accurate as humans, and can help practitioners to make more accurate decisions in
less time. However, there are still many issues that need to be clarified and overcome to extend the use of AI in orthodontics in daily clinical practice.
References
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