Dentsply - AI is the jewel in the crown and it isn’t cloud cuckoo land!

Artificial intelligence is all over the news, and seems to be pervading everything. Our dental and periodontal professions must surely be looking at how it will affect oral health.

In this series of interviews, the European Federation of Periodontology is exploring what our partners are doing, or perhaps NOT doing with AI.

In this interview, we talk to Dr. Anna Jerebko, VP, Head of Clinical Applications in Software Engineering & User Experience at Dentsply Sirona. 

Dentsply Sirona absolutely loves AI.  It uses it in many different areas, from designing crowns and abutments whilst very cleverly modelling how orthodontic treatment might look like at various stages.  More of which later but let’s start with crowns. How can AI help? Anna Jerebko explains: “The biogeneric AI in CEREC software is trained using 3D surface images of healthy teeth, the antagonist teeth, both jaws. The AI learns from these examples and then automatically creates a restoration proposal that the dentist can later modify according to their preferences.”

This is truly amazing. AI learns to analyze 3D surface scans of a tooth needing a crown and then designs a crown that should be a perfect fit!  It gets even better than that though! AI can help design not only the crown but also inlays, onlays, bridges, abutments, or veneers—all during one office visit! In most cases, these restorations, designed with the help of AI, can be produced directly in the dentist’s office. The fit should be perfect, and the dentist always has the final say, allowing them to make any necessary changes on screen before milling begins. With intraoral scanners like Primescan®, which allow for high-precision digital impressions of the patient’s mouth, they have effectively replaced the old-fashioned method of using a kind of "goo" to make a mold from which a crown would be made and AI in CEREC has simplified the restoration design process.

So much for AI and crowns. Similar AI technology is used for custom abutments made in Dentsply Sirona's Atlantis manufacturing facilities. An abutment connects a dental implant to an artificial tooth. Anna Jerebko adds, “Abutments are also calculated with the help of AI and milled automatically.” A doctor scans the patient’s mouth with an intraoral scanner in the office and sends the surface scans along with CBCT scans (a type of 3D X-ray) and other images. The dental technicians at Atlantis then design the abutment shape with the help of AI. The manufacturing is highly automated, and a dental technician oversees each final abutment design, along with the dentist who ordered it. So, if you can save a tooth with a crown, AI will design it for you, and if you sadly lose a tooth and need an implant, AI will help design that for you as well! 

However, the third example of AI use is possibly even more "jaw-dropping!" Orthodontic treatment, as many parents of teenagers know, can be time-consuming and potentially risky. What sort of treatment is best, how will it turn out, what might a patient look like after treatment has been completed? Anna Jerebko has personal experience with this too. “When I was considering orthodontic treatment for my son, I realized that the costs in the U.S. aren't fully covered by insurance. Parents have to navigate various options and make important decisions. Should we go with traditional wires or clear aligners? And how will my son's smile look in the end?”

AI can come to the rescue here too, using semantic processing and understanding of intraoral scanner input to enable 3D visualization of a potential aligner treatment outcome. Dentsply Sirona has created an application) that generates a 3D visualization of how a patient’s potential new smile might look after clear aligner treatment. This helps the dentist communicate the treatment stages and the complexity of the treatment to the patient. This is so clever that you can fast forward month by month to visualize how the treatment is likely to progress throughout the different stages.

All of this is happening now, but what about the future? “I think the fundamental breakthrough will come from storing patients' scans and treatment outcome data in the cloud, allowing access to vast amounts of data.” Anna Jerebko goes on to explain why. “This type of medical imaging data is not yet available in large quantities, unlike common everyday images or texts. Medical imaging AI lags behind general AI development. There are millions of examples available to train ChatGPT. For crowns or other restorations, as well as treatments and treatment outcomes, that data is stored in each doctor’s office, kept on their own machines.”

Anna’s vision is that all this data, anonymized for patient privacy, is available for AI training in the cloud—millions of scans from millions of patients. The trained AI models won’t store patient data or images themselves but will use that data to learn about every eventuality any individual person might have. With every dentist having access to AI trained on massive amounts of data and treatment outcomes, the treatments of the future will be highly personalized and much more successful.

Not cloud cuckoo land at all, but a wonderful new reality