Indonesian Journal of Dental Medicine

Application of artificial intelligence for dental age estimation in children and adolescents: A review

Arofi Kurniawan — 2025-12-02

Background: Accurate dental age estimation is essential across multiple disciplines, including forensic identification, pediatric dentistry, and legal medicine. Conventional approaches, while extensively utilized, are constrained by observer subjectivity, population-dependent variation, and limited reproducibility. The emergence of artificial intelligence (AI) particularly through machine learning (ML) and deep learning (DL) technologies has introduced a transformative shift in age estimation, offering automated, data-driven alternatives that enhance precision, consistency, and efficiency. Purpose: This review aims to critically examine the current applications of AI in dental age estimation for children and adolescents. Review: An online literature search was conducted in the PubMed database using a structured set of keywords, complemented by manual searches through Google Scholar to ensure comprehensive coverage. Nine relevant studies were identified, encompassing a range of artificial intelligence (AI) approaches, including artificial neural networks (ANN), convolutional neural networks (CNN), support vector machines (SVM), and other machine learning (ML) algorithms. These models were applied to established dental age estimation methods such as those proposed by Demirjian, Willems, Cameriere, and Al-Qahtani. Overall, AI-based models demonstrated superior performance compared to traditional techniques, showing lower mean absolute error values and higher classification accuracy across various age categories. Notably, several models achieved accuracy levels exceeding 90%, highlighting the potential of AI to enhance precision and reliability in dental age estimation. Conclusion: Artificial intelligence demonstrates significant potential in improving the accuracy, efficiency, and reproducibility of dental age estimation in children and adolescents. While current findings are promising, further validation across diverse populations and standardized protocols is necessary before widespread forensic and clinical adoption.

The effect of gargling with 10% concentration of green betel leaf (Piper betle L.) decoction on gingivitis in pregnant women

Yanuar Firmansyah — 2025-11-19

Background: In pregnant women, gingivitis can result from hormonal fluctuations, local oral conditions, and behavioural factors. Bacteria and inflammatory mediators may enter the circulation and reach the uterus, which can increase the risk of low birth weight and preterm delivery. The decoction of green betel leaves exhibits antibacterial properties that may help prevent gingivitis. Purpose: This study addresses the high prevalence of gingivitis among pregnant women at Unit Pelayanan Terpadu (UPT) Pusat Kesehatan Masyarakat (Puskesmas) / Health Centre Kamal. It aims to evaluate the effects of gargling a 10% green betel leaf decoction on gingivitis in pregnant women at UPT Puskesmas Kamal, Bangkalan District. Methods: This study employed a quasi-experimental design, involving 83 pregnant women as respondents. The gingival index, as proposed by Loe and Silness, was measured both before and after gargling to assess the impact of the intervention. Additionally, an observation sheet was utilised to evaluate participants’ adherence to the gargling regimen at home. Data were analysed using the Wilcoxon test. Results: The results indicated an improvement in the average initial gingival index from 2.1013, classified as severe, to 1.2787, classified as moderate. The Wilcoxon test yielded a significance value of p<0.05, demonstrating a statistically significant effect of gargling a 10% green betel leaf (Piper betle L.) decoction on gingivitis in pregnant women at UPT Puskesmas Kamal, Bangkalan District. Conclusion: Betel leaf (Piper betle L.) can reduce the prevalence of gingivitis in pregnant women.

Oral health knowledge and tooth loss among elderly relationships

Noerfarida Puspawati — 2025-11-19

Background: Tooth loss is recognized as one of the major oral health challenges among the elderly. As people age, biological changes occur, including transformations in the oral tissue structure, commonly due to tooth loss. Poor oral health among the elderly is influenced by various factors, one of which is behaviour. Oral hygiene practices are closely linked to knowledge. The primary concern of this study is that most elderly patients attending the Prosthodontics Clinic at UNAIR Dental and Oral Hospital exhibit suboptimal dental function. Purpose: The objective of this study is to investigate the relationship between oral health knowledge and tooth loss in the elderly population. Methods: This study employed a cross-sectional design and involved 54 elderly individuals as respondents. Data were collected using a questionnaire to assess the respondents' level of dental health knowledge and a clinical assessment form to record tooth loss. The data were analyzed using the chi-square test to determine the association between elderly individuals’ knowledge of dental health and tooth loss at the Prosthodontics Specialty Clinic of UNAIR Dental and Oral Hospital in 2025. Results: The results showed that 42 elderly participants (77.8%) had a good level of dental health knowledge. However, 33 elderly participants (61.1%) had fewer than 20 functional teeth, indicating suboptimal dental function. A statistically significant association was found between dental health knowledge and tooth loss among the elderly, with a p-value of 0.043. Conclusion: Despite adequate oral health knowledge, tooth loss remains prevalent among the elderly, indicating the need for further research into additional contributing factors.

Parental knowledge of oral and dental health maintenance and caries in children with down syndrome relationships in Universitas Airlangga Dental Hospital

Oktiana Zumaroh — 2025-11-19

Background: Down syndrome is a genetic disorder caused by trisomy of chromosome 21. Individuals with Down syndrome have immunological deficiencies that increase their susceptibility to oral infections, including dental caries. One important factor affecting the prevalence of dental caries in children with Down syndrome is parental understanding. Purpose: This study aims to examine the relationship between parental knowledge of oral health maintenance and the incidence of dental caries in children with Down syndrome visiting the Dental and Oral Hospital of Universitas Airlangga in 2025. Methods: A cross-sectional study was conducted involving 30 parents of children with Down syndrome attending Dental and Oral Hospital of Universitas Airlangga. Data were collected using a questionnaire to assess parental knowledge and a DMF-T index to evaluate the children's dental caries status. The relationship between dental caries incidence and parental knowledge was examined using the Spearman rank correlation test. Results: Up to 21 parents or guardians (70%) exhibited a deficient degree of understanding, and 10 children (33.3%) exhibited significantly elevated DMF-T scores. The Spearman rank test indicated a significant correlation (p = 0.023), indicating that there was a relationship between parents’ knowledge of oral health care and dental caries in kids with Down syndrome visiting Dental and Oral Hospital of Universitas Airlangga. Conclusion: Dental cavities in children with Down syndrome are inversely correlated with parental or guardian knowledge; the higher the caries rate, the lower the knowledge.

Malocclusion detection in an effort to improve dental and oral health and prevent stunting during the COVID-19 pandemic

Dwi Rahmawati — 2025-11-20

Background: Dental caries remains one of the primary health problems. Stunting has become a critical health priority in Indonesia, representing a nutritional disorder that results in children having lower height compared to their peers. There was a significant relationship between oral health problems and growth stunting, where dental and oral health issues can contribute to stunting development, and vice versa. Early detection of malocclusion is crucial for preventing complications and can provide both short-term and long-term benefits in maintaining optimal growth and development. Purpose: to enhance dental and oral health knowledge for malocclusion detection as an effort to prevent stunting among elementary school children during the corona virus disease-19 (COVID-19) pandemic. Methods: This analytical observational study was conducted at SDN Medowo III, Kediri Regency, East Java, involving 100 participants from grades 4, 5, and 6. Intervention by video education and presentation education booklet. Data collection was performed through pre-test and post-test questionnaires. Frequency distribution analysis was conducted using SPSS version 23. Results: The study showed significant improvement in dental and oral health knowledge across all grade levels. Pre-test scores for dental health knowledge were 58%, 64%, and 60% for grades 4, 5, and 6, respectively, which increased to 80%, 82%, and 85% in post-test evaluations. Similarly, stunting knowledge improved from 59%, 68%, and 70% in the pre-test to 80%, 81%, and 83% in the post-test across the respective grades. Conclusion: The educational intervention effectively enhanced elementary school children's knowledge regarding dental and oral health and stunting prevention during COVID-19.

Aesthetic smile component before and after extraction and non-extraction orthodontic treatment in Class I Angle malocclusion patient

Ervina Restiwulan Winoto — 2025-12-02

Background: Approximately 80% of Indonesians suffer from malocclusion, a disease related to oral health issues. Orthodontic treatment, whether extraction or non-extraction, enhances the smile's aesthetics and stomatognathic function. To guarantee a result that is both practical and aesthetically pleasing, treatment selection necessitates thorough investigation. Purpose: the aim of this study is to compare the appearance of smiles in class I Angle type 1 malocclusions before and after orthodontic treatment. Methods: This study is an analytical retrospective study using frontal photos and a sample of medical records of orthodontic patients who finished orthodontic treatment at the Dental Hospital/Rumah Sakit Gigi dan Mulut Pendidikan (RSGMP), Universitas Airlangga (UNAIR), between 2017 and 2024. There were 46 non-extraction cases and 37 extraction cases. Result: Following premolar extraction, the buccal corridor increased by 3.11% ± 7.33% (p < 0.05) and the smile width by 1.49% ± 4.43%. Only grin breadth increased significantly (1.64% ± 4.23%) in the non-extraction group. There were no discernible differences between the extraction and non-extraction groups in Class I Angle malocclusion patients, according to the independent t-test findings. Conclusion: The extraction and non-extraction groups' average smile aesthetics scores before and after treatment do not differ significantly in Class I Angle malocclusion patients at RSGMP UNAIR.

Transverse dimension maxillary arch smile aesthetics comparison in non-extraction and extraction in Class I Angle malocclusion

Fatimah Nur Amalia — 2025-12-02

Background: Malocclusion may affect aesthetic facial profile, and oral health-related quality of life. There are two orthodontic treatments to improve the facial profile, especially the aesthetics of the transverse dimension maxillary smile aesthetic (TDMASA), namely, extraction and non-extraction in the orthodontic treatments. Purpose: This study was conducted in order to compare extraction and non-extraction in orthodontic treatment on the aesthetics of TDMASA variables in patients with Class I Angle type 1 malocclusion at Dental Hospital / Rumah Sakit Gigi dan Mulut Pendidikan (RSGMP,) Universitas Airlangga (UNAIR) in the period 2017-2024. Methods: There were 19 extraction samples and 33 non-extraction samples, taken by means of total sampling technique. Intercanine Width (ICW) and Inter Molar Width (IMW) were measured using digital calipers. Smile width (SW) and maximum dental width (MDW) were measured using ImageJ software. Data analysis used a paired t-test to determine the difference in ICW, IMW, SW, and MDW and the ratio of ICW/SW, ICW/MDW, and MDW/SW before and after extraction and non-extraction treatments and an independent t-test to compare the results of ICW, IMW, SW, and MDW and the ratio of ICW/SW, ICW/MDW, and MDW/SW between extraction and non-extraction treatments. Results: There was a significant increase in ICW, IMW, SW, MDW, and MDW/SW ratio, and a significant decrease in ICW/SW and ICW/MDW in the extraction group (P<0.05). Conclusion: There was a significant difference in extraction and non-extraction case in orthodontic treatment on the aesthetics of TDMASA variables in patients with Class I Angle type 1 malocclusion.

Repositioning and Fixation of an Intruded Immature Permanent Tooth in a Pediatric Dental Trauma Case

Sindy Cornelia Nelwan — 2025-12-02

Background: Intrusive luxation is one of the most severe types of dental trauma, especially in children with immature permanent teeth. Immediate and appropriate management is crucial to preserve pulp vitality and ensure proper root development. Purpose: This case report aims to present the management of an intruded immature permanent maxillary incisor in a pediatric patient through surgical repositioning and flexible splinting. Case: An 8-year-old boy presented three days after a football-related fall with a 6 mm intrusion of the permanent maxillary right central incisor. The tooth showed no mobility, and no root fracture was detected radiographically, although the periodontal space was reduced. Case Management: Due to the severity of the intrusion, immediate surgical repositioning under local anesthesia was performed. The tooth was carefully luxated and repositioned, followed by splinting using brackets and ligature wire from tooth #54 to #63 for three weeks. Antibiotics, analgesics, and antiseptic mouth rinse were prescribed. The tooth was kept out of occlusion, and pulp testing at three weeks indicated vitality. The splint was removed without complications, and a five-month follow-up confirmed stable teeth, an asymptomatic condition, and ongoing root and periodontal healing. Conclusion: Early surgical repositioning combined with flexible splinting can yield favorable outcomes in managing intrusive luxation in immature permanent teeth. Timely intervention and continuous follow-up are essential to preserve pulp vitality, support root development, and prevent complications such as resorption and ankylosis.

One-visit preformed space maintainer: A case report

Erika Setyowati — 2025-12-02

Background: In paediatric dentistry, space maintainer is crucial for maintaining arch length after early tooth loss. Dental arch development can be greatly impacted by the early loss of primary teeth, particularly posterior teeth like primary molars. Adjacent teeth may drift, the midline may deviate, the length of the arch may shorten, and the emergence of permanent successors may be disrupted. Purpose: The goal of this case study is to demonstrate how well a prefabricated space maintainer works for a young child who needs few dental appointments. Case: The lower right primary first molar of a 5-year-old kid had significant caries. With neighbouring teeth intact and no indications of infection or systemic anomalies, a clinical and radiographic evaluation confirmed the need for extraction. Case Management: Tooth #84 was extracted under local anaesthesia the same day, and a prefabricated band and loop space maintainer was chosen. Without the need for laboratory procedures, the appliance was modified chairside and cemented in a single visit. For the underlying permanent successor, it offered appropriate space maintenance. To evaluate oral hygiene and appliance stability, the patient was scheduled for routine follow-ups. This case demonstrates the clinical advantage of utilising a premade band and loop space maintainer in a single-visit procedure after a young child's non-restorable primary molars were extracted. Conclusion: When cooperation or access to care is restricted, preformed space maintainers provide a rapid, efficient, and kid-friendly way to preserve arch integrity after early tooth loss in the primary dentition.