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      Artificial Intelligence in Dentistry: Chances and Challenges

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          Abstract

          The term “artificial intelligence” (AI) refers to the idea of machines being capable of performing human tasks. A subdomain of AI is machine learning (ML), which “learns” intrinsic statistical patterns in data to eventually cast predictions on unseen data. Deep learning is a ML technique using multi-layer mathematical operations for learning and inferring on complex data like imagery. This succinct narrative review describes the application, limitations and possible future of AI-based dental diagnostics, treatment planning, and conduct, for example, image analysis, prediction making, record keeping, as well as dental research and discovery. AI-based applications will streamline care, relieving the dental workforce from laborious routine tasks, increasing health at lower costs for a broader population, and eventually facilitate personalized, predictive, preventive, and participatory dentistry. However, AI solutions have not by large entered routine dental practice, mainly due to 1) limited data availability, accessibility, structure, and comprehensiveness, 2) lacking methodological rigor and standards in their development, 3) and practical questions around the value and usefulness of these solutions, but also ethics and responsibility. Any AI application in dentistry should demonstrate tangible value by, for example, improving access to and quality of care, increasing efficiency and safety of services, empowering and enabling patients, supporting medical research, or increasing sustainability. Individual privacy, rights, and autonomy need to be put front and center; a shift from centralized to distributed/federated learning may address this while improving scalability and robustness. Lastly, trustworthiness into, and generalizability of, dental AI solutions need to be guaranteed; the implementation of continuous human oversight and standards grounded in evidence-based dentistry should be expected. Methods to visualize, interpret, and explain the logic behind AI solutions will contribute (“explainable AI”). Dental education will need to accompany the introduction of clinical AI solutions by fostering digital literacy in the future dental workforce.

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          Most cited references15

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          Ending the neglect of global oral health: time for radical action

          Oral diseases are a major global public health problem affecting over 3·5 billion people. However, dentistry has so far been unable to tackle this problem. A fundamentally different approach is now needed. In this second of two papers in a Series on oral health, we present a critique of dentistry, highlighting its key limitations and the urgent need for system reform. In high-income countries, the current treatment-dominated, increasingly high-technology, interventionist, and specialised approach is not tackling the underlying causes of disease and is not addressing inequalities in oral health. In low-income and middle-income countries (LMICs), the limitations of so-called westernised dentistry are at their most acute; dentistry is often unavailable, unaffordable, and inappropriate for the majority of these populations, but particularly the rural poor. Rather than being isolated and separated from the mainstream health-care system, dentistry needs to be more integrated, in particular with primary care services. The global drive for universal health coverage provides an ideal opportunity for this integration. Dental care systems should focus more on promoting and maintaining oral health and achieving greater oral health equity. Sugar, alcohol, and tobacco consumption, and their underlying social and commercial determinants, are common risk factors shared with a range of other non-communicable diseases (NCDs). Coherent and comprehensive regulation and legislation are needed to tackle these shared risk factors. In this Series paper, we focus on the need to reduce sugar consumption and describe how this can be achieved through the adoption of a range of upstream policies designed to combat the corporate strategies used by the global sugar industry to promote sugar consumption and profits. At present, the sugar industry is influencing dental research, oral health policy, and professional organisations through its well developed corporate strategies. The development of clearer and more transparent conflict of interest policies and procedures to limit and clarify the influence of the sugar industry on research, policy, and practice is needed. Combating the commercial determinants of oral diseases and other NCDs should be a major policy priority.
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            Robust and Communication-Efficient Federated Learning From Non-i.i.d. Data

            Federated learning allows multiple parties to jointly train a deep learning model on their combined data, without any of the participants having to reveal their local data to a centralized server. This form of privacy-preserving collaborative learning, however, comes at the cost of a significant communication overhead during training. To address this problem, several compression methods have been proposed in the distributed training literature that can reduce the amount of required communication by up to three orders of magnitude. These existing methods, however, are only of limited utility in the federated learning setting, as they either only compress the upstream communication from the clients to the server (leaving the downstream communication uncompressed) or only perform well under idealized conditions, such as i.i.d. distribution of the client data, which typically cannot be found in federated learning. In this article, we propose sparse ternary compression (STC), a new compression framework that is specifically designed to meet the requirements of the federated learning environment. STC extends the existing compression technique of top- k gradient sparsification with a novel mechanism to enable downstream compression as well as ternarization and optimal Golomb encoding of the weight updates. Our experiments on four different learning tasks demonstrate that STC distinctively outperforms federated averaging in common federated learning scenarios. These results advocate for a paradigm shift in federated optimization toward high-frequency low-bitwidth communication, in particular in the bandwidth-constrained learning environments.
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              Convolutional neural networks for dental image diagnostics: A scoping review

                Author and article information

                Journal
                J Dent Res
                J. Dent. Res
                JDR
                spjdr
                Journal of Dental Research
                SAGE Publications (Sage CA: Los Angeles, CA )
                0022-0345
                1544-0591
                21 April 2020
                July 2020
                : 99
                : 7
                : 769-774
                Affiliations
                [1 ]Department of Operative and Preventive Dentistry, Charité – Universitätsmedizin Berlin, Berlin, Germany
                [2 ]Department of Video Coding and Analytics, Fraunhofer Heinrich Hertz Institute, Berlin, Germany
                Author notes
                [*]F. Schwendicke, Department for Operative and Preventive Dentistry, Charité – Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin, 14197, Germany. Email: falk.schwendicke@ 123456charite.de
                Author information
                https://orcid.org/0000-0002-6283-3265
                Article
                10.1177_0022034520915714
                10.1177/0022034520915714
                7309354
                32315260
                0bf87781-c51b-4731-8ae5-354d22833b78
                © The Author(s) 2020

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

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                Discovery!

                decision-making,diagnostic systems,informatics,dental,deep learning,machine learning

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