Enhancing Endodontic Practice with Artificial Intelligence: A Vision for the Future

By Dr. Tung Bui

In the rapidly evolving field of endodontics, artificial intelligence (AI) stands at the forefront of innovation, promising to redefine traditional practices and improve patient outcomes. Our previous exploration into the realm of AI laid a foundational understanding of its history, mechanisms, development processes, and its initial forays into the endodontic landscape. Building upon this groundwork, we delve deeper in response to our readers’ curiosity and the growing intrigue surrounding AI’s practical applications, its reality versus the hype, and the tangible impacts it holds for the future of endodontic practice.

Endodontists often task switch amongst multifaceted roles, encompassing the responsibilities of a dentist, radiologist, surgeon, and CEO/manager/business owner, yet we face the challenge of having consistent consensus in diagnosis and treatment planning amongst our peers as witnessed by our dynamic discussions on Connection. Should we recommend root canal treatment or vital pulp therapy? Should we go for retreatment or apical surgery? Does this crown fracture warrant completion of root canal treatment or should it be extracted? This issue is compounded by the reliance on grayscale radiographs, which offer 64,000 shades of gray, despite the human eye’s ability to discern only around 900, and the solitary nature of endodontic practice, where collaboration is scarce, leading to potential misdiagnoses and under/over-treatment. However, the endodontic community is meticulously data-driven and enthusiastic about technology, embracing tools such as the surgical operating microscope, CBCT imaging, advanced adjunctive irrigation technologies, and, recently, artificial intelligence (AI). These advancements not only enhance diagnostic accuracy but also foster patient trust. When a clinician points to a lesion that is also highlighted by AI software, this automated “second opinion” builds trust with the patient and confidence of the clinician. Nevertheless, the isolation in which endodontists often work hampers the establishment of a peer-reviewed feedback loop, critical for continuous improvement. Despite AI’s obvious use case, the adoption of innovative technologies, undergoes a phased integration, transitioning from hype to widespread acceptance over time—a journey that is taking less time than projected, positioning endodontists as a leader in adopting AI among dental specialties. This rapid embrace of AI is revolutionizing the detection of apical radiolucencies and fractures, reducing diagnostic errors, and setting the stage for a future where endodontics and AI together will significantly improve disease detection, reduce errors, predict outcomes, and ultimately enhance oral and overall health, diminishing the societal burden.

The conversation surrounding AI in endodontics, is fraught with both exaggerated claims and under-appreciated potential. AI, at its core, is a tool designed to augment human capabilities, not replace them. Think of AI as a combination of a virtual personal assistant, mentor, and colleague. In endodontics, AI’s value proposition includes automating mundane tasks, enhancing diagnostic accuracy, streamlining treatment planning, and offering predictive insights into patient outcomes. However, these advancements are contingent upon the integration of high-quality data, sophisticated algorithms, and, most importantly, the expertise of endodontic specialists who guide AI’s learning and application processes. Hence, it is of utmost importance that endodontists be involved in the research and development of AI systems to be integrated into the future of endodontic practice.

AI’s implementation in Endodontic practice heralds a significant shift towards data-driven decision-making. By leveraging high quality datasets and learning from each interaction, AI tools can identify patterns and nuances in Endodontic conditions that might elude even the most experienced practitioners. In research, AI opens new avenues for inquiry and innovation, guiding endodontic specialists toward more effective and efficient treatment protocols.   Presently, Endodontic research has been prolific on computer vision; AI’s ability to identify and label radiographic findings. Studies diving into diagnosis, treatment planning, individualistic outcome are the next waves of research focus. AI can also help develop novel research ideas and offer unique solutions to problems.

For early adopters, today’s emerging market offers a range of AI-powered tools designed to integrate seamlessly into endodontic practices. From current offerings of diagnostic aids that interpret radiographs with remarkable accuracy to future predictive models that assess the risk of post-treatment complications, these tools exemplify AI’s practical applications in the field. AI technologies contribute to detecting diseases earlier and with greater accuracy and automation. Examples of AI systems improving diagnostic accuracy and reducing errors underscore AI’s role in elevating the standard of patient care within endodontics, automating routine tasks, and analyzing data with speed and precision unattainable by humans. However, the adoption of such tools requires a discerning approach, ensuring they meet the high standards of patient care and align with the specific needs of endodontists. One should define clear objectives, research AI options, evaluate AI solutions with pilot projects, and adapt based on findings.    Below, in Table 1, is a sample of commercially available AI products and services that members may wish to research and implement in their endodontic practice.

Table 1: Company, AI Products and Service, and Website

CDT Software (e-VolDXS)	AI filters for CBCT volumes	cdtsoftware.com
Overjet	Computer vision, insurance claim automation	overjet.ai
Planet DDS	Computer vision	planetdds.com
Pearl	Computer vision, practice management	hellopearl.com
AI:Dental	Computer vision	aidental.ai
Dentrix Detect AI (Videa Health  & Henry Schein collaboration)	Computer vision	dentrix.com/products/dentrix-detect-ai
Videa Health	Computer vision	videa.ai
Denti AI	Computer vision, automated treatment planning, touch free voice controlled dental charting	denti.ai
Diagnocat	2D & 3D Computer vision, automated radiographic report	diagnocat.com/us/
Carestream Dental	AI Insights: 2D & 3D computer vision, metal artifact reduction filter, automated radiographic report	carestreamdental.com/en-gb/csd-products/software/imaging-software/ai-insights/
Patient Prism	Operations efficiency and marketing effectiveness	patientprism.com
SmartBot 360	Chat bot for healthcare websites	smartbot360.com
Palantir	AI solutions for endodontic researchers	palantir.com/offerings/health/
C3Ai	Enterprise AI for large healthcare models	c3.ai/industries/healthcare-industry/
YOMI by Neocis	Guided robot surgery	neocis.com/products-and-services/yomi-robot/
Magic Leap	Augmented reality for healthcare	magicleap.com/ar-healthcare

 

As AI becomes adopted into endodontic practice, it brings not only advancements but also ethical use of patient data, algorithmic biases, and existential concerns. The conversation around the existential concerns of AI, while important, should not overshadow the potential benefits and advancements that AI promises to bring to our field. The point of singularity, a concept often associated with the moment AI surpasses human intelligence, has profound implications for the field of endodontics. As AI evolves, it brings transformative potential to this dental specialty, particularly in diagnosing and treating root canal issues. By integrating AI algorithms that can analyze complex patterns in radiographic images far beyond human capability, endodontics is on the cusp of a significant leap in precision and effectiveness. This advancement not only promises to enhance the accuracy of diagnosing diseases within the intricate anatomy of the tooth but also optimizes treatment planning and outcomes. Furthermore, AI-driven technologies can facilitate personalized patient care and predict potential complications, thereby reducing procedural errors and improving overall patient experiences. In essence, as we approach the singularity, the intersection of AI and endodontics could redefine the standards of care, making treatments more efficient, less invasive, and more successful, ultimately leading to a new era in dental healthcare.  The future of AI in endodontics is not a narrative of replacement but of enhancement, where AI and human expertise partner up to push the boundaries of what’s possible in patient care.

Looking to the future, AI’s trajectory within endodontics appears poised for exponential growth and integration. The balance between leveraging AI for its unparalleled capabilities and ensuring that it does not encroach upon the professional judgment and personal touch of endodontic specialists will be crucial. By fostering a dialogue that prioritizes ethical considerations, continuous learning, and adaptability, endodontists can ensure that they remain at the forefront of their profession, guiding AI’s integration in a manner that benefits patients and practitioners alike.

The integration of AI into endodontics offers a promising horizon filled with enhanced diagnostic capabilities, improved patient outcomes, and groundbreaking research opportunities. However, as we navigate this exciting yet uncertain future, it is paramount that we proceed with insight and caution, ensuring that AI serves as a tool to augment the irreplaceable expertise of endodontic specialists, rather than a replacement.

To delve deeper into endodontic-related AI topics, attend the AAE24 Annual Meeting in Los Angeles for the following AI presentations (Table 2):

Table 2

AI-Powered Marketing: Revolutionizing Endodontic Practice Engagement (PPRC), by AAE’s Chief Marketing and Communications Officer, Kim FitzSimmons. Thursday, April 18, 10-11 a.m., room 503.

Clinical Application of AI for Endodontic Clinicians as Well as Its Applications for Public, by Dr. Omid Dianat. Thursday, April 18, 10-11 a.m., theater 411.

Educator Forum – AI in Education, by Dr. Nauman Chatha.  Thursday, April 18, 3:15-4:15 p.m., room 503.

The Use of AI and Digital Workflow in Surgical Endodontics. Think Outside the Box! By Dr. Mohammed Alharbi. Friday, April 19, 10:15-11 a.m., room 518.

Artificial Intelligence – Pitfalls, Challenges and Solutions, by Drs. Frank Setzer and Asma Khan. Friday, April 19, 10:15-11:45 a.m., room 408A.

Pushing the Limits in Endodontics Utilizing a new CBCT AI software (e-VOLDx), laser irrigation and Dynamic Real Time Navigation with Scopeye over head projection, by Dr. Mohamed Fayad. Saturday, April 20, 12:15-1:45 p.m., Petree Hall C.

Unleashing the Kraken of Artificial Intelligence; A Bane or a Boon? By Dr. Nauman Chatha. Saturday, April 20, 2-3 p.m., room 408A

 

Dr. Tung Bui is a Board-certified endodontist with Specialized Dental Partners, practicing in Tucson, Arizona. He also serves as a clinical endodontic instructor and lecturer with the NYU Langone AEGD Tucson program and Spartanburg Regional Healthcare System AEGD program. When not extending the life of teeth, he is sourcing and roasting exquisitely rare third-wave coffees and pursuing outdoor adventures. As a futurist investor, he devotes his time into exploring emerging and disruptive technologies. He currently chairs the AAE Connection Committee. Disclosure: The author has no financial interests, and the opinions expressed are solely his and not those of the AAE.  AI tools were used for editing. You can contact Dr. Tung Bui at apexologist@gmail.com.