CLINICAL tive diagnoses are only one tool in the pathologist’s toolbox. A basal cell carcinoma, for example, is a fairly simple diagnosis to deduce, even on clinical examination only. However, a pathologist’s report may include further information on the staging and progression of a cancerous lesion (Dourmishev et al., 2013). A pathologist needs to be ready to investigate anything suspicious (including incipient findings) by synthesising chart review information, holding discussions with clinicians, consulting old reports and concurrent labs, judging patient-specific factors and conducting additional special investigations. At the end of
the day, the pathologist is the focal spokesperson who uses their wealth of experience to set the baseline for treatment planning. This is why it is difficult to believe artificial intelligence will inherit a greater role beyond screening, but decision-support is going to make our pathologists much more efficient, accurate and consistent. The mounting demand for and the current dearth of pathologists could stabilise more once the technology matures and develops.
Conclusion
“Could pathologists be replaced by robots” is unnecessarily alarmist, and the wrong question to be
addressing. Perhaps a more useful question is “How can Artificial Intelligence enhance the work of pathologists?”. AI approaches can rapidly analyse complex images to provide decision-making guidance. Additional studies are needed to identify optimal imaging approaches for each clinical need and to finalise the configuration and clinical guidance outcomes of AI-based algorithms. It is an exciting field with many pioneers leading the effort, but not one where humans are at risk of being ‘superseded’ any time soon.
Factors affecting the osseointegration of dental implants An introduction to modern day implant osseointegration.
Christianna Iris Papadopoulou, Dimitrios Angelakis, Greece
D
ental implants have become a more common treatment for replacing missing teeth. In clinical dentistry, the goal of dental implants is to increase patient satisfaction in terms of improved chewing efficiency, physical health, and esthetics. In 1965, Brånemark introduced the term “osseointegration” to describe the process of bone growing right up to the implant surface, with no soft tissue in between. When osseointegration occurs, the im-
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plant is held so tightly in place by the bone, that there is no relative movement between the two. The process typically takes four to six months to occur. Kieswetter et al. described this process in his article in 1996 in more detail. Some days after implantation, bone regeneration is regulated by several growth and differentiation factors that are released around the implant. In 2003 Davies stated that the process of bone regeneration is
formed either on the implant surface or from the surrounding bone towards the implant surface. Finally, bone remodeling occurs by replacing immature with mature bone at the implant site, providing biological (mechanical) stability. To be considered successful, an osseointegrated oral implant has to meet certain criteria. As Karthik et al. described in 2013, these basic criteria are immobility, absence of peri-implant radiolucency, adequate width of
