I am Sheela Roth from Pearl, head of clinical education, and we are really excited. We have, doctor Lou Graham here today, and we are cohosting this webinar with our Patterson team. So I'm gonna turn it over to Laurie. She's our field marketing manager from Patterson. She's gonna kick us off, and then we will introduce Lou and, walk you through the world of two d AI. Thanks again for spending your time with us. Lori, thanks for being here with us today.

Yeah. Hi, everybody.

Just on behalf of Patterson Dental and Pearl, I'd like to welcome everyone. We're so glad you could join us today.

We are looking forward to hearing from doctor Graham and sharing more about Pearl AI.

As Sheela said, my name is Lori. I work, on our product marketing team at Patterson Dental.

Prior to my time on my team now, I spent three years as a territory rep in Denver.

So having said that, I spent, you know, my fair share of time partnering with vendors and, introducing new products to all of my offices.

So what I can say is all the products I have shared with my offices, Pearl has been the most well received and from all team members. There really are benefits for each person in the office. So, I mean, this is why we're so glad to not only partner with Pearl, but to have integrations in in both Eaglesoft and our cloud based solution, Fuze.

So thanks again, guys, for joining us today. I'm gonna turn it back over to Sheela, Pearl to get us started.

Excellent. Thank you, Lori. And I can attest to that working with the Patterson team and the native integration. So exciting to see what they're bringing to you today. Without further ado, I will introduce doctor Lou Graham. Doctor Graham has quite the history in the dental space, not only being a director in a previous dental school, but owning a practice, being the founder of the paddock sorry, Catapult Group, and also being able to walk us through a consistent way to really focus on patient care in a minimally invasive type of, dentistry approach. And as he walks us through today, I want you to open your mind to all the things that we're facing on a daily basis with radiograph review, case presentations, and Lou's gonna share how to overcome some of those obstacles.

Welcome, everybody.

I'm gonna walk you through how my experience over the last four years has really involved two d AI from really its infancy into really its impact within our practice of four hygienists, four doc four GPs, periodontists, and an endodontist. So I'll I'll start off and say it's great to be here, and let's start off with the sad truth.

And the sad truth is is that you go to school for years and years, and you spend hours upon hours of studying.

And yet the perception of dentistry can be this.

So this is from TikTok, and I and in TikTok, you I I know there's a ton of stuff going on, but this guy is broadcasting our dentist running the biggest scam in America, which I find truly, truly offensive.

And and when you look at the comments section here with over almost three thousand comments and you see all the comments by other people, whether dentistry is a money grab, dentistry is a scam, here's the deal. If it doesn't hurt, let them fix anything.

I I really feel that we've gone from a trusted profession via now an online medium where there can be a lot of distrust, and it's shared distrust.

And when you add this to the component of where we're at today, that people may actually trust computers more than human beings.

And when you also look at the fact that you have an increasing concern over the intrusion of algorithms, and it's a key word today in daily AI, But people may be more willing to trust a computer than a fellow human being.

And so that's what we're gonna talk about today. How do we integrate both into our practices?

And I see this as really a huge challenge for every team member in the practice, every team member.

And so I wanna start with building trust today.

And as and as we build trust, you have to ask yourself then what is trust? And when you look and ask yourself what is trust, trust really has six key components.

I talk about reliability.

I talk about sincerity. I talk about commitment, consistency, competence, and integrity.

Each of these six key items runs into trust.

And how do you get the most important aspect in your office is the patient to trust you?

It's really the most important thing.

And for these six traits, really to build trust, I would tell you the most important thing is listening to your patient. You gotta listen. Why are they there? What are their concerns?

What kind of personality are they?

And then how do you offer the most appropriate diagnostics to customize their care?

And that's today's course.

Optimizing two d AI into all your practices and how it could and and and you have to understand this, how it can help you build trust with your patients.

Like, you can think your patients should just trust you, but given the parameters and all the noise we're at today, how do we optimize that trust?

So I wanna start with really an interesting thought.

Imagine flipping a coin, and you went into Google and you typed in dental radiography, sensitivity, and specificity.

And if you did do that, this is what comes up.

Sensitivity in general is the ability to or the probability of a positive AI test when disease is present. So if a cavity is there, how often is the sensitivity a hundred percent? In other words, you're the whatever you're imaging or whatever you're testing is there a hundred percent.

Specificity means there's no disease. Nothing's going on. And how accurate then is the specificity?

So if we take that into account let's start with calculus.

Digital radiography had an average sensitivity of fifty percent.

So the calculus is there, and yet radio graphs and your eyes are identifying it only fifty percent of the time. If it's not there, the accuracy goes much more much higher to eighty two percent.

Well, they found that the larger the calculus, the more sensitive you are in detecting it. No kidding.

So right now, it's really fifty fifty just in detecting calculus.

Let's go to carries.

And when you look at carries, it has a sensitivity of fifty eight percent. So what does that mean?

In teeth that clinically scored as showing dental caries, only fifty eight percent were found to have radio translucency or translucency.

So we're at, again, fifty eight percent for dental X rays for caries.

So let's show you a patient named Jim.

So Jim comes in seeing me, and I'm taking out an old composite that's breaking down.

And when you look at this, how good is your sensitivity AI reading this X-ray?

Do you see decay on the number one icon, the number two icon, or the number three icon?

Where do you see decay? Do you see decay?

And I would tell you you're guessing.

And this is routinely what I've seen in my career, where all of a sudden you start taking out the composite, and there you see decay on the mesial of the of the two.

Yet you look at that x-ray, and now you go, maybe it's there.

There was nothing on the distal.

And and again, do we really wanna be guessing? And that's my biggest concern.

So let's take a look then at the next next case.

I'm following a patient lower AI cuspids, lower by cuspids. Let's take even a closer look.

On the distal of number twenty, you see no decay. You don't see it?

Yeah. Using in in in this case, KaryView, which is a NHERI technology near infrared radiation, you can see quite clearly there are distal there's distal caries, and we would call them d two caries well into dentin.

Well evident.

And two years later on this x-ray, you can see the restoration and the depth of the restoration.

But yet, if you look at the comparative slide in two thousand and fifteen, you wouldn't have seen it. We would have been guessing.

So many dentists out there have dropped into an occlusal and then see lateral caries in approximately, and you're looking at your X-ray and going, I see nothing.

And that's the discrepancy of how accurate we can read X rays with our eyes.

Let's talk periapical pathology.

The study showed dentists correctly AI periapical pathology forty three percent of the time. So it's there, but we're not correctly assessing it. In bone loss, we're correctly assessing only fifty seven percent of the time. So, basically, these are the challenges.

And when you look at two d imaging, which has its own restrictions, that this was a patient who came into our office. They were swollen over this summer, and two d radiographics showed two d radiographics showed maybe a small lesion on the top of the second bicuspid.

But when you take a three d image, it's as clear as day. I mean, if you don't see the three d image, then you've got a problem.

But these are limitations with two d images, which gets me back to decades and decades and decades of research have shown that basically we're flipping a coin.

Dentists use Explorers.

Dentists use and hygienists use X rays.

Explorers are incredibly inaccurate for fissure decay because of fluoride remineralization, and X rays truly are limited with our own eyes of what we're looking at.

And as it currently stands, and maybe this is where some of the mistrust lies in our profession, dentistry is still a very, very subjective profession.

Very. Because if you put two dentists in a room, you could get three opinions. And you all know exactly what I'm talking about. If there's a hygienist watching today, if you brought two or three dentists in your own practice or two or three dentists you've worked for, you're gonna get multiple opinions often on the same lesion.

And this is the reason we need two d AI.

I am absolutely convinced that every practice can benefit from two d AI. I have no doubt about it.

And I I break it down into three concepts of success.

The first is diagnosis. You're gonna see enhanced diagnostics.

The second is opportunity, which I'll explain, and the third is communication.

And this is for everybody in the practice.

So when you look at diagnostically, what two d AI brings to the table, you have to understand that AI can detect more shades of gray than the human eye. You just have to understand that.

That in the study in the bottom of the screen, they said humans can identify thirty shades of gray.

Well, if AI is trained and can identify between five hundred and eight hundred shades of gray, this is how it can be a great asset and a great adjunct to your practices.

So case at hand, two studies. Just two I'm gonna show you.

This study, which is titled deep learning approaches for caries detection and segmentation on dental bitewing X rays shows the sensitivity. Again, the correct diagnosis if caries are present with AI went up into the eightieth percentiles.

So we're increasing this almost twenty five to thirty percent with AI from our own eyes. Well, I think that's huge. I think everybody in here would think that's huge.

Now if you also understand that based on the AI algorithms to really detect more dental caries or the lack thereof dental caries, that will make us far more, I think, efficient, and you'll see why this will make you more efficient in how you read X rays, and I think far more, I think, diagnostic.

So I think diagnostically for caries, this is huge.

Let's talk bone loss. So this was a study where they're talking about deep neural networks for evaluating bone loss.

And I earlier showed you we were in the fifty seven percent range. Now we're in the mid to high eighties.

So, again, a thirty percent jump in under in seeing more bone loss and AI identifying that bone loss. Yeah. It's easy to identify greater bone loss, but it still has a better efficacy of mild to moderate bone loss. And I'm gonna bring this all together in clinical and show you how this works.

You just have to understand the benefits of two d AI.

The second thing that most people don't know is the opportunity at hand with two d AI.

Because what's going on is that the computers are basically now evaluating your X rays.

Pearl, Overjet, companies like them, they've injected tremendous amounts of data into computers to train them on how to read X rays.

And because they can evaluate grayscale so much better, that's how two d AI can really help. So you take this proprietary softwares.

Now you add the algorithms that obviously you don't see, machine deep learning, and this is two d AI. And with this information, computers are seeing opportunities that your offices have missed each and every day in our patients' X rays.

This is probably the biggest home run of what Pearl and similar companies offer.

So what kind of data are they pulling out?

They're pulling out data to identify areas for implants. Usually, those are either, I would call it edentulous areas or they're, teeth that cannot be salvaged. They're just they're gone. They're they gotta be removed. Those would be implant opportunities. Endodontics would routinely be lesions that are seen on the X rays. I'm gonna get into scaling.

Restorative really breaks down into two. Is it new decay, or is it recurrent decay?

And all of this data is compiled office by office. So this is the data from Pearl that I'm gonna share with you in my own office. So I'm gonna show you we're not perfect.

My team's not perfect. Lou Graham's not perfect. And you know what? Neither are you out there.

So why not have two d AI? Don't be intimidated by it.

I would say grasp it. So let me just show you a couple of opportunity funnels.

If we look at over the last twelve months and just go to the focus on number one there, endocandidates.

An endocandidate is AI by is defined by finding periapical pathology.

If you look at the number two hundred and fourteen next to endocandidates, only fifty seven point eight percent of those lesions have been found in our practice.

So, basically, they're sitting there. We haven't identified them. And so we've only treatment plan fifty seven point eight percent.

If you identify five or ten more of those, it pays for Pearl for a year, and that's just Ndau.

Now you look at scaling candidates.

I saw this in our office. We had a hygiene meeting, and my hygienist were not happy with what I was sharing with them. And I got four great hygienists.

And what the software identified using calculus and bone loss, which I'm gonna show you, we had only correctly treatment planned twenty four percent of all our scaling candidates.

Only twenty four percent.

Pearl identifies all of this and even has additional graphs for your team.

And this is a graph that shows you planning performance.

We were lowest in scaling and planning, meaning we underdiagnosed.

Yes. We had completed a high percentage of those treatments, which is great, but we had treatment planned a lot of work, meaning we missed it.

So in the morning, when I go in and I'm now gonna explain the dashboard, I just wanna highlight in one week how many scaling opportunities we did not identify in a practice. You wanna talk about ROI, this is ROI.

These are four days of patients. Monday, Tuesday, Wednesday, and Friday. Thursday, I think we had a we took a team day that week.

We identified fifteen scaling patients in four days. Now that could be a forty three forty one or a forty three forty two.

You know what you charge for a forty three forty one and a forty three forty two.

And these were all not treatment plan patients.

So I really believe as much as we focus on new patients, there's so much work in our offices that we have just not found. We have not identified, and we owe it to our patients to treatment plan them correctly.

So I'm just gonna walk you through how I do kind of my morning huddles.

And this is my morning data courtesy of Pearl.

So I had a patient scheduled for three PM that day. I'm in my office at six thirty. I start at seven.

And she's seventy nine year old lady, upper denture, lower partial. We've made those, and we've done some minor restorations on her.

And in the past, my morning routine would always be reading through my electronic charts and x rays. That's what my morning routine is, and I'm sure it's the same morning routine.

If you're not getting to the office and prepping for your day, I think that's a big mistake, and you're gonna really run behind. So I'm a really big planner for my day.

So four or five years ago now, could be five at this point, I really brought in Pearl as a beta test for the company.

And as I brought them into the company, I'm gonna show you just the impact in one patient, Bridgette, in my morning huddle.

In her case, and I'm just highlighting now my notes page in our computer system, my associate had identified on her last recall appointment, Carrie's on twenty five distal.

And with Carrie's on twenty five distal, they set up a half an hour. Fine. So she's coming in for a half an hour, and then you could go, okay. What's the big deal, Lou? So this is how I go through my notes forever in my career.

And I would ask each of you how much time do you spend on an X-ray, and it's usually probably most people would say five to ten seconds max. And yet you look at what's on an X-ray here, seven composites, a crown, a root canal, a post, potential caries, potential pathology, tooth anatomy, bone anatomy, all on one X-ray. Five seconds? Wow. It's a lot.

So now with second opinion, I wanna show you how this is gonna impact your diagnostics and how it impacted our schedule at the office.

When you take your X rays and the Pearl software comes up, what you're looking for are dots, and the dots are color coded.

So the AI has now identified where my arrow is, a pink dot, which is caries on one x-ray and a blue dot, which is periapical pathology.

So now instead of just reading all your x rays, which you'll do anyway, and you AI do this in fifteen or twenty seconds, now you're gonna be focusing on what Pearl found.

And when you look at what Pearl found here in a comparison of what we traditionally look at and what Pearl found, man, there's a lot of data here.

A lot of data, which we're gonna go in and identify step by step.

So the first thing is AI will tell you is is that you take your you you open up your X-ray in second opinion now. You move your cursor over to the caries, and it will show you how deep the caries is. Is it how much cementum, dentin, and enamel? Well, there's no doubt we're gonna restore this patient, but it's also telling you data.

As you move your cursor over to number twenty two, it has now identified a second lesion that my doctor missed on the exam and my hygienist missed. So now I've gotten additional caries that needs to be treated, but there's more.

What was missed was the radiolucency.

Just like the data suggests, we miss radiolucency.

So this data is always on. I'm just highlighting it individually, but each icon is always on.

So now we've missed the radio lucency, and I'm seeing this in my morning review.

I'm catching this all because second opinion in my morning review of this patient is giving me all this information in seconds.

This is the bone measurement.

All of this data is coming to me.

Part of Pearl, it allows you to do a lot with this data.

One of those is to measure the lesions.

So there's a measurement button. There's a contrast button. There's a zoom button.

And all of this can be used in front of the patient or prepping for your day.

So when you look at a typical black and white X-ray versus Pearl, who would want a black and white X-ray? Nobody.

There's no reason you'd want that because look at how much more information and how fast you can assess it and plan your day and plan your visits.

So now here's the tough question. So she's coming into the practice at three o'clock. It's six thirty in my office, and I need more information. So what am I gonna do?

I'm gonna go back and wanna see had I missed this lesion in the past.

Has is it growing?

And so what we did is we pulled up four X rays of over four over seven years.

And in two thousand fourteen, I didn't see it. Two thousand fifteen, you can start to see it. I didn't identify it.

Two thousand eighteen, I was not the one at the office that visit. It's definitely present.

And a year before in twenty twenty one, you can absolutely see that lesion is growing.

It was never identified in my office, and I'm the first one to admit I missed it in two thousand fifteen.

Other doctors missed it in eighteen, twenty one, and twenty two.

And you know what? Nobody wants to miss these things. This is why you want two d a I.

Now how did this end up changing the appointment?

So I I hate stress.

I hate running behind.

So we called the patient and told them we're gonna change the appointment to sixty minutes.

Doctor Graham found an additional cavity, and we're gonna need to take a cone beam on the patient to identify an area.

Now my front team person may say, doctor Graham in reviewing your x rays has some concerns, so he wants to add time on your visit. That's all that has to be said.

But the fact is the patient now knows I'm prepping before they're coming in. That shows more value, more trust.

I take the CBCT.

I explain to the patient what's going on.

And often, they may not even need an endo consult because I'll take the CBCT, send it to the endodontist, and we make a plan.

So my patients may not even need a separate consult.

And this is the courtesy I give to my patients. This builds trust because I'm doing all this for my patients, and this is why I've been PPO free my entire career. I just believe you go the added distance, and this is what Pearl allowed me.

There's no doubt this adds communication.

And let me just show you from a hygienist standpoint, of course, from the doctor standpoint, but from the hygienist standpoint, I think it's even more critical, more essential.

So for me, I'm showing it my initial exams, but routinely, it's periodic bitewings that we're taking.

And I don't even routinely take FMXs anymore because we just do that with a combing, so we take bitewings and CBCTs.

So this is how you up your game on a recall exam. This is the circle.

This is how I break down an hour for a patient, an hour, not a half an hour, an hour.

And this is for prophys or perio maintenances.

The initial, I'll call it five minutes, is the hygienist building her relationship, his or her relationship with the patient, establishing credibility.

We've got some new tests in the office. I went to a course. This is what the doctor is looking at doing. You're just building office credibility.

The hygienists are trained in our office to offer no more to do no more than twenty to twenty five minutes of therapy on a patient. We're not talking scaling and planning. We're talking routine prophys or perio maintenances. It's twenty to twenty five minutes because the bulk of the time then is clinical screenings.

And the problem is that traditional diagnostics, a, they were not sensitive enough, and they're not set up to enhance communication.

Let me show you what I mean.

Traditionally, we've used explorers, which are not accurate, perio probes, which are very subjective based on angle pressure, And even bleeding on probing is only thirty percent predictive of future disease. Only thirty percent.

And so the normal armamentarium in most hygiene operatories is an explorer, a probe, and an x-ray.

And we've kind of gone through all three earlier today. This is how I bring it home for all of you.

So I believe enhanced diagnostics equates to enhanced trust and ultimately far more treatment plan conversions.

Absolutely far more.

So what what are we doing in our office?

We use Valscope as part of our oral cancer screening.

We know when patients are due for their CBCTs.

We use TransIllumination or NHERI and fluorescences as Carrie's diagnostics.

Our patients can be scanned every year digitally, looking for tooth movement, recession, wear, occlusion.

Two d AI is now obviously incorporated. We have intraoral cameras, and now we have genetic tests and salivary tests. And you're going, how can you do all this? That's why we need clinical screening time.

You start doing all of this for your patients.

I'm just telling you, this is how we have four full time hygienists.

And when they get a cancellation, that patient may have to wait another month until there's another opening because we bring so much more value added to d a I is part of that.

And now after the hygienist is going through her findings and prepping for the doctor to come in, this is how we look at it.

Are you going to just tell the patient? Of course not. You're gonna sit them up.

You're gonna pull that monitor over, and you're gonna start to show them what's going on in their mouth.

And if you involve them AI I'm talking about, they're gonna understand this. They're gonna want their work done because they're gonna understand they need to have this work done.

So when you look at it, whether we find the lesion on Velscope, deeper caries on two d AI using, a different imaging part of, two d AI with Pearl called tooth parts, which I'll show you, or you're showing occlusal wear with iTero over a year and a changing occlusion.

This is where hygienes go.

And if you wanna be PPO free, and I know it's hard, but we have I can tell you there are absolute ways to do this in every practice, and I am not in a wealthy area at all.

So what I what I'd like to do is really show you a case. And I wanna show you the value of AI in exams, and and it's huge in initial exams, but I'm gonna bring up a recall exam, and it's on a patient named Rosa.

So Rosa comes in. She's your sixty seven year old patient.

She's got implant dentistry, restorative dentistry, history of perio treatments for twenty years.

She's a type two diabetic, long struggle with a one c, now has developed cardiac issues and high blood pressure.

She flosses twice a day. She's a power brusher, and she wears a night guard. So you think all should be good.

So we take a routine X rays that day on her.

And immediately with Pearl, what comes up are where those checkboxes are.

She's got calculus, carries noted, carries progressed noticed, and a periapical radial lucency. It all comes up instantly.

So we click on second opinion.

And in second opinion, there's your boxes and there's your dots.

And all four quadrants of her bitewings all four quadrants on her bitewings have subgingival calculus.

Some have caries, and there's a periapical pathology on one of her PAs.

K?

So now she's got four bitewings with calculus.

I wanna focus on only number one because we're limited in time.

This is what you normally pull up.

Watch how I'm gonna blow you away and how you're gonna have so much more information, and I'm just gonna walk you through icon by icon how my hygienist does this.

First icon she's gonna show is subgingival calculus, lower molar on the distal of the canine. She's AI she's showing the patient what has been identified. Now could you have caught this? Maybe on number thirty, but I doubt on number six. But this is what AI does.

Now let's talk bone measurements.

So now we're now looking at bone measurements from the CEJ to the crest of the bone.

Look how much more detailed this image is than just a typical black and white image.

Now if you click on the icon two parts, now all of a sudden you can explain what's going on with subgingival calculus, probing not probing, that's a bone bone bone depth.

But yet you can identify the different tooth parts so it's all colorized.

But I think the money in this patient, the money was comparing past images.

So let me show you comparing.

We went in and compared from twenty twenty three to twenty twenty four.

And if you look, the distal of number four has progressed from a white, what we call reading to an orange reading, which means we have progressive bone loss.

On the mesial of her upper bicuspid in yellow, it has progressed to orange. So she's losing bone year over year. We're showing you, and yet could you really identify that without this? I'm gonna say no.

And on the bottom bicuspid, it went from a normal CEJ to crestal bone, and she has lost some bone, and that's why it's in yellow.

You can see that a new area of subgingival calculus was found on the distal of the canine.

All of this enhances your opportunity after you probed her.

So when you look at her probings and her bleeding her her her probings and bleeding on probing scores, she has twenty four bleeding points. Now you're gonna do that through perio probing.

She's been identified with two d AI as far as having subgingival calculus and continued bone loss.

And her blood tests have shown she's got a one c challenge. So how are you gonna get her diabetes under control if she's got active periodontal disease?

You know it's all related. You know it's all related.

And now as your office starts to take all of this information, what are you gonna do? Are you just gonna do a perio maintenance or a prophy on this patient? Of course not.

You're gonna do active therapy, so now you're gonna book her for active therapy.

And whether you wanna do bacterial DNA testing, saliva testing, or genetic testing, that's another course on another day of what we do.

And as a hygienist, are you bringing in the latest of specialty products AI Slate, which is a power flosser, Live Fresh, which is a toothpaste that removes two hundred and fifty percent more plaque than all the leading brands out there that we routinely are giving us samples?

Are you gonna offer a probiotic? Are you gonna put her on perio protect? There are so many more things we can be doing for our patients once we identify the problems, and I feel two d AI really complements the process.

When the patient is reevaluated in three months, you may do a bacterial or saliva test to see are her periodontal pathogens going down.

It depends on the saliva test. This is all within our means today to offer our patients. This is what we do in our practice.

So to me, there is a huge financial win in this. Let me be clear. There's a huge financial win. You're gonna do more work. You're gonna diagnose more things.

And this is from Pearl. Pearl showed average production in an office, definitely not ours, was two fifty four per visit.

After Pearl was implemented, it then increased seventy four dollars per visit. Well, if it's seventy four dollars per visit, and if this is, let's call it AI, and there's eight hygiene appointments, you basically in one day pay for Pearl just in hygiene.

So there's no question there's a huge financial win, but you're not selling more dentistry. You're just diagnosing more dentistry.

And and with that diagnostics comes opportunity and enhanced communication.

And in the entire process, you're just building trust.

And this has been the impact of Pearl and two d AI in our practice.

I really appreciate you joining us today. And so what I'd love to do is handle some questions from all of you, and there are a few that have come up.

And so let me just answer a few of those, and you can type in some more as I'm doing this.

So Ruka asked, can the porosity of bone also be diagnosed? And the answer is not to my knowledge.

It's not evaluating the porosity.

There are tests that do that. Combining technologies are doing that. I don't believe that is part of two d AI yet.

So, Lou, tell us a little bit about, integrating this in the practice.

Okay. Let us know you know, you had a pretty big practice. You had a lot of hygienists. We worked together with training.

I know some teams feel like they're worried about how is my whole team gonna use this, and what would you tell them?

And then I'll answer more questions that came in.

AI I believe that the entire team is trained together. So we were onboarded with training.

Now there are videos and additional training.

We were all onboarded together, and I believe there were probably back then two or three initial training, Sheela.

I will tell you that I immediately got into this along with two of my four hygienists.

Not everybody gets it, and I will tell you as a team, everybody has to get it. Do I think it's hard? Absolutely not. I absolutely don't think it's hard. And once it's integrated into your practice, you're really not looking at black and white X rays ever again. You're just looking at two d AI images and understanding what they're bringing out. I hope I answered your question.

You did. And then also with native integrations, even easier. So that's the great thing about Patterson. I'm gonna turn it back over to you because I do think there are a lot of clinical questions in here. So let's see. Great.

So Janet asks, caries versus CEJ.

And, Janet, let me basically tell you this. Is two d AI perfect? Absolutely not, Janet.

Absolutely not. Nothing is perfect. The studies don't show it's perfect, but two d AI will continue to advance more and more beyond the eighties, hopefully, into the nineties by the more input and the better algorithms and deep learning. But what it allows you to do, Janet, if something is picked up on second opinion, you're gonna go take a closer look.

And if it's not there, it's not there.

If you have transillumination or other diagnostics and it's been identified by Pearl, you may then wanna transilluminate the tooth interproximally, and there are many technologies out there for that or fluorescent tube.

But can you still mistake caries in a CEJ, which is your question? The answer is yes. And I wanna be clear. Nothing is perfect.

Livio, you asked, are there any advances in three d CBCT for AI? And the answer is it's right around the corner.

Pearl will be coming out with two d AI for Panarexes.

That will absolutely be coming out near term. And from what I've I'm already working with two companies who are coming out with three d AI, and I do see that not far not far down the road. It's called how close will it be as far as accuracy.

Does Pearl have its own dedicated software?

My answer would be, of course, the answer is yes, but it works with your imaging systems.

So whether it's integrated into your Patterson system or your DEXIS system, it that's how it integrates with it. Is that the correct way to look at that, Sheela, if you don't mind me asking?

Yep. We have the standalone, but then we also have the native integration as well as inside of Fuse coming and also with Eaglesoft. So it's very exciting. No extra screens necessary.

Okay. So I'm just gonna answer back to Janet, and she asked, don't be sorry. How does AI differentiate?

Well, I wanna be clear here that on the slide that I showed you, the gray scale, AI is trying to differentiate, obviously, between the CEJ and carriers. There's no doubt about it. And that's, again, back to the gray scales.

And and I will say, are there false positives? Meaning, they believe it's that that the two d AI identifies carries and it's not there? I've absolutely seen that.

But, again, would I rather have a second set of eyes, which is second opinion, and the answer is yes.

Next question, still in three d eight, is there AI allowing uploading of intraoral scans?

Sorry. This just went up. Hang on one second. Hang on.

Hang on.

Three d allowing uploading of intraoral scans and looking into occlusal issues due to heat map of occlusal distances as teeth wear due to disocclusion.

I I I think, Libeo, that's just a question about heat mapping with digital scanning.

I AI really think that's another discussion way beyond the presentation of this. You can absolutely email me, and I'm happy to discuss that.

How does how does this distinguish a radiographic anomaly?

I have to understand, Ruka, what you're talking about as a radiographic anomaly. In other words, is it there or is it not there? I I need you to reply because I really this is the limitation of doing chat on this. I just don't know what you mean.

Carly asks, with the native integrations, we aren't seeing everything that the second opinion platform shows.

Do you have that logged in separately? Sheela, I would have you answer that particular question if you don't mind.

Yeah. There's a lot of additional features, but also on the native integration, majority of all of the, identification of pathologies, the case presentation tools, and as well as the practice intelligence side of things, that's living inside of Pearl still. But I do think the teams enjoy being able to have the images taken in the native integration. They just appear there. And, again, the same pathologies identified, the same models are used, and the same case presentation tools.

Exactly.

So I know this has been asked a few times. My email is my first name, Lou, and it's at catapult education, one word, Lou at catapult education dot com. You're absolutely more free to follow-up with me with some of these questions. I'm more than happy to answer them. I think we're good, Sheela.

You got it.

Well, thank you so much, Lou, for the incredible presentation.

Your case studies are just so resonating with all of us because we've all been there, and, we appreciate you and all you're doing to share with clinicians.

Thank you to the Patterson team for joining us, and, feel free to reach out to us if you have any questions as well as with doctor Graham. And we hope you have a wonderful day, and we look forward to seeing you all soon.

Bye bye, everybody.

Take care.

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