Advances in the Diagnosis of Oral and Maxillofacial Disease

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 8869

Special Issue Editor

Special Issue Information

Dear Colleagues,

The forthcoming Special Issue of the journal Diagnostics, titled "Advances in the Diagnosis of Oral and Maxillofacial Disease", will present cutting-edge developments in the field of diagnosing conditions affecting the mouth, jaw, and related structures. This comprehensive collection of articles will delve into the latest advancements in diagnostic techniques, technologies, and methodologies, aiming to enhance early detection, accurate diagnosis, and effective management of oral and maxillofacial diseases.

The contributions within this edition will explore various aspects of diagnostic modalities, including advanced radiology techniques such as cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI), which will offer detailed anatomical information for precise diagnosis and treatment planning. Additionally, the authors will discuss the application of optical imaging and diagnostic tools, providing insights into non-invasive methods for detecting early signs of disease and monitoring treatment responses.

Pathology and biopsy techniques will also be discussed, highlighting the role of histopathological analysis in confirming diagnoses and guiding therapeutic interventions. Furthermore, the integration of molecular diagnostics and medical screening protocols will be explored, showcasing the potential of genetic and molecular markers in early disease detection and personalized treatment approaches.

This Special Issue will also address prognostic assessment and the identification of biomarkers associated with disease progression and treatment response. By synthesizing the latest research findings and clinical insights across these diverse diagnostic modalities, this edition will serve as a valuable resource for clinicians, researchers, and healthcare professionals involved in the diagnosis and management of oral and maxillofacial diseases. Ultimately, these advancements will contribute to improved patient care, treatment outcomes, and quality of life.

Dr. Luis Eduardo Almeida
Guest Editor

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Keywords

  • maxillofacial disease
  • oral disease
  • biomarkers
  • prognosis
  • periodontal disease
  • machine learning
  • MRI
  • CBCT

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Published Papers (10 papers)

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Research

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10 pages, 1987 KiB  
Article
Comparative Immunohistochemical Analysis of Craniopharyngioma and Ameloblastoma: Insights into Odontogenic Differentiation
by Ban A. Salih and Bashar H. Abdullah
Diagnostics 2024, 14(20), 2315; https://doi.org/10.3390/diagnostics14202315 - 17 Oct 2024
Viewed by 204
Abstract
Background and objectives: Histopathological similarities between craniopharyngioma (CP) and ameloblastoma (AB) have long been recognized, particularly the shared features of palisading columnar epithelium and stellate reticulum-like areas. This study aimed to investigate potential odontogenic differentiation in CP akin to AB using immunohistochemical odontogenic [...] Read more.
Background and objectives: Histopathological similarities between craniopharyngioma (CP) and ameloblastoma (AB) have long been recognized, particularly the shared features of palisading columnar epithelium and stellate reticulum-like areas. This study aimed to investigate potential odontogenic differentiation in CP akin to AB using immunohistochemical odontogenic markers. Methods: We analyzed AMELX, ODAM, and CK19 expression in 44 cases (20 CP and 24 AB). Results: While AMELX and ODAM showed diffuse strong positive expression in both tumors with no significant statistical differences, CK19 expression was notably higher in CP. Conclusion: The markers AMELX and ODAM associated with odontogenic differentiation exhibited similar profiles in both tumors due to shared similar embryological origins. Notably, CK19, a biomarker of odontogenic epithelium, showed even higher expression, suggesting distinct pathways. These findings offer insights into tumor biology and may aid in diagnostic and therapeutic approaches. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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11 pages, 4780 KiB  
Article
Assessment of Reliability, Agreement, and Accuracy of Masseter Muscle Ultrasound Thickness Measurement Using a New Standardized Protocol
by Mateusz Rogulski, Małgorzata Pałac, Tomasz Wolny and Paweł Linek
Diagnostics 2024, 14(16), 1771; https://doi.org/10.3390/diagnostics14161771 - 14 Aug 2024
Viewed by 496
Abstract
There is no validated method of assessing masseter muscle thickness (MMT) by ultrasound imaging (US). However, this is important to ensure study and measurement quality of MMT by US in future studies, as MMT differs depending on the examined area. Thus, this study’s [...] Read more.
There is no validated method of assessing masseter muscle thickness (MMT) by ultrasound imaging (US). However, this is important to ensure study and measurement quality of MMT by US in future studies, as MMT differs depending on the examined area. Thus, this study’s aim was to present a new standardized method for assessing the MMT by US and to evaluate the reliability, consistency, and accuracy of its measurements. We also compared the results of MMT measurements obtained by US and computer tomography (CT). The study included nine healthy adults. The US and CT scans were collected in a supine rest position with the mandible in relaxed position. US measurements were determined according to a new standardized protocol (with precise probe location). The MMT measured by CT and US over a seven-day interval showed excellent intra-rater reliability. The mean MMT measured by CT was 12.1 mm (1.74) on the right side and 11.9 mm (1.61) on the left side. The mean MMT measured by US was 12.7 mm (2.00) on the right side and 11.5 mm (1.37) on the left side. The mean percent error in MMT measurement between CT and US was below 6%. A strong linear relationship was found between the CT and US measurements of the MMT on both body sides (p < 0.001, r ≥ 0.93). The proposed method of MMT measurement using US demonstrated excellent reliability, yielding results similar to those obtained from CT images. We recommend the use of this standardization protocol in further studies where precise assessment of MMT by US is expected. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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14 pages, 2236 KiB  
Article
In Vivo Regulation of Active Matrix Metalloproteinase-8 (aMMP-8) in Periodontitis: From Transcriptomics to Real-Time Online Diagnostics and Treatment Monitoring
by Nur Rahman Ahmad Seno Aji, Tülay Yucel-Lindberg, Ismo T. Räisänen, Heidi Kuula, Mikko T. Nieminen, Maelíosa T. C. Mc Crudden, Dyah Listyarifah, Anna Lundmark, Fionnuala T. Lundy, Shipra Gupta and Timo Sorsa
Diagnostics 2024, 14(10), 1011; https://doi.org/10.3390/diagnostics14101011 - 15 May 2024
Cited by 2 | Viewed by 1182
Abstract
Background: This study investigated in vivo regulation and levels of active matrix metalloproteinase-8 (aMMP-8), a major collagenolytic protease, in periodontitis. Methods: Twenty-seven adults with chronic periodontitis (CP) and 30 periodontally healthy controls (HC) were enrolled in immunohistochemistry and transcriptomics analytics in order to [...] Read more.
Background: This study investigated in vivo regulation and levels of active matrix metalloproteinase-8 (aMMP-8), a major collagenolytic protease, in periodontitis. Methods: Twenty-seven adults with chronic periodontitis (CP) and 30 periodontally healthy controls (HC) were enrolled in immunohistochemistry and transcriptomics analytics in order to assess Treponema denticola (Td) dentilisin and MMP-8 immunoexpression, mRNA expression of MMP-8 and its regulators (IL-1β, MMP-2, MMP-7, TIMP-1). Furthermore, the periodontal anti-infective treatment effect was monitored by four different MMP-8 assays (aMMP-8-IFMA, aMMP-8-Oralyzer, MMP-8-activity [RFU/minute], and total MMP-8 by ELISA) among 12 CP (compared to 25 HC). Results: Immunohistochemistry revealed significantly more Td-dentilisin and MMP-8 immunoreactivities in CP vs. HC. Transcriptomics revealed significantly elevated IL-1β and MMP-7 RNA expressions, and MMP-2 RNA was slightly reduced. No significant differences were recorded in the relatively low or barely detectable levels of MMP-8 mRNAs. Periodontal treatment significantly decreased all MMP-8 assay levels accompanied by the assessed clinical indices (periodontal probing depths, bleeding-on-probing, and visual plaque levels). However, active but not total MMP-8 levels persisted higher in CP than in periodontally healthy controls. Conclusion: In periodontal health, there are low aMMP-8 levels. The presence of Td-dentilisin in CP gingivae is associated with elevated aMMP-8 levels, potentially contributing to a higher risk of active periodontal tissue collagenolysis and progression of periodontitis. This can be detected by aMMP-8-specific assays and online/real-time aMMP-8 chair-side testing. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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13 pages, 3085 KiB  
Article
Frequency and Demographic Analysis of Odontogenic Tumors in Three Tertiary Institutions: An 11-Year Retrospective Study
by Asma Almazyad, Mohammed Alamro, Nasser Almadan, Marzouq Almutairi and Turki S. AlQuwayz
Diagnostics 2024, 14(9), 910; https://doi.org/10.3390/diagnostics14090910 - 26 Apr 2024
Cited by 1 | Viewed by 1176
Abstract
Odontogenic tumors (OTs) are distinct conditions that develop in the jawbones, exhibiting diverse histopathological features and variable clinical behaviors. Unfortunately, the literature on this subject in Saudi Arabia remains sparse, indicating a pressing need for more comprehensive data concerning the frequency, demographics, treatment [...] Read more.
Odontogenic tumors (OTs) are distinct conditions that develop in the jawbones, exhibiting diverse histopathological features and variable clinical behaviors. Unfortunately, the literature on this subject in Saudi Arabia remains sparse, indicating a pressing need for more comprehensive data concerning the frequency, demographics, treatment modalities, and outcomes of OTs. Objectives: The study aims to evaluate the frequency, demographic features, treatment, and outcomes of OTs across three tertiary medical centers. Methods and Material: OT cases were identified in King Abdulaziz Medical City (KAMC), King Fahad Medical City (KFMC), and Prince Sultan Military Medical City (PSMMC) from January 2010 to December 2021. Results: Ninety-two OT cases were identified from the anatomical pathology laboratories of three tertiary hospitals. KFMC contributed the highest number of cases (43.5%), followed by KAMC (30.4%) and PSMMC (26.1%). The median age of OT patients was 29 years (range: 5–83), with males representing more than half of the patients (56.5%). The mandible was the most frequent site of OT occurrence (72.5%), with ameloblastoma being the predominant OT (63.0%), followed by odontoma (19.5%). Among the treatment modalities, bone resection was employed the most (51.0%), followed by enucleation (25.6%). Notably, 11.5% of OT cases with available follow-up data exhibited recurrence, with ameloblastoma accounting for eight recurrent cases. Conclusions: Although OTs are relatively common in the jaws, they are rare in anatomical pathology laboratories and the general population. This study contributes valuable insights into the epidemiology characteristics, treatment trends, and recurrence rates of OTs in Saudi Arabia. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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Review

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18 pages, 2530 KiB  
Review
Anatomical Factors of the Anterior and Posterior Maxilla Affecting Immediate Implant Placement Based on Cone Beam Computed Tomography Analysis: A Narrative Review
by Milica Vasiljevic, Dragica Selakovic, Gvozden Rosic, Momir Stevanovic, Jovana Milanovic, Aleksandra Arnaut and Pavle Milanovic
Diagnostics 2024, 14(15), 1697; https://doi.org/10.3390/diagnostics14151697 - 5 Aug 2024
Cited by 1 | Viewed by 809
Abstract
Background: The aim of this narrative review was to provide insights into the influence of the morphological characteristics of the anatomical structures of the upper jaw based on cone beam computed tomography (CBCT) analysis on the immediate implant placement in this region. Material [...] Read more.
Background: The aim of this narrative review was to provide insights into the influence of the morphological characteristics of the anatomical structures of the upper jaw based on cone beam computed tomography (CBCT) analysis on the immediate implant placement in this region. Material and Methods:To conduct this research, we used many electronic databases, and the resulting papers were chosen and analyzed. From the clinical point of view, the region of the anterior maxilla is specific and can be difficult for immediate implant placement. Findings: Anatomical structures in the anterior maxilla, such as the nasopalatine canal and accessory canals, may limit and influence the implant therapy outcome. In addition to the aforementioned region, immediate implant placement in the posterior maxilla may be challenging for clinicians, especially in prosthetic-driven immediate implant placement procedures. Data presented within the recently published materials summarize the investigations performed in order to achieve more reliable indicators that may make more accurate decisions for clinicians. Conclusion: The possibility for immediate implant placement may be affected by the NPC shape in the anterior maxilla, while the presence of ACs may increase the incidence of immediate implant placement complications. The variations in IRS characteristics may be considered important criteria for choosing the implant properties required for successful immediate implant placement. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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Other

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19 pages, 1522 KiB  
Systematic Review
Oral Health-Related Quality of Life in Temporomandibular Disorder Patients and Healthy Subjects—A Systematic Review and Meta-Analysis
by Lujain AlSahman, Hamad AlBagieh and Roba AlSahman
Diagnostics 2024, 14(19), 2183; https://doi.org/10.3390/diagnostics14192183 - 30 Sep 2024
Viewed by 393
Abstract
(1) Background: Temporomandibular disorders (TMD) signs and symptoms affect the quality of life of patients because they impose an incapacity to participate in daily life activities, causing both physical and psychological discomfort. This review aims to provide the most accurate, comprehensive, and up-to-date [...] Read more.
(1) Background: Temporomandibular disorders (TMD) signs and symptoms affect the quality of life of patients because they impose an incapacity to participate in daily life activities, causing both physical and psychological discomfort. This review aims to provide the most accurate, comprehensive, and up-to-date description of all information available regarding OHRQoL in TMD. (2) Methods: A systematic search of articles from January 2013 till August 2023 was performed on five databases to identify articles, including TMD and oral health-related quality of life. Two calibrated reviewers performed the search following inclusion and exclusion criteria. A manual search of reference articles was also performed. The data were analyzed qualitatively by combining a meta-analysis and GRADE evidence. The Newcastle–Ottawa scale for cross-sectional and case-control studies was utilized to assess the quality of the included studies. (3) Results: The initial search consisted of 738 articles without the removal of duplicates. Fifteen articles were included in this systematic review, and ten were included in the meta-analysis. Almost all the included observational studies reported poor OHRQoL among patients with different types of TMD. The results of the meta-analysis with a standard mean difference (SMD) and that included seven studies suggest high heterogeneity with I2 = 99%, SMD (95% CI) = 3.18 (1.90, 4.46), p-value < 0.01. The odds ratio analyzed for three included articles in the meta-analysis reported statistical significance (p-value < 0.01) with OR = 8.21 (2.39, 28.25) and a heterogeneity of 86%. The certainty of evidence by GRADE resulted in a downgraded level of evidence, indicating that the OHRQoL of TMD patients may differ slightly from the healthy controls. (4) Conclusions: The impact of OHRQoL on the TMD was deemed to be significant. Overall, the OHRQoL is low for any type and intensity of pain among TMD patients and controls. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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12 pages, 2497 KiB  
Systematic Review
The Frequency of Risk Factors for Cleft Lip and Palate in Mexico: A Systematic Review
by Sandra López-Verdín, Judith A. Solorzano-López, Ronell Bologna-Molina, Nelly Molina-Frechero, Omar Tremillo-Maldonado, Victor H. Toral-Rizo and Rogelio González-González
Diagnostics 2024, 14(16), 1753; https://doi.org/10.3390/diagnostics14161753 - 12 Aug 2024
Viewed by 873
Abstract
Background: Cleft lip and palate is an anomaly that affects both women and men. It is considered to be among the most frequent congenital abnormalities and is related to modifications in chromosomal DNA and multiple genetic alterations. This anomaly can also be associated [...] Read more.
Background: Cleft lip and palate is an anomaly that affects both women and men. It is considered to be among the most frequent congenital abnormalities and is related to modifications in chromosomal DNA and multiple genetic alterations. This anomaly can also be associated with various environmental factors, such as tobacco and alcohol consumption, medication use, and exposure to different environmental and industrial toxic substances. The objective of this study was to document the frequency of risk factors related to cleft lip and palate through a systematic review of Mexican studies. Methods: In this systematic review, a bibliographic search was conducted following PRISMA guidelines in the databases Scielo, ScienceDirect, PubMed, and EBSCO. Keywords related to cleft lip and palate, epidemiology, and risk factors were used. In all, 3 independent reviewers (J.A.S.L., S.L.V., and N.M.F.) selected and evaluated a total of 17 articles included in this analysis, achieving a coefficient of κ = 0.84. Results: The analysis revealed that the highest frequency of conducted studies was in the State of Mexico. The most common risk factors identified were environmental, pharmacological, consumption habits, and gynecological factors. Conclusions: Identifying the main risk factors for cleft lip and palate in the Mexican population will enable the implementation of preventive measures aimed at reducing exposure to these factors. Additionally, early intervention can improve the quality of life for individuals affected by this condition. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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18 pages, 575 KiB  
Systematic Review
Is There a Relationship between Salivary Cortisol and Temporomandibular Disorder: A Systematic Review
by Lujain AlSahman, Hamad AlBagieh and Roba AlSahman
Diagnostics 2024, 14(13), 1435; https://doi.org/10.3390/diagnostics14131435 - 5 Jul 2024
Cited by 1 | Viewed by 948
Abstract
Background: This systematic review examines and evaluates the relationship between salivary cortisol levels and temporomandibular disorder (TMD) in young adult patients. Method: Six databases—PubMed, Scopus, Web of Science, Google Scholar, ProQuest, and Cochrane Library—were utilized to screen eligible studies. A systematic search was [...] Read more.
Background: This systematic review examines and evaluates the relationship between salivary cortisol levels and temporomandibular disorder (TMD) in young adult patients. Method: Six databases—PubMed, Scopus, Web of Science, Google Scholar, ProQuest, and Cochrane Library—were utilized to screen eligible studies. A systematic search was performed based on PECO questions and eligibility criteria. The research question for this review was “Do salivary cortisol levels correlate with TMD in individuals aged 18–40?” The risk of bias for quality assessment was determined by the Cochrane tool. PRISMA guidelines were followed while performing this review. Result: A total of fourteen studies were included in this review. Of these, eleven were observational studies (four cross-sectional and seven case–control), and three were randomized control trials. Eleven of the included studies presented a low to moderate risk in the qualitative synthesis. The total sample size of the included studies was 751 participants. The included studies suggest higher salivary cortisol levels in TMD patients than in healthy individuals. Conclusions: The findings of this review indicate higher salivary cortisol levels in adult patients with TMD than in healthy controls. Thus, supportive psychological treatment and clinical modalities should be provided to patients with TMD. Moreover, higher-quality studies with low heterogeneity are required to support this finding. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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76 pages, 992 KiB  
Systematic Review
Immunohistochemical Analysis of Dentigerous Cysts and Odontogenic Keratocysts Associated with Impacted Third Molars—A Systematic Review
by Luis Eduardo Almeida, David Lloyd, Daniel Boettcher, Olivia Kraft and Samuel Zammuto
Diagnostics 2024, 14(12), 1246; https://doi.org/10.3390/diagnostics14121246 - 13 Jun 2024
Viewed by 1208
Abstract
Objective: This systematic review investigates the diagnostic, prognostic, and therapeutic implications of immunohistochemical markers in dentigerous cysts (DCs) and odontogenic keratocysts (OKCs) associated with impacted third molars. Materials and Methods: A comprehensive search strategy was employed across major databases including MEDLINE/PubMed, EMBASE, and [...] Read more.
Objective: This systematic review investigates the diagnostic, prognostic, and therapeutic implications of immunohistochemical markers in dentigerous cysts (DCs) and odontogenic keratocysts (OKCs) associated with impacted third molars. Materials and Methods: A comprehensive search strategy was employed across major databases including MEDLINE/PubMed, EMBASE, and Web of Science, from the inception of the databases to March 2024. Keywords and Medical Subject Heading (MeSH) terms such as “dentigerous cysts”, “odontogenic keratocysts”, “immunohistochemistry”, “Ki-67”, and “p53” were used. The PRISMA 2020 guidelines were followed to ensure methodological rigor. Inclusion criteria encompassed studies on humans and animals providing definitive diagnoses or specific signs and symptoms related to DCs and OKCs, with results on protein expression derived from immunohistochemistry, immune antibody, proteomics, or protein expression methods. Results: Of the 159 studies initially identified, 138 met the inclusion criteria. Our analysis highlighted significantly higher expressions of Ki-67 (22.1% ± 4.7 vs. 10.5% ± 3.2, p < 0.001), p53 (15.3% ± 3.6 vs. 5.2% ± 1.9, p < 0.001), and Bcl-2 (18.4% ± 3.2 vs. 8.7% ± 2.4, p < 0.001) in OKCs compared to DCs, indicating a higher proliferative index, increased cellular stress, and enhanced anti-apoptotic mechanisms in OKCs. Additionally, PCNA levels were higher in OKCs (25.6% ± 4.5 vs. 12.3% ± 3.1, p < 0.001). Genetic mutations, particularly in the PTCH1 gene, were frequently observed in OKCs, underscoring their aggressive behavior and potential malignancy. Conclusions: The findings emphasize the significant role of immunohistochemical markers in distinguishing between DCs and OKCs, with elevated levels of Ki-67, p53, Bcl-2, and PCNA in OKCs suggesting a higher potential for growth and recurrence. Genetic insights, including PTCH1 mutations, further support the need for personalized treatment approaches. These markers enhance diagnostic accuracy and inform targeted therapeutic strategies, potentially transforming patient management in oral and maxillofacial surgery. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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25 pages, 801 KiB  
Systematic Review
Performance of Artificial Intelligence Models Designed for Automated Estimation of Age Using Dento-Maxillofacial Radiographs—A Systematic Review
by Sanjeev B. Khanagar, Farraj Albalawi, Aram Alshehri, Mohammed Awawdeh, Kiran Iyer, Barrak Alsomaie, Ali Aldhebaib, Oinam Gokulchandra Singh and Abdulmohsen Alfadley
Diagnostics 2024, 14(11), 1079; https://doi.org/10.3390/diagnostics14111079 - 22 May 2024
Cited by 1 | Viewed by 1056
Abstract
Automatic age estimation has garnered significant interest among researchers because of its potential practical uses. The current systematic review was undertaken to critically appraise developments and performance of AI models designed for automated estimation using dento-maxillofacial radiographic images. In order to ensure consistency [...] Read more.
Automatic age estimation has garnered significant interest among researchers because of its potential practical uses. The current systematic review was undertaken to critically appraise developments and performance of AI models designed for automated estimation using dento-maxillofacial radiographic images. In order to ensure consistency in their approach, the researchers followed the diagnostic test accuracy guidelines outlined in PRISMA-DTA for this systematic review. They conducted an electronic search across various databases such as PubMed, Scopus, Embase, Cochrane, Web of Science, Google Scholar, and the Saudi Digital Library to identify relevant articles published between the years 2000 and 2024. A total of 26 articles that satisfied the inclusion criteria were subjected to a risk of bias assessment using QUADAS-2, which revealed a flawless risk of bias in both arms for the patient-selection domain. Additionally, the certainty of evidence was evaluated using the GRADE approach. AI technology has primarily been utilized for automated age estimation through tooth development stages, tooth and bone parameters, bone age measurements, and pulp–tooth ratio. The AI models employed in the studies achieved a remarkably high precision of 99.05% and accuracy of 99.98% in the age estimation for models using tooth development stages and bone age measurements, respectively. The application of AI as an additional diagnostic tool within the realm of age estimation demonstrates significant promise. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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