Search Results (1,098)

Background/Objectives: Artificial intelligence (AI) has been increasingly used to support radiological assessment in dentistry. We benchmarked machine learning (ML), deep learning (DL), and a hybrid optimization-assisted approach for the automatic five-class image-level classification of dental restorations (filling, implant, root canal treatment, fixed partial denture/bridge, crown) on panoramic radiographs. Methods: We analyzed 353 anonymized panoramic images comprising 2137 labeled restorations, acquired on the same device. Images were cropped and enhanced (histogram equalization and CLAHE), and texture features were extracted with GLCM. A three-stage pipeline was evaluated: (i) GLCM-based features classified by conventional ML and a baseline DL model; (ii) Hybrid Grey Wolf–Particle Swarm Optimization (HGWO-PSO) for feature selection followed by SVM; and (iii) a CNN trained end-to-end on raw images. Performance was assessed with an 80/20 per-patient split and 5-fold cross-validation on the training set. While each panoramic radiograph may contain multiple restorations, in this study we modeled the task as single-label, image-level classification (dominant restoration type) due to pipeline constraints; this choice is discussed as a limitation and motivates multi-label, localization-based approaches in future work. The CNN baseline was implemented in TensorFlow 2.12 (CUDA 11.8/cuDNN 8.9) and trained with Adam (learning rate 1 × 10⁻⁴), with a batch size 32 and up to 50 epochs with early stopping (patience 5); data augmentation included horizontal flips, ±10° rotations, and ±15% brightness variation. A post hoc power analysis (G*Power 3.1; α = 0.05, β = 0.2) confirmed sufficient sample size (n = 353, power > 0.84). Results: The HGWO-PSO + SVM configuration achieved the highest accuracy (73.15%), with macro-precision/recall/F1 = 0.728, outperforming the CNN (68.52% accuracy) and traditional ML models (SVM 67.89%; DT 59.09%; RF 58.33%; K-NN 53.70%). Conclusions: On this single-center dataset, the hybrid optimization-assisted classifier moderately improved detection performance over the baseline CNN and conventional ML. Given the dataset size and class imbalance, the proposed system should be interpreted as a decision-supportive tool to assist dentists rather than a stand-alone diagnostic system. Future work will target larger, multi-center datasets and stronger DL baselines to enhance generalizability and clinical utility. Full article

Third molar extraction is a common oral surgical procedure that can be accompanied by challenges in wound healing and bone regeneration. Materials such as bone substitute materials (BSMs) and platelet-rich fibrin (PRF) are often used to support socket regeneration. This prospective randomized controlled split-mouth clinical trial compared PRF application combined with BSM versus PRF alone in patients requiring bilateral third molar extraction. A total of 15 patients underwent standardized osteotomy procedures, with sockets filled either with PRF alone (control group) or with BSM + PRF on opposite sides (test group) under general anesthesia and with patients blinded to the treatment allocation. Postoperative pain and swelling were measured over 7 days using a visual analog scale and anatomical distance measurements, respectively. Bone regeneration was evaluated using cone beam computed tomography (CBCT) scans after an average healing period of six months, with results showing no significant differences between groups in terms of postoperative pain or swelling (n = 12; 3 patients were lost to randomization). However, CBCT imaging revealed covered socket residuum (CSR)—non-mineralized areas within the socket—in the PRF only group, whereas the BSM + PRF group demonstrated more homogeneous and mineralized bone formation throughout the extraction sites (n = 8; 5 patients were lost to follow-up). These non-mineralized areas represent covered socket residuum within the extraction sockets, which poses a clinical risk of infection and may negatively affect the dental health of the adjacent second molar. Based on the presented findings, we recommend combining BSM with PRF to support bone regeneration and regulate the postoperative pain and swelling following third molar extraction. Nevertheless, further research is required to determine the most suitable BSM type in this regard. Full article

Background/Objectives: Hyposalivation is a prevalent yet underrecognized factor contributing to oral health deterioration, often influenced by systemic disease, medication use, and recreational drug exposure. With rising use of mental health and cardiovascular medications, as well as increasing marijuana use among younger populations, there is a need to assess real-world data on xerostomia and hyposalivation prevalence and associated risk factors. This study aimed to evaluate the prevalence of hyposalivation and xerostomia, and its etiological associations among adult patients at the University of Nevada, Las Vegas (UNLV) School of Dental Medicine Clinics. Methods: A retrospective cohort study was conducted using electronic health record (EHR) data from 1600 randomly selected patients aged 30 years and older, treated between 1 January 2014, and 31 May 2023. Data on demographics, medical and social history, medication use, and oral health status were extracted. Hyposalivation was identified via chart review, and multivariate logistic regression was used to analyze associated risk factors. Results: Hyposalivation and xerostomia were identified in 705 patients (44.06%). Marijuana use was the strongest independent predictor across all age groups (RR = 3.10, p < 0.05). Among patients aged 30–35, use of antihypertensive (OR = 3.05, p < 0.05) and mental health medications (OR = 1.81, p < 0.05) were significantly associated with hyposalivation. A strong correlation was also found between hyposalivation and elevated caries risk (χ² = 205.99, p < 0.001). Conclusions: Hyposalivation and xerostomia are increasingly observed in younger adults, linked to pharmacological and behavioral factors. Full article

Background/Aim: Furcation lesions in primary molars are critical in pediatric dentistry, often guiding treatment decisions between root canal therapy and extraction. This study introduces a deep learning-based clinical decision-support system that directly maps radiographic lesion characteristics to corresponding treatment recommendations—a novel contribution in the context of pediatric dental imaging, also represents the first integration of panoramic radiographic classification of primary molar furcation lesions with treatment planning in pediatric dentistry. Materials and Methods: A total of 387 anonymized panoramic radiographs from children aged 3–13 was labeled into five distinct bone lesion categories. Three object detection models (YOLOv12x, RT-DETR-L, and RT-DETR-X) were trained and evaluated using stratified train-validation-test splits. Diagnostic performance was assessed using precision, recall, mAP@0.5, and mAP@0.5–0.95. Additionally, qualitative accuracy was evaluated with expert-annotated samples. Results: Among the models, RT-DETR-X achieved the highest performance (mAP@0.5 = 0.434), representing modest but clinically promising diagnostic capability, despite the limitations of a relatively small, single-center dataset. Specifically, RT-DETR-X achieved the highest diagnostic accuracy (mAP@0.5 = 0.434, Recall = 0.483, Precision = 0.440), followed by YOLOv12x (mAP@0.5 = 0.397, Precision = 0.442) and RT-DETR-L (mAP@0.5 = 0.326). All models successfully identified lesion types and supported corresponding clinical decisions. The system reduced diagnostic ambiguity and showed promise in supporting clinicians with varying levels of experience. Conclusions: The proposed models have potential for standardizing diagnostic outcomes, especially in resource-limited settings and mobile clinical environments. Full article

Background: Artificial intelligence technologies are increasingly integrated into dental practice, offering potential improvements in diagnostic accuracy, treatment planning, and patient outcomes. However, the extent and quality of evidence supporting these applications remain unclear. Methodology: We conducted a systematic literature search using PubMed, Cochrane Library, Embase, and IEEE Xplore databases from January 2015 to December 2024. Search terms included combinations of “artificial intelligence,” “machine learning,” “deep learning,” “dentistry,” “diagnosis,” and “treatment planning.” Studies evaluating AI systems in clinical or laboratory settings with measurable outcomes were included. Data extraction followed PRISMA guidelines, and methodological quality was assessed using the QUADAS-2 tool. Results: Twenty-three studies met the inclusion criteria. Most focused on diagnostic accuracy (n = 21), with few addressing treatment planning (n = 1) or outcome prediction (n = 1). Reported accuracies ranged from 82–94% for caries detection, 85–92% for periodontal disease assessment, and 88–96% for oral lesion identification. Orthodontic applications achieved 95–98% accuracy in cephalometric landmark identification, while implant planning studies demonstrated up to 96% agreement with expert strategies. Despite promising technical performance, 79% of studies were retrospective and conducted in controlled research settings, with limited external or prospective clinical validation. Risk of bias was highest in patient selection due to frequent use of case–control designs and archived imaging datasets. Conclusions: AI shows significant promise for enhancing dental diagnostics and treatment planning. However, most applications require further clinical validation before routine implementation. The disconnect between laboratory performance and real-world clinical validation represents a critical gap that must be addressed. Current AI systems should be viewed as diagnostic aids rather than replacements for clinical judgment. Practitioners considering AI adoption should understand current limitations and evidence quality, particularly the lack of prospective clinical validation in diverse populations. Full article

Background/Objectives: Certain components of natural products help maintain the oral microbiota balance, thereby promoting oral health. This study aimed to identify natural components with anticariogenic properties by analyzing evidence from in vivo studies. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was performed across multiple databases and included English-language studies published between 2013 and 2025. The review included intervention and comparative studies that examined the effects of dietary habits involving natural components in participants of any age, with or without dental caries. Results: A total of 77 studies were included in the review, most of which were clinical trials conducted in pediatric populations. To assess the impact of the interventions, most studies measured outcomes such as Streptococcus mutans levels, dental caries incidence, and salivary pH, among other parameters. The most frequently studied components included probiotics, plant extracts, sugar substitutes, propolis, arginine, dairy products, among others. Significant effects were most reported on biological risk factors (72.8%). In addition, 16.9% of the studies reported a statistically significant reduction in clinically diagnosed dental caries. Conclusions: This review identified preliminary evidence suggesting that certain natural compounds may play a role in modulating cariogenic factors. However, further high-quality studies are needed to strengthen the evidence base and confirm these findings. The protocol for this review was registered on the Open Science Framework platform. Full article

There is a need to develop comprehensive guidelines to encourage the promotion of oral hygiene care among older adults and to assist caregivers in this endeavor, taking into consideration the specific challenges that arise from aging, comorbidities and caregiving. This review was conducted by searching across relevant literature from meta-databases including Academic Google, PubMed, Scielo and Scopus for studies published from 2020 to 2024. PRISMA guidelines were followed. We included articles that described oral hygiene methods, caregiver education and mechanization status of older adults. Common themes, best practices, and gaps in current guidelines were tracked using extracted and analyzed data. The review revealed multiple factors affecting the oral hygiene of older adults, with themes relating to physical impairment, cognitive dysfunction, and caregiver involvement. Highlighted between the approaches are individualized therapy for oral hygiene, caregiver education, and the use of technology to improve adherence to oral hygiene. Barriers like dental care access, underlying medical conditions complicating dental treatments, and cost considerations were identified. The findings emphasize the necessity of clear recommendations that can help caregivers and advance dental care for older adults. Full article

Background: Oral infections such as dental caries and candidiasis are mediated by resilient biofilms, which are increasingly tolerant to conventional antimicrobials. This study investigated the antimicrobial and antibiofilm effects of Salvia officinalis and Nigella sativa CO₂ extracts against Streptococcus mutans and Candida albicans, with emphasis on synergistic interactions. Methods: Extracts were analyzed using gas chromatography–mass spectrometry analysis (GC–MS) and evaluated through planktonic MIC/MBC assays, time–kill kinetics, and biofilm models (MBIC/MBEC, biomass, metabolic activity). A novel three-dimensional checkerboard (3D-CB) and fractional inhibitory concentration index (FICI) approach was applied to optimize extract ratios, concentrations, and exposure times. Results: S. officinalis extract showed greater activity against S. mutans (MIC 256 mg/L; MBC 512 mg/L), while N. sativa was more effective against C. albicans (MIC 256 mg/L; MFC 512 mg/L). Both extracts reduced biofilm biomass and metabolic activity by over 70% at higher doses. Synergy was confirmed at ratios of 70:30 (S. officinalis: N. sativa) for S. mutans (FICI 0.38) and 40:60 for C. albicans (FICI 0.42). The achieved synergistic effect further decreased MBEC values fourfold and prolonged post-antibiotic effects. Conclusions: Synergistic S. officinalis–N. sativa formulations enhanced antimicrobial activity against oral pathogens in both planktonic and biofilm states, supporting their potential as next-generation dental antimicrobials. Full article

Background: Interprofessional collaboration is vital for comprehensive, patient-centered care. Despite growing recognition of oral–systemic health links, the integration of dentists into healthcare teams remains limited. This scoping review mapped existing evidence on dental professionals’ roles within interprofessional healthcare, identifying key benefits, barriers, and facilitators. Methods: A systematic search of PubMed, SCOPUS, and Web of Science identified English-language studies (2014 to 2024) focused on collaboration between dental and non-dental providers. Studies addressing oral–systemic health without team-based integration were excluded. Screening and data charting followed the PRISMA-ScR framework using JBI data extraction and critical appraisal tools. Data were synthesized thematically by collaboration model, outcomes, and influencing factors. Results: Nine studies met the inclusion criteria. Integrating dental professionals into healthcare teams improved patient outcomes, quality of life, and satisfaction. Effective models included nurse practitioner–dentist partnerships and medical–dental collaboration in pediatrics and chronic disease care. Barriers included poor communication, lack of interoperable electronic health records, role ambiguity, and limited interprofessional training. Key facilitators were supportive policies, integrated care structures, professional education, and strong team communication. Conclusions: Integrating dentists into interprofessional teams enhances healthcare delivery and patient outcomes. However, significant barriers remain. Addressing communication gaps, implementing shared health records, and expanding interprofessional education are essential steps toward more cohesive care. Future research should evaluate scalable integration frameworks and incorporate patient perspectives to inform team-based care. Full article

The development of bioactive dental materials with antimicrobial and biocompatible properties is important for improving clinical outcomes and reducing complications associated with intraoral devices. This study presents a novel approach that combines a 3D-printed shape-memory resin (TC-85DAC) with green-synthesized zinc oxide nanoparticles (ZnO NPs) to enhance biological performance. ZnO NPs were synthesized using Dysphania ambrosioides extract, producing quasi-spherical particles with a crystalline hexagonal structure and sizes between 15 and 40 nm. Resin discs were coated with ZnO NPs at 10%, 20%, and 30%, then assessed for biocompatibility with human gingival fibroblasts and antibacterial activity against Porphyromonas gingivalis and Streptococcus mutans. Surface roughness was also considered with and without ZnO NPs. Biocompatibility assays revealed a concentration- and time-dependent increase in cell viability, with the highest values at 30% ZnO NPs after 72 h of exposure to the NPs. Antibacterial testing confirmed the inhibition of both species, with Porphyromonas gingivalis showing greater sensitivity. Surface roughness increased with higher ZnO NPs concentrations, significantly influencing biological interactions. The integration of green-synthesized ZnO NPs with shape-memory resin produced a multifunctional dental material with improved bioactivity. This sustainable strategy enables bioactive coatings on 3D-printed resins, with potential applications in the next generation of smart dental devices. Full article

Objectives: This systematic review aimed to evaluate the association between oral health—particularly dental caries and dysbiosis of the oral microbiome—and respiratory diseases across different age groups and clinical settings, with emphasis on microbial overlap, clinical outcomes, and preventive strategies. Methods: A systematic search was conducted in PubMed, Scopus, Embase, Web of Science, and the Cochrane Library up to June 2025. Eligible studies included randomized controlled trials, cohort, case–control, and cross-sectional investigations examining the relationship between oral diseases or microbiome alterations and respiratory outcomes. Data on study design, population, oral health parameters, microbial taxa, and respiratory endpoints were extracted. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT, 2018). Results: Twenty studies met the inclusion criteria, encompassing pediatric, adult, and elderly populations. Poor oral health, reflected by higher caries indices and periodontal inflammation, was consistently associated with increased risk of lower respiratory tract infections (LRTI), aspiration events, ventilator-associated pneumonia (VAP), and impaired pulmonary function. Oral microbiome analyses revealed enrichment of Veillonella, Prevotella, Klebsiella, and Pseudomonas species in both oral and airway samples, supporting the oral cavity as a reservoir for respiratory pathogens. Interventional evidence from intensive care and nursing home settings demonstrated that structured oral care—particularly daily toothbrushing and chlorhexidine-based plaque control—significantly reduced pneumonia incidence. Conclusions: This review confirms a clinically relevant and biologically plausible link between oral dysbiosis, dental caries, and respiratory disease. Oral biofilms contribute to infection risk through microaspiration and microbial seeding of the lower airways. Integrating oral screening, hygiene maintenance, and treatment of active oral disease into respiratory care pathways may reduce respiratory morbidity and mortality, particularly among high-risk populations such as ICU patients, older adults, and individuals with chronic lung disease. Full article

Objective: The aim of this study was to evaluate surface roughness (R_a) and microbial adhesion on four provisional prosthodontic materials in comparison to zirconium oxide. Methods: Four provisional prosthodontic restorative materials were evaluated in this study: poly methyl methacrylate (PMMA) acrylic resin (ALIKE; GC America Inc., Alsip, IL, USA), dimethacrylate (Bis-acryl) resin (Integrity; Dentsply Sirona, Charlotte, NC, USA), 3D-printed temporary crown and bridge resin (Formlabs Inc., Somerville, MA, USA), prepolymerized poly methyl methacrylate (milled PMMA) (Harvest Dental Laboratory Products, Brea, CA, USA), and zirconium oxide (Ivoclar Vivadent AG, Liechtenstein, Germany). A total of 90 samples were prepared and divided into two groups per material (treated and untreated). Provisional material samples were prepared per manufacturer’s instructions, polished with the same sequence using acrylic burs followed by Acrylipro silicone polishers (Brasseler, Savannah, GA, USA), and pumice with a goat brush. Zirconia was polished with a green grinding stone (ZR Grinders; Brassseler, Savannah, GA, USA), followed by a feather lite (Dialite ZR polisher; Brasseler, Savannah, GA, USA). The Ra of all samples was measured using a digital profilometer. Sterilized samples were incubated in Todd Hewitt yeast extract (THY) broth containing Candida albicans SC5314 and Streptococcus mutans BM71 at 37 °C under anaerobic conditions for 72 h. Subsequently, the number of colony-forming units (CFU) adhered to each sample was determined by serial dilution plating. Normality and homoscedasticity were assessed prior to statistical analysis. Welch’s ANOVA was then performed to evaluate differences among all samples, followed by Games–Howell post hoc tests for pairwise comparisons. A p < 0.05 was considered significant in all experiments. Results: Zirconia demonstrated the lowest surface roughness and significantly reduced adhesion of S. mutans and C. albicans compared to all other materials (p < 0.001). Milled PMMA exhibited significantly lower roughness and microbial adhesion than conventional PMMA (p < 0.001), with no significant difference from Printed PMMA in microbial adhesion. Additional pairwise differences were observed between Bis-acryl and PMMA (p = 0.0425), Milled and Printed PMMA (p < 0.0001), and Bis-acryl and Printed PMMA (p < 0.0001). Conclusions: Zirconia and milled PMMA showed superior surface properties and reduced microbial adhesion, supporting their use in long-term provisional restorations. Materials with higher microbial retention, such as self-curing PMMA, bis-acryl, and 3D-printed resins, may be less suitable for extended use. These findings guide material selection to improve clinical outcomes and highlight the need for further in vivo research. Full article

Background/Objectives: Dental caries, one of the most common oral diseases worldwide, represents a major public health concern. Contemporary dentistry has established several non-invasive approaches and resin infiltration, as a micro-invasive path, in the treatment of white spot lesions (WSLs). This study aimed to evaluate the effect of different WSL treatments on enamel surface microhardness. Materials and Methods: Seventy-five intact human premolars extracted upon orthodontic indication and the demineralizing solution composed of acetic acid, monopotassium phosphate and calcium chloride with pH = 4.4 and exposure time 96 h were used. The samples were randomly divided into five groups (n = 15): I—intact enamel (control group); II—artificial white spot lesion; III—artificial WSL treated with fluoride varnish; IV—artificial WSL treated with casein phosphopeptide—amorphous calcium phosphate (CPP-ACP) paste; V—resin-infiltrated artificial WSL. The surface microhardness was determined using the Oliver–Pharr method and a spherical indenter (Shimadzu Indenter, Kyoto, Japan). One-way analysis of variance (ANOVA) followed by a Post Hoc test (Bonferroni) was used with a level of significance set at p < 0.05. Results: Resin-infiltrated white spot lesions showed comparable microhardness mean value as the control group: 68.23 (±21.45) and 63.57 (±18.89), respectively (p > 0.05). Also, resin infiltration increased enamel microhardness compared to WSL values, with a statistically significant difference (p < 0.05). Fluoride varnish and CPP-ACP treatment resulted in equivalent values (50.84 ± 14.35 and 50.99 ± 15.31, respectively). Conclusions: Different WSL treatments (fluoride varnish, CPP-ACP and resin infiltration) produced comparable enamel microhardness values. Among the tested agents, resin infiltration resulted in higher microhardness values, while fluoride varnish and CPP-ACP demonstrated equivalent outcomes. Full article

Dental caries is a major global health concern, with Streptococcus mutans playing a key role in biofilm formation and acid production, which lead to enamel demineralization. Natural products, particularly plant-derived extracts, offer promising alternatives to conventional antibacterial agents. This study aimed to analyze the chemical composition of Ferula varia 70% ethanol extract (FVE) and evaluate its potential to inhibit biofilm formation by S. mutans. The aerial parts of F. varia were extracted with 70% ethanol and analyzed using LC-UV-ESI-MS/MS to determine the chemical profile. The anti-biofilm activity of FVE was evaluated using a crystal violet assay against S. mutans. Phytochemical analysis identified 14 compounds, including major phenolic acids (e.g., chlorogenic acid, gallic acid) and flavonoids (e.g., isoquercitrin, isorhamnetin-3-O-glucoside). FVE exhibited significant, dose-dependent inhibition of S. mutans biofilm formation. Importantly, the FVE concentration of 5 mg/mL inhibited S. mutans biofilm development by 100%. The potent antibiofilm activity of FVE against S. mutans is likely due to the synergistic action of its rich content of phenolic acids and flavonoids, which possess known anti-virulence properties. These findings support the potential use of FVE as a natural ingredient in oral hygiene products to prevent dental plaque and caries. Full article

Background: This study aims to evaluate the effect of different types of platelet concentrates (autologous blood biomaterials) on the migration potential of human dental pulp stem (hDPSCs). Materials and Methods: Our team created a model of human dental pulp stem cells (hDPSCs). Various types of AB biomaterials were produced from blood samples from volunteers using the protocols presented: A-PRF+, Gel A-PRF+, and Solid PRF. The scratch wound healing assay was used to examine the closure of the experimental wounds on day 1 and day 14. The wound areas were quantified using Image J software. Statistical analysis was performed with the Kruskal–Wallis and Mann–Whitney U tests, as the data did not follow a normal distribution, which was confirmed by the Shapiro–Wilk test (p < 0.05). Results: The results demonstrate significantly faster closure of the experimental wounds on day 14 of the studied biomaterials AB: A-PRF+, Gel A-PRF+, and Solid PRF compared to the control group of cells. Gel A-PRF+ exhibited the most pronounced stimulatory effect on cell migration (p = 0.0036 vs. control), followed by Solid PRF and A-PRF+. Conclusions: The results indicate that autologous blood platelet concentrates stimulate the migration of hDPSCs in vitro. Gel A-PRF+ demonstrated the strongest effect, underscoring its potential clinical relevance for applications in tissue engineering. Full article