Search Results (152)

Artificial Intelligence, especially Convolutional Neural Networks (CNN), is gaining importance in health sciences, including forensic odontology. This study aimed to systematically analyze elements for automated dental status registration on OPGs using CNNs, on different image segments and resolutions. A dataset of 1400 manually annotated digital OPGs was divided into train, test, and validation sets (75%–12.5%–12.5%). Pre-trained and from-scratch models were developed and evaluated on images from full OPGs to individual and segmented teeth and sizes from 256 px to 1820 px. Performance was measured by Sørensen–Dice coefficient for segmentation and mean average precision (mAP) for detection. For segmentation, the UNet Big model was the most successful, using segmented or individual images, achieving 89.14% for crown and 84.90% for fillings, and UNet with 79.09% for root canal fillings. Caries presented a significant challenge, with the UNet model achieving the highest score of 64.68%. In detection, YOLOv5x6, trained from scratch, achieved the highest mAP of 98.02% on 1820 px images. Larger image resolutions and individual tooth inputs significantly improved performance. This study confirms the success of CNN models in specific tasks on OPGs. Image quality and input (individual tooth, resolutions above 640 px) critically influenced model competence. Further research with from-scratch models, higher resolutions, and smaller image segments is recommended. Full article

Objectives: The aim of this study was to evaluate the performance of GPT-4o in identifying nine common dental conditions on panoramic radiographs, both overall and at specific tooth sites, and to assess whether the use of different tooth numbering systems (FDI and Universal) in prompts would affect its diagnostic accuracy. Methods: Fifty panoramic radiographs exhibiting various common dental conditions including missing teeth, impacted teeth, caries, endodontically treated teeth, teeth with restorations, periapical lesions, periodontal bone loss, tooth fractures, cracks, retained roots, dental implants, osteolytic lesions, and osteosclerosis were included. Each image was evaluated twice by GPT-4o in May 2025, using structured prompts based on either the FDI or Universal tooth numbering system, to identify the presence of these conditions at specific tooth sites or regions. GPT-4o responses were compared to a consensus reference standard established by an oral-maxillofacial radiology team. GPT-4o’s performance was evaluated using balanced accuracy, sensitivity, specificity, and F1 score both at the patient and tooth levels. Results: A total of 100 GPT-4o responses were generated. At the patient level, balanced accuracy ranged from 46.25% to 98.83% (FDI) and 49.75% to 92.86% (Universal), with the highest accuracies for dental implants (92.86–98.83%). F1-scores and sensitivities were highest for implants, missing, and impacted teeth, but zero for caries, periapical lesions, and fractures. Specificity was generally high across conditions. Notable discrepancies were observed between patient- and tooth-level performance, especially for implants and restorations. GPT-4o’s performance was similar between using the two numbering systems. Conclusions: GPT-4o demonstrated superior performance in detecting dental implants and treated or restored teeth but inferior performance for caries, periapical lesions, and fractures. Diagnostic accuracy was higher at the patient level than at the tooth level, with similar performances for both numbering systems. Future studies with larger, more diverse datasets and multiple models are needed. Full article

Background/Objectives: This retrospective observational study evaluated associations among dentition type, age, systemic conditions, and oral pathology in pediatric patients. Methods: A six-month retrospective analysis was conducted in a specialized pediatric hospital. Patients (n = 155; 0–18 years) were grouped as clinically healthy with oro-maxillofacial diseases or with systemic diseases. Data included dental/periodontal status, anomalies, gingival bleeding index, IOTN score and oral mucosal conditions. Statistical tests (chi-square, ANOVA, and correlations) were applied. Results: Chronic gingivitis was most frequently associated with primary dentition. Caries and root debris were more frequent in ages 4–6, while acute gingivitis appeared in younger children. Orthodontic treatment need increased with age, especially in mixed dentition. Periodontal diseases were most often linked to digestive pathologies. Conclusions: Oral health in children showed associations with age, dentition type, and systemic conditions. Findings highlight associations rather than causation, underscoring the importance of prevention, early monitoring, and age-appropriate interdisciplinary management. Full article

Background. Orthodontic extrusion (OE), or forced eruption, is a conservative technique used to recover teeth affected by coronal fractures, traumatic intrusions, or severe caries. It involves applying light, continuous forces to induce vertical tooth movement, promoting tissue remodeling through periodontal ligament stimulation. Materials and Methods. This narrative review included studies investigating OE as a therapeutic approach for the management of deep or subgingival carious lesions, traumatic dental injuries (such as intrusion or fracture), or for alveolar ridge augmentation in implant site development. OE is typically performed using fixed appliances such as the straight-wire system or, in selected cases, clear aligners. Forces between 30 and 100 g per tooth are applied, depending on the clinical situation. In some protocols, OE is combined with fiberotomy to minimize gingival and bone migration. Results. Studies show that OE leads to significant vertical movement and increases in buccal bone height and interproximal septa. It enhances bone volume in targeted sites, making it valuable in implant site development. Compared to surgical crown lengthening, OE better preserves periodontal tissues and improves esthetics. Conclusions. In this narrative review is analized how OE is effective for managing traumatic intrusions and compromised periodontal sites, particularly when paired with early endodontic treatment. It reduces the risks of ankylosis and root resorption while avoiding invasive procedures like grafting. Although clear aligners may limit axial tooth movement, OE remains a minimally invasive, cost-effective alternative in both restorative and implant dentistry. Full article

Background/Objectives: Dental caries is the most prevalent oral condition worldwide. Consequences of untreated dental caries (CUDC) can range from pulp damage and soft tissue ulceration due to root debris to more severe issues, such as fistulas and abscesses. Rural communities might be more vulnerable to CUDC because of lower socioeconomic status, poorer access to healthcare, and lower education levels. The objective of this study was to evaluate and compare the prevalence of CUDC in rural and urban areas in schoolchildren aged 8 to 12 years in the State of Mexico. Methods: A cross-sectional study was conducted using the PUFA index, considering the presence of pulp involvement (P), soft tissue ulcerations due to root remnants (U), fistulas (F), and abscesses (A). The independent variable was the geographic area (rural or urban), and the covariates were nutritional status, hyposalivation, having one’s own toothbrush, and having received topical fluoride in the last year. Logistic regression models were fitted, calculating odds ratios (ORs) and 95% confidence intervals (CIs). Results: The prevalence of CUDC (PUFA > 0) was 42.9% in rural areas and 25.9% in urban areas. Residing in a rural area (OR: 2.15, 95% CI 1.38–3.34, p = 0.001), hyposalivation (OR: 1.93, 95% CI 1.11–3.37, p = 0.020), and professional fluoride application (OR: 0.15, 95% CI 0.07–0.32, p < 0.001) were associated with the prevalence of CUDC. Conclusions: To prevent caries and its clinical consequences due to the lack of treatment, it is important to promote timely care seeking and access to dental care services, considering the conditions of each geographic area. Full article

Background/Objectives: The diagnosis of pediatric dental conditions from panoramic radiographs is uniquely challenging due to the dynamic nature of the mixed dentition phase, which can lead to subjective and inconsistent interpretations. This study aims to develop and rigorously validate an advanced deep learning model to enhance diagnostic accuracy and efficiency in pediatric dentistry, providing an objective tool to support clinical decision-making. Methods: An initial comparative study of four state-of-the-art YOLO variants (YOLOv8, v9, v10, and v11) was conducted to identify the optimal architecture for detecting four common findings: Dental Caries, Deciduous Tooth, Root Canal Treatment, and Pulpotomy. A stringent two-tiered validation strategy was employed: a primary public dataset (n = 644 images) was used for training and model selection, while a completely independent external dataset (n = 150 images) was used for final testing. All annotations were validated by a dual-expert team comprising a board-certified pediatric dentist and an experienced oral and maxillofacial radiologist. Results: Based on its leading performance on the internal validation set, YOLOv11x was selected as the optimal model, achieving a mean Average Precision (mAP50) of 0.91. When evaluated on the independent external test set, the model demonstrated robust generalization, achieving an overall F1-Score of 0.81 and a mAP50 of 0.82. It yielded clinically valuable recall rates for therapeutic interventions (Root Canal Treatment: 88%; Pulpotomy: 86%) and other conditions (Deciduous Tooth: 84%; Dental Caries: 79%). Conclusions: Validated through a rigorous dual-dataset and dual-expert process, the YOLOv11x model demonstrates its potential as an accurate and reliable tool for automated detection in pediatric panoramic radiographs. This work suggests that such AI-driven systems can serve as valuable assistive tools for clinicians by supporting diagnostic workflows and contributing to the consistent detection of common dental findings in pediatric patients. Full article

Background: Childhood cancer is considered one of the main causes of mortality and morbidity worldwide. There is strong evidence of the oral toxic effects of oncologic treatments, but their incidence is difficult to determine. The novel therapeutic strategies in Pediatric Oncology have led to increased survival in this population, resulting in an increased incidence of long-term effects, which diminish the patient’s quality of life. Methods: The search for articles started on 5 November 2024 and ended on 5 December 2024. Following the PRISMA Statement, a total of 1266 articles were obtained, from which 13 were selected for review. All articles were considered to be of high quality. The antineoplastic treatments used in them were chemotherapy, radiotherapy, surgery and immune therapy. Results: Most articles were cohorts and case controls. Only one case report was obtained. The results revealed that the most prevalent sequelae in the pediatric population after antineoplastic treatment were enamel alterations, microdontia, dental caries, periodontal disease, gingivitis, hyposalivation, alteration of the oral microbiome, alteration of mandibular bone density and malocclusion. The lesions are different depending on the therapy used. Conclusions: Oncologic treatments in children with cancer cause multiple oral sequelae such as microdontia, dental caries, enamel alterations, salivary gland alterations, mucositis and root resorption. It cannot be concluded which therapy has the most detrimental effect as each has a different mechanism of action in the oral cavity. Full article

Background: Gingival recession is a common condition involving apical displacement of the gingival margin, leading to root surface exposure and associated complications such as dentin hypersensitivity and root caries. Among the most effective treatment options are the tunneling technique (TUN) and the coronally advanced flap (CAF), both combined with connective tissue grafts (CTGs). This study aimed to evaluate and compare the clinical outcomes of TUN + CTG and CAF + CTG in terms of root coverage and keratinized tissue width (KTW) over a 6–12-month follow-up. Methods: A randomized, double-blind clinical trial was conducted following CONSORT guidelines (ClinicalTrials.gov ID: NCT06228534). Participants were randomly assigned to receive either TUN + CTG or CAF + CTG. Clinical parameters, including gingival recession depth (REC) and KTW, were assessed at baseline as well as 6 months and 12 months postoperatively using a calibrated periodontal probe. Statistical analysis was performed using descriptive statistics and linear mixed models to compare outcomes over time, with a significance level set at 5%. Results: Both techniques demonstrated significant clinical improvements. At 6 months, mean root coverage was 100% in CAF + CTG cases and 97% in TUN + CTG cases, while complete root coverage (REC = 0) was observed in 100% and 89% of cases, respectively. At 12 months, root coverage remained stable, at 99% in the CAF + CTG group and 97% in the TUN + CTG group. KTW increased in both groups, with higher values observed in the CAF + CTG group (3.53 mm vs. 3.11 mm in TUN + CTG at 12 months). No significant postoperative complications were reported. Conclusions: Both TUN + CTG and CAF + CTG are safe and effective techniques for treating RT1 and RT2 gingival recession, offering high percentages of root coverage and increased KTW. While CAF + CTG achieved slightly superior coverage and tissue gain, the TUN was associated with better aesthetic outcomes and faster recovery, making it a valuable alternative in clinical practice. Full article

Root caries is a form of decay affecting root surfaces of teeth, often exacerbated by periodontal disease, reduced salivary flow, and compromised mucosal health, all factors strongly influenced by nutrition. Despite this connection, few studies have addressed the role of vitamins in oral health. This study examines the association between serum levels of alpha-carotene (α-carotene), a potent antioxidant and proxy for vitamin A, and the experience of root caries. Using data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES), we conducted a cross-sectional analysis and applied a weighted multiple logistic regression model, adjusting for potential confounders including age, sex, education level, race, income-to-poverty ratio, and presence of gum disease. Higher serum α-carotene levels were inversely associated with root caries. Each unit increase in serum α-carotene was associated with a 9% decrease in the odds of having root caries (OR = 0.91; 95% CI: 0.86–0.97; p = 0.004). In this nationally representative sample of U.S. adults, lower serum α-carotene levels were associated with a higher prevalence of root caries. These findings highlight the potential role of nutritional assessment and integration in oral health. Longitudinal and mechanistic studies are needed to confirm and further explore α-carotene’s effects on oral health. Full article

Dental caries can cause premature loss of deciduous teeth, affecting children’s growth and development. Endodontic treatment using polymer posts is an effective solution. This study explores biodegradable root canal posts made from Polylactic Acid (PLA), Polycaprolactone (PCL), and amorphous calcium phosphate (ACP), aiming to enhance mechanical properties, minimize polymer degradation acidity, and prevent inflammation. A root canal post with a spherical head and serrated structure was designed and produced via micromolding and optimized using the Taguchi experimental method. The melt temperature, injection speed, and holding speed were analyzed for their influence on shrinkage, revealing an optimal rate of 2.575%, representing the sum of axial and radial shrinkage. The melt temperature had the highest impact (55.932%), followed by holding speed (33.575%), with there being minimal effect from injection speed. The composite exhibited a flexural strength of 21.936 MPa, a modulus of 2.083 GPa, and a hydrophilic contact angle of 73.73 degrees. Cell survival tests confirmed biocompatibility, with a survival rate exceeding 70% and no toxicity. These findings highlight the potential of PLA/PCL/ACP composites, combined with injection molding, for developing biodegradable root canal posts in primary teeth. Full article

Background: AI has been adopted in dentistry for diagnosis, decision making, and therapy prognosis prediction. This systematic review aimed to identify AI models in dentistry, assess their performance, identify their shortcomings, and discuss their potential for adoption and integration in dental practice in the future. Methodology: The sources of the papers were the following electronic databases: PubMed, Scopus, and Cochrane Library. A total of 20 out of 947 needed further studies, and this was encompassed in the present meta-analysis. It identified diagnostic accuracy, predictive performance, and potential biases. Results: AI models demonstrated an overall diagnostic accuracy of 82%, primarily leveraging artificial neural networks (ANNs) and convolutional neural networks (CNNs). These models have significantly improved the diagnostic precision for dental caries compared with traditional methods. Moreover, they have shown potential in detecting and managing conditions such as bone loss, malignant lesions, vertical root fractures, apical lesions, salivary gland disorders, and maxillofacial cysts, as well as in performing orthodontic assessments. However, the integration of AI systems into dentistry poses challenges, including potential data biases, cost implications, technical requirements, and ethical concerns such as patient data security and informed consent. AI models may also underperform when faced with limited or skewed datasets, thus underscoring the importance of robust training and validation procedures. Conclusions: AI has the potential to revolutionize dentistry by significantly improving diagnostic accuracy and treatment planning. However, before integrating this tool into clinical practice, a critical assessment of its advantages, disadvantages, and utility or ethical issues must be established. Future studies should aim to eradicate existing barriers and enhance the model’s ease of understanding and challenges regarding expense and data protection, to ensure the effective utilization of AI in dental healthcare. Full article

Pediatric dentistry continually seeks effective and efficient treatments for young patients, especially within pediatric endodontics, where cooperation can often be challenging. This in vivo study aimed to evaluate the effectiveness of a novel photodynamic therapy (PDT) protocol using a 5-aminolevulinic acid gel (Aladent, ALAD) combined with light irradiation during the endodontic treatment of primary teeth. This study included primary teeth requiring root canal therapy due to carious lesions or trauma, with clinical symptoms suggesting irreversible pulpitis or acute apical periodontitis. Following local anesthesia and isolation with a rubber dam, carious lesions were excavated, and access to the pulp chamber was established. Canal preparation included determining the working length and using a sequence of k-files. Afterward, ALAD gel was applied, and the patients were divided into two groups based on their visit duration (Group A with a single visit, Group B returning after one week). Microbiological analysis was conducted on the samples taken before and after treatment. The findings demonstrated significant antibacterial efficacy of the PDT protocol in reducing root canal bacterial load, suggesting ALAD-based PDT may serve as an alternative to traditional endodontic treatment in cases where retaining primary teeth is essential for orthodontic or strategic reasons. Clinically, improvement in symptoms and fistula resolution were observed. Treatment time, patient compliance, and protocol safety in pediatric applications are also discussed, highlighting the protocol’s potential to enhance clinical outcomes in pediatric endodontics. Full article

Objectives: The objective of this study was to examine the relationship between multimorbidity and root caries among older American adults. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2017–2020, a cross-sectional nationally representative survey of civilian noninstitutionalised Americans was used. The analysis included dentate adults aged 50 years and older. The presence of root caries or root restoration was assessed through clinical dental examinations. Multimorbidity was identified by the existence of five common and serious chronic diseases, namely, diabetes, cancer, coronary heart disease, chronic pulmonary disease and stroke. An aggregate variable of these five conditions was created. Logistic regression models were used to assess the association between multimorbidity and root caries (outcome), adjusting for sociodemographic factors and health behaviours. Results: The analysis included 3274 dentate participants (mean age: 63.6 years), 18.2% had root caries, while 14%. had multimorbidity (two or more conditions). The mean number of multimorbidities was 0.65. The count of multimorbidity was significantly associated with root caries, with odds ratios (OR) of 1.26 (95% Confidence Interval (CI): 1.03, 1.52) in a model adjusting for age, gender, ethnicity, income, and education. After additionally adjusting for dental visits and smoking, the association between multimorbidity and root caries lost statistical significance (OR 1.20, 95% CI: 0.97, 1.48). Conclusions: Individuals with greater numbers of chronic conditions appeared to have higher probabilities of having root caries. However, the significant association was eliminated after accounting for strong behavioural predictors of root caries. The higher level of root caries among those with multimorbidity could be attributed to xerostomia caused by being on multiple medications. The findings highlight the need for interventions to prevent root caries among those with multimorbidity. Full article

Objectives: We aimed to evaluate the condition of retained primary molars in case of mandibular second premolar agenesis. Materials and Methods: In total, 2692 panoramic radiographs of adolescent patients were analyzed to determine the prevalence of tooth agenesis. Patients (N = 156) with at least one mandibular second premolar agenesis were further explored to determine the presence and condition of retained primary teeth. Teeth were classified as good or poor based on root resorption, infraocclusion, caries, and restorations. Results: The prevalence of mandibular second premolar agenesis was 5.8% (N = 156). For the set period for this study, 138 (58.5%) primary molars were present. Out of these retained teeth, N = 83 were in good condition. There was a statistically significant positive weak correlation between age and the level of root resorption (rs = 0.348, n = 138, p < 0.001). There was no association between infraocclusion and the level of root resorption (p = 0.747). Signs of infraocclusion were noted in 32 out of 138 teeth. There was no association between gender and the presence of infraocclusion (p = 0.067) and the presence or lack of infraocclusion and the therapeutic status of a tooth (p = 0.450). Only 28 out of 138 (20.3%) were intact. There was a significant difference in the level of root resorption between restored and/or carious (median = 3, IQR 2–4) and intact teeth (median = 2, IQR 1.75–3), U = 1168, p = 0.044, r = 0.242. Conclusions: Overall, 35.2% of corresponding primary molars were present in oral cavity, and were in good condition, and could potentially be preserved in the long term. Full article

Background/Objectives: Parental attitudes play a crucial role in shaping children’s oral health habits and preventing dental diseases. This study aimed to explore the theoretical pathways through which parental behavior and attitudes toward child oral health can influence the dental caries experience as measured by the dmf-t index in preschool children in Lithuania. Methods: A cross-sectional study was conducted involving 302 children aged 4–7 years and their parents (262 mothers). Parental attitudes were assessed using the Parental Attitudes Towards Child Oral Health (PACOH) scale. For the children, the following variables were considered: sex, age, dental caries experience (dmf-t index in the primary dentition), oral hygiene index (Silness–Löe Plaque Index), toothbrushing frequency, and parental assistance with toothbrushing. Structural Equation Modeling (SEM) was applied for the data analysis. Results: The main path through which parental attitudes towards child oral health influenced the dmf-t index was via toothbrushing frequency (β = −0.17) or parental assistance with toothbrushing (β = 0.24). These factors were then linked to the oral hygiene index (β = 0.20 and β = −0.47, respectively), which ultimately influenced dmf-t (β = 0.52). The parents’ attitudes and toothbrushing frequency per se had no significant effect on children’s dmf-t (β = −0.06 and β = −0.04, respectively). The final model met all goodness-of-fit criteria: Chi-square test p = 0.211, Incremental Fit Index IFI = 0.994, Tucker–Lewis Index TLI = 0.982, Comparative Fit Index CFI = 0.994, and Root Mean Square Error of Approximation RMSEA = 0.038. Conclusions: Findings from this study demonstrate that parents play a significant role in determining children’s oral health. Regular toothbrushing, parental assistance with toothbrushing, and good oral hygiene are critical factors linking parents’ oral health-related attitudes to a child’s experience of early caries. Identifying the associations between dental caries risk factors helps plan interventions. Full article