Clinical Oral Investigations最新文献

{"title":"Validation of 3D intraoral scanner use for detecting caries lesions around dental restorations: A diagnostic accuracy study.","authors":"Bruna Machado Fernandes, Anelise Fernandes Montagner, Sarah Arangurem Karam, Françoise Helene van de Sande, Marcos Britto Correa","doi":"10.1007/s00784-026-07226-7","DOIUrl":"10.1007/s00784-026-07226-7","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to validate the use of a 3D intraoral scanner (IOS) for detecting secondary caries lesions around restorations using image-based CARS-derived severity categories, compared with visual-tactile clinical examination.</p><p><strong>Materials and methods: </strong>A diagnostic validation study was conducted at the university clinical facilities, from July 2023 to September 2024, including adult patients with amalgam or composite resin restorations on anterior and posterior teeth. The restorations were assessed using visual-tactile clinical examination, adopted as the clinical reference standard, and IOS image-based assessment. Sensitivity, specificity, predictive values, binary-classification AUC, and clinical-IOS agreement were estimated. Confidence intervals for diagnostic accuracy measures were obtained using participant-level cluster bootstrap resampling.</p><p><strong>Results: </strong>A total of 299 restorations in 41 patients were assessed. IOS sensitivity varied, with 75% (95% CI: 66.2-82.0) at the initial lesion threshold, 40% (95% CI: 20.8-57.7) at the moderate lesion threshold, and 57.1% (95% CI: 33.3-100.0) at the severe lesion threshold. Specificity was consistently high, with 84.1% (95% CI: 78.7-89.4), 97.4% (95% CI: 95.6-99.2), and 99.7% (95% CI: 98.7-99.7) at the initial, moderate, and severe lesion thresholds, respectively. Binary-classification AUC values were 0.79 (95% CI: 0.75-0.84), 0.69 (95% CI: 0.58-0.78), and 0.78 (95% CI: 0.66-1.00) at the initial, moderate, and severe lesion thresholds, respectively. Positive predictive value was highest at the severe lesion threshold (80%), while the negative predictive value was especially high at this threshold (99%). Exact clinical-IOS agreement was 77.9%, whereas linearly weighted observed agreement was 91.1%, with a linearly weighted kappa coefficient of 0.53.</p><p><strong>Conclusions: </strong>The 3D intraoral scanner is a complementary tool for assessing secondary caries lesions, showing high specificity across lesion thresholds. Sensitivity varied according to lesion severity and was less precise at the severe threshold due to the small number of severe lesions. Future research should increase sample sizes and explore combining IOS with other diagnostic methods to improve detection, especially for moderate lesions and higher caries prevalence.</p><p><strong>Clinical relevance: </strong>Conventional IOS images may assist in documenting and assessing visible changes around restorations. Clinical interpretation should consider the observed sensitivity limitations and incorporate visual-tactile examination and radiographic assessment when indicated.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of transfer learning in predicting peri-implantitis onset from intraoral radiograph: A multi-center longitudinal retrospective study.","authors":"Muhammad H A Saleh, Luigi Nibali, Abdusalam E Alrmali, Vito Carlo Alberto Caponio, Pasquale Santamaria, Francesco Fanelli, Khrystyna Zhurakivska, Hom-Lay Wang, Giuseppe Troiano","doi":"10.1007/s00784-026-07181-3","DOIUrl":"10.1007/s00784-026-07181-3","url":null,"abstract":"<p><strong>Background: </strong>The growing application of artificial intelligence in dentistry has opened new opportunities for predicting peri-implantitis (PI) using convolutional neural networks (CNNs). Transfer learning, where knowledge from a model pre-trained on a large dataset is adapted to a new, domain-specific task, may enhance performance, particularly when medical datasets are limited. This study evaluated the ability of several pre-trained CNN architectures applied to baseline 2D intraoral radiographs to predict peri-implantitis onset.</p><p><strong>Methods: </strong>A retrospective multi-center study was conducted at the University of Michigan and King's College London. A total of 195 implants (146 from Michigan and 49 from London) placed in 108 maintained patients were included. For each implant, a baseline periapical radiograph taken up to one year after prosthetic restoration was analyzed. Five pre-trained CNN architectures (ResNet50, DenseNet, VGG16, InceptionV3, EfficientNet) were combined with four transfer learning strategies: feature extraction (hybrid and non-hybrid), partial fine-tuning (50% of layers), and full fine-tuning. Models were trained using patient-wise splits to avoid leakage, and performance was evaluated on an independent test set using accuracy, area under the ROC curve (AUC), sensitivity, and specificity.</p><p><strong>Results: </strong>All CNN architectures showed variable performance across transfer learning strategies. The non-hybrid feature extraction approach provided the most consistent discrimination, with the best models achieving AUC values between 0.74 and 0.83. InceptionV3 reached the highest AUC (0.83). Fine-tuning strategies yielded modest or low performance, with AUCs generally ranging from 0.42 to 0.69 across architectures.</p><p><strong>Conclusion: </strong>Non-hybrid feature extraction applied to pre-trained CNNs showed the most promising, though moderate, performance for predicting PI onset from baseline intraoral radiographs. These findings indicate that transfer learning may assist early risk stratification in implant dentistry, but larger prospective studies are needed before clinical adoption.</p><p><strong>Clinical relevance: </strong>Deep learning models may serve as adjunctive tools to identify implants at higher risk for future PI based on routine baseline radiographs, supporting more individualized maintenance protocols and earlier preventive interventions.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulpotomy of deciduous molars with deep caries using three different hydraulic calcium silicate cements: a short-term pilot randomized controlled split-mouth study.","authors":"Ulrike Urmann, Isabelle M Schenke, Karl-Anton Hiller, Wolfgang Buchalla, Katrin Bekes, Matthias Widbiller, Frederike Schenke, Fabian Cieplik, Konstantin J Scholz","doi":"10.1007/s00784-026-07116-y","DOIUrl":"10.1007/s00784-026-07116-y","url":null,"abstract":"<p><strong>Objectives: </strong>This randomized, controlled split-mouth study evaluated the short-term clinical survival of three hydraulic calcium silicate cements for pulp capping after pulpotomy in primary molars under general anesthesia.</p><p><strong>Materials and methods: </strong>Thirty-three children aged 2 to 6 years, each with three carious primary molars (ICDAS 4-6), were recruited for treatment under general anesthesia. Following pulpotomy, the pulp was randomly covered with one of the materials: ProRoot MTA (Dentsply Sirona), Biodentine (Septodont), or TotalFill BC RRM Putty (FKG). The teeth were restored with steel crowns. Clinical survival rate at 5 and 10 months, application time, treatment costs and oral health-related quality of life (OHRQoL) were evaluated using the ECOHIS-G questionnaire. Data analysis was performed using non-parametric methods (α = 0.05).</p><p><strong>Results: </strong>All 84 treated teeth remained in situ for up to 10 months without clinical symptoms. TotalFill BC RRM Putty had the significantly shortest application time (median 75.5 s; p ≤ 0.001) compared to Biodentine (259 s) and ProRoot MTA (200.5 s). Biodentine resulted in the significantly lowest treatment cost (median €42.45; p ≤ 0.001), ProRoot MTA in the highest (€74.37; TotalFill BC RRM Putty: €60.01). The treatments generally led to improved OHRQoL (Median ECOHIS-G score: initial 5, after 5 months 4, after 10 months 2.5).</p><p><strong>Conclusions: </strong>All investigated hydraulic calcium silicate cements showed no differences in short-term clinical outcomes after pulpotomy in primary molars.</p><p><strong>Clinical relevance: </strong>Material selection may therefore be guided by practical factors such as handling time and treatment costs, while long-term outcomes, which require further investigations, should be considered. German Clinical Trials Registry: Ref. DRKS00030041.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and ultrasonographic assessment of periodontal tissue response during the early fixed-retention phase: A prospective cohort study.","authors":"Metehan Ozdemir, Sefa Aydindogan, Zehra Ileri","doi":"10.1007/s00784-026-07225-8","DOIUrl":"10.1007/s00784-026-07225-8","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate periodontal hard- and soft-tissue changes during the early fixed-retention phase after orthodontic treatment using high-frequency intraoral ultrasonography, with a focus on post-treatment sagittal tooth inclination.</p><p><strong>Methods: </strong>In this prospective cohort study, 53 systemically healthy participants who had completed fixed orthodontic treatment within the preceding week were followed for 6 months. Overall, 636 anterior teeth were categorized as maxillary retroclination (U-Ret), maxillary proclination (U-Pro), mandibular retroclination (L-Ret) and mandibular proclination (L-Pro). Clinical periodontal parameters and ultrasonographic measurements were recorded at baseline, 3 months, and 6 months. Ultrasound outcomes included marginal bone level (MBL), marginal bone thickness (MBT), supracrestal tissue height (STH), and gingival thickness at 1 (GT1) and 2 mm (GT2) apical to the free gingival margin. Data were analyzed using linear and generalized linear mixed-effects models.</p><p><strong>Results: </strong>Plaque index, gingival index, and bleeding on probing generally decreased, while probing depth remained stable. From baseline to 6 months, keratinized tissue width decreased significantly in proclination groups and increased in retroclination groups (p<0.001). In contrast, ultrasonography detected inclination-dependent structural changes. U-Pro and L-Pro groups showed significant reductions in MBT, GT1, and GT2 over 6 months (p<0.001), while L-Ret demonstrated significant increases in MBT and GT (p<0.001). MBL remained stable across all groups.</p><p><strong>Conclusions: </strong>The early fixed-retention phase may appear clinically stable while showing measurable buccal tissue changes, particularly around proclined teeth with a thin phenotype.</p><p><strong>Clinical relevance: </strong>Intraoral ultrasonography may help clinicians monitor subtle periodontal hard- and soft-tissue adaptations during orthodontic retention. (Clinical Trial Registration Number: NCT07414264).</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Stafne bone defect: a systematic review.","authors":"Thomas Laidin, Francesca Mangione","doi":"10.1007/s00784-026-07212-z","DOIUrl":"10.1007/s00784-026-07212-z","url":null,"abstract":"<p><strong>Objectives: </strong>Atypically located Stafne bone defects (SBDs) may be challenging to identify because they deviate from the typical posterior mandibular presentation. This systematic review aims to analyze and synthesize the radiographic, anatomical, and histological characteristics of atypically located SBDs reported in the literature and to assist clinicians in orienting the diagnostic hypothesis.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was conducted in the PubMed, Scopus, Embase, and Web of Science databases up to January 2026. Eligibility criteria included English-language case reports and case series describing atypically located Stafne bone defects (SBDs). Study selection, data extraction, and quality assessment were performed independently by two reviewers using an adapted assessment tool for case reports.</p><p><strong>Results: </strong>Seventy studies encompassing 91 atypical cases were included. Atypically located SBDs were most frequently reported in the anterior mandible. Despite their variable localization, these defects share key anatomical and radiographic features with classical SBDs, including well-defined unilocular radiolucencies and lingual cortical depressions. Advanced imaging modalities, particularly cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI), play an important role in confirming these features and in orienting the diagnostic hypothesis. Histological analysis, when available, most commonly revealed normal salivary gland tissue without evidence of neoplastic transformation.</p><p><strong>Conclusions: </strong>Atypically located SBDs demonstrate consistent radiographic and anatomical characteristics that may assist clinicians in orienting the diagnostic hypothesis. This review improves the understanding of this under-recognized anatomical variant and highlights the importance of appropriate imaging evaluation in ambiguous cases.</p><p><strong>Clinical relevance: </strong>Recognition of these features may facilitate accurate diagnosis and help avoid unnecessary invasive procedures.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From bioactivity to biofunctional restorative materials: reappraising terminology and evidence.","authors":"Gabriela De Alencar Pinto Magalhães, Franklin R Tay","doi":"10.1007/s00784-026-07216-9","DOIUrl":"https://doi.org/10.1007/s00784-026-07216-9","url":null,"abstract":"<p><strong>Objectives: </strong>To critically appraise use of the term bioactivity in restorative dentistry and to propose a framework that aligns terminology with biological context, demonstrated mechanism, evidence level, and clinical relevance.</p><p><strong>Methods: </strong>This narrative review examined conceptual papers, policy statements, standards, review articles, laboratory evidence, and clinical syntheses on restorative materials carrying bioactive claims. The Hench definition, the Fédération Dentaire Internationale (FDI) Policy Statement, and the scope of International Organization for Standardization (ISO) 23,317 were compared with conditions at enamel, dentine, and pulp interfaces. Claimed mechanisms and validation methods were organised within a five-tier framework.</p><p><strong>Results: </strong>In the Hench formulation, bioactivity is an interfacial outcome in which a specific host response culminates in a stable bond between a material and living tissue. Ion exchange and apatite precipitation can be mechanistic precursors, but they do not establish that endpoint. Most direct restorative materials act at enamel, dentine, or oral-fluid interfaces and should be described by their demonstrated functions. Biofunctional restorative material is proposed as an umbrella designation for intentional, mechanism-specific chemical or biological functions beyond structural restoration. Evidence is dominated by laboratory studies, and consistent clinical superiority over conventional materials has not been demonstrated. The five-tier framework separates restorative performance, defined mechanism, functional challenge testing, biological validation, and clinical translation.</p><p><strong>Conclusions: </strong>Bioactivity should be reserved for applications in which Hench-type tissue bonding or integration is demonstrated, not inferred from ion release or apatite precipitation in simulated body fluid. Biofunctionality more accurately describes the wider restorative domain and permits claims to be matched to mechanism and evidence.</p><p><strong>Clinical significance: </strong>The FDI Policy Statement places conditions on use of the term bioactive but does not require that ion-releasing or mineral-precipitating restorative materials carry that label. ISO 23,317 is an initial screening method for bone-contacting implant materials, not a nomenclature standard for dentine-targeted restoratives. Application-qualified biofunctional terminology may improve claim accuracy, product evaluation, and clinical communication.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An oxygen-releasing mouthwash shows species-dependent antibacterial and antibiofilm activity against periodontal pathogens.","authors":"Fatemah M AlAhmari, Rhodanne Nicole A Lambarte, Terrence S Sumague, Mary Grace B Vigilla, Marwa Y Shaheen, Sumaiah Ajlan, Lamees Alssum, Amani M Basudan, Abdurahman A Niazy","doi":"10.1007/s00784-026-07203-0","DOIUrl":"10.1007/s00784-026-07203-0","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated whether an oxygen-releasing mouthwash formulation (O₂MW) produces species-dependent antibacterial, antibiofilm, and gene expression responses in Aggregatibacter actinomycetemcomitans and Prevotella intermedia compared with 0.12% chlorhexidine under planktonic and biofilm conditions in vitro.</p><p><strong>Materials and methods: </strong>Minimum inhibitory concentrations (MICs) were determined using a resazurin-based broth microdilution, and minimum bactericidal concentration (MBC) by agar subculture. Agar diffusion assessed growth inhibition. Biofilm biomass was quantified using crystal violet staining, while pre-formed biofilm structure and membrane integrity were examined by confocal laser scanning microscopy (CLSM). Quantitative PCR assessed adhesion-, toxin-, oxidative-stress-, and iron-associated genes. Molecular docking used sodium perborate as a representative oxygen-releasing constituent.</p><p><strong>Results: </strong>O₂MW MICs were 3.13% for A. actinomycetemcomitans and 50% for P. intermedia. MBC was detected only for A. actinomycetemcomitans. Agar diffusion showed inhibition zones from 0.78% O₂MW for A. actinomycetemcomitans, whereas P. intermedia showed zones only at 50% and 100% O₂MW. O₂MW reduced biofilm biomass, with minimum biofilm inhibitory concentration (MBIC) values of 1.56% and 25%, respectively. CLSM showed reduced biomass and thickness at higher concentrations. Sub-MIC O₂MW increased expression of adhesion- and virulence-associated genes, particularly ltxA in A. actinomycetemcomitans and oxidative-stress and iron-associated genes, including ahpF, ftnA, and feoB in P. intermedia. Docking suggested pathway-level involvement only.</p><p><strong>Conclusions: </strong>O₂MW showed species-dependent antibacterial and antibiofilm activity, with greater effects at lower concentrations against A. actinomycetemcomitans. The findings support further preclinical and host-cell evaluation before clinical translation.</p><p><strong>Clinical relevance: </strong>O₂MW may have potential as an adjunct for periodontal biofilm control, but pathogen-specific responses warrant further evaluation.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal assessment of age-related changes in antegonial notch depth in untreated individuals.","authors":"Mohamad Rustom, Balazs J Denes, Stavros Kiliaridis, Gregory S Antonarakis","doi":"10.1007/s00784-026-07154-6","DOIUrl":"10.1007/s00784-026-07154-6","url":null,"abstract":"<p><strong>Introduction: </strong>The role of the antegonial notch as an indicator of growth remains controversial in the literature. This study examined how antegonial notch depth changes during growth and whether craniofacial morphology is associated with its depth.</p><p><strong>Methods: </strong>A longitudinal sample of 250 untreated healthy individuals (42% female) from the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection was analysed at three time points: ages 7-8, 13-14, and 17-18 years. Antegonial notch depth was measured from standardized lateral cephalograms. Multilevel general linear regression was applied to evaluate whether skeletal morphology could predict antegonial notch depth.</p><p><strong>Results: </strong>Antegonial notch depth changed significantly over time (p < 0.001) with a medium effect size. Males consistently had deeper notches than females. Sagittal molar relationships showed no significant influence on notch depth. Multilevel modelling revealed that only the gonial angle was a statistically significant predictor of notch depth (B = - 0.014, p = 0.044), with deeper antegonial notches being measured in individuals with smaller gonial angles, while the intermaxillary angle showed no significant association (p = 0.064). Neither ANB nor the mandibular plane angle had any significant predictive value on antegonial notch depth.</p><p><strong>Conclusion: </strong>Antegonial notch depth undergoes modest sex-specific changes during adolescence and is minimally associated with craniofacial morphology. Only the gonial angle was a significant predictor (deeper notches in mandibles with smaller gonial angles), suggesting that notch depth primarily reflects localized bone remodelling.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and external validation of an AI pipeline for automated estimation of a radiographic DMFT (rDMFT) score from panoramic radiographs: a feasibility study.","authors":"Babak Saravi, Veronika Shavlokhova, Ashraf Türky, Daman Deep Singh, Felix Schrader, Andreas Vollmer, Norbert Kübler, Christoph Sproll, Lara Schorn","doi":"10.1007/s00784-026-07214-x","DOIUrl":"10.1007/s00784-026-07214-x","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the feasibility of estimating a radiographic Decayed-Missing-Filled-Teeth score (rDMFT), a proxy for the clinical DMFT index, from a single panoramic radiograph with a position-aware deep-learning pipeline.</p><p><strong>Materials and methods: </strong>A tooth-status detector and a tooth-numbering detector (32 FDI positions), trained on DENTEX 2023, were combined in a position-aware read-out (one tooth per FDI position, third molars excluded, missing teeth = 28 - occupied positions) and validated on 100 panoramic radiographs from an independent hospital against a two-dentist, radiograph-based reference (intraclass correlation coefficient, ICC; mean absolute error, MAE; Bland-Altman analysis).</p><p><strong>Results: </strong>Against the reference, the pipeline reached an ICC of 0.84 (95% CI 0.74 to 0.90) and an MAE of 2.38, below the between-dentist agreement in point estimate (ICC 0.88, MAE 2.13), with larger errors against each dentist alone (MAE 3.00 and 2.73) and a bias of + 1.14 units from caries over-detection; agreement was highest for filled (r 0.90) and lowest for decayed teeth (r 0.34; dentists 0.16). In the 26 radiographs with missing teeth the missing count was exact in 42% (62% within ± 1 tooth), and missing teeth were over-called in 15 of 74 complete dentitions; tooth loss was no longer overlooked (26 of 26 detected), but the overall ICC was 0.84 versus 0.90 without numbering.</p><p><strong>Conclusions: </strong>Automated rDMFT estimation is feasible, but agreement was lower in point estimate than between two dentists, with larger errors against each dentist. The missing component now responds to actual tooth loss but remains imprecise and is over-called in some complete dentitions; the decayed component is unreliable. The pipeline is a research building block, not a decision-support or triage tool.</p><p><strong>Clinical relevance: </strong>rDMFT is a radiographic proxy, not a clinical measure, and the pipeline is not proposed for clinical use; any application would first require validation in unselected cohorts against clinically determined reference standards.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histological effects of chitosan, chitosan-carried hyaluronic acid, and photobiomodulation on palatal wound healing in rats: an in vivo study.","authors":"Nasrin Esfahanizadeh, Mahsa Soleimani, Sobhan Ghaemi, Pejman Mortazavi, Hesam Aldin Hoseinzadeh, Neda Hakimiha, Hooman Hatami, Seyed Ali Mosaddad","doi":"10.1007/s00784-026-07221-y","DOIUrl":"https://doi.org/10.1007/s00784-026-07221-y","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the histological effects of topical chitosan (CS), a hyaluronic acid-chitosan gel (HA/CS), and photobiomodulation (PBM) on palatal wound healing in rats.</p><p><strong>Methods: </strong>Sixty male Wistar rats were randomized to control, CS, HA/CS, or PBM groups (n = 15/group). Standardized 5-mm full-thickness palatal wounds were created. Gels were applied three times daily; PBM (660 nm, 150 mW, 4.2 J/cm², 14 s) was administered on days 0, 1, 3, 5, 7, 10, and 13. Five independent animals/group were assessed on days 3, 7, and 14. The animal was the experimental unit, and re-epithelialization was the prespecified primary outcome. Ordinal scores were compared at each endpoint using Kruskal-Wallis and Bonferroni-adjusted Dunn tests.</p><p><strong>Results: </strong>HA/CS had higher re-epithelialization scores than control on days 3 (adjusted p = 0.003) and 7 (adjusted p = 0.024), and than PBM on day 3 (adjusted p = 0.015). PBM exceeded control on day 7 (adjusted p = 0.024). All day-14 animals had the maximum epithelial score. HA/CS had higher fibroblast scores than control on day 3; all interventions had higher fibroblast and angiogenesis scores than control on days 7 and 14. Collagen scores exceeded control with CS and HA/CS on day 3 and HA/CS on days 7 and 14.</p><p><strong>Conclusions: </strong>The tested HA/CS formulation showed favorable early epithelial and selected stromal findings. Day-14 epithelial scores showed a ceiling effect. HA-specific effects and HA-CS synergy cannot be established.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"30 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}