International dental journal最新文献

{"title":"Secular Trends in the Incidence, Prevalence, and Disability-Adjusted Life Years of Caries in Permanent Teeth in Six Asian Countries: 1990 to 2021","authors":"Min Deng ,&nbsp;Xihua Yuan ,&nbsp;Xiaoying Zhu ,&nbsp;Jiaqiang Wei ,&nbsp;Minsi Li ,&nbsp;Ziyi Yang ,&nbsp;Na Yu ,&nbsp;Xiaofeng Qin","doi":"10.1016/j.identj.2025.100841","DOIUrl":"10.1016/j.identj.2025.100841","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Untreated dental caries in permanent teeth is a significant public health problem, particularly in Asia. This study compared the long-term trends in the incidence, prevalence, and disability-adjusted life year (DALY) rates of untreated dental caries in permanent teeth between China, India, Japan, South Korea, Thailand, and Singapore from 1990 to 2021. This selection provides a comprehensive representation of economic, healthcare, and demographic diversity in Asia, making our findings widely applicable.</div></div><div><h3>Methods</h3><div>Data were obtained from the Global Burden of Disease Study 2021. Changes in both the annual percentage and average annual percentage were calculated using joinpoint regression analysis. Independent age, period, and cohort effects were estimated by age–period–cohort analysis.</div></div><div><h3>Results</h3><div>From 1990 to 2021, the overall age-standardized incidence rate showed an increasing trend in China, India, and Thailand and a decreasing trend in Japan, Korea, and Singapore. The standardized prevalence and DALY rates decreased among countries, with Korea having the highest prevalence rate and India and Thailand having the highest prevalence and DALY rates. On age–period–cohort analysis, (1) the 20 to 24-year age group carried the highest caries risk, which declined with increasing age (age effect); (2) an overall decreasing or flat trend was observed (period effect); and (3) Japan, Singapore, and South Korea showed increasing incidence, prevalence, and DALY rates, whereas China, India, and Thailand exhibited decreasing prevalence and DALY rates (cohort effect).</div></div><div><h3>Conclusion</h3><div>This study revealed notable regional variations in the burden of untreated dental caries in permanent teeth across Asia from 1990 to 2021. These findings provide valuable insights for policymakers and healthcare professionals to develop targeted and evidence-based oral health strategies in the region.</div></div><div><h3>Clinical Relevance</h3><div>These findings underscore the need to develop targeted oral health solutions in Asia.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100841"},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediating Effects of Systemic Inflammation on the Association Between Body Roundness Index and Periodontitis in US Adults","authors":"Hui Zhang ,&nbsp;Zhengyun Ren ,&nbsp;Xi Peng ,&nbsp;Tailin Guo","doi":"10.1016/j.identj.2025.04.012","DOIUrl":"10.1016/j.identj.2025.04.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Aim&lt;/h3&gt;&lt;div&gt;Periodontitis is a highly prevalent chronic inflammatory disease affecting periodontal tissues. While the Body Roundness Index (BRI), has emerged as a novel anthropometric measure for evaluating obesity-related health risks, its relationship with periodontal health remains unexplored. Although systemic inflammation is recognized as a key role in both obesity and periodontitis. However, whether BRI affects periodontitis, the mediating role of systemic inflammation in BRI-related periodontitis has not been elucidated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;Data were derived from the National Health and Nutrition Examination Survey (NHANES) 2009-2014, comprising 8415 participants aged ≥18 years. We analysed BRI's correlation with periodontal disease using binary logistic regression models. Restricted Cubic Spline (RCS) modelling explored nonlinear patterns. The predictive performance of BRI for periodontitis was compared with traditional anthropometric indices using Receiver Operating Characteristic (ROC) curves. Mediation models assessed how systemic inflammation (SII, SIRI) bridges the BRI-periodontitis link.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In the fully adjusted model, participants in higher BRI quartiles showed progressively increased odds of periodontitis compared with those in the lowest quartile (Q1), with odds ratios of 1.33 (95% CI: 1.07-1.65, &lt;em&gt;P&lt;/em&gt; = .010) for Q2, 1.48 (95% CI: 1.16-1.88, &lt;em&gt;P&lt;/em&gt; = .004) for Q3, and 1.70 (95% CI: 1.20-2.40, &lt;em&gt;P&lt;/em&gt; = .010) for Q4. RCS analysis indicated a linear relationship between BRI and periodontitis risk (nonlinearity &lt;em&gt;P&lt;/em&gt; = .201). ROC curves revealed that BRI demonstrated superior predictive performance for periodontitis compared to BMI. The mediation analysis indicated that SII (5.37%, 95% CI: 0.86%-15.02%, &lt;em&gt;P&lt;/em&gt; &lt; .001) and SIRI (8.92%, 95% CI: 2.73%-22.13%, &lt;em&gt;P&lt;/em&gt; &lt; .05) partially mediated the BRI-periodontitis association.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our study demonstrates that elevated BRI is positive associated with an increased risk of periodontitis. Systemic inflammation, as reflected by SII and SIRI, partially mediates this relationship.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;ClinicalRelevance&lt;/h3&gt;&lt;div&gt;Body Roundness Index (BRI), has emerged as a novel anthropometric indicator that more precisely estimates visceral adiposity and body fat percentage. Obesity, particularly the dysfunction of adipose tissue in visceral obesity, leads to the secretion of many pro-inflammatory factors, triggering systemic inflammatory responses. Systemic inflammation is recognized as a key role in both obesity and periodontitis. However, whether BRI affects periodontitis, the mediating role of systemic inflammation in BRI-related periodontitis has not been elucidated. This study supports that BRI is significantly associated with an increased risk of periodontitis, and systemic inflammation partially mediates this relationship. These ","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100832"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Carnitine Palmitoyltransferase I Isotypes in Gingival Tissues of Human Periodontitis","authors":"Yue Shen ,&nbsp;Lu Lin ,&nbsp;Weijun Yu,&nbsp;Zhurong Cui,&nbsp;Tingting Lin,&nbsp;Shucheng Hu,&nbsp;Yuanjie Shi,&nbsp;Yuting Gu,&nbsp;Min Jin,&nbsp;Eryi Lu","doi":"10.1016/j.identj.2025.100837","DOIUrl":"10.1016/j.identj.2025.100837","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Carnitine palmitoyltransferase I (CPT1), the rate-limiting enzyme of fatty acid oxidation, plays a crucial role in inflammation. However, the relation between CPT1 and periodontitis is obscure. This study aimed to reveal the expression pattern of CPT1 (CPT1A, CPT1B, CPT1C) in periodontitis and their correlation with clinical parameters.</div></div><div><h3>Methods</h3><div>The public dataset was used to identify biological processes related to lipid metabolism and validate the differential expression of CPT1 between healthy and periodontitis groups. Forty-seven healthy gingival samples and 47 periodontitis gingival samples were gathered. Subsequently, real-time quantitative polymerase chain reaction was used to measure CPT1 expression. Their protein levels were assessed using western blotting and histological analysis. Single-cell analysis using GSE164241 was conducted to observe CPT1A and CPT1C expression in different cell types, followed by immunofluorescence validation. Finally, the correlation of CPT1A and CPT1C with clinical parameters was estimated, and receiver operating characteristic curves were constructed.</div></div><div><h3>Results</h3><div>Most biological processes related to lipid metabolism shared the gene <em>CPT1A</em>, and the expression of CPT1A and CPT1C in the periodontitis group was upregulated. Besides, both CPT1A and CPT1C were expressed mainly in endothelial cells, and their expression was elevated in endothelial cells of periodontitis. Furthermore, CPT1A and CPT1C were correlated with clinical parameters, and CPT1A could serve as a diagnostic marker of periodontitis.</div></div><div><h3>Conclusions</h3><div>Our findings elucidated the expression of CPT1 in gingival tissues of periodontitis and demonstrated the association of CPT1 with periodontitis.</div></div><div><h3>Clinical relevance</h3><div>This study found the positive correlation of the expression of CPT1A and CPT1C in gingival tissues with clinical parameters, which might lay a foundational framework for further elucidating the underlying mechanisms of lipid metabolism and periodontitis and pave the way for exploring potential therapeutic targets.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100837"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamics of Dental Education, Organization, and Regulation of Dental Practice in Europe 2016-2023","authors":"Thomas Gerhard Wolf ,&nbsp;Peter Lingström ,&nbsp;Jacques Deniaud ,&nbsp;Ralf Friedrich Wagner ,&nbsp;Gerhard Konrad Seeberger ,&nbsp;Oliver Zeyer ,&nbsp;Alfred Büttner ,&nbsp;Angela Rovera ,&nbsp;Paula Perlea ,&nbsp;Simona Dianišková ,&nbsp;Freddie Sloth-Lisbjerg ,&nbsp;Guglielmo Campus","doi":"10.1016/j.identj.2025.100852","DOIUrl":"10.1016/j.identj.2025.100852","url":null,"abstract":"<div><h3>Background</h3><div>This study examines shifts in dental education, organization of dentists, changes in regulation of dental practice across European countries and comparing differences between 2016 and 2023 of member states of the FDI World Dental Federation and WHO-Europe region.</div></div><div><h3>Methods</h3><div>Surveys conducted by the ERO-FDI in 2016 and 2023 included 45 countries (34 ERO and 11 non-members). Data on practice types, legal frameworks, education, and organization were collected via national dental associations. Statistical analyses employed t-tests and Fisher's exact tests to compare the two surveys over time.</div></div><div><h3>Results</h3><div>Private practice (self-employment) remained the dominant model (48.65%±28.28%, confidence interval (CI) [43.11 / 54.19]), followed by employment in private practice (24.32% ± 20.33%, CI [20.34/28.30]) and group practice (15.27%±20.39%, CI [11.27/19.27]), public health system (13.76%±20.17% (CI [9.81, 17.71]), municipal/national clinic (8.98%±17.86% CI [5.48/12.48]), oral healthcare center (6.61%±14.19% CI [3.83/9.39]), university clinic (4.90%±6.82% CI [3.56/6.24]), and industry (0.36%±0.78% CI [0.21/0.51]). Statistically significant growth was observed in group practice (two-tailed; F=14.53 <em>P &lt;</em> .01) and oral healthcare center (two-tailed; F=30.72 <em>P &lt;</em> .01). Male/female dental student ratio remained stable at approximately 1:2 (two-tailed; F=0.87, <em>P =</em> .66 (m); F=0.85, <em>P =</em> .60 (f)). A total of two-thirds of the countries allow non-dental investor-led oral healthcare centers (<em>P</em> = 1.00).</div></div><div><h3>Conclusions</h3><div>European dentistry is currently undergoing significant changes, including an increasing adoption of corporate and group practice models, approximately a 2:1 female to male ratio in dental education, and a growing urban-rural divide in care. Legal frameworks and the increasing involvement of non-dental investors could affect the quality and accessibility of care, particularly in rural areas. Future research should examine the long-term impact of these changes on patient care, dentist satisfaction, and the demand for flexible working models.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100852"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Accuracy and Performance of ChatGPT-4o in Solving Japanese National Dental Technician Examination","authors":"Hikaru Fukuda ,&nbsp;Masaki Morishita ,&nbsp;Kosuke Muraoka ,&nbsp;Shino Yamaguchi ,&nbsp;Taiji Nakamura ,&nbsp;Manabu Habu ,&nbsp;Izumi Yoshioka ,&nbsp;Shuji Awano ,&nbsp;Kentaro Ono","doi":"10.1016/j.identj.2025.100847","DOIUrl":"10.1016/j.identj.2025.100847","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>With advancements in artificial intelligence (AI), its role in education and examinations is expanding. This study aimed to evaluate the accuracy and response capability of ChatGPT-4o in solving questions from the Japanese National Dental Technician Examination (JNDTE). By analysing the AI’s answers to a variety of questions, including both text-based items and those containing visual information across multiple domains, we examined the practicality of using AI as a supportive tool for learning and assessment in dental education.</div></div><div><h3>Materials and methods</h3><div>A total of 400 JNDTE questions (2018-2022) were analysed using ChatGPT-4o. Standardized prompts were used, and statistical analysis was conducted using Fisher’s exact test.</div></div><div><h3>Results</h3><div>The AI demonstrated high accuracy in basic knowledge-based questions but lower accuracy in specialized topics requiring technical skills. Notably, accuracy decreased when visual elements (figures, tables, and photographs) were present. The highest accuracy was observed in ‘Dental materials, laboratory equipment, and processing technology’ (84.1%), while the lowest was in ‘Orthodontic technology’ (46.2%) and ‘Pediatric dental technology’ (50.0%). The AI particularly struggled with interpreting radiographic images and procedural workflows.</div></div><div><h3>Conclusions</h3><div>ChatGPT-4o demonstrated reasonable proficiency with JNDTE-related knowledge, suggesting its potential application as a supplementary tool in dental education. However, its limitations in processing visual and technical content highlight the need for advancements in AI-driven image recognition and simulation-based learning.</div></div><div><h3>Clinical Relevance</h3><div>The findings of this study highlight the potential application of AI models like ChatGPT-4o as a supplementary tool in dental technician education and examination preparation. Enhancing AI-driven image recognition and simulation-based learning could improve its effectiveness in dental education and clinical training, ultimately contributing to better learning outcomes and skill development for future dental technicians.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100847"},"PeriodicalIF":3.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VPA Enhances Pulp Regeneration by Regulating LPS-Induced Human Dental Pulp Stem Cells Odontogenic Differentiation","authors":"Zhihua Wang ,&nbsp;Minghao Wang ,&nbsp;Zhirong Luo ,&nbsp;Yi Fu ,&nbsp;Xiaomiao Zhu ,&nbsp;Dongyu Li ,&nbsp;Wenkai Jiang ,&nbsp;Xiaogang Cheng ,&nbsp;Chengxiong Cai ,&nbsp;Xiaoru Zhu ,&nbsp;Paul R. Cooper ,&nbsp;Shengchao Wang ,&nbsp;Wenxi He","doi":"10.1016/j.identj.2025.100850","DOIUrl":"10.1016/j.identj.2025.100850","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to investigate the effect of valproic acid (VPA) exposure on pulp inflammation and regeneration.</div></div><div><h3>Methods</h3><div>The effects of VPA on pulp regeneration and reparative dentin formation were examined using cone-beam computed tomography (CBCT) and histological staining in vivo after 3 months of endodontic regenerative procedures (ERPs). In vitro, the effect of VPA on the odontogenic differentiation of human dental pulp stem cells (hDPSCs) was assessed using mineralization assays following lipopolysaccharide (LPS) exposure. Western blotting, quantitative real-time polymerase chain reaction, and reverse transcriptase polymerase chain reaction were performed to analyze changes in gene and transcript expression. Mineralization and transfection assays were conducted to evaluate the roles of histone deacetylase (HDAC)2 and HDAC5.</div></div><div><h3>Results</h3><div>Three months post-ERPs, CBCT imaging revealed well-sealed crowns and normal root apices with no apparent periapical lesions in all groups. The hDPSCs+VPA group exhibited a greater presence of neoformed connective tissues, dentin-like tissues and odontoblast-like cells compared to the hDPSCs group. Furthermore, mineralization assays demonstrated that VPA enhanced LPS-induced odontoblastic differentiation. In particular, during this process, VPA significantly downregulated the expression of HDAC2 and HDAC5 in hDPSCs treated with VPA and LPS, HDAC2 knockdown reduced odontoblastic protein production and the calcified nodules formation, while HDAC5 inhibition promoted odontoblastic differentiation in hDPSCs. Overexpression of HDAC2 or HDAC5 in the presence of VPA and LPS played the opposite role during the odontoblastic differentiation of hDPSCs.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that VPA improved pulp regeneration by regulating LPS-induced odontogenic differentiation of hDPSCs, primarily through modulation of HDAC2 and HDAC5 activity.</div></div><div><h3>Clinical Relevance</h3><div>These data demonstrate that VPA is a highly effective pharmacological candidate for dental pulp maintenance and regeneration, highlighting its clinical significance in restorative dentistry.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100850"},"PeriodicalIF":3.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to ‘Treating buccal abscess from residual root in edentulous patient’ [International Dental Journal, Volume 74, Supplement 1, October 2024, Page S247]","authors":"Berkan Duman,&nbsp;Gülce Ecem Doğancalı,&nbsp;Abdulkadir Burak Çankaya,&nbsp;Mehmet Ali Erdem","doi":"10.1016/j.identj.2025.02.029","DOIUrl":"10.1016/j.identj.2025.02.029","url":null,"abstract":"","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100791"},"PeriodicalIF":3.2,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multi-National Questionnaire-Based Analysis of Dental Students’ Knowledge of the Management of Deep Caries and the Exposed Pulp","authors":"Venkateshbabu Nagendrababu ,&nbsp;Arindam Dutta ,&nbsp;Ana Arias ,&nbsp;Aleksandar Jakovljevic ,&nbsp;Ahmed Hieawy ,&nbsp;Frank C. Setzer ,&nbsp;Jugoslav Ilic ,&nbsp;Milos Beloica ,&nbsp;Meric Karapinar Kazandag ,&nbsp;Nandini Suresh ,&nbsp;Paul V. Abbott ,&nbsp;Raghavendra M. Shetty ,&nbsp;Srinivasan Narasimhan ,&nbsp;Victoria SH Yu ,&nbsp;Vellore Kannan Gopinath ,&nbsp;Ya Shen ,&nbsp;Henry F. Duncan","doi":"10.1016/j.identj.2025.100844","DOIUrl":"10.1016/j.identj.2025.100844","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>To evaluate knowledge regarding the management of deep carious lesions and exposed pulps among undergraduate and postgraduate endodontic students from ten dental institutions across ten countries, and the impact of operator (material, antibiotic prescription) and patient-related (age, symptoms) factors on their treatment protocols.</div></div><div><h3>Methods</h3><div>An online questionnaire was distributed to evaluate student knowledge of the management of deep caries and exposed pulp related to four clinical scenarios. Simple descriptive statistics were used to describe the data and McNemar tests were employed to identify significant differences between the scenarios. The P-value was set at 5%.</div></div><div><h3>Results</h3><div>A total of 435 undergraduates and 139 postgraduates from ten dental schools participated in this survey. The final survey included 401 responses from undergraduates and 127 from postgraduates for statistical analysis. When symptoms were present, the majority of undergraduate and postgraduate students preferred non-selective (complete) caries removal over selective (partial) caries removal in young patients. The majority of postgraduates preferred partial pulpotomy in younger patients and pulpectomy and root canal treatment (RCT) in older patients. The majority of undergraduates preferred pulpectomy and RCT in both young/old patients when symptoms were present. The majority of undergraduates and postgraduates opted for mineral trioxide aggregate and Biodentine, respectively, when treating the exposed pulp. Systemic antibiotics were not recommended by both undergraduates and postgraduates, regardless of the patient's age and symptoms.</div></div><div><h3>Conclusion</h3><div>Among the scenarios surveyed, the majority of undergraduates and postgraduates preferred: a) pulpectomy and RCT for older patients in the presence or absence of symptoms; b) hydraulic calcium silicate cements as pulp capping material; and c) did not recommend systemic antibiotics.</div></div><div><h3>Clinical relevance</h3><div>The majority of students choose non-selective (complete) caries removal in all cases and if the pulp is exposed, the use of hydraulic calcium silicate cements iwas the preferred material. Systemic antibiotics are considered unnecessary, irrespective of the patient's age and symptoms.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100844"},"PeriodicalIF":3.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-Based Diagnostic Performance of LLMs vs CNNs for Oral Lichen Planus: Example-Guided and Differential Diagnosis","authors":"Paak Rewthamrongsris ,&nbsp;Jirayu Burapacheep ,&nbsp;Ekarat Phattarataratip ,&nbsp;Promphakkon Kulthanaamondhita ,&nbsp;Antonin Tichy ,&nbsp;Falk Schwendicke ,&nbsp;Thanaphum Osathanon ,&nbsp;Kraisorn Sappayatosok","doi":"10.1016/j.identj.2025.100848","DOIUrl":"10.1016/j.identj.2025.100848","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>The overlapping characteristics of oral lichen planus (OLP), a chronic oral mucosal inflammatory condition, with those of other oral lesions, present diagnostic challenges. Large language models (LLMs) with integrated computer-vision capabilities and convolutional neural networks (CNNs) constitute an alternative diagnostic modality. We evaluated the ability of seven LLMs, including both proprietary and open-source models, to detect OLP from intraoral images and generate differential diagnoses.</div></div><div><h3>Methods</h3><div>Using a dataset with 1,142 clinical photographs of histopathologically confirmed OLP, non-OLP lesions, and normal mucosa. The LLMs were tested using three experimental designs: zero-shot recognition, example-guided recognition, and differential diagnosis. Performance was measured using accuracy, precision, recall, F1-score, and discounted cumulative gain (DCG). Furthermore, the performance of LLMs was compared with three previously published CNN-based models for OLP detection on a subset of 110 photographs, which were previously used to test the CNN models.</div></div><div><h3>Results</h3><div>Gemini 1.5 Pro and Flash demonstrated the highest accuracy (69.69%) in zero-shot recognition, whereas GPT-4o ranked first in the F1 score (76.10%). With example-guided prompts, which improved consistency and reduced refusal rates, Gemini 1.5 Flash achieved the highest accuracy (80.53%) and F1-score (84.54%); however, Claude 3.5 Sonnet achieved the highest DCG score of 0.63. Although the proprietary models generally excelled, the open-source Llama model demonstrated notable strengths in ranking relevant diagnoses despite moderate performance in detection tasks. All LLMs were outperformed by the CNN models.</div></div><div><h3>Conclusion</h3><div>The seven evaluated LLMs lack sufficient performance for clinical use. CNNs trained to detect OLP outperformed the LLMs tested in this study.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100848"},"PeriodicalIF":3.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heimler Syndrome With Tooth Agenesis, Abnormal Enamel and Dentin Mineralization, Root Maldevelopment, and PEX1 Mutation","authors":"Piranit N. Kantaputra ,&nbsp;Atitaya Apivatthakakul ,&nbsp;Massupa Kaewgahya ,&nbsp;Sissades Tongsima ,&nbsp;Chumpol Ngamphiw ,&nbsp;Thanapat Sastraruji ,&nbsp;Panwarit Sukantamala ,&nbsp;Bruce M. Carlson ,&nbsp;Katsushige Kawasaki ,&nbsp;James R. Ketudat Cairns ,&nbsp;Nuntigar Sonsuwan ,&nbsp;Atsushi Ohazama","doi":"10.1016/j.identj.2025.04.002","DOIUrl":"10.1016/j.identj.2025.04.002","url":null,"abstract":"<div><div>Biallelic variants in the <em>PEX1</em> and PEX6 genes are implicated in Heimler syndrome, which is characterized by amelogenesis imperfecta, sensorineural hearing loss, retinitis pigmentosa, and nail defects. The objective of this study is to find the genetic variant and to analyze the teeth of a patient with Heimler syndrome. Clinical and radiographic examination and whole exome sequencing were performed on a Heimler syndrome patient and his parents. Scanning electron microscopy and micro-computed tomography were performed on a tooth. Immunohistochemical study of Pex1 was performed. Mutant protein models were made. The authors report an 18-year-old male with Heimler syndrome who carried a compound heterozygous (c.2966T&gt;C; p.Ile989Thr and c.2097_2098insT; p.Ile700TyrfsTer42) mutation in the <em>PEX1</em> gene. Clinical manifestations included amelogenesis imperfecta of the posterior permanent teeth, mild sensorineural hearing loss, retinitis pigmentosa, and leukonychia. SEM showed enamel and dentin dysmineralization. The newly findings include arachnodactyly, tooth agenesis, microdontia, root maldevelopment, and failure of tooth eruption. The p.Ile700TyrfsTer42 variant is predicted to produce a non-viable protein. The p.Ile989Thr variant is predicted to disrupt its interaction with PEX6. A patient with Heimler syndrome may have arachnodactyly, tooth agenesis, microdontia, delayed dental development, root maldevelopment, enamel and dentin dysmineralization, and failure of tooth eruption.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100821"},"PeriodicalIF":3.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}