Journal of Dental SciencesPub Date : 2026-07-01eCollection Date: 2026-01-01DOI: 10.1016/j.jds.2025.07.3466
Xiaochi Chang, Yanghao Zhao, Yang Wang, Chang Shu, Yi Feng, Yichong Sun, Guangxun Zhu, Jianxia Hou
{"title":"N-acetylcysteine restores osteogenesis in human periodontal ligament stem cells by attenuating HIF-1α-driven oxidative stress and glycolytic reprogramming.","authors":"Xiaochi Chang, Yanghao Zhao, Yang Wang, Chang Shu, Yi Feng, Yichong Sun, Guangxun Zhu, Jianxia Hou","doi":"10.1016/j.jds.2025.07.3466","DOIUrl":"10.1016/j.jds.2025.07.3466","url":null,"abstract":"<p><strong>Background/purpose: </strong>Periodontitis-associated hypoxia signaling and oxidative stress severely impair the regenerative capacity of human periodontal ligament stem cells (hPDLSCs). This study investigated whether antioxidant intervention rescues hPDLSC osteogenesis under CoCl<sub>2</sub>-induced HIF-1α stabilization by modulating PI3K/Akt/HIF-1α/HO-1 signaling and glycolytic reprogramming.</p><p><strong>Materials and methods: </strong>Primary hPDLSCs isolated from healthy premolars were characterized by flow cytometry and multilineage differentiation. To simulate periodontitis-associated stress, a CoCl<sub>2</sub>-induced HIF-1α-stabilizing condition was established. Cells were treated with the antioxidant N-acetylcysteine (NAC), the glycolysis inhibitor 2-deoxy-d-glucose (2-DG), or the PI3K inhibitor LY294002. Redox balance (DCFH-DA, MDA, GPX activity), glycolysis-related markers (HK2, GLUT1, lactate), and osteogenic-related markers (RUNX2, ALP, OCN) were quantified via qRT-PCR, Western blot, and biochemical assays, alongside an analysis of the PI3K/ Akt/HIF-1α/HO-1 signaling axis.</p><p><strong>Results: </strong>CoCl<sub>2</sub> exposure triggered profound redox imbalance and significantly impaired hPDLSC osteogenesis. Crucially, NAC effectively reversed these damages and restored osteogenic capacity. Mechanistically, CoCl<sub>2</sub>-induced HIF-1α stabilization activated PI3K/Akt/HO-1 signaling, a pathological cascade attenuated by either NAC or targeted PI3K inhibition. Furthermore, CoCl<sub>2</sub> forced a pronounced glycolytic shift characterized by upregulated HK2, GLUT1, and lactate production, which was directly intercepted by ROS clearance. Functionally, targeted glycolysis inhibition via 2-DG also successfully rescued the osteogenic potential of HIF-1α-stabilized hPDLSCs.</p><p><strong>Conclusion: </strong>HIF-1α stabilization suppresses hPDLSC osteogenesis by inducing both oxidative stress and pathological glycolytic reprogramming. Targeted antioxidant intervention effectively mitigates these impairments, highlighting the ROS/PI3K/Akt/HIF-1α axis as a key link between redox imbalance and metabolic dysfunction, and suggesting a potential therapeutic target for periodontal regeneration.</p>","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"1486-1498"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of Dental SciencesPub Date : 2026-07-01eCollection Date: 2026-01-01DOI: 10.1016/j.jds.2025.07.3548
Alexander Patera Nugraha, Guang Hong, Kunhua Yang, Ida Bagus Narmada, Fedik Abdul Rantam, Diah Savitri Ernawati, I Gusti Aju Wahju Ardani, Adya Pramusita, Nurul Aisyah Rizky Putranti, Naora Dewi Rahma Fadzila, Al Zayyan Shenaya Aurora, Reisya Irfanny Farizaldi, Muhammad Luthfi, Putri Cahaya Situmorang, Wibi Riawan, Kotaro Tanimoto
{"title":"Mesenchymal stem cells derived from gingiva normoxic or hypoxic-preconditioning allogenous transplantation affect orthodontic tooth movement in vivo.","authors":"Alexander Patera Nugraha, Guang Hong, Kunhua Yang, Ida Bagus Narmada, Fedik Abdul Rantam, Diah Savitri Ernawati, I Gusti Aju Wahju Ardani, Adya Pramusita, Nurul Aisyah Rizky Putranti, Naora Dewi Rahma Fadzila, Al Zayyan Shenaya Aurora, Reisya Irfanny Farizaldi, Muhammad Luthfi, Putri Cahaya Situmorang, Wibi Riawan, Kotaro Tanimoto","doi":"10.1016/j.jds.2025.07.3548","DOIUrl":"10.1016/j.jds.2025.07.3548","url":null,"abstract":"<p><strong>Background/purpose: </strong>Gingival mesenchymal stem cells (GMSC) show promising qualities in immunoregulation, immunomodulation in regeneration of periodontal tissue during orthodontic tooth movement (OTM). This study aimed to elucidate allogenous GMSC normoxia and hypoxic preconditioning transplantation in the OTM model using New Zealand rabbits (<i>Oryctolagus cuniculus</i>) by examining nuclear factor kappa beta (NF-κB), tumour necrosis factoralpha (TNF-α), nuclear factor associated T-cell-1 (NFATc1), Runt-related transcription factor 2 (RUNX2), Osteocalcin.</p><p><strong>Materials and methods: </strong>Four groups were established from forty-eight, healthy, young male rabbits divided into the following respective groups: p1: normoxic GMSC transplantation with OTM, p2: hypoxic GMSC transplantation with OTM, k2: OTM only, and K1: phosphate buffered saline (PBS) only. In order to advance the mandibular first molar mesially, a fixed orthodontic appliance was applied. The rabbit was transplanted with 10<sup>6</sup> hypoxic or normoxic GMSC in 50 μl of PBS into afflicted gingiva after one day of OTM. All experimental animals were sacrificed on days 7, 14, and 28. Furthermore, mandibular tissue was isolated for the sample to examine NFKβ, TNF-α, NFATc1, osteocalcin, RUNX2 expression, and OTM rate.</p><p><strong>Results: </strong>There was a considerable increase in OTM rate, osteocalcin and RUNX2 expression in P2 on day 28 with significantly different between groups. In contrast to other groups, the P2 group's expression of NFKβ, TNF-α, and NFATc1 was considerably lower on day 28 in the tension side of the alveolar bone (<i>P</i> ≤ 0.05).</p><p><strong>Conclusion: </strong>GMSC hypoxia-preconditioning transplantation increases the OTM rate through the RUNX2-osteocalcin-OTM rate stimulation pathway in rabbits (<i>O. cunniculus</i>).</p>","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"1801-1808"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"When two become three: Endoscope-assisted Caldwell-Luc removal of an unexpected third dental bur in the maxillary sinus.","authors":"Ling-Wei Huang, Wei-Chen Huang, Sheng-Hong Wang, Ken-Chung Chen","doi":"10.1016/j.jds.2025.07.3464","DOIUrl":"10.1016/j.jds.2025.07.3464","url":null,"abstract":"","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"2006-2008"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of Dental SciencesPub Date : 2026-07-01eCollection Date: 2026-01-01DOI: 10.1016/j.jds.2025.07.3479
Seiya Hayashi, Yoshinori Fujita, Yoshinari Myoken
{"title":"OK-432 sclerotherapy for a plunging ranula extending into the parapharyngeal space.","authors":"Seiya Hayashi, Yoshinori Fujita, Yoshinari Myoken","doi":"10.1016/j.jds.2025.07.3479","DOIUrl":"10.1016/j.jds.2025.07.3479","url":null,"abstract":"","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"2009-2010"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of Dental SciencesPub Date : 2026-07-01eCollection Date: 2026-01-01DOI: 10.1016/j.jds.2025.07.3542
Yuchen Fan, Suning Mao, Guanru Wang, Guile Zhao, Shiyong Zhuang, Fan Yang, Liu Liu, Honglin Li, Chunjie Li, Yubin Cao
{"title":"Deciphering novel targets in salivary gland pleomorphic adenoma by integrating plasma proteomics and parotid transcriptomics analyses.","authors":"Yuchen Fan, Suning Mao, Guanru Wang, Guile Zhao, Shiyong Zhuang, Fan Yang, Liu Liu, Honglin Li, Chunjie Li, Yubin Cao","doi":"10.1016/j.jds.2025.07.3542","DOIUrl":"10.1016/j.jds.2025.07.3542","url":null,"abstract":"<p><strong>Background/purpose: </strong>Pleomorphic adenoma (PA) is the most common salivary gland benign tumor, with its molecular drivers elusive due to a lack of experimental models. This study aimed to decipher novel targets in PA by systematically integrating plasma protein quantitative trait loci (pQTL)-based Mendelian randomization (MR) with multi-omics profiling of parotid gland tissues.</p><p><strong>Materials and methods: </strong>We performed two-sample MR using 5450 plasma pQTLs and genome-wide association study summary for benign or broader salivary gland diseases from FinnGen consortium. Bulk RNA-sequencing (RNA-seq) and single-cell RNA-seq (scRNA-seq) comparing PA to normal tissue were used for transcriptomic validation. Immunohistochemistry (IHC) was applied for protein-level validation in human PA, adenoid cystic carcinoma (ACC), and murine inflammatory lesions.</p><p><strong>Results: </strong>MR identified 12 plasma proteins associated with benign salivary gland tumor risk. Transmembrane serine protease 6 (TMPRSS6) was the only protein significantly risk-increasing for both benign and broader salivary gland diseases. Strikingly, mitogen-activated protein kinase kinase 4 (MAP2K4) showed opposite MR effects between benign and all-lesion outcomes. Bulk RNA-seq showed limited concordance with MR findings, while scRNA-seq revealed a unique plastic epithelium and partially validated candidates at cellular resolution. Critically, IHC confirmed MAP2K4 protein overexpression specifically in human PA, but not in ACC or inflammatory lesions, while TMPRSS6 was downregulated in established pathologies despite its genetic risk association.</p><p><strong>Conclusion: </strong>By integrating plasma proteome-based causal inference with parotid tissue multi-omics, this study unveils MAP2K4 as a potential PA-specific driver. This integrative framework provides novel, context-specific targets for further functional investigation in salivary gland tumorigenesis.</p>","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"1739-1755"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oral pathogens reprogram endothelial barrier and angiotensin-converting enzyme2/endothelial nitric oxide synthase-nitric oxide signaling to promote blood pressure dysregulation.","authors":"Ming-Shou Hsieh, Tung-Nien Hsu, Chin-Sheng Huang, Ting-Yi Renn, Kuang-Tai Kuo, Kuo-Yao Lin, Wei Jen Chang","doi":"10.1016/j.jds.2025.07.3494","DOIUrl":"10.1016/j.jds.2025.07.3494","url":null,"abstract":"<p><strong>Background/purpose: </strong>Although periodontal disease is associated with an increased risk of hypertension, the endothelial mechanisms linking oral inflammation to vascular dysfunction remain unclear. We investigated whether <i>Porphyromonas gingivalis</i> lipopolysaccharide (<i>Pg</i>-LPS) can directly disturb endothelial homeostasis and whether macrophage -endothelial crosstalk further worsens endothelial injury.</p><p><strong>Materials and methods: </strong>Human umbilical vein endothelial cells (HUVECs) were exposed to <i>Pg</i>-LPS alone or co-cultured (transwell system) with <i>Pg</i>-LPS-primed human monocytic cells -derived macrophages. Endothelial dysfunction was assessed through nitric oxide (NO) production, endothelial nitric oxide synthase (eNOS) phosphorylation, inflammatory and adhesion molecule expression, as well as junctional and cytoskeletal changes. Macrophage activation was evaluated by nuclear factor kappa B (NF-κB) signaling and M1-like inflammatory polarization. Mechanistic studies were further carried out with inhibitors against toll-like receptor 4 (TLR4), rho-associated kinase (ROCK), NOS, and the angiotensin-converting enzyme 2 (ACE2) signaling axis.</p><p><strong>Results: </strong><i>Pg</i>-LPS directly triggered endothelial inflammation, with increased interleukin-6 and -8, vascular cell adhesion molecule-1/intercellular adhesion moldcule-1 expression, enhanced reactive oxygen species and endothelial permeability. <i>Pg</i>-LPS also suppressed eNOS activation and NO production, and disturbed ACE/ACE2 balance. In co-culture, <i>Pg</i>-LPS-stimulated macrophages further aggravated endothelial inflammation, barrier dysfunction, and NO-related signaling impairment. TLR4 inhibition attenuated inflammatory and barrier-disruptive responses, while modulation of the ACE/ACE2-eNOS pathway altered endothelial NO signaling.</p><p><strong>Conclusion: </strong><i>Pg</i>-LPS disrupts endothelial barrier integrity and NO signaling both directly and indirectly through inflammatory macrophage-endothelial crosstalk, involving TLR2/4-NF- κB, Rho/ROCK signaling and ACE2/eNOS imbalance. These findings provide mechanistic insight into how periodontal inflammation may contribute to vascular dysfunction relevant to blood pressure dysregulation.</p>","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"1402-1410"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of Dental SciencesPub Date : 2026-07-01eCollection Date: 2026-01-01DOI: 10.1016/j.jds.2025.07.3459
Hung-Pin Lin, Chun-Pin Chiang
{"title":"Orthokeratinized odontogenic cyst of the mandible - A case report.","authors":"Hung-Pin Lin, Chun-Pin Chiang","doi":"10.1016/j.jds.2025.07.3459","DOIUrl":"10.1016/j.jds.2025.07.3459","url":null,"abstract":"","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"1997-1999"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postoperative conductive hearing loss after full-arch-implantation surgery under general anesthesia in an oral submucous fibrosis patient: A case report.","authors":"Hao-Chen Wang, Fu-Chuan Tsai, Chia-Che Wu, Chih-Yuan Fang","doi":"10.1016/j.jds.2025.07.3488","DOIUrl":"10.1016/j.jds.2025.07.3488","url":null,"abstract":"","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"2011-2013"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of Dental SciencesPub Date : 2026-07-01eCollection Date: 2026-01-01DOI: 10.1016/j.jds.2025.07.3458
Yu-Hsueh Wu, Yi-Pang Lee, Julia Yu-Fong Chang, Yi-Ping Wang, Andy Sun, Chun-Pin Chiang
{"title":"Prevalences of vitamin B12 deficiency, pernicious anemia, macrocytosis, and hyperhomocysteinemia in 532 serum gastric parietal cell antibody-positive oral mucosal disease patients.","authors":"Yu-Hsueh Wu, Yi-Pang Lee, Julia Yu-Fong Chang, Yi-Ping Wang, Andy Sun, Chun-Pin Chiang","doi":"10.1016/j.jds.2025.07.3458","DOIUrl":"10.1016/j.jds.2025.07.3458","url":null,"abstract":"<p><strong>Background/purpose: </strong>Our previous studies found the serum gastric parietal cell antibody (GPCA) positivity in 12.3%-26.7% of atrophic glossitis (AG), burning mouth syndrome (BMS), and oral lichen planus (OLP) patients. This study assessed whether GPCA-positive oral mucosal disease (GPCA<sup>+</sup>OMD) patients (including 284 AG, 109 BMS, and 139 OLP patients) had significantly higher frequencies of microcytosis, macrocytosis, anemia, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than healthy control subjects (HCSs) or GPCA-negative OMD (GPCA<sup>-</sup>OMD) patients.</p><p><strong>Materials and methods: </strong>The mean corpuscular volume, blood Hb, and serum iron, vitamin B12, homocysteine, and GPCA levels were measured and compared between any two of three groups of 532 GPCA<sup>+</sup>OMD patients, 532 disease-, age- and sex-matched GPCA<sup>-</sup>OMD patients, and 532 age- and sex-matched HCSs.</p><p><strong>Results: </strong>We found that 532 GPCA<sup>+</sup>OMD patients had significantly higher frequencies of microcytosis, macrocytosis, anemia, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than 532 HCSs (all <i>P</i>-values <i><</i>0.001) and significantly higher frequencies of macrocytosis, macrocytic anemia including pernicious anemia (PA), serum vitamin B12 deficiency, and hyperhomocysteinemia than 532 GPCA<sup>-</sup>OMD patients (all <i>P</i>-values <i><</i>0.001). Moreover, 532 GPCA<sup>-</sup>OMD patients also had significantly higher frequencies of microcytosis, macrocytosis, anemia, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than 532 HCSs (all <i>P</i>-values <i><</i>0.001). PA (39.4%) and normocytic anemia (34.3%) were the two most common types of anemia in 137 anemic GPCA<sup>+</sup>OMD patients.</p><p><strong>Conclusion: </strong>GPCA<sup>+</sup>OMD patients have significantly higher frequencies of macrocytosis, macrocytic anemia including PA, serum vitamin B12 deficiency, and hyperhomocysteinemia than HCSs or GPCA<sup>-</sup>OMD patients.</p>","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"1662-1670"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A visualized AI-assisted framework for pre-surgical evaluation of implant pathways on periapical radiographs.","authors":"Yuan-Jin Lin, Chiung-An Chen, Yi-Cheng Mao, Zi-Chun Kao, Li-Hsin Chang, Shun-Yuan Tian, Shih-Lun Chen, Wei-Chen Tu","doi":"10.1016/j.jds.2025.07.3554","DOIUrl":"10.1016/j.jds.2025.07.3554","url":null,"abstract":"<p><strong>Background/purpose: </strong>Implant pathway assessment is a crucial part of pre-operative planning before performing implant surgery at the site of a missing tooth. Dentists frequently use the periapical radiograph (PA) as a tool for preliminary evaluation of the implant pathway. However, the manual interpretation process is time-consuming and inherently subjective, making it susceptible to variations in PA-based implant pathway judgment due to the operator's experience. This study aims to establish an automated and objective framework that integrates an algorithm and deep learning to analyze the implant pathway preliminarily.</p><p><strong>Materials and methods: </strong>We analyzed 1,200 PAs containing missing teeth and reserved 120 PAs for testing. We first used segmentation model to identify the teeth adjacent to the missing tooth site. This segmentation served as the foundation for the GeoPath algorithm for visualized implant pathway. The results were compared with actual preliminary clinical assessment outcomes to evaluate feasibility.</p><p><strong>Results: </strong>The segmentation model achieved a precision of 96.73 %, a sensitivity of 97.12 %, and a specificity of 99.27 %, and obtained a Cohen's κ score of 0.93, which confirmed an agreement between the automated auxiliary detection results and the dentist's ground truth annotations. Furthermore, the angular error was only 2.79°, which confirmed a lower average root mean square error (RMSE) of 0.10433. This effectively reduced the time required for dentists' clinical PA assessment by 87.19 %.</p><p><strong>Conclusion: </strong>The automated implant pathway assessment framework for PAs can serve as an auxiliary tool for senior dentists during initial clinical diagnosis and as a method for training new dentists.</p>","PeriodicalId":15583,"journal":{"name":"Journal of Dental Sciences","volume":"21 3","pages":"1859-1866"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}