Journal of the American Dental Association最新文献

{"title":"Summary of the Veterans Health Administration’s First International Symposium on Artificial Intelligence in Dentistry","authors":"Donald J. DeNucci DDS, MS,&nbsp;Elizabeth Nuñez DMD, MST,&nbsp;Owais A. Farooqi DDS, MDS, MPH,&nbsp;Christopher Balaban DDS, MSc,&nbsp;Ibrahim Sevki Bayrakdar DDS, PhD,&nbsp;Michael M. Bornstein Dr Med Dent,&nbsp;Adam Foresman MSc, MBA,&nbsp;Seth A. Gibree DMD,&nbsp;Reinhilde Jacobs DDS, MSc, PhD,&nbsp;Joshua Mueller PhD,&nbsp;Falk Schwendicke Dr Med Dent, MDPH,&nbsp;Philippe Salah PhD,&nbsp;Dmitri Tuzoff MS","doi":"10.1016/j.adaj.2025.05.018","DOIUrl":"10.1016/j.adaj.2025.05.018","url":null,"abstract":"<div><h3>Background</h3><div>The Veterans Health Administration’s First International Symposium on Artificial Intelligence in Dentistry, held virtually on October 11, 2024, marked a step toward improving oral health care for veterans through the adoption of cutting-edge artificial intelligence (AI) technologies. AI offers the potential to transform dental diagnostics, treatment planning, and care delivery; however, its clinical application in dentistry remains limited. The symposium addressed this gap by means of highlighting innovations and implementation strategies to help clinicians prepare for the technological changes reshaping oral health care.</div></div><div><h3>Types of Studies Reviewed</h3><div>The authors summarized presentations and panel discussions from the symposium, encompassing developments in AI-assisted cariology, maxillofacial radiology, diagnostic and presurgical planning, clinical workflows, remote monitoring, and the ethical and regulatory landscape. The review is based on content submitted by the symposium’s presenters, reflecting their research, operational experience, and emerging innovations.</div></div><div><h3>Results</h3><div>The presentations established that AI technologies can standardize diagnostics, reduce interoperator variability, and enhance clinical decision making through predictive analytics, digital simulations, and multimodal data integration. AI applications exhibited high specificity in detecting pathologies, improved early intervention capabilities, and optimized treatment planning. Key findings emphasized the value of responsible AI adoption within institutional settings, such as the US Department of Veterans Affairs, supported by means of clinician engagement, regulatory guidance, and ethical oversight.</div></div><div><h3>Conclusions and Practical Implications</h3><div>Integrating AI into dental practice can improve diagnostic accuracy, streamline administrative processes, and enhance access to care. These tools offer substantial benefits for large health care systems, such as the Veterans Health Administration, including greater efficiency, personalization of treatment, and improved outcomes, particularly in underserved or resource-limited environments.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Pages 649-657"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767251","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":"Embracing frameworks, moral courage, and reflection in the ethical decision-making process","authors":"Fotini V. Anagnostopoulos-King DMD, PBC-RE","doi":"10.1016/j.adaj.2025.05.011","DOIUrl":"10.1016/j.adaj.2025.05.011","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Pages 683-685"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497409","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":"Artificial intelligence algorithm for real-time diagnostic assist in orofacial pain","authors":"Glenn Thomas Clark DDS, MS,&nbsp;Anette Vistoso Monreal DDS, MS,&nbsp;Nicolas Veas BS,&nbsp;Gerald E. Loeb MD","doi":"10.1016/j.adaj.2025.05.002","DOIUrl":"10.1016/j.adaj.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Misdiagnosis is prevalent in clinical practice due to incomplete and sometimes inconsistent data, which generate errors in the traditional diagnostic process. Orofacial pain, with its wide range of conditions, poses a considerable diagnostic challenge, particularly for inexperienced clinicians.</div></div><div><h3>Case Description</h3><div>A structured, machine learning–compatible note-taking system was used to document clinical history and examination features from 1,020 patients at an orofacial pain clinic. A naïve Bayesian inference algorithm was used to compute and display the probability of various diagnoses as data were added to the medical record during a clinical encounter. Its accuracy compared favorably with 5 machine learning algorithms for 5 new cases of each of 10 diagnoses varying in their prevalence in the database.</div></div><div><h3>Practical Implications</h3><div>The authors speculated that the key to achieving reasonable concordance was the highly structured electronic medical record, which included disease-defining or unique features of most diagnoses. Extension of these methods to broader clinical domains will require similar attention.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Pages 664-673"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285091","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":"Yellowish nodule at the midline of the maxillary vestibule in a man","authors":"Brenda Corrêa Santos DDS,&nbsp;Hélen Kaline Farias Bezerra DDS,&nbsp;Pablo Agustin Vargas DDS, PhD, FRCPath,&nbsp;Alan Roger Santos-Silva DDS, PhD,&nbsp;Márcio Ajudarte Lopes DDS, PhD","doi":"10.1016/j.adaj.2024.08.015","DOIUrl":"10.1016/j.adaj.2024.08.015","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Pages 658-663"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372178","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":"Diagnostic accuracy of detecting caries and other intraoral findings using parent-obtained smartphone photographs in teledentistry","authors":"Mirissa D. Price DMD,&nbsp;Steven D. Ureles DMD, MS, MSc,&nbsp;Hesham Alhazmi BDS, MS, DMSc,&nbsp;Rosalyn M. Sulyanto DMD, MS,&nbsp;Man Wai Ng DDS, MPH","doi":"10.1016/j.adaj.2025.05.003","DOIUrl":"10.1016/j.adaj.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>The authors evaluated whether parent-obtained smartphone photographs can accurately assess frank caries and other intraoral findings compared with point-of-care clinical examination findings.</div></div><div><h3>Methods</h3><div>Children’s parents submitted intraoral photographs for a teledentistry consultation before dental rehabilitation in the operating room. Two calibrated dentists recorded hard- and soft-tissue findings from the photographs. These findings were compared with clinical findings recorded in the operating room. Sensitivity, specificity, likelihood ratios, prevalence, accuracy, and positive and negative predictive values were calculated for occlusal, frontal, and combined views. Fagan nomogram was used to predict caries risk graphically.</div></div><div><h3>Results</h3><div>Of 138 patients, 70% were in primary dentition and 30% were in mixed dentition. All photographic views had high specificity for detecting caries (range, 97.1%-100.0%). Except for the mandibular anterior dentition, which had a sensitivity of 67.2% (95% CI, 53.5% to 79.0%), when all photographic views were combined, the maxillary occlusal and frontal images together showed high sensitivity of 94.8% through 99.1% in detecting caries in the primary dentition. Similar trends were observed for the mixed dentition. Combined photographs had an accuracy of 94.1% through 100.0%, with the positive likelihood ratio exceeding 33.3 for all photographs and sextants. Positive likelihood ratio ranged from 44.5 through 132.7 for detecting caries in primary dentition. Low sensitivity was found for detecting demineralization and soft-tissue findings.</div></div><div><h3>Conclusions</h3><div>Parents can reliably obtain accurate and clinically meaningful intraoral photographs using a smartphone when following a written photograph guide.</div></div><div><h3>Practical Implications</h3><div>Parent-obtained smartphone photographs can provide accurate and clinically meaningful detection of frank caries in the primary and mixed dentitions.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Pages 601-610.e1"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497408","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":"The World Health Organization Framework Convention on Tobacco Control at 20 years","authors":"Habib Benzian DDS, PhD, MScDPH,&nbsp;Eugenio Beltrán-Aguilar DMD, MPH, MS, DrPH,&nbsp;Judith Mackay MBChB","doi":"10.1016/j.adaj.2025.05.015","DOIUrl":"10.1016/j.adaj.2025.05.015","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Pages 678-682"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767252","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":"Three-dimensional changes in hard-tissue symmetry and soft-tissue parameters after stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation","authors":"Madiha Mohammed Saleh Ahmed BDS, MSc, PhD,&nbsp;Pengyu Chen BDS, MSc,&nbsp;Zhongyi Xiao BDS, MSc,&nbsp;Chunshen Li BDS, MSc,&nbsp;Cui Zhang BDS,&nbsp;Xin Wang BDS, MSc,&nbsp;Moutaz Mohammed Saleh Ahmed BDS,&nbsp;Badr Sultan Saif BDS, MSc, PhD,&nbsp;Xi Chen BDS, MSc, PhD,&nbsp;Yunshan Zhao BDS, MSc, PhD,&nbsp;Abeer A. Almashraqi BDS, MSc, PhD","doi":"10.1016/j.adaj.2025.05.012","DOIUrl":"10.1016/j.adaj.2025.05.012","url":null,"abstract":"<div><h3>Background</h3><div>The authors analyzed 3-dimensional changes in hard-tissue symmetry (HTS) and associated soft-tissue contour (STC) and evaluated soft-tissue thickness (STT) after stabilization splint (SS) therapy in adult patients with temporomandibular joint disorder (TMD) and mandibular deviation (MD).</div></div><div><h3>Methods</h3><div>In this retrospective clinical study, 35 adults with TMD and MD were treated with SS therapy; the patients’ mean (SD) age was 25.14 (6.11) years. Pre- and posttherapy cone-beam computed tomography scans were analyzed. HTS, STC, and STT were analyzed in 3 dimensions. A paired <em>t</em> test or Wilcoxon rank sum test was used and <em>P</em> less than .05 was considered significant.</div></div><div><h3>Results</h3><div>Patients received SS therapy for a mean (SD) of 9.49 (4.02) months. HTS parameters (ie, mandibular midline shift angle and anterior, middle, and posterior symmetry) on the deviated side decreased significantly (<em>P</em> &lt; .001, <em>P</em> &lt; .001, <em>P</em> &lt; .010, and <em>P</em> &lt; .042, respectively). The associated STC (ie, soft-tissue chin canting, soft-tissue anterior symmetry, soft-tissue middle symmetry, and soft-tissue posterior symmetry) on the deviated side decreased significantly (<em>P</em> &lt; .001, <em>P</em> &lt; .001, <em>P</em> &lt; .012, and <em>P</em> &lt; .041, respectively). The hard-tissue chin deviation was improved in 85.71% of the patients and associated soft-tissue chin deviation was improved in 74.29%.</div></div><div><h3>Conclusions</h3><div>In patients with TMD and MD, SS therapy resulted in considerable correction of HTS in roll rotation, centering the mandible, and soft tissue followed hard-tissue movement, resulting in improved STC and associated soft-tissue chin deviation. However, STT remained unchanged.</div></div><div><h3>Practical Implications</h3><div>SS therapy offers a noninvasive option for improving HTS and STC in adult patients with TMD and MD and contributes to the diagnosis and treatment of clinical conditions. However, its application is influenced by factors such as cost, accessibility, follow-up needs, and patient compliance.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Pages 626-637"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553865","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":"Tirzepatide gains US Food and Drug Administration approval for the management of obstructive sleep apnea","authors":"Mohamed G. Hassan BDS, MSc, PhD,&nbsp;Dina G. Hassan MBBCh, MSc, Dr rer nat,&nbsp;Gamaleldin A. Hassan BSc, MSc, PhD","doi":"10.1016/j.adaj.2025.05.007","DOIUrl":"10.1016/j.adaj.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) is a common condition characterized by repeated airway collapse during sleep, leading to breathing interruptions. OSA increases the risk of developing hypertension, heart disease, stroke, and respiratory complications, reducing overall health and quality of life. The authors aimed to provide oral health care providers with an update on the US Food and Drug Administration–approved medication tirzepatide (Zepbound; Lilly) and its implications for multidisciplinary OSA management and oral health care–related services.</div></div><div><h3>Types of Studies Reviewed</h3><div>A comprehensive MEDLINE search was conducted, and original research articles and systematic reviews related to OSA and tirzepatide were reviewed.</div></div><div><h3>Results</h3><div>A multidisciplinary approach involving lifestyle modifications, pharmaceutical interventions, oral appliance therapy, and surgical options tailored to patient-specific needs is required for effective management of OSA. In 2024, the US Food and Drug Administration approved tirzepatide for managing obesity in adults with OSA. By means of promoting weight loss, tirzepatide has been found to reduce breathing interruptions and enhance sleep quality. Although dental care providers do not prescribe tirzepatide, they play a critical role in early identification and referral of patients at risk of experiencing OSA through clinical screening. They recognize craniofacial features associated with airway obstruction, provide oral appliance therapy, and collaborate closely with health care providers.</div></div><div><h3>Practical Implications</h3><div>Tirzepatide offers a novel approach to managing OSA by means of targeting metabolic and inflammatory factors that contribute to this condition. It has the potential to affect oral health, including the management of periodontal disease, dental implant procedures, and orthodontic interventions. Dental care providers should consider patient-centered needs and the interrelationship between systemic health and oral health.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Pages 620-625"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497411","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":"Association Directory","authors":"","doi":"10.1016/S0002-8177(25)00363-0","DOIUrl":"10.1016/S0002-8177(25)00363-0","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Page A14"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767211","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":"Dental plaque","authors":"Jessica L. Mark Welch PhD,&nbsp;Gary G. Borisy PhD","doi":"10.1016/j.adaj.2025.05.005","DOIUrl":"10.1016/j.adaj.2025.05.005","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 8","pages":"Pages 674-677"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528473","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}