Journal of the American Dental Association最新文献

{"title":"United in purpose","authors":"Richard J. Rosato DMD","doi":"10.1016/j.adaj.2026.07.017","DOIUrl":"10.1016/j.adaj.2026.07.017","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 945-947"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912650","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":"ADA 2026 Scientific Session concurrent meetings","authors":"","doi":"10.1016/j.adaj.2026.07.006","DOIUrl":"10.1016/j.adaj.2026.07.006","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Page 1071"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961571","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":"Living evidence-informed guideline on the early detection of oral squamous cell carcinoma and potentially malignant disorders","authors":"Ankita Shashikant Bhosale BDS, MPH,&nbsp;Carolina Martins-Pfeifer DDS, MSc, PhD,&nbsp;Francisca Verdugo-Paiva DDS, MSc,&nbsp;Olivia Urquhart MPH,&nbsp;Alonso Carrasco-Labra DDS, MSc, PhD,&nbsp;Julia Pimentel DDS,&nbsp;A. Ross Kerr DDS, MSD,&nbsp;Marco Magalhaes DDS, MSc, PhD,&nbsp;Carol Anne Murdoch-Kinch DDS, PhD,&nbsp;JoAnn Gurenlian RDH, MS, PhD,&nbsp;Nishant Agrawal MD,&nbsp;Anil K. Chaturvedi PhD,&nbsp;Eva Grayzel BA,&nbsp;Alexander T. Pearson MD, PhD,&nbsp;James C. Melville DDS,&nbsp;Anita S.H. Patel DMD,&nbsp;Alessandro Villa DDS, PhD, MPH,&nbsp;Michael Glick DMD,&nbsp;Mark W. Lingen DDS, PhD","doi":"10.1016/j.adaj.2026.04.010","DOIUrl":"10.1016/j.adaj.2026.04.010","url":null,"abstract":"<div><h3>Background</h3><div>Identifying oral potentially malignant disorders and oral cavity cancer early can lead to better patient outcomes. The guideline panel evaluated the usefulness of light-based adjuncts for screening adults without mucosal abnormalities and for determining the need for biopsy among adults with mucosal abnormalities in the oral cavity or on the lip.</div></div><div><h3>Types of Studies Reviewed</h3><div>The authors conducted a living systematic review to evaluate evidence on the benefits and harms of light-based adjuncts and a scoping review to assess people and clinician values and preferences regarding the use of light-based adjuncts and biopsy of mucosal abnormalities. The guideline panel used this evidence to formulate recommendations according to the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework. The framework also guided the panel’s consideration of required resources, equity, acceptability, and feasibility in shaping the final recommendations.</div></div><div><h3>Results</h3><div>The guideline panel formulated 2 recommendations and 2 good practice statements. For adults with and without mucosal abnormalities, they formulated conditional recommendations against the use of light-based adjuncts on the basis of very low certainty evidence. The good practice statements urge clinicians to perform a clinical oral examination in all adult patients.</div></div><div><h3>Conclusions and Practical Implications</h3><div>Biopsy remains the reference standard for establishing a definitive diagnosis of an oral potentially malignant disorder and oral squamous cell carcinoma. All adults should undergo a clinical oral examination in primary care settings. When implementing or adapting these recommendations, local contexts should be considered to promote equitable access to early detection.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 968-979"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143768","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":"An extensive cystic radiolucency in the right maxilla","authors":"Ajay Kumar Verma BDS,&nbsp;Anjali Narwal MDS,&nbsp;Mala Kamboj MDS,&nbsp;Anju Devi MDS,&nbsp;Gopikrishnan Vijayakumar MDS,&nbsp;Sivakumar N MDS","doi":"10.1016/j.adaj.2025.08.019","DOIUrl":"10.1016/j.adaj.2025.08.019","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 1048-1053.e1"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251608","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":"Light-based adjuncts to determine the need for biopsy for early detection of oral squamous cell carcinoma and potentially malignant disorders","authors":"Olivia Urquhart MPH,&nbsp;Francisca Verdugo-Paiva DDS, MSc,&nbsp;Carolina Martins-Pfeifer DDS, MSc, PhD,&nbsp;Ankita Shashikant Bhosale BDS, MPH,&nbsp;Carla Massignan DDS, MS, PhD,&nbsp;Dalia Meisha BDS, MPH, CAGS, DScD,&nbsp;Kelly K. O’Brien MSLIS,&nbsp;Ana María Rojas-Gómez DDS, MSc,&nbsp;Michael Glick DMD,&nbsp;Mark W. Lingen DDS, PhD,&nbsp;Alonso Carrasco-Labra DDS, MSc, PhD","doi":"10.1016/j.adaj.2026.03.028","DOIUrl":"10.1016/j.adaj.2026.03.028","url":null,"abstract":"<div><h3>Background</h3><div>Early detection of oral potentially malignant disorders and oral cancer has the potential to decrease negative consequences associated with late-stage diagnosis and improve prognosis. Light-based adjunct devices could have a role in oral cancer diagnostic pathways before definitive diagnosis with biopsy. In this living systematic review, the authors assessed the benefits and harms of light-based adjuncts to detect oral potentially malignant disorders and oral squamous cell carcinoma.</div></div><div><h3>Types of Studies Reviewed</h3><div>The authors enhanced and updated systematic searches from systematic reviews in several databases (ie, MEDLINE, Epistemonikos, Embase, and Cochrane Central Register of Controlled Trials) through November 25, 2025. The authors independently screened and extracted diagnostic impact and test accuracy studies in duplicate using the Grading of Recommendations Assessment, Development and Evaluation approach and assessed the certainty in the evidence.</div></div><div><h3>Results</h3><div>The authors identified 36 diagnostic test accuracy studies, 0 impact studies for people with mucosal abnormalities, and 0 studies for people without abnormalities. Low through very low certainty pooled sensitivity data across autofluorescence and tissue reflectance light-based tests (range, 0.86-0.91) in people with mucosal abnormalities could be acceptable. Pooled specificities (range, 0.26-0.56) suggested the test could result in many false-positive results.</div></div><div><h3>Conclusions and Practical Implications</h3><div>The clinical usefulness of light-based adjuncts cannot be determined with a high degree of certainty for patients with or without mucosal abnormalities. Unnecessary anxiety, biopsies, and costs related to false-positive results in people with mucosal abnormalities need to be considered when balancing the test’s clinical usefulness. The absence of evidence among people without mucosal abnormalities is problematic.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 980-992"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143807","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":"Immunoglobulin light-chain amyloidosis in the setting of multiple myeloma diagnosed from oral biopsy","authors":"Efstathios Pettas DDS, MSc,&nbsp;Sook-Bin Woo DMD, MMSc","doi":"10.1016/j.adaj.2026.02.003","DOIUrl":"10.1016/j.adaj.2026.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Immunoglobulin light-chain (AL) amyloidosis, the most common clinical form of systemic amyloidosis, is a serious condition that may affect the oral mucosa. Although macroglossia is the most common manifestation, other oral mucosal sites may be involved. This case report describes AL amyloidosis diagnosed by oral biopsy in a patient who was subsequently found to have multiple myeloma.</div></div><div><h3>Case Description</h3><div>A 58-year-old woman sought treatment because of multifocal oral nodules, fatigue, weight loss, shoulder and low back pain, congestive heart failure, chronic anemia, cough, episodes of vision loss, proteinuria, and neuropathy in the hands. Oral biopsy confirmed the presence of amyloid deposition, and the workup established a diagnosis of AL amyloidosis in the setting of λ light-chain multiple myeloma. Six months after the initiation of treatment with daratumumab, cyclophosphamide, bortezomib, and dexamethasone there was a 46-fold decrease in free serum λ light chains. The patient reported less fatigue, improvement in appetite, and weight gain despite persistent macroglossia. After several treatment modifications, hematologic response was achieved with elranatamab, despite adverse events.</div></div><div><h3>Practical Implications</h3><div>AL amyloidosis is a complex, potentially life-threatening condition that requires a multidisciplinary approach. This article highlights the role of the dentist in facilitating the diagnosis through a simple oral biopsy. Since dentists are often the first specialists to encounter oral manifestations of systemic disease, heightened awareness is crucial for timely recognition and referral.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 1041-1046"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775173","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":"Impact of rectangular collimation on the quality and retake of intraoral radiographs","authors":"Daniel P. Turgeon DMD, MSc,&nbsp;Anthony Nasrallah,&nbsp;Caroline Bissonnette DMD, MSc,&nbsp;Anaïs Landry-Schönbeck DMD, MSc,&nbsp;Duy Dat Vu DMD, MSc,&nbsp;Caroline Nguyen Ngoc DMD, MSc","doi":"10.1016/j.adaj.2026.02.001","DOIUrl":"10.1016/j.adaj.2026.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Intraoral radiograph machines have evolved over the past century, but their design, especially the collimator, has changed little. Although circular collimation is easier to use, it exposes the patient to more radiation. Rectangular collimation reduces this dose by 50% through 60% but increases the risk of experiencing positioning errors. The authors aimed to determine whether the radioprotection benefits outweigh the technical disadvantages.</div></div><div><h3>Methods</h3><div>This retrospective study included intraoral radiographs obtained by dental students with both standard circular collimation and rectangular collimation. Two independent blinded evaluators analyzed the radiographs to identify all types of errors and retakes.</div></div><div><h3>Results</h3><div>The rates of cone cuts and cone cuts requiring retakes were 20.9% and 5.7%, respectively, with rectangular collimation. These rates were substantially higher than with circular collimation (1.8% and 0.7%, respectively). The differences in the proportion of retakes due to cone cuts between rectangular collimation (27.2%) and circular collimation (36.0%) were not statistically significant. Moreover, the overall retake rate was not significantly different between rectangular collimation (16.9%) and circular collimation (16.7%) (<em>P</em> = .922).</div></div><div><h3>Conclusions</h3><div>The number of retakes was not significantly higher with rectangular collimation, despite a significant increase in cone cuts. It should be recommended that clinicians with proper training use this type of collimation in conjunction with a positioning device due to the considerable reduction in radiation exposure.</div></div><div><h3>Practical Implications</h3><div>Special attention must be paid to cone positioning and clinical training to fully benefit from the radioprotective advantages of rectangular collimation.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 993-998"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486674","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":"Lost in translation","authors":"Tal Robbins Sastow DMD, MS,&nbsp;George Rumman MD, DDS,&nbsp;Harry Dym DDS","doi":"10.1016/j.adaj.2025.11.009","DOIUrl":"10.1016/j.adaj.2025.11.009","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 948-949"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912010","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":"Ethical dimensions of artificial intelligence integration into dental practice","authors":"Chintan Narad DDS, MDS,&nbsp;Krishma Sharda MDS,&nbsp;Sakshi Sharma Aasdhir MDS","doi":"10.1016/j.adaj.2026.02.004","DOIUrl":"10.1016/j.adaj.2026.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) is increasingly applied in dentistry to enhance diagnosis and treatment planning. Its integration raises ethical challenges concerning privacy, consent, algorithmic fairness, and professional accountability.</div></div><div><h3>Types of Studies Reviewed</h3><div>The authors synthesized peer-reviewed literature from dental and medical databases. Data were extracted from studies in which researchers addressed ethical principles, legal implications, and regulatory perspectives on AI use in dentistry.</div></div><div><h3>Results</h3><div>Four major ethical domains of autonomy, beneficence, nonmaleficence, and justice were included as central to AI in dentistry. Key concerns include potential bias in algorithms, inequitable technology access, and threats to data confidentiality. The literature supports developing regulatory frameworks and ethical guidelines to ensure safe, fair, and accountable AI implementation in dental settings.</div></div><div><h3>Conclusions and Practical Implications</h3><div>Responsible AI integration demands transparency, patient involvement, and ethical literacy among dental care professionals. Establishing governance standards and interdisciplinary dialogue will help preserve trust and fairness in AI-assisted oral health care.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 999-1004"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775243","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":"Multimodal risk assessment for oral potentially malignant disorders","authors":"Michael E. Troka DMD,&nbsp;Alessandro Villa DDS, PhD, MPH,&nbsp;James C. Gates DMD, MD","doi":"10.1016/j.adaj.2026.06.001","DOIUrl":"10.1016/j.adaj.2026.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Oral potentially malignant disorders exhibit heterogeneous malignant transformation risk that clinical approaches fail to adequately predict. Histopathologic dysplasia grading, the reference standard of risk assessment, is associated with poor interobserver reliability and limited prognostic discrimination. It is necessary to define other potential patient- and tissue-associated risk modifiers to improve patient-specific disease prediction.</div></div><div><h3>Types of Studies Reviewed</h3><div>PubMed was queried for patient- and specimen-derived factors as they relate to oral cancer and oral potentially malignant disorders, with preference for systematic review and meta-analysis articles published within the past 5 years. When not available, guidelines from the American Cancer Society, National Cancer Institute, or other national organizations or the most recent best articles were referenced to support the data presented.</div></div><div><h3>Results</h3><div>Within patient-associated factors, validated measures of tobacco and alcohol exposure, clinical lesion characteristics, systemic health factors including metabolic syndrome components, comorbidity risk, and dental health indexes were found. Within specimen-derived data, tissue-based analyses encompassing histopathology and advanced molecular profiling (genomic, epigenomic, transcriptomic, spatial approaches), blood-based germline and somatic mutation analysis, and saliva-based microbiome characterization and inflammatory biomarker assessment were addressed.</div></div><div><h3>Practical Implications</h3><div>Malignant transformation reflects intersecting patient and specimen risk pathways that affect each patient differently; no single modality captures this complexity. Realizing precision prognostication in oral precancer will require coordinated expansion and standardization of data collection across research groups. This review is intended to guide covariate selection for prospective study design, improve reproducibility, and ultimately enable the development of validated multimodal risk prediction tools for clinical deployment.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 1018-1028"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912614","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}