Dental Traumatology最新文献

{"title":"Simulation-Based Education in Traumatic Dental Injuries: A Systematic Review.","authors":"Tony Prud'homme, Inès Bouillaud, Camille Boëffard, Alexis Gaudin, Roselyne Clouet","doi":"10.1111/edt.70124","DOIUrl":"https://doi.org/10.1111/edt.70124","url":null,"abstract":"<p><strong>Background/aim: </strong>Learning traumatic dental injury management is challenging for dental students. Although clinical guidelines provide structured recommendations, it remains difficult to translate theoretical knowledge into clinical decision-making for complex trauma cases. Various types of simulation are increasingly used in dental education and may represent a valuable approach for improving training in dental traumatology. The aim of this systematic review was to evaluate the use of simulation-based education in dental traumatology among dental students, focusing on knowledge acquisition, clinical performance, and self-confidence.</p><p><strong>Materials and methods: </strong>Following PRISMA guidelines, a systematic search was conducted in the MEDLINE/PubMed and Scopus databases in January 2026, with prior registration on PROSPERO (CRD420261296263). Inclusion criteria targeted studies involving dental students and evaluating simulation-based training in dental traumatology, in English, reporting on knowledge, performance, or self-confidence. The risk of bias was evaluated using the Risk of Bias in Non-randomized Studies of Interventions and the Risk of Bias in Randomized Trials tools.</p><p><strong>Results: </strong>Out of 880 records initially identified, six studies met the inclusion criteria. All six studies investigated procedural simulation through hands-on training using physical models. Simulation-based training was consistently associated with improvements in knowledge, clinical performance, and self-confidence in managing traumatic dental injuries. However, all studies operated at Kirkpatrick levels 1-2, and three presented a high risk of bias.</p><p><strong>Conclusions: </strong>Simulation-based training in the management of traumatic dental injuries shows preliminary potential educational benefits, particularly in terms of students' self-confidence and perceived competence. However, all included studies assessed outcomes only at the first two levels of the Kirkpatrick model, with no assessment of clinical behavior change or patient outcomes. Greater diversity in simulation modalities and improved standardization of simulation protocols are needed. Simulation scenarios should be better aligned with established frameworks used in healthcare simulation-based education. Moreover, future studies evaluating simulation in dental education would benefit from more rigorous methodological designs and standardized outcome measures.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867947","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":"Artificial Intelligence Chatbots and Large Language Models for Traumatic Dental Injury Management and Decision Support: A Systematic Review With Function-Based Narrative Synthesis and Exploratory Meta-Analysis.","authors":"Carlos M Ardila, Eliana Pineda-Vélez, Alejandro I Díaz-Laclaustra","doi":"10.1111/edt.70122","DOIUrl":"https://doi.org/10.1111/edt.70122","url":null,"abstract":"<p><p>Traumatic dental injuries require rapid, accurate, and context-sensitive decisions, particularly during emergencies such as tooth avulsion, luxation injuries, and trauma involving the primary dentition. Artificial intelligence (AI) chatbots and large language models (LLMs) are increasingly used by patients, caregivers, students, and clinicians for immediate information and decision support, yet their reliability in dental trauma remains uncertain. This systematic review aimed to evaluate the accuracy, consistency, safety, guideline concordance, and clinical applicability of AI chatbots and LLMs for traumatic dental injury management and decision support. PubMed, Scopus, and Embase were searched through April 2026. Eligible studies evaluated AI-generated responses against clinical guidelines, expert assessment, validated dental trauma scenarios, photographs, real cases, standardized questions, or other reproducible reference standards. Twenty-eight studies met the eligibility criteria. A function-based narrative synthesis classified the evidence into five translational functions: patient- and caregiver-facing emergency guidance, guideline-based diagnostic and management benchmarking, domain-specific or document-grounded workflows, multimodal and real-case validation, and avulsion-specific prognostic or advanced decision support. An exploratory meta-analysis of nine study-level estimates with comparable binary outcomes demonstrated a pooled proportion of accurate or guideline-concordant responses of 81.7%, although heterogeneity was very high. Across studies, performance varied according to model, prompt format, reference standard, input type, and assessment methodology. Safety concerns included incomplete recommendations, misleading information, inconsistent responses, limited readability, unreliable references, and injury-specific performance variability. Overall, current evidence indicates that AI chatbots and LLMs can support dental trauma information retrieval and supervised clinical decision support, particularly when constrained by curated guidelines or domain-specific workflows. However, the available evidence remains limited by substantial methodological heterogeneity and limited real-world validation and therefore does not support the autonomous use of these systems for emergency traumatic dental injury management. Trial Registration: PROSPERO; CRD420261394046.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834913","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":"Usability Evaluation and Longitudinal Educational Outcomes of the ToothSOS Application for Parental Emergency Management of Traumatic Dental Injuries.","authors":"Makbule Buse Dundar Sari, Tuğba Aydoğdu, Berkant Sezer","doi":"10.1111/edt.70119","DOIUrl":"https://doi.org/10.1111/edt.70119","url":null,"abstract":"<p><strong>Background/aim: </strong>Appropriate first-aid management of traumatic dental injuries (TDIs) is highly time-sensitive and critically influences prognosis. Parents frequently represent the first point of contact following injury. Although the ToothSOS mobile application (App) is based on current guidelines of the International Association of Dental Traumatology, evidence integrating usability assessment using validated instruments with longitudinal knowledge retention in parental populations remains limited. This study evaluated the usability of the ToothSOS App using the validated System Usability Scale (SUS) and examined parental knowledge gain and retention over time.</p><p><strong>Materials and methods: </strong>In this prospective longitudinal questionnaire-based study, parents were assessed at baseline (T0), immediately after application use (T1), and one month later (T2). Knowledge of fracture and avulsion management was measured using standardized true-false items. Perceived usability, the primary outcome, was assessed using the SUS. Nonparametric repeated-measures analyses were performed.</p><p><strong>Results: </strong>A total of 149 parents completed all assessments. The ToothSOS App demonstrated high perceived usability, with a mean SUS score of 78.4 ± 8.3, exceeding the established benchmark for above-average usability. Knowledge scores differed significantly across time points (Friedman χ² = 187.920, p < 0.001), increasing from a median of 5 (IQR: 2) at baseline to 9 (IQR: 2) at T1 and remaining elevated at 8 (IQR: 3) at one month. The proportion of parents reporting adequate management knowledge increased markedly over time (p < 0.001), accompanied by significant improvements in confidence (p < 0.001). An apparent negative association was observed between baseline knowledge and knowledge retention (Spearman's rho = -0.557, p < 0.001).</p><p><strong>Conclusion: </strong>This study demonstrates that the ToothSOS App is not only educationally effective but also highly usable. Integrating usability assessment using a validated measurement instrument with longitudinal evaluation of knowledge and confidence provides a clinically meaningful framework for optimizing digital first-aid tools in time-sensitive dental trauma management.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814645","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":"Prevalence of Traumatic Dental Injuries in 12-Year-Old Adolescents in Brazil: A Comparative Analysis of 2010 and 2023.","authors":"Pamela Barbosa Dos Santos, Gabriel Pereira Nunes, Michael Henrique Araujo Monteiro, Maria Helena Monteiro de Barros Miotto, Altair Antoninha Del Bel Cury","doi":"10.1111/edt.70114","DOIUrl":"https://doi.org/10.1111/edt.70114","url":null,"abstract":"<p><strong>Objective: </strong>To analyze changes in the prevalence and severity of traumatic dental injuries in permanent incisors among 12-year-old Brazilian adolescents.</p><p><strong>Methods: </strong>This study was designed as a secondary analysis of data from two nationally representative, population-based cross-sectional surveys. Dental trauma was assessed using the O'Brien Index, according to World Health Organization (WHO) guidelines, with examinations restricted to permanent incisors. The outcome measures were the prevalence of dental trauma, defined as the presence of at least one affected tooth, and the mean number of affected teeth. Results were stratified according to injury severity. Analyses were conducted at the national and regional levels using absolute and relative frequencies. 95% confidence intervals were calculated to assess the precision of the estimates and support comparisons between surveys and geographic regions.</p><p><strong>Results: </strong>Nationally, the prevalence of traumatic dental injuries decreased from 20.5% in 2010 to 13.7% in 2023, whereas the proportion of adolescents without trauma increased from 79.5% to 86.3%. This decline was observed across all Brazilian regions, although regional differences remained evident. In 2023, the Southeast region presented the lowest prevalence of traumatic dental injuries, while the highest prevalences were observed in the Northeast and Central-West regions. Enamel fractures were the most common type of injury in both surveys, despite a reduction from 16.5% to 8.5%, followed by enamel-dentin fractures, which decreased from 3.7% to 1.4%. More severe conditions, including pulp involvement and tooth loss resulting from trauma, were uncommon in both survey years. The inclusion of the \"treated fracture\" category in 2023 showed that only 3.4% of adolescents had restored traumatic injuries. The mean number of teeth affected by enamel fractures declined from 0.20 in 2010 to 0.12 in 2023.</p><p><strong>Conclusions: </strong>The prevalence of dental trauma among 12-year-old Brazilian adolescents decreased substantially between 2010 and 2023. However, the low proportion of treated injuries suggests significant limitations in access to timely care, with potential prognostic implications. Furthermore, the unequal distribution of dental trauma, with higher prevalence in the North and Northeast regions, reflects persistent social and regional inequalities in oral health.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809110","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":"Comparison of Distance Learning and Face-to-Face Learning Approaches for Teaching Tooth Avulsion Management to Undergraduate Dental Students: A Randomised Controlled Educational Trial.","authors":"Aakash Gupta, Shagun Gill, Aditi Kulshrestha, Amanurrahman Zubair Ahemad, Ashmita Ghosh, Sasmita Dalai","doi":"10.1111/edt.70118","DOIUrl":"https://doi.org/10.1111/edt.70118","url":null,"abstract":"<p><strong>Background: </strong>Tooth avulsion is a dental emergency requiring immediate, evidence-based intervention to optimise periodontal and pulpal outcomes. Adequate education of dental students in avulsion management is therefore critical. While distance learning platforms, including online video modules, are increasingly used in dental education, their effectiveness relative to traditional face-to-face instruction in teaching avulsion management remains unclear.</p><p><strong>Aim: </strong>To compare the effectiveness of distance learning and face-to-face education approaches in improving knowledge, clinical decision-making, and confidence regarding the management of tooth avulsion among undergraduate dental students.</p><p><strong>Methods: </strong>This randomised controlled educational trial enrolled 120 undergraduate dental students (4th year). Participants were randomly allocated to either a distance learning group (Group I), which received guideline-based video modules on tooth avulsion management delivered via online platforms, or a face-to-face learning group (Group II), which received conventional interactive lectures and interactions. Knowledge acquisition was assessed using validated multiple-choice questionnaires, while clinical decision-making skills were evaluated through standardised, scenario-based simulated avulsion cases, with a rubric used to assign scores. Secondary outcomes include knowledge retention, self-reported confidence, and learner satisfaction.</p><p><strong>Results: </strong>A total of 120 4th-year undergraduate dental students were randomised, and 113 completed the 8-week follow-up. Both educational approaches significantly improved knowledge scores compared with baseline (p < 0.001). The face-to-face learning group achieved significantly higher post-intervention knowledge scores than the distance- learning group (18.2 ± 1.4 vs. 16.8 ± 1.7; mean difference, 1.4 points; 95% CI, 0.84-1.96; p < 0.001) and demonstrated superior scenario-based clinical decision-making, knowledge retention, and self-reported confidence at the 8-week follow-up (p < 0.001). Learner satisfaction was high in both groups but was significantly greater following face-to-face instruction (p < 0.001).</p><p><strong>Conclusion: </strong>Distance learning platforms are effective tools for enhancing academic knowledge and awareness of guidelines in tooth avulsion management, especially in remote areas. However, face-to-face instruction was associated with higher knowledge retention, confidence, and scenario-based clinical decision-making scores. These findings support integrating distance learning as a complementary component rather than a replacement for conventional face-to-face training in dental trauma education.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809162","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":"Development and Evaluation of an Online Learning Tool for Undergraduate Education in Dental Traumatology.","authors":"Anne C O'Connell, Rona Leith, Isabel C Olegário","doi":"10.1111/edt.70117","DOIUrl":"https://doi.org/10.1111/edt.70117","url":null,"abstract":"<p><strong>Aim: </strong>To develop a self-paced digital learning tool incorporating newer learning strategies for dental students to supplement existing undergraduate teaching in dental traumatology (DT). The secondary aim was to pilot the learning tool to evaluate learner experience and changes in immediate knowledge scores.</p><p><strong>Materials and methods: </strong>An online course was designed within the EdApp platform using learning strategies, such as gamification, case-based learning and microlearning. Seven core topics were identified and course content was prepared based on contemporary scientific literature. Content included interactive cases, clinical images, short videos, formative questions and immediate feedback. Each lesson was evaluated by content experts. Final year undergraduate dental students were invited to complete the course in a pilot study. Learner experience was evaluated using platform analytics, Likert-scale confidence ratings and open-ended feedback. A single-group pre-test and post-test design was used to compare knowledge scores before and immediately after course completion. Paired t-test was used to evaluate differences between scores (α = 5%).</p><p><strong>Results: </strong>The module was completed by 25 students. The mean completion time was 3.5 h (range 1.5-6 h) using mobile phones, tablets and computers. Knowledge scores were significantly higher immediately after course completion compared to baseline (p < 0.001). Three students did not provide feedback but the remaining participants provided positive feedback on the course duration, content clarity, readability, sequence, quality of images and videos. There was a high level of perceived confidence following course completion.</p><p><strong>Conclusion: </strong>A self-paced digital learning tool in dental traumatology was successfully developed and was well received by the undergraduate students. Participation was associated with significantly improved knowledge immediately after course completion. Self-paced digital learning tools can provide an effective adjunct to traditional undergraduate teaching methods in dental traumatology, but further studies are needed to evaluate longer-term knowledge retention and clinical performance.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801873","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":"Descriptive Evaluation of Medium- and Long-Term Complications of Traumatic Dental Injuries in Children and Adolescents Reporting to a Tertiary Care Hospital.","authors":"Shailja Srivastava, Nitesh Tewari, Vijay Prakash Mathur, Morankar Rahul, Kalpana Bansal, Georgios Tsilingaridis","doi":"10.1111/edt.70112","DOIUrl":"https://doi.org/10.1111/edt.70112","url":null,"abstract":"<p><strong>Background/aims: </strong>Traumatic dental injuries (TDIs) frequently present with acute symptoms, yet many adverse outcomes manifest months or years later as medium- and long-term consequences. These sequelae, such as pulp necrosis with infection of root canal system, periapical radiolucency, and external inflammatory resorption, pose significant diagnostic and therapeutic challenges. Evidence describing such healing complications as the first presenting complaint remains limited. The aim of this study was to describe the pattern of such complications in children and adolescents reporting to a tertiary care hospital and to evaluate associated patient- and injury-related factors.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted on patients aged 6-18 years presenting with a history of TDI to permanent teeth and exhibiting clinical and/or radiographic signs of medium- and long-term complications. Standardized assessment protocols were followed, including NA0D classification for injury type, Miller's criteria for mobility, thermal and electric pulp testing for pulp sensibility, and radiographic evaluation using RVG and CBCT when indicated. Medium- and long-term consequences were categorized using established criteria. Statistical analysis included Student's t-test and ordered logistic regression.</p><p><strong>Results: </strong>A total of 185 participants (218 teeth) were evaluated. Maxillary central incisors were most frequently affected (39.9%). The predominant injuries were enamel-dentin fractures (43.1%) and complicated crown fractures (41.3%). The most common medium- and long-term consequences were periapical radiolucency (90.3%), pulp necrosis with infection of root canal system (77.1%), and external inflammatory resorption (67.4%). Delay in reporting showed significant associations with discoloration, tenderness on percussion, and external inflammatory resorption (p < 0.01). Type of injury was significantly associated with multiple complications. Root maturity and age showed limited association.</p><p><strong>Conclusion: </strong>Medium- and long-term complications of TDIs predominantly involved pulp necrosis with infection of root canal system, apical pathology, and external inflammatory resorption. Longer delays in seeking care significantly increased the likelihood of adverse outcomes. The findings highlight the need for improved awareness, early emergency management, and future research focusing on combined injury patterns to better predict long-term prognosis.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714684","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":"Accuracy of Chatbot-Based Health Advice Related to Traumatic Dental Injuries: A Systematic Review and Meta-Analysis.","authors":"Nitesh Tewari, Amna Afrin Kidwai, Ekta Wadhwani, Mugilan Ravi, Georgios Tsilingaridis, Priscilla Barbosa Ferreira Soares, Paulo César Bandeira Junqueira, Caroline Garcia Orsi, Partha Haldar, Carlos José Soares","doi":"10.1111/edt.70113","DOIUrl":"https://doi.org/10.1111/edt.70113","url":null,"abstract":"<p><strong>Background/aims: </strong>The growing use of generative artificial intelligence, especially chatbots, has motivated researchers to test the accuracy of health advice provided. Though there are studies comparing chatbot health advice for traumatic dental injuries (TDI), variable results have been reported. Hence, this systematic review aimed to assess contemporary chatbots for their ability to accurately and reliably provide responses to different types of questions related to emergency care of TDI.</p><p><strong>Methods: </strong>The protocol was developed using the Cochrane Handbook and the Chatbot-Assessment-Reporting-Tool (CHART) statement and registered in the Open Science Framework. A literature search, based on the research question, was conducted in PubMed, EMBASE, Scopus, and Web of Science on September 19th, 2025, without any limitations. Screening of titles and abstracts and later full text, and data extraction were performed. These steps were followed by qualitative synthesis and meta-analysis. The quality of studies was assessed using their compliance with CHART.</p><p><strong>Results: </strong>The review included 10 articles published in 2024 and 2025. Seven contemporary chatbots were evaluated with different themes and types of questions. Eight of the studies showed good compliance with CHART (≥ 75%). The overall pooled accuracy was 65% (95% CI 52%-78%, I² = 88%) in ChatGPT-3.5, 79% (95% CI 61%-93%, I² = 88.8%) in ChatGPT-4.0, and 70% (95% CI 60%-79%, I² = 86.4%) in Gemini.</p><p><strong>Conclusion: </strong>Overall accuracy of chatbot-generated advice was moderate, with substantial variation depending on the type of questions assessed. The meta-analysis demonstrated a suggestive trend of higher accuracy for ChatGPT-4.0, followed by Gemini, Copilot P, and ChatGPT-3.5. However, these findings should not be interpreted as evidence of clinical reliability, as even limited inaccuracies in emergency dental trauma advice may contribute to delayed or inappropriate management and adverse outcomes.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714738","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":"Deep Learning-Based Detection of Simulated Root Resorption in Scenarios Involving Image-Degrading Artifacts: An in Vitro Study.","authors":"Orlando Aguirre Guedes, Letícia Junqueira de Pádua Sesti Gomes Moussa, Lucas Rodrigues de Araújo Estrela, Raoni Florentino da Silva Teixeira, Cyntia Rodrigues de Araújo Estrela, Raul Vitor Arantes Monteiro, Gordon Lai, Carlos Estrela","doi":"10.1111/edt.70105","DOIUrl":"10.1111/edt.70105","url":null,"abstract":"<p><strong>Background/aim: </strong>This study developed a deep learning-based convolutional neural network (CNN) model for detecting external root resorption (ERR) in periapical radiographs and cone-beam computed tomography (CBCT) scans, particularly in the presence of image-degrading artifacts.</p><p><strong>Material and methods: </strong>A total of 480 bovine incisors were allocated into four experimental conditions (n = 120) according to the presence and absence of root canal treatment and ERR. Resorption defects were made 5 mm from the root apex using a round diamond bur. All specimens were imaged using periapical radiography and CBCT under standardized acquisition protocols. CBCT images were processed using a post-processing CBCT software, with and without the Blooming Artifact Reduction (BAR 1) algorithm, and with a volumetric rendering reconstruction tool. A pre-trained AlexNet CNN was adapted using transfer learning for four-class image classification. The CNN performance was evaluated using standard classification metrics, including overall accuracy, precision, recall, and F1-score.</p><p><strong>Results: </strong>CNN performance varied across imaging modalities. Periapical radiography yielded perfect classification (100% accuracy). High accuracy was also observed for CBCT without BAR 1 (95.83%) and CBCT with BAR 1 (97.92%). CBCT with three-dimensional reconstruction showed reduced performance (73.96%), particularly in endodontically treated teeth without root resorption.</p><p><strong>Conclusions: </strong>Deep learning-based CNN model demonstrated high diagnostic performance for detecting ERR, strongly influenced by image acquisition and processing protocols.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680692","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":"Hank's Balanced Salt Solution Supplemented With L-Ascorbic Acid Modulates Periodontal Ligament Cell Inflammation and Regenerative Responses: An In Vitro and Ex Vivo Study.","authors":"Li Fuan Poh, Dalia Abdullah, Sook Luan Ng, Eason Soo, Amy Kia Cheen Liew","doi":"10.1111/edt.70107","DOIUrl":"https://doi.org/10.1111/edt.70107","url":null,"abstract":"<p><strong>Background: </strong>Successful management of an avulsed tooth depends on preserving periodontal ligament viability during the extraoral period. Although Hank's Balanced Salt Solution (HBSS) is recommended for storage of avulsed teeth, it lacks bioactive components that actively support tissue repair. This study evaluated whether supplementation with L-ascorbic acid (L-AA) could enhance biological responses associated with periodontal healing.</p><p><strong>Material and methods: </strong>Complementary in vitro and ex vivo models were used. Cultured human periodontal ligament cells were exposed to HBSS, HBSS supplemented with L-AA, or Dulbecco's Modified Eagle Medium containing fetal bovine serum. Wound closure, inflammatory cytokine expression, matrix metalloproteinase expression, and collagen type I alpha 1 chain gene and protein expression were evaluated. In the ex vivo model, 18 freshly extracted premolars were stored in the respective media for 24 h at 4°C before assessment of periodontal ligament tissue viability and gene expression. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>The optimized concentration of L-AA was 175 μg/mL. Supplementation of HBSS with L-AA resulted in significantly greater wound closure than HBSS alone. In both in vitro and ex vivo models, L-AA supplementation significantly reduced the expression of pro-inflammatory cytokines and matrix metalloproteinases while enhancing the expression of collagen type I alpha 1 chain. Although periodontal ligament tissue viability was numerically higher following supplementation, differences were not statistically significant.</p><p><strong>Conclusions: </strong>Supplementation of HBSS with L-AA favorably modulated inflammatory and extracellular matrix-related responses in cultured and ex vivo periodontal ligament tissues. Although no significant improvement in tissue viability was observed, the findings suggest potential biological benefits relevant to periodontal repair. Further studies are required to validate these findings in animal replantation models and determine their clinical relevance.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680647","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}