{"title":"Advancing precision dentistry: the integration of multi-omics and cutting-edge imaging technologies-a systematic review.","authors":"Neelam Das","doi":"10.3389/fdmed.2025.1581738","DOIUrl":"10.3389/fdmed.2025.1581738","url":null,"abstract":"<p><strong>Background: </strong>The convergence of multi-omics, advanced imaging technologies, and artificial intelligence (AI) is reshaping diagnostic strategies in precision dentistry. This systematic review critically assesses how the integration of multi-omics (genomics, proteomics, metabolomics), advanced imaging modalities (CBCT, MRI), and AI-based techniques synergistically enhances diagnostic accuracy, clinical decision-making, and personalized care in dentistry.</p><p><strong>Methods: </strong>The review follows PRISMA 2020 guidelines. A total of 50 studies published between 2015 and 2024 were selected using a PICOS framework. Analytical tools included meta-analysis (Forest and Funnel plots), risk of bias assessment, VOS viewer-based bibliometric mapping, and GRADE evidence grading.</p><p><strong>Results: </strong>Multi-omics approaches revealed key biomarkers such as TP53, IL-1, and MMPs in early diagnosis. CBCT reduced diagnostic error by 35% (CI: 30%-40%), while MRI improved soft-tissue evaluation by 25% (CI: 18%-32%). AI tools, including convolutional neural networks and radiomics, led to a 40% reduction in diagnostic time (CI: 33%-45%) and improved lesion classification.</p><p><strong>Conclusion: </strong>Integrating AI with omics and imaging technologies enhances diagnostic precision in dentistry. Future efforts must address data standardization, ethical implementation, and validation through multicenter trials for clinical adoption.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"6 ","pages":"1581738"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A prospective evaluation of subgingival irrigation with i-PRF following non-surgical treatment of peri-implantitis.","authors":"Laurie Deterville, Jérôme Frédéric Lasserre, Selena Toma","doi":"10.3389/fdmed.2025.1568889","DOIUrl":"10.3389/fdmed.2025.1568889","url":null,"abstract":"<p><strong>Introduction: </strong>Peri-implantitis, an inflammatory condition around dental implants, is challenging to manage with conventional non-surgical treatments alone. Emerging adjunctive therapies like glycine air-polishing and injectable platelet-rich fibrin (i-PRF) show potential to enhance decontamination.</p><p><strong>Aim: </strong>To clinically and radiographically evaluate the efficacy of glycine air-polishing and the adjunctive use of injectable platelet rich fibrin (i-PRF) for the non-surgical treatment of slight peri-implantitis.</p><p><strong>Methods: </strong>For this prospective case series, nine patients (<i>n</i> = 14 implants), with at least one implant with a slight peri-implantitis (radiographic bone loss visible and up to 4 mm) were enrolled. All treated implants received the same treatment: non-surgical mechanical debridement with an air abrasive device (PERIOFLOW®) followed by a subgingival irrigation with an injectable platelet rich fibrin (i-PRF). The following clinical parameters were measured: Plaque Index (PI), Bleeding on Probing (BoP), Suppuration on Probing (SoP), Probing Pocket Depth (PPD), Relative Attachment Level (RAL) and Recession (REC). They were assessed at baseline (M0), 3 and 6 months (M3 and M6). To compare bone level (BL), radiographs were taken at M0 and M6 (<i>p</i> > 0.05, ANOVA, Bonferroni).</p><p><strong>Results: </strong>Results indicated that PI significantly decreased over 6 months to a mean value of <0.05. Both BoP (<i>p</i> < 0.05) and SoP (<i>p</i> < 0.05) were substantially reduced at 3 months, although a slight increase was noted at 6 months. Mean PPD was 3.61 ± 0.25 mm (<i>p</i> < 0.05) at M6, and RAL gain was significantly improved at 6 months (7.76 ± 0.34 mm, <i>p</i> < 0.05). BL showed a significant grain at 6 months (<i>p</i> < 0.05). Most mucosal recession occurred within the first 3 months, with no significant change at 6 months.</p><p><strong>Conclusion: </strong>The application of i-PRF after a subgingival debridement using glycine air-polishing shows significant improvement of clinical parameters and a bone level stability for at least six months. However, if we consider that no bleeding on probing is needed to control the disease, none of the implants were considered successfully treated. Further randomized clinical trials are needed to evaluate the benefits of i-PRF as an adjuvant to the treatment of peri-implantitis.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"6 ","pages":"1568889"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eiko Yamada, Kalie Dominick, Rachel J Kulchar, Joseph Twohig, Zohreh Khavandgar, Margaret Beach, Eileen Pelayo, Alan Baer, Paola Perez, Blake M Warner
{"title":"Multiparameter flow cytometry enables immune profiling and IFN pathway analysis in human minor salivary glands.","authors":"Eiko Yamada, Kalie Dominick, Rachel J Kulchar, Joseph Twohig, Zohreh Khavandgar, Margaret Beach, Eileen Pelayo, Alan Baer, Paola Perez, Blake M Warner","doi":"10.3389/fdmed.2025.1590516","DOIUrl":"10.3389/fdmed.2025.1590516","url":null,"abstract":"<p><strong>Aim/introduction: </strong>We aimed to achieve direct quantitative measurement of activated and therapeutically actionable pathways (e.g., Type-I interferon) in target organs of autoimmune disease using flow cytometry of human salivary glands. Sjögren's Disease (SjD) is a systemic autoimmune disorder characterized by lymphocytic inflammation and dysfunction of the lacrimal and salivary glands. Minor salivary glands are routinely biopsied and are used for the histopathological diagnosis of SjD. In this study, we optimized the dissociation, permeabilization, antibody panel, and analytical parameters to characterize both the immune and epithelial cells in the glands, and the activation status of a specified pathway by measuring intracellular phosphorylated proteins.</p><p><strong>Methods: </strong>Fresh human MSG biopsies were dissociated into single-cell suspensions and permeabilized under optimized conditions. MSG suspensions were stained for cell surface and intracellular markers then analyzed using nine-color conventional flow cytometry, including two intracellular markers.</p><p><strong>Results: </strong>Our optimized dissociation and permeabilization protocols for human MSG preserved key cell surface markers. Our flow cytometry panel identified major immune cell populations and distinguished epithelial cells via cytokeratin-18. We demonstrate the protocol's utility showing differential interferon pathway activity in SjD vs. healthy MSG leukocytes and epithelial cells. We provide guidance on panel selection, analytical capabilities, and the impact of cell yield on resolution using conventional flow cytometry.</p><p><strong>Conclusion: </strong>Our optimized protocol enables high-resolution characterization of immune and epithelial cell populations in human MSG, preserving key markers and capturing interferon pathway activity. Our protocol provides a robust framework for the direct study of immune heterogeneity and signaling dynamics in SjD at single cell resolution.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"6 ","pages":"1590516"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Noha Waleed Barakat, Mahmoud Mokhtar El Far, Ahmed Mustafa Hashim Kotb
{"title":"Overdenture pickup without retaining material; a novel dental technique.","authors":"Noha Waleed Barakat, Mahmoud Mokhtar El Far, Ahmed Mustafa Hashim Kotb","doi":"10.3389/fdmed.2025.1589993","DOIUrl":"10.3389/fdmed.2025.1589993","url":null,"abstract":"<p><p>This article describes a novel technique for overdenture metal housing pickup for a digitally fabricated overdenture using an extraoral scanner and ExoCAD software. This technique could help the clinician save time and reduce the hassle of extra visits and additional laboratory steps.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"6 ","pages":"1589993"},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raúl Castro-Casarrubias, Natividad Castro-Alarcón, Salvador Reyes-Fernández, Elena Salazar-Hernández, Mirna Vázquez-Villamar, Norma Samanta Romero-Castro
{"title":"Subgingival microbiota and genetic factors (A-2570G, A896G, and C1196T TLR4 polymorphisms) as periodontal disease determinants.","authors":"Raúl Castro-Casarrubias, Natividad Castro-Alarcón, Salvador Reyes-Fernández, Elena Salazar-Hernández, Mirna Vázquez-Villamar, Norma Samanta Romero-Castro","doi":"10.3389/fdmed.2025.1576429","DOIUrl":"10.3389/fdmed.2025.1576429","url":null,"abstract":"<p><strong>Background: </strong>Subgingival microbiota play an important role in maintaining oral health. Subgingival dysbiosis leads to the aggregation of highly pathogenic bacteria, and the host's genetics modulates the innate immune response. The interaction between these two factors plays an important role in the aggravation of periodontitis. Therefore, evaluating the association between the TLR-4 polymorphisms and subgingival microbiota in patients with periodontitis is necessary.</p><p><strong>Methods: </strong>We included 58 cases with periodontitis and 53 controls without periodontitis in this study. A896G, A-2570G, and C1196T polymorphisms of the <i>TLR4</i> gene were determined by the polymerase chain reaction and restriction fragment length polymorphism technique. The DNA-DNA checkerboard hybridization technique was used for the identification and quantification of 18 bacterial species of subgingival plaque.</p><p><strong>Results: </strong><i>Cutibacterium acne</i>s occurred in greater number and frequency than other bacterial species ( <math><mover><mi>χ</mi> <mo>¯</mo></mover> </math> 1.32 E + 05) in individuals with periodontitis. Patients with <i>C. acnes</i> had a higher risk [odds ratio (OR)= 3.82 (95% confidence interval (CI): 1.37-10.3)] of developing periodontitis (<i>p</i> < 0.05), as did those with orange and red complex bacteria (<i>Treponema denticola</i>, <i>Tannerella forsythia</i>, <i>Porphyromonas gingivalis</i>, <i>Prevotella nigrescens</i>, <i>Prevotella intermedia, Fusobacterium periodonticum</i>, <i>Fusobacterium nucleatum</i>, <i>Eubacterium nodatum,</i> and <i>Campylobacter rectus</i>). The A/G genotype of SNP -2570 of the <i>TLR4</i> gene was identified as a risk factor for the development of periodontitis [OR = 2.28 (95% CI: 1.04-5.00)]. Furthermore, there was an antagonistic biological effect of the presence of bacteria such as <i>Capnocytophaga gingivalis</i> [OR = 0.44 (95% CI: 0.20-1.96)] and <i>C. rectus</i> [OR = 0.39 (95% CI: 0.18-0.87)] (<i>p</i> < 0.05). The A/G genotype of SNP-2570 was correlated with greater clinical attachment loss and periodontal pocket depth.</p><p><strong>Conclusions: </strong>The agonistic or antagonistic biological effect of each bacterial species depends on the genotype present in each individual and the destruction processes of dental support tissues.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"6 ","pages":"1576429"},"PeriodicalIF":1.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Turki Alshehri, Israa Alkhalifah, Areeb Alotaibi, Alaa F Alsulaiman, Abdullah Al Madani, Basil Almutairi, Abdulrahman A Balhaddad
{"title":"The impact of <i>Caralluma munbyana</i> extracts on <i>Streptococcus mutans</i> biofilm formation.","authors":"Turki Alshehri, Israa Alkhalifah, Areeb Alotaibi, Alaa F Alsulaiman, Abdullah Al Madani, Basil Almutairi, Abdulrahman A Balhaddad","doi":"10.3389/fdmed.2025.1575161","DOIUrl":"10.3389/fdmed.2025.1575161","url":null,"abstract":"<p><strong>Background/objectives: </strong><i>Caralluma</i> plants have a wide range of anti-inflammatory and antimicrobial activities. This study aims to assess the antibacterial effect of water, methanol, and ethanol extracts of <i>Caralluma munbyana</i> against <i>Streptococcus mutans</i> biofilms.</p><p><strong>Methods: </strong>Three extracts of <i>C. munbyana</i> were prepared using water, methanol, and ethanol. Multiple concentrations ranging between 2.93 and 93.75 mg/ml were achieved, alongside a control group with no extract, and incubated with an overnight culture of <i>S. mutans</i>. In the following day, the total absorbance was measured at 595 nm. Then, the biofilms were fixed and stained with 0.5% crystal violet to measure the biofilm absorbance at 490 nm. One-way ANOVA and Tukey's <i>post-hoc</i> tests were applied to identify which specific concentrations differed from the control.</p><p><strong>Results: </strong><i>C. munbyana</i> methanol and ethanol extracts significantly affected the total absorbance of <i>S. mutans</i> (<i>P</i> ≤ 0.001) at 46.87 and 93.75 mg/ml. For biofilm inhibition, <i>C. munbyana</i> water extract was effective (<i>P</i> ≤ 0.001) in reducing the biofilm growth at 23.44 (1.34 ± 0.08), 46.87 (1.31 ± 0.15), and 93.75 (1.04 ± 0.07) mg/ml when compared to the control (1.58 ± 0.11). More reduction was observed among methanol and ethanol extracts, as <i>C. munbyana</i> methanol extract significantly (<i>P</i> ≤ 0.001) inhibited the <i>S. mutans</i> biofilm growth at 23.44 (0.99 ± 0.15), 46.87 (0.12 ± 0.02), and 93.75 (0.09 ± 0.01) mg/ml. Similarly, <i>C. munbyana</i> ethanol extract's biofilm inhibition was observed at the concentrations of 23.44 (0.45 ± 0.12), 46.87 (0.10 ± 0.02), and 93.75 (0.09 ± 0.04) mg/ml.</p><p><strong>Conclusion: </strong>These findings suggest that <i>C. munbyana</i> possesses antibacterial properties against <i>S. mutans</i> biofilms, particularly through its methanol and ethanol extracts.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"6 ","pages":"1575161"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amanda Rodriguez, Oliver Kripfgans, Fabiana Aellos, Diego Velasquez, Alejandra Baltazar, Hsun-Liang Chan
{"title":"Non-invasive and quantitative methods for assessment of blood flow in periodontal and oral soft tissues: a systematic review.","authors":"Amanda Rodriguez, Oliver Kripfgans, Fabiana Aellos, Diego Velasquez, Alejandra Baltazar, Hsun-Liang Chan","doi":"10.3389/fdmed.2025.1587821","DOIUrl":"10.3389/fdmed.2025.1587821","url":null,"abstract":"<p><strong>Objectives: </strong>Understanding the available methods to study blood flow in the oral cavity can enhance knowledge of research methodology on periodontal circulation related to disease initiation and progression as well as wound healing. This study aims to systematically review non-invasive techniques that allow for the assessment of oral tissue perfusion in clinical and pre-clinical studies.</p><p><strong>Methods: </strong>A complete electronic literature search in 5 databases (NLM PubMed, Embase, EBSCOhost CINAHL, EBSCOhost Dentistry and Oral Sciences Source, and Wiley Cochrane Central Register of Controlled Trials) was conducted by two reviewers. The search terms included gingival blood flow, tissue perfusion, imaging perfusion, soft tissue perfusion, diagnostic, vascularization, soft tissue, and microvascularization. The focused question is: What are the available non-invasive and quantitative imaging techniques used to evaluate oral and periodontal tissue perfusion?</p><p><strong>Results: </strong>A total of 79 articles were included for qualitative analysis. Various methods were identified, including Laser Doppler Flowmetry (LDF), Laser Speckle Contrast Imaging (LSCI), Spectral Imaging Methods (such as Diffuse Reflectance Spectroscopy), Ultrasound (US), Intravital Video Microscopy, and Oral Videocapillaroscopy. LDF is the most applied to estimate blood flow in a small focal area for the study of periodontal diseases and oral wound healing, among other indications. LSCI, providing surrogate superficial blood flow values in a 2-dimensional, larger field-of-view, has been used for similar reasons. The use of cross-sectional ultrasound is on a rise to record blood velocity and blood volume using color flow and color power modes, respectively. Comparisons of the available technologies revealed their strengths and limitations related to their spatial resolution, sensitivity, reliability, accuracy, invasiveness, dependence of (image) data in the field of view relative to probe positioning and angulation, and safety. The ideal features of such a device pertinent to probe geometry, data acquisition, recording, and infection control needs were also discussed.</p><p><strong>Conclusions: </strong>A few imaging technologies have been identified in the literature to study blood flow in the oral cavity. These methods could potentially augment our ability to diagnose oral diseases and monitor wound healing objectively and timely. In combination, these could potentially enhance treatment outcomes significantly.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"6 ","pages":"1587821"},"PeriodicalIF":1.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maram A AlGhamdi, Shaimaa M Fouda, Yousif A Al-Dulaijan, Soban Q Khan, Mai El Zayat, Raghad Al Munif, Zainab Albazroun, Fatma Hamza Amer, Ahmed Tharwat Al Ammary, Amr A Mahrous, Mohammed M Gad
{"title":"Nanocomposite 3D printed resins containing titanium dioxide (TiO<sub>2</sub>) nanoparticles: an <i>in vitro</i> analysis of color, hardness, and surface roughness properties.","authors":"Maram A AlGhamdi, Shaimaa M Fouda, Yousif A Al-Dulaijan, Soban Q Khan, Mai El Zayat, Raghad Al Munif, Zainab Albazroun, Fatma Hamza Amer, Ahmed Tharwat Al Ammary, Amr A Mahrous, Mohammed M Gad","doi":"10.3389/fdmed.2025.1581461","DOIUrl":"10.3389/fdmed.2025.1581461","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of different titanium dioxide nanoparticle (TN) concentrations on the color stability and surface properties of additively fabricated (AF) denture base resins after thermal cycling.</p><p><strong>Methods: </strong>Two types of AF denture base resins, NextDent and ASIGA, were used to fabricate a total of 120 disc-shaped (10 × 2 mm) specimens (<i>n</i> = 10). The specimens of each resin were divided into 2 groups according to the concentration of titanium dioxide nanoparticles (1 wt.%, 2 wt.% TN) in addition to a control group of pure resin for each material. The specimens' color change, hardness, and surface roughness (Ra) were tested after thermal cycling (5,000 cycles). Collected data was analyzed using ANOVA and <i>post hoc</i> Tukey's test (α = 0.05). The color change was referred to the National Bureau of Standards (NBS).</p><p><strong>Results: </strong>The addition of TN resulted in significant color changes in NextDent, with unacceptable changes according to the NBS (8.84 for 1 wt.% TN and 8.28 for 2 wt.% TN). In contrast, ASIGA showed significantly less color change than NextDent, and the changes remained within clinically acceptable limits. For hardness, in comparison to the pure group, TN addition didn't show any significant change in terms of TN concentrations and material type (<i>P</i> > 0.05), and the highest hardness value was recorded with NextDent/2 wt.%TN (16.6 ± 9.0 VHN). TN addition significantly increased Ra in NextDent, which was concentration-dependent (<i>p</i> = 0.001), while AISGA showed no change in Ra with TN addition (<i>p</i> = 0.693).</p><p><strong>Conclusion: </strong>Nanocomposite denture base resins containing TN increased the color change and surface roughness with no change in hardness. The effect of TN was material-dependent; therefore, resin material selection for nanocomposite preparation should be considered.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"6 ","pages":"1581461"},"PeriodicalIF":1.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hamza Al Salieti, Hanan M Qasem, Sakhr Alshwayyat, Noor Almasri, Mustafa Alshwayyat, Amira A Aboali, Farah Alsarayrah, Lina Khasawneh, Mohammed Al-Mahdi Al-Kurdi
{"title":"Predicting alveolar nerve injury and the difficulty level of extraction impacted third molars: a systematic review of deep learning approaches.","authors":"Hamza Al Salieti, Hanan M Qasem, Sakhr Alshwayyat, Noor Almasri, Mustafa Alshwayyat, Amira A Aboali, Farah Alsarayrah, Lina Khasawneh, Mohammed Al-Mahdi Al-Kurdi","doi":"10.3389/fdmed.2025.1534406","DOIUrl":"10.3389/fdmed.2025.1534406","url":null,"abstract":"<p><strong>Background: </strong>Third molar extraction, a common dental procedure, often involves complications, such as alveolar nerve injury. Accurate preoperative assessment of the extraction difficulty and nerve injury risk is crucial for better surgical planning and patient outcomes. Recent advancements in deep learning (DL) have shown the potential to enhance the predictive accuracy using panoramic radiographic (PR) images. This systematic review evaluated the accuracy and reliability of DL models for predicting third molar extraction difficulty and inferior alveolar nerve (IAN) injury risk.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed, Scopus, Web of Science, and Embase until September 2024, focusing on studies assessing DL models for predicting extraction complexity and IAN injury using PR images. The inclusion criteria required studies to report predictive performance metrics. Study selection, data extraction, and quality assessment were independently performed by two authors using the PRISMA and QUADAS-2 guidelines.</p><p><strong>Results: </strong>Six studies involving 12,419 PR images met the inclusion criteria. DL models demonstrated high accuracy in predicting extraction difficulty (up to 96%) and IAN injury (up to 92.9%), with notable sensitivity (up to 97.5%) for specific classifications, such as horizontal impactions. Geographically, three studies originated in South Korea and one each from Turkey and Thailand, limiting generalizability. Despite high accuracy, demographic data were sparsely reported, with only two studies providing patient sex distribution.</p><p><strong>Conclusion: </strong>DL models show promise in improving the preoperative assessment of third molar extraction. However, further validation in diverse populations and integration with clinical workflows are necessary to establish its real-world utility, as limitations such as limited generalizability, potential selection bias and lack of long-term follow up remain challenges.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"6 ","pages":"1534406"},"PeriodicalIF":1.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}