Diagnosing dental diseases from radiographs is time-consuming and challenging due to the subtle nature of diagnostic evidence. Existing methods, which rely on object detection models designed for natural images with more distinct target patterns, struggle to detect dental diseases that present with far less visual support. To address this challenge, we propose {\bf DentalX}, a novel context-aware dental disease detection approach that leverages oral structure information to mitigate the visual ambiguity inherent in radiographs. Specifically, we introduce a structural context extraction module that learns an auxiliary task: semantic segmentation of dental anatomy. The module extracts meaningful structural context and integrates it into the primary disease detection task to enhance the detection of subtle dental diseases. Extensive experiments on a dedicated benchmark demonstrate that DentalX significantly outperforms prior methods in both tasks. This mutual benefit arises naturally during model optimization, as the correlation between the two tasks is effectively captured. Our code is available at https://github.com/zhiqin1998/DentYOLOX.
Dental template and parametric dental models are important tools for various applications in digital dentistry. However, constructing an unbiased dental template and accurate parametric dental models remains a challenging task due to the complex anatomical and morphological dental structures and also low volume ratio of the teeth. In this study, we develop an unbiased dental template by constructing an accurate dental atlas from CBCT images with guidance of teeth segmentation. First, to address the challenges, we propose to enhance the CBCT images and their segmentation images, including image cropping, image masking and segmentation intensity reassigning. Then, we further use the segmentation images to perform co-registration with the CBCT images to generate an accurate dental atlas, from which an unbiased dental template can be generated. By leveraging the unbiased dental template, we construct parametric dental models by estimating point-to-point correspondences between the dental models and employing Principal Component Analysis to determine shape subspaces of the parametric dental models. A total of 159 CBCT images of real subjects are collected to perform the constructions. E
Dental image analysis plays a pivotal role in supporting accurate diagnosis and treatment planning in oral healthcare. Although recent advances have produced dental AI models for specific tasks and individual imaging modalities, their isolated designs limit practical use in real-world clinical workflows. In this paper, we present OralAgent, the first dental-specialized AI agent that unifies multimodal reasoning, tool-based decision-making, and knowledge-grounded retrieval within an end-to-end automated framework. It integrates 22 visual analysis tools and 368 widely-used classical dental textbooks, enabling autonomous reasoning, planning, tool use, knowledge retrieval, and multi-step workflow execution. Furthermore, we introduce OralCorpus, a large-scale, high-quality bilingual textual resource containing 134.8M tokens curated for dental retrieval-augmented generation (RAG). To evaluate models' multidisciplinary dental knowledge, we construct OralQA-ZH, a Chinese multiple-choice question benchmark consisting of 798 items across eleven oral subspecialties. Extensive experiments demonstrate that OralAgent achieves state-of-the-art performance on the MMOral-Uni, MMOral-OPG, and OralQA
Pediatric dental segmentation is critical in dental diagnostics, presenting unique challenges due to variations in dental structures and the lower number of pediatric X-ray images. This study proposes a custom SegUNet model with a VGG19 backbone, designed explicitly for pediatric dental segmentation and applied to the Children's Dental Panoramic Radiographs dataset. The SegUNet architecture with a VGG19 backbone has been employed on this dataset for the first time, achieving state-of-the-art performance. The model reached an accuracy of 97.53%, a dice coefficient of 92.49%, and an intersection over union (IOU) of 91.46%, setting a new benchmark for this dataset. These results demonstrate the effectiveness of the VGG19 backbone in enhancing feature extraction and improving segmentation precision. Comprehensive evaluations across metrics, including precision, recall, and specificity, indicate the robustness of this approach. The model's ability to generalize across diverse dental structures makes it a valuable tool for clinical applications in pediatric dental care. It offers a reliable and efficient solution for automated dental diagnostics.
Early detection of dental disease is crucial to prevent adverse outcomes. Today, dental X-rays are currently the most accurate gold standard for dental disease detection. Unfortunately, regular X-ray exam is still a privilege for billions of people around the world. In this paper, we ask: "Can we develop a low-cost sensing system that enables dental self-examination in the comfort of one's home?" This paper presents ToMoBrush, a dental health sensing system that explores using off-the-shelf sonic toothbrushes for dental condition detection. Our solution leverages the fact that a sonic toothbrush produces rich acoustic signals when in contact with teeth, which contain important information about each tooth's status. ToMoBrush extracts tooth resonance signatures from the acoustic signals to characterize varied dental health conditions of the teeth. We evaluate ToMoBrush on 19 participants and dental-standard models for detecting common dental problems including caries, calculus, and food impaction, achieving a detection ROC-AUC of 0.90, 0.83, and 0.88 respectively. Interviews with dental experts validate ToMoBrush's potential in enhancing at-home dental healthcare.
The scarcity and high cost of expert annotations in dental imaging present a significant challenge for the development of AI in dentistry. DINOv3, a state-of-the-art, self-supervised vision foundation model pre-trained on 1.7 billion images, offers a promising pathway to mitigate this issue. However, its reliability when transferred to the dental domain, with its unique imaging characteristics and clinical subtleties, remains unclear. To address this, we introduce DinoDental, a unified benchmark designed to systematically evaluate whether DINOv3 can serve as a reliable, off-the-shelf encoder for comprehensive dental image analysis without requiring domain-specific pre-training. Constructed from multiple public datasets, DinoDental covers a wide range of tasks, including classification, detection, and instance segmentation on both panoramic radiographs and intraoral photographs. We further analyze the model's transfer performance by scaling its size and input resolution, and by comparing different adaptation strategies, including frozen features, full fine-tuning, and the parameter-efficient Low-Rank Adaptation (LoRA) method. Our experiments show that DINOv3 can serve as a strong un
Dental crown restoration is one of the most common treatment modalities for tooth defect, where personalized dental crown design is critical. While computer-aided design (CAD) systems have notably enhanced the efficiency of dental crown design, extensive manual adjustments are still required in the clinic workflow. Recent studies have explored the application of learning-based methods for the automated generation of restorative dental crowns. Nevertheless, these approaches were challenged by inadequate spatial resolution, noisy outputs, and overextension of surface reconstruction. To address these limitations, we propose \totalframework, a margin-aware mesh generation framework comprising CrownDeformR and CrownSegger. Inspired by the clinic manual workflow of dental crown design, we designed CrownDeformR to deform an initial template to the target crown based on anatomical context, which is extracted by a multi-scale intraoral scan encoder. Additionally, we introduced \marginseg, a novel margin segmentation network, to extract the cervical margin of the target tooth. The performance of CrownDeformR improved with the cervical margin as an extra constraint. And it was also utilized a
The design of restorative dental crowns from intraoral scans is labor-intensive for dental technicians. To address this challenge, we propose a novel voxel-based framework for automated dental crown design (VBCD). The VBCD framework generates an initial coarse dental crown from voxelized intraoral scans, followed by a fine-grained refiner incorporating distance-aware supervision to improve accuracy and quality. During the training stage, we employ the Curvature and Margin line Penalty Loss (CMPL) to enhance the alignment of the generated crown with the margin line. Additionally, a positional prompt based on the FDI tooth numbering system is introduced to further improve the accuracy of the generated dental crowns. Evaluation on a large-scale dataset of intraoral scans demonstrated that our approach outperforms existing methods, providing a robust solution for personalized dental crown design.
Accurate dental diagnosis is essential for oral healthcare, yet many individuals lack access to timely professional evaluation. Existing AI-based methods primarily treat diagnosis as a visual pattern recognition task and do not reflect the structured clinical reasoning used by dental professionals. These approaches also require large amounts of expert-annotated data and often struggle to generalize across diverse real-world imaging conditions. To address these limitations, we present OMNI-Dent, a data-efficient and explainable diagnostic framework that incorporates clinical reasoning principles into a Vision-Language Model (VLM)-based pipeline. The framework operates on multi-view smartphone photographs,embeds diagnostic heuristics from dental experts, and guides a general-purpose VLM to perform tooth-level evaluation without dental-specific fine-tuning of the VLM. By utilizing the VLM's existing visual-linguistic capabilities, OMNI-Dent aims to support diagnostic assessment in settings where curated clinical imaging is unavailable. Designed as an early-stage assistive tool, OMNI-Dent helps users identify potential abnormalities and determine when professional evaluation may be nee
Digital dentistry has made significant advances with the advent of deep learning. However, the majority of these deep learning-based dental image analysis models focus on very specific tasks such as tooth segmentation, tooth detection, cavity detection, and gingivitis classification. There is a lack of a specialized model that has holistic knowledge of teeth and can perform dental image analysis tasks based on that knowledge. Datasets of dental images with captions can help build such a model. To the best of our knowledge, existing dental image datasets with captions are few in number and limited in scope. In many of these datasets, the captions describe the entire mouth, while the images are limited to the anterior view. As a result, posterior teeth such as molars are not clearly visible, limiting the usefulness of the captions for training vision-language models. Additionally, the captions focus only on a specific disease (gingivitis) and do not provide a holistic assessment of each tooth. Moreover, tooth disease scores are typically assigned to individual teeth, and each tooth is treated as a separate entity in orthodontic procedures. Therefore, it is important to have captions
Periodontitis and dental caries are common oral diseases affecting billions globally. While observational studies suggest links between these conditions and lung cancer, causality remains uncertain. This study used two sample Mendelian randomization (MR) to explore causal relationships between dental traits (periodontitis, dental caries) and lung cancer subtypes, and to assess mediation by pulmonary function. Genetic instruments were derived from the largest available genome wide association studies, including data from 487,823 dental caries and 506,594 periodontitis cases, as well as lung cancer data from the Transdisciplinary Research of Cancer in Lung consortium. Inverse variance weighting was the main analytical method; lung function mediation was assessed using the delta method. The results showed a significant positive causal effect of dental caries on overall lung cancer and its subtypes. Specifically, a one standard deviation increase in dental caries incidence was associated with a 188.0% higher risk of squamous cell lung carcinoma (OR = 2.880, 95% CI = 1.236--6.713, p = 0.014), partially mediated by declines in forced vital capacity (FVC) and forced expiratory volume in o
Efficient analysis and processing of dental images are crucial for dentists to achieve accurate diagnosis and optimal treatment planning. However, dental imaging inherently poses several challenges, such as low contrast, metallic artifacts, and variations in projection angles. Combined with the subjectivity arising from differences in clinicians' expertise, manual interpretation often proves time-consuming and prone to inconsistency. Artificial intelligence (AI)-based automated dental image analysis (DIA) offers a promising solution to these issues and has become an integral part of computer-aided dental diagnosis and treatment. Among various AI technologies, deep learning (DL) stands out as the most widely applied and influential approach due to its superior feature extraction and representation capabilities. To comprehensively summarize recent progress in this field, we focus on the two fundamental aspects of DL research-datasets and models. In this paper, we systematically review 260 studies on DL applications in DIA, including 49 papers on publicly available dental datasets and 211 papers on DL-based algorithms. We first introduce the basic concepts of dental imaging and summar
Multimodal large language models (MLLMs) have emerged as a promising paradigm for dental image analysis. However, their ability to capture the multi-level cognitive processes required for radiographic analysis remains unclear. Here, we present a comprehensive benchmark to evaluate the cognitive capabilities of MLLMs in dental radiographic analysis. It spans three critical imaging modalities, i.e., periapical, panoramic, and lateral cephalometric radiographs, and defines four cognitive categories: perception, comprehension, prediction, and decision-making. The benchmark comprises 27 clinically grounded tasks derived from public datasets, with manually curated annotations and 3,820 clinician assessments for evaluation. Six frontier MLLMs, including GPT-5.2 and GLM-4.6, are evaluated. We demonstrate the performance gap between MLLMs and clinicians in dental practice, delineate model strengths and limitations, characterize failure patterns, and provide recommendations for improvement. This data resource will facilitate the development of next-generation artificial intelligence systems aligned with clinical cognition, safety requirements, and workflow complexity in dental practice.
Age assessment is crucial in forensic and judicial decision-making, particularly in cases involving undocumented individuals and unaccompanied minors, where legal thresholds determine access to protection, healthcare, and judicial procedures. Dental age assessment is widely recognized as one of the most reliable biological approaches for adolescents and young adults, but current practices are challenged by methodological heterogeneity, fragmented data representation, and limited interoperability between clinical, forensic, and legal information systems. These limitations hinder transparency and reproducibility, amplified by the increasing adoption of AI- based methods. The AIdentifyAGE ontology is domain-specific and provides a standardized, semantically coherent framework, encompassing both manual and AI-assisted forensic dental age assessment workflows, and enabling traceable linkage between observations, methods, reference data, and reported outcomes. It models the complete medico-legal workflow, integrating judicial context, individual-level information, forensic examination data, dental developmental assessment methods, radiographic imaging, statistical reference studies, and
Integrating deep learning into healthcare enables personalized care but raises trust issues due to model opacity. To improve transparency, we propose a system for dental age estimation from panoramic images that combines an opaque and a transparent method within a natural language generation (NLG) module. This module produces clinician-friendly textual explanations about the age estimations, designed with dental experts through a rule-based approach. Following the best practices in the field, the quality of the generated explanations was manually validated by dental experts using a questionnaire. The results showed a strong performance, since the experts rated 4.77+/-0.12 (out of 5) on average across the five dimensions considered. We also performed a trustworthy self-assessment procedure following the ALTAI checklist, in which it scored 4.40+/-0.27 (out of 5) across seven dimensions of the AI Trustworthiness Assessment List.
Accurate interpretation of pediatric dental clinical records and safe antibiotic prescribing remain persistent challenges in dental informatics. Traditional rule-based clinical decision support systems struggle with unstructured dental narratives, incomplete radiographic descriptions, and complex safety constraints. To address these limitations, this study proposes a Knowledge-Guided Large Language Model (KG-LLM) that integrates a pediatric dental knowledge graph, retrieval-augmented generation (RAG), and a multi-stage safety validation pipeline for evidence-grounded antibiotic recommendation. The framework first employs a clinical NER/RE module to extract structured entities and relations from dental notes and radiology reports. Relevant guidelines, drug-safety rules, and analogous historical cases are subsequently retrieved from the knowledge graph and supplied to the LLM for diagnostic summarization and dose-drug-duration prediction. Safety assurance is achieved through a dual-layer validation mechanism combining deterministic rule checking with a learned classifier for detecting allergies, contraindications, and dosing errors. Experiments on 32,000 de-identified pediatric denta
Multimodal Large Language Models (MLLMs) have exhibited immense potential across numerous medical specialties; yet, dentistry remains underexplored, in part due to limited domain-specific data, scarce dental expert annotations, insufficient modality-specific modeling, and challenges in reliability. In this paper, we present OralGPT-Omni, the first dental-specialized MLLM designed for comprehensive and trustworthy analysis across diverse dental imaging modalities and clinical tasks. To explicitly capture dentists' diagnostic reasoning, we construct TRACE-CoT, a clinically grounded chain-of-thought dataset that mirrors dental radiologists' decision-making processes. This reasoning supervision, combined with our proposed four-stage training paradigm, substantially strengthens the model's capacity for dental image understanding and analysis. In parallel, we introduce MMOral-Uni, the first unified multimodal benchmark for dental image analysis. It comprises 2,809 open-ended question-answer pairs spanning five modalities and five tasks, offering a comprehensive evaluation suite to date for MLLMs in digital dentistry. OralGPT-Omni achieves an overall score of 51.84 on the MMOral-Uni bench
Dental fluorosis is a chronic disease caused by long-term overconsumption of fluoride, which leads to changes in the appearance of tooth enamel. It is an important basis for early non-invasive diagnosis of endemic fluorosis. However, even dental professionals may not be able to accurately distinguish dental fluorosis and its severity based on tooth images. Currently, there is still a gap in research on applying deep learning to diagnosing dental fluorosis. Therefore, we construct the first open-source dental fluorosis image dataset (DFID), laying the foundation for deep learning research in this field. To advance the diagnosis of dental fluorosis, we propose a pioneering deep learning model called masked latent transformer with the random masking ratio (MLTrMR). MLTrMR introduces a mask latent modeling scheme based on Vision Transformer to enhance contextual learning of dental fluorosis lesion characteristics. Consisting of a latent embedder, encoder, and decoder, MLTrMR employs the latent embedder to extract latent tokens from the original image, whereas the encoder and decoder comprising the latent transformer (LT) block are used to process unmasked tokens and predict masked toke
Dental triage is a safety-critical clinical routing task that requires integrating multimodal clinical information (e.g., patient complaints and radiographic evidence) to determine complete referral plans. We present Dental-TriageBench, the first expert-annotated benchmark for reasoning-driven multimodal dental triage. Built from authentic outpatient workflows, it contains 246 de-identified cases annotated with expert-authored golden reasoning trajectories, together with hierarchical triage labels. We benchmark 19 proprietary, open-source, and medical-domain MLLMs against three junior dentists serving as the human baseline, and find a substantial human--model gap, on fine-grained treatment-level triage. Further analyses show that accurate triage requires both complaint and OPG information, and that model errors concentrate on cases with multiple referral domains, where MLLMs tend to produce overly narrow referral sets and omission-heavy errors. Dental-TriageBench provides a realistic testbed for developing multimodal clinical AI systems that are more clinically grounded, coverage-aware, and safer for downstream care.
Background: Oral diseases affect nearly 3.5 billion people worldwide, yet the comparative clinical potential of large-scale AI models in dentistry remains poorly understood. Three distinct model categories have emerged: language-generative models, discriminative vision foundation models, and dental-specific foundation models, with no unified review examining their relationships and collective limitations. Methods: Following PRISMA-ScR guidelines, we systematically searched four databases (PubMed, Google Scholar, Scopus, arXiv), screened independently by two reviewers. After applying inclusion/exclusion criteria, 97 studies (2020-2026) were included. We propose a two-dimensional classification framework organizing models by architectural paradigm and dental specialization degree. Results: Language-generative models excel at text-based tasks (clinical reasoning, licensing exams, patient communication) but show inconsistent performance on image-dependent diagnostics. Adapted SAM and CLIP variants achieve strong tooth segmentation and lesion detection results. Dental-specific models (DentVFM, DentVLM, OralGPT) demonstrate strongest performance on complex multimodal tasks. Integrated pi