The integration of LLMs in the healthcare sector offers significant potential for improving medical practice and patient care. They assist in medical diagnosis by analyzing patient symptoms and other relevant data. This systematic review proposes to assess the existing literature on the use of LLMs. The comprehensive review was conducted in PubMed, Web of Science, Google Scholar and Scopus databases using keywords related to LLMs for articles published in English language at all times. Data was extracted to determine the applications, evaluation criteria and outcomes of LLMs in dentistry. Of 1142 records, 38 studies fulfilled the inclusion criteria. Among all studies, ChatGPT-3.5 was the most frequently used LLM. Most of the studies addressed patient questions during or after dental treatment. Most studies asked open-ended questions, and the Likert scale was the most used evaluation scale. This systematic review has shown that LLMs can increase efficiency, improve patient care and diagnostic support in dentistry. However, due to the risk of incorrect and incomplete information, LLMs should be used as clinical decision support tools. To increase their effectiveness and reliability, they should be trained on rigorously validated and continuously updated data sets.
This review aimed to integrate the available data published in the literature on metastatic lesions in the oral and maxillofacial region (MOMR) and to produce an updated comprehensive analysis of its clinical characteristics, treatment, and prognosis. An electronic database search was conducted for articles concerning MOMR in Japan. The incidence and characteristics of MOMR were investigated, and the survival time was analyzed. This systematic review identified 211 studies, including 356 cases. There was a male predominance (n = 250/70.2 %) and the mean age at the diagnosis was 62.1 (range, 4-91) years old. The most common primary site was the lungs (n = 104/29.2 %). Oral metastasis sites were equally frequent in the jawbone (n = 182/51.1 %) and soft tissue (n = 174/48.9 %). Among these, the mandible and gingiva were the most common. The most common clinical presentation was a nodule (n = 317/90.3 %). The presence of metastases to other organs (P = 0.009) and uncontrolled primary lesions (P < 0.001) was associated with a shortened survival. This systematic review provides important insights into the clinical features, diagnosis, and treatment of MOMR in Japan and will assist clinicians in their appropriate management.
Temporomandibular disorders (TMD) are a heterogeneous group of conditions frequently associated with pain and functional impairment. Arthrocentesis has been proposed as a minimally invasive therapeutic option; however, its comparative effectiveness versus other treatments remains uncertain. To evaluate the effectiveness of arthrocentesis compared with other therapeutic modalities in patients with TMD, focusing on pain relief and mandibular functional outcomes. A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Randomized controlled trials comparing arthrocentesis with other therapeutic interventions for TMD were included. Comparator interventions included conservative therapies (e.g., occlusal splints, physiotherapy, and pharmacological treatment), intra-articular injections, arthroscopy, and alternative arthrocentesis-based protocols. Primary outcomes were pain intensity assessed by visual analogue scale (VAS) and mandibular functional outcomes, including maximum mouth opening (MMO), maximum incisal opening (MIO), masticatory efficiency, mandibular movements, and overall joint mobility. Pooled estimates were calculated using mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CI). Certainty of evidence was assessed using the GRADE approach. Thirty-two randomized controlled trials were included in the quantitative synthesis. No statistically significant difference in pain reduction was observed between arthrocentesis and comparator interventions (MD = -0.25; 95% CI -1.09-0.59; p = 0.55), with very high heterogeneity (I² = 96%). No statistically significant differences were found for maximum incisal opening (MIO), mandibular movements, or overall joint mobility. Masticatory efficiency showed a small statistically significant improvement favoring arthrocentesis (SMD = 1.15; 95% CI 0.22-2.08), based on very low-certainty evidence. Overall, the certainty of evidence ranged from low to very low across outcomes, and heterogeneity was substantial in most analyses. Arthrocentesis may provide modest symptomatic improvement in selected patients with TMD; however, it does not demonstrate superiority over alternative therapeutic modalities for most functional outcomes. Given the substantial heterogeneity and low certainty of the available evidence, these findings should be interpreted cautiously. Further well-designed randomized controlled trials with standardized diagnostic criteria, clearly defined comparators, and longer follow-up are required to better define the role of arthrocentesis in the management of temporomandibular disorders. Current evidence does not demonstrate clear superiority of arthrocentesis over alternative therapeutic modalities for pain reduction or functional improvement in temporomandibular disorders. While arthrocentesis may be considered as a minimally invasive approach in selected patients, particularly those who do not respond to conservative management, its clinical benefits remain uncertain due to substantial heterogeneity and low certainty of evidence. Therefore, arthrocentesis should be interpreted as a potential adjunctive option within a stepwise treatment strategy rather than as a definitive or superior intervention.
Evaluate the bond strength performance of the different types of adhesive systems to the primary tooth enamel. This study was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/YURB4). A two-stage literature search was conducted by two independent reviewers on PubMed, Embase, Web of Science, Scopus, and gray literature to identify in vitro studies evaluating the bond strength of different adhesive systems to primary tooth enamel. The risk of bias was evaluated with the QUIN tool. A Bayesian network meta-analysis was conducted to evaluate the bond strength at 24 h. The final sample was composed of 14 articles. The 2-bottle universal adhesive system with phosphoric acid etching (PAE) was statistically similar to the 3-step etch-and-rinse (E&R). In addition, self-etch and etch-and-rinse adhesives with the same number of steps had similar performances. In the ranking, 3-step E&R had the highest probability of being ranked the best adhesive, while 1-step self-etch without PAE had the lowest. All studies had a low risk of bias. 2-bottle universal adhesive systems with PAE can probably provide similar bond strength to primary tooth enamel compared to 3-Step E&R. In addition, the similar performance of some of the tested adhesive systems indicates the possibility to reduce clinical steps.
The longevity of an extraoral prosthesis depends on its physical and mechanical properties and user maintenance. Faced with multiple outcome measures, researchers find it difficult to determine the most appropriate extraoral prosthetic material. This comprehensive review evaluates the most used extraoral prosthesis materials and qualitatively assesses their longevity and function. The study aims to identify and interpret the results of current updates on the factors that affect longevity and functionality. This comprehensive review summarizes and evaluates differences in the properties of commonly used extraoral maxillofacial prosthetic materials. The review was planned to focus on all factors related to the longevity and function of the extraoral maxillofacial prosthetics. An electronic search covered English articles in PubMed, Scopus, Google Scholar, Web of Science, and grey literature. Manual searching was also performed. Six authors participated in the screening. Search engines extracted 1107 records, and 88 studies were included for qualitative and bias assessments. Silicones are the most frequently used extraoral maxillofacial prosthetic materials. Heat-cured silicones are more color-stable than those cured at room temperature. Additional ingredients and processing techniques affect prosthesis longevity.
The bidirectional association between oral diseases caused by plaque and the inflammatory bowel disease remains unclear. Here, we comprehensively searched PubMed, EMBASE, Web of Science, and the Cochrane Library from inception to August 2024 to identify relevant studies. The relative risk (RR) from periodontal disease studies and the decayed, missing, and filled teeth (DMFT) index from caries-related studies was pooled, and calculating 95 % confidence intervals (CIs). Subgroup analysis, sensitivity analysis, and cumulative meta-analysis were employed to evaluate the robustness of the findings. The research adhered to PRISMA 2020 guidelines, incorporating 26 studies for systematic review and 20 for meta-analysis. The results indicated no significant increase in the overall risk of inflammatory bowel disease (IBD) in patients with periodontal disease (RR 1.31, 95 % CI 0.98-1.35); however, the risk of ulcerative colitis (UC) was higher compared to controls (RR 1.34, 95 % CI 1.04-1.73). Among IBD patients, the risk of periodontal disease was significantly elevated (RR 2.14, 95 % CI 1.62-2.81), as was the risk of dental caries (WMD = 2.51, 95 % CI 0.97-4.06). Additionally, UC patients exhibited a higher incidence of caries compared to Crohn's disease (CD) patients (WMD = 3.97, 95 % CI 1.94-6.00). Sensitivity analyses and cumulative meta-analyses confirmed the stability of the results. In conclusion, IBD patients, particularly those with UC, should prioritize stringent oral hygiene to mitigate the risks of periodontal disease and dental caries. The association between periodontal disease and IBD warrants further investigation, and high-quality clinical studies are needed to provide more definitive and reliable evidence.
Dental implants have been widely used with success, but long-term usage sometimes leads to implant loss. The purpose of this review was to summarize the etiology of early and late failure requiring dental implant removal and the treatment strategies for the removal of failed implants and reimplantation. Early failures are often caused by patient-related factors, such as smoking, diabetes, radiotherapy, bone quality, and periodontitis of the remaining natural teeth. The most common cause of late failure is peri-implantitis, followed by implant fracture and implant malpositioning. Implants should be removed if they are mobile or if their superstructure cannot be maintained (e.g., implant fracture). For peri-implantitis, implant removal should be determined based on the patient's age and esthetic needs, the implant site, and the severity of bone loss. Many reports have been published on implant removal techniques. The reverse torque technique should always be the first choice because of its low invasiveness. The weighted survival rate for the replacement of failed implants is 86.3%, with a much lower survival rate after the second or subsequent implantations. Therefore, patient-specific problems, such as smoking habits and bruxism, should be checked before reimplantation and controlled to the greatest extent possible.
Single-cell RNA sequencing (scRNA-seq) has advanced the understanding of cellular heterogeneity and molecular dynamics in human dental tissues. This systematic review critically evaluated scRNA-seq studies exploring the cellular composition of human dental tissues, comparing in situ and cultured environments under both healthy and diseased conditions. Original research articles meeting the inclusion criteria were assessed for cell type identification, transcriptional profiles, analytical platforms, and other key biological insights by two independent authors. A total of fifteen studies that met the inclusion criteria revealed diverse cell populations, including mesenchymal stem cells (MSCs), immune cells, endothelial cells, and odontoblast-like cells, each exhibiting distinct transcriptional signatures in homeostasis, regeneration, and disease. Key findings included distinct MSC subpopulations, including THY1 +, CD24 +, FRZB +, and NOTCH3 +/PDGFRB +, exhibiting unique differentiation potential, along with significant heterogeneity in odontoblast lineage. Moreover, carious dental pulp undergoes a fibrotic transcriptional shift (e.g., COL1A1, FN1, and TNC), whereas periodontitis exhibits increased expression of pro-inflammatory cytokines (IL-1β and TNFα) and diminished periodontal MSC regenerative capacity. This review underscores the contributions of scRNA-seq in providing unprecedented insights into the complexity and functional heterogeneity of dental tissues, offering a foundation for advancing targeted regenerative therapies and guiding future translational research in dental medicine.
Polymethyl methacrylate (PMMA) resins are widely used in dental prostheses due to their excellent physical, mechanical, and aesthetic properties. However, their susceptibility to microbial colonization can compromise oral and systemic health. Titanium dioxide (TiO₂), with its photocatalytic activity, has gained attention for its antimicrobial potential. This systematic review investigates how the physicochemical properties of TiO₂ affect its antimicrobial efficacy in PMMA-TiO₂ composites, aiming to optimize their performance and clinical effectiveness. PubMed, Embase, Scopus, ScienceDirect, Web of Science, Google Scholar, and ProQuest were searched in October 2024. Articles were selected in two stages by two blinded researchers based on predefined eligibility criteria. Risk of bias was assessed using the RobDEMAT tool. A comprehensive search identified 1464 articles, which were screened by title and abstract according to inclusion criteria. Of the 28 studies selected for full-text review, 24 were included in this systematic review, all of which were in vitro studies. Due to the high heterogeneity of the selected studies, which prevented statistical analysis of the data, a descriptive analysis was performed. The balance between concentration, size, crystallinity, and surface morphology can enhance TiO₂ photocatalytic activity and reduce microbial adhesion. Synthesis and functionalization strategies can overcome limitations, expanding the clinical applicability, efficiency, and durability of PMMA-TiO₂ composites.
This review aimed to evaluate the efficacy of different interventions used on the palatal donor area in the treatment of postoperative pain after free gingival graft and connective tissue graft techniques, and their impact in the oral-health related quality of life (OHRQOL). This study was conducted according to PRISMA. A search was conducted in four electronic databases and the grey literature. The interventions found were grouped according to biological plausibility and mechanisms of action: Mechanical Barriers; Topical Drugs; Hemostatic Agents; Other Therapies (photobiomodulation, ozonotherapy and others). Fifty-four studies were included and 43 different interventions were reported. The most commonly reported intervention was collagen hemostatic sponge, either alone or combined with other interventions, followed by platelet-rich fibrin and photobiomodulation. Postoperative pain evaluation using the Visual Analogue Scale (VAS) generally indicated that interventions improved pain over time. However, comparing the superiority of interventions is challenging, as studies often combine different interventions with different mechanisms of action. OHRQOL also showed improvement over time, but the comparison between interventions is limited, since few studies used a validated tool. The methodological diversity among studies is considerable, requiring a cautious interpretation of individual studies.
Residual ridge (RR) refers to the clinical alveolar ridge that remains after the bone and soft tissues have healed following tooth extraction. This ridge undergoes resorption, which is most rapid during the first six months of post-extraction. Subsequently, bone resorption continues at a slower pace throughout life, leading to significant loss of jaw structure over time. This process is commonly known as residual ridge resorption (RRR). RRR is a major factor contributing to the loss of stability and retention, especially in mandibular complete dentures. Severe resorption of the maxillary and mandibular ridges can also lead to a sunken cheek appearance, poorly fitting and unstable dentures, and associated pain and discomfort. Though the etiology of residual ridge resorption remains unclear. It is believed that certain cytokines and individual genetic variations may influence the RRR process. Thus, reviewing the studies that discuss genetic association with the health and resorption of alveolar bone may give clear view on the etiology, help to define the risk and strategize preventive and personalized management of the disease. Hence, we undertook a scoping review to understand the potential genetic factors influencing the Residual ridge resorption (RRR). This review employed PRISMA-ScR extension protocols for scoping review. The results of the study provided significant association between genetic polymorphisms, especially of single gene nucleotide polymorphisms with mandibular residual ridge resorption. Hence understanding the genetic predisposition of patients can guide the clinicians in identifying patients at higher risk of RRR, enabling preventive measures, proactive intervention and careful designing of the prothesis.
Sodium hypochlorite is known as the standard irrigant for root canal treatment. However, current guidelines emphasize careful use because of risk of soft-tissue injury. Despite the growing interest in alternative irrigants, standardized evaluation methods remain unclear. The aim of this systematic review was to provide a structured overview of current methodological practices and to offer evidence-informed guidance for future ex vivo research. A systematic search was conducted in PubMed, ScienceDirect, and Web of Science following the PRISMA 2020 guidelines to identify original articles published over the past decade that evaluated root canal irrigants, including their antibacterial properties, using ex vivo models. Twenty-nine studies were included in this review. Enterococcus faecalis was the most frequently used strain. Evaluation methods often included colony-forming unit counts from sample eluates, morphological analyses using scanning electron microscopy, and Live/Dead staining. This review reveals that ex vivo research on root canal irrigants focuses on the removal of two critical domains - organic pathological tissue and smear layer, while our results represent the most frequent patterns in antibacterial and cleaning assessments. Considering the reaction mechanisms of irrigants, implementing corresponding cytotoxicity or biocompatibility testing would be desirable to establish evidence-based safety evaluation in future studies.
This systematic review and meta-analysis evaluated the effectiveness of temporomandibular joint (TMJ) mobilization in individuals with temporomandibular disorders (TMDs), using data from randomized controlled trials (RCTs) and before-after studies without control groups. Human studies assessing outcomes, including muscle activity, pain intensity, oral and cervical range of motion, and self-reported measures before and after mobilization, and comparing these results with those of individuals who received other conventional TMD treatments, were considered. Study selection and data extraction were performed by two independent reviewers, with a third reviewer resolving any disagreements. Of the 652 studies identified, five met the inclusion criteria. The evidence shows improvements in pain intensity, range of motion, and other patient-reported outcomes, following TMJ mobilization. These effects were observed immediately after treatment, showed a slight decrease at one week, and were further enhanced at four weeks. Compared to the control group, our meta-analyses demonstrate a significant reduction in pain intensity (mean difference = -2.90) and a significant improvement in mouth opening (mean difference = 10.76) at four weeks post-mobilization. The findings indicate that TMJ mobilization may serve as an effective short-term intervention for managing TMD, especially in the initial stages of treatment. However, further RCTs with long-term follow-up are warranted.
To map the knowledge structure of large language model (LLM) applications in the dental field (LADF) through a dual-database scientometric study that highlights trends, collaborations, hotspots, and future directions. The Web of Science and Scopus were searched on August 1, 2025. LLM-related articles in dentistry were screened. After removing duplicates, 311 English articles and reviews were included in the study. Bibliometrix (v5.0) was used for characteristic and citation analyses. CiteSpace (v6.4.R1) was used for keyword analysis. The number of publications surged from 24 (2023) to 182 (Jan-Aug 2025). Among all publications, 90% were original research articles. Two-thirds were open-access, funded mainly by governments. As for the collaboration network, author and institutional networks were fragmented. National-level collaboration was stronger. High-income countries dominated the LADF output. Keyword clustering revealed a hub-and-spoke structure that included three research frontiers: 1. broadening applications, 2. deepening clinical use, and 3. comparative evaluation, with accuracy and quality as central themes. LADF has expanded rapidly, but research remains fragmented. Shared datasets, stronger global collaboration, and the development of standardized evaluation metrics, particularly for diagnostic and question-answering proficiencies, are necessary to address the central themes of accuracy and quality.
Dental and oral management (DOM) is a long-established treatment modality. This scoping review aimed to narratively review previous studies, examine the effects of perioperative DOM, and identify the available evidence. A literature search was conducted using the PubMed electronic database for studies published between January 1, 2000, and March 8, 2022. The search yielded 43 studies, most of which were published in the last 10 years. The results of this study confirmed that improved perioperative oral hygiene is effective in preventing postoperative pneumonia. Our results also suggested that preoperative DOM is effective in preventing postoperative surgical site infections. Perioperative DOM is effective in reducing the incidence of postoperative pneumonia, SSI, and postsurgical complications. Further studies are needed to elucidate the various mechanism of DOM and to examine efficient intervention methods and timing.
This scoping review aimed to collect, analyze, synthesize, and interpret the current data concerning antibacterial resin-based composites. The study followed the recommendations of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews. The searches were conducted in the PubMed, Embase, Web of Science, and Scopus databases. Studies evaluating efficacy, physical and chemical properties, cytotoxicity, and preventive effect against recurrent caries lesions provided by antibacterial resin-based composites published in the last 5 years and without language restriction were included. Fifty-three papers were analyzed. Only in vitro, in situ, and animal studies were published. The DMAHDM (dimethylaminohexadecyl methacrylate) was the most prevalent antibacterial agent in the resin composites and showed efficacy, did not increase cytotoxicity, nor jeopardize chemical and physical properties. The most used biofilm model and the test to evaluate the antibacterial effect was Streptococcus Mutans and the Colony Forming Unit Count. Antibacterial resin-based composites have performed exceedingly well in the large number of in vitro studies evaluated. However, clinical trials assessing the prevention of recurrent caries are absent and need to be further conducted to assure that using an antibacterial resin composite is a valid way to avoid restoration replacement due to recurrent caries.
This systematic review assesses the diagnostic accuracy, feasibility, and clinical performance of artificial intelligence (AI)-based smartphone imaging tools for detecting dental caries. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy (PRISMA-DTA) guidelines, five databases: PubMed, Scopus, Web of Science, Embase, and Cochrane Library, were searched up to March 26, 2025. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD420251047689). Diagnostic accuracy and feasibility of AI-driven analysis of smartphone-based dental images for the detection of dental caries were assessed. Risk of bias and applicability were evaluated using QUADAS-2. Fourteen studies met the inclusion criteria. AI models, particularly YOLO variants, DenseNet201, and MobileNetV3, demonstrated high diagnostic accuracy, especially for cavitated lesions, with some outperforming junior dentists. Enhanced YOLO models achieved up to 85.5 % mean average precision. Tools were generally user-friendly and suitable for community or at-home screening. However, sensitivity for early or non-cavitated lesions varied. AI-driven smartphone imaging shows promise as an accessible and reliable tool for caries detection, particularly in low-resource or remote settings. Further research is needed to improve early lesion detection, ensure clinical validation, and support equitable implementation.
Peri-implant diseases, characterized by inflammatory conditions affecting peri-implant tissues, encompass peri-implant mucositis and peri-implantitis. Peri-implant mucositis is an inflammatory lesion limited to the mucosa around an implant, while peri-implantitis extends from the mucosa to the supporting bone, causing a loss of osseointegration. For non-surgical treatments, we tested the null hypothesis that the presence or absence of air-polishing made no difference. The study focused on randomized controlled trials (RCTs) comparing air-polishing with mechanical or ultrasonic debridement, evaluating outcomes such as bleeding on probing (BOP), probing depth (PD), plaque index/plaque score (PI/PS), clinical attachment level (CAL), bone loss, and mucosal recession (MR). Two independent reviewers conducted data extraction and quality assessments, considering short-term (<6 months) and long-term (≥6 months) follow-up periods. After screening, ten articles were included in the meta-analysis. In nonsurgical peri-implant disease management, air-polishing moderately mitigated short-term PI/PS for peri-implant mucositis and showed a similar improvement in long-term BOP and bone loss for peri-implantitis compared to the control group. The Egger test found no evidence of publication bias except for the long-term PI/PS of peri-implant mucositis. Leave-one-out analysis confirmed the stability of the results. The findings highlight the need for future research with longer-term follow-up and high-quality, multi-center, large-sample RCTs.
This scoping review explores the potential applications of surface pre-reacted glass-ionomer (S-PRG) filler-containing dental materials in geriatric dentistry. A literature search across four databases (CINAHL, MEDLINE, PubMed, and Web of Science) identified 324 articles, of which 51, including 39 in vitro, 1 in situ, 1 preclinical, and 10 clinical studies, met the inclusion criteria. These reports demonstrate that, across the domains of preventive, restorative, endodontic, and prosthodontic dentistry, S-PRG filler-containing materials consistently exhibit bioactive properties, such as fluoride-release and recharge, multi-ion release, acid-buffering, anti-demineralization, remineralization, and antimicrobial activity. In preventive dentistry, S-PRG filler-based dentin coating agents, varnishes, and toothpastes show promising effects for caries prevention and periodontal pathogen control. In restorative dentistry, S-PRG filler-based composites and adhesives demonstrate bioactivity and favorable long-term clinical results. In prosthodontics, S-PRG filler-based denture base resins, tissue conditioners, and denture adhesives offer protective and antimicrobial effects. These multifunctional properties support the roles of S-PRG filler-containing dental materials as both preventive and therapeutic agents for managing common oral health issues in older adults, including root caries, periodontal disease, and denture stomatitis. Further clinical and longitudinal studies are needed to confirm their effectiveness and guide their use in geriatric care.
Regulated cell death (RCD) and survival pathways have emerged as critical factors in periodontal tissue breakdown. However, their precise roles and interactions remain poorly understood. This systematic review aimed to synthesize current evidence regarding the involvement of RCD and survival mechanisms in the progression of periodontitis. A systematic literature search was conducted in PubMed/MEDLINE, Web of Science and Scopus, complemented by manual searching in Google Scholar, following PRISMA guidelines. After removing duplicates, 549 studies underwent title and abstract screening. Of these, 56 articles were selected for full-text review and 18 studies met the eligibility criteria and were included in the final synthesis. Ferroptosis, pyroptosis and necroptosis were consistently associated with inflammatory exacerbation, alveolar bone loss and disease progression. In contrast, autophagy and apoptosis exhibited dual roles-protective or destructive-depending on cell types, disease stage and experimental conditions. Most studies utilized ligature-induced periodontitis animal models. Several studies also demonstrated the therapeutic potential of modulating specific RCD pathways to control inflammation and promote periodontal tissue regeneration, highlighting possible translational strategies for host-modulation therapy of periodontitis. This systematic review consolidates the pivotal role of RCD in the progression of periodontitis. Targeting RCD pathways may represent novel therapeutic strategies to reduce periodontal inflammation and tissue destruction.