Despite its investigative potential, few studies have reported the use of artificial intelligence (AI) in oral cytology. Oral mucosal cells display significant cellular atypia due to inflammatory stimulation or denaturation, whereas well-differentiated oral squamous cell carcinomas do not always show remarkable cellular atypia. The presence of noncancerous atypical cells alongside ill-defined tumor cells poses significant challenges to the development of effective AI tools. Thus, we aimed to investigate the effect of these atypical cells on AI performance.
Materials and methods
We used 29 cases of non-neoplastic lesions, including gingivitis, stomatitis, and 17 squamous cell carcinomas for supervised learning and validation. The cells were classified into four categories: normal, cancer, orange-suspicious, and green-suspicious. Orange and green suspicious cells indicated tumor cells lacking definitive morphological features. Annotation was performed using VoTT v2.2.0, and YOLOv7 as the object detection model, with model training being performed in six ways.
Results
The model that learned orange- and green-suspicious cells as cancer exhibited the highest detection capabilities, but also yielded a high number of false positives. In contrast, the model that excluded information about suspicious cells could rightfully identify some suspicious cells as cancer with fewer false positives.
Conclusions
Discriminating ill-defined tumor cells from atypical non-neoplastic cells based solely on morphology is challenging. Classifying suspicious cells as cancer often results in numerous false positives. Conversely, AI trained on normal and cancer can reveal previously unnoticed cancerous features in suspicious cells.
{"title":"AI performance in oral cytology for differentiating poorly defined tumor cells from reactive atypia","authors":"Kaori Oya , Kazuma Kokomoto , Mami Okamoto , Yuko Kondo , Sunao Sato , Kazunori Nozaki , Mitsunobu Kishino , Satoru Toyosawa","doi":"10.1016/j.jobcr.2025.10.003","DOIUrl":"10.1016/j.jobcr.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Despite its investigative potential, few studies have reported the use of artificial intelligence (AI) in oral cytology. Oral mucosal cells display significant cellular atypia due to inflammatory stimulation or denaturation, whereas well-differentiated oral squamous cell carcinomas do not always show remarkable cellular atypia. The presence of noncancerous atypical cells alongside ill-defined tumor cells poses significant challenges to the development of effective AI tools. Thus, we aimed to investigate the effect of these atypical cells on AI performance.</div></div><div><h3>Materials and methods</h3><div>We used 29 cases of non-neoplastic lesions, including gingivitis, stomatitis, and 17 squamous cell carcinomas for supervised learning and validation. The cells were classified into four categories: normal, cancer, orange-suspicious, and green-suspicious. Orange and green suspicious cells indicated tumor cells lacking definitive morphological features. Annotation was performed using VoTT v2.2.0, and YOLOv7 as the object detection model, with model training being performed in six ways.</div></div><div><h3>Results</h3><div>The model that learned orange- and green-suspicious cells as cancer exhibited the highest detection capabilities, but also yielded a high number of false positives. In contrast, the model that excluded information about suspicious cells could rightfully identify some suspicious cells as cancer with fewer false positives.</div></div><div><h3>Conclusions</h3><div>Discriminating ill-defined tumor cells from atypical non-neoplastic cells based solely on morphology is challenging. Classifying suspicious cells as cancer often results in numerous false positives. Conversely, AI trained on normal and cancer can reveal previously unnoticed cancerous features in suspicious cells.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1773-1778"},"PeriodicalIF":0.0,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Artificial intelligence (AI) transforms dentistry and holds considerable promise for maxillofacial prosthodontics (MFP). Applications in imaging, computer-aided design and manufacturing (CAD/CAM), and additive manufacturing are improving diagnosis, treatment planning, and prosthetic rehabilitation for patients with craniofacial abnormalities. Despite advances in materials and digital workflows, challenges remain in achieving optimal accuracy, efficiency, and customisation in prosthetic design. The integration of AI in maxillofacial prosthodontics is still in its early stages. Currently, there is no review detailing the scope, trends, potential, and limitations of AI in this field. A scoping review is therefore necessary to consolidate existing evidence, identify knowledge gaps, and suggest directions for future research and clinical application. This review objective is to systematically map and analyse the current literature on AI in maxillofacial prosthodontics, focusing on its role in craniofacial rehabilitation.
Methods
This scoping review adhered to the methodological framework of Arksey and O'Malley (2005) and was guided by the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis (2020). Reporting complied with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines to ensure clarity and reproducibility. The review was registered with the Open Science Framework (registration number: www.osf.io/3b9jr). Electronic databases, including Medline via PubMed, Scopus, Cochrane Database, Science Direct, Google Scholar, and Semantic Scholar, were searched up to 7 June 2025. Full-text English articles containing the keywords “Artificial Intelligence and Maxillofacial Prosthodontics” and related terms were included.
Results
This scoping review included 35 articles from diverse geographic regions. The studies addressed several specific applications of AI in maxillofacial prosthodontics, including the production of implant-supported auricular prostheses, coloration of maxillofacial prostheses, evaluation of facial attractiveness in patients with clefts, capture of 3D impressions of cleft palates, identification of hypernasality, assessment of lip symmetry, and detection of teeth in cleft lip and palate cases.
Conclusion
Artificial intelligence offers significant opportunities for maxillofacial prosthodontics, especially in imaging, digital design, and prosthesis production. Progress in this area requires interdisciplinary teamwork, large-scale clinical trials, and the development of standardized validation methods to ensure safe and effective clinical application.
{"title":"Artificial intelligence for maxillofacial prosthodontics: A technological shift in craniofacial rehabilitation- a scoping review","authors":"Anupama Aradya , Koduru Sravani , M.B. Ravi , K.N. Raghavendra Swamy , S. Ganesh , K. Pradeep Chandra , H.K. Sowmya , B.V. Jayashankar , Nisarga Vinod Kumar , K.M. Sangeeta","doi":"10.1016/j.jobcr.2025.10.006","DOIUrl":"10.1016/j.jobcr.2025.10.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Artificial intelligence (AI) transforms dentistry and holds considerable promise for maxillofacial prosthodontics (MFP). Applications in imaging, computer-aided design and manufacturing (CAD/CAM), and additive manufacturing are improving diagnosis, treatment planning, and prosthetic rehabilitation for patients with craniofacial abnormalities. Despite advances in materials and digital workflows, challenges remain in achieving optimal accuracy, efficiency, and customisation in prosthetic design. The integration of AI in maxillofacial prosthodontics is still in its early stages. Currently, there is no review detailing the scope, trends, potential, and limitations of AI in this field. A scoping review is therefore necessary to consolidate existing evidence, identify knowledge gaps, and suggest directions for future research and clinical application. This review objective is to systematically map and analyse the current literature on AI in maxillofacial prosthodontics, focusing on its role in craniofacial rehabilitation.</div></div><div><h3>Methods</h3><div>This scoping review adhered to the methodological framework of Arksey and O'Malley (2005) and was guided by the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis (2020). Reporting complied with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines to ensure clarity and reproducibility. The review was registered with the Open Science Framework (registration number: <span><span>www.osf.io/3b9jr</span><svg><path></path></svg></span>). Electronic databases, including Medline via PubMed, Scopus, Cochrane Database, Science Direct, Google Scholar, and Semantic Scholar, were searched up to 7 June 2025. Full-text English articles containing the keywords “Artificial Intelligence and Maxillofacial Prosthodontics” and related terms were included.</div></div><div><h3>Results</h3><div>This scoping review included 35 articles from diverse geographic regions. The studies addressed several specific applications of AI in maxillofacial prosthodontics, including the production of implant-supported auricular prostheses, coloration of maxillofacial prostheses, evaluation of facial attractiveness in patients with clefts, capture of 3D impressions of cleft palates, identification of hypernasality, assessment of lip symmetry, and detection of teeth in cleft lip and palate cases<strong>.</strong></div></div><div><h3>Conclusion</h3><div>Artificial intelligence offers significant opportunities for maxillofacial prosthodontics, especially in imaging, digital design, and prosthesis production. Progress in this area requires interdisciplinary teamwork, large-scale clinical trials, and the development of standardized validation methods to ensure safe and effective clinical application.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1749-1766"},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1016/j.jobcr.2025.10.005
Ramesh Chandra Patra, Deepti Agrawal Garg, A. Yashudas
Background
Temporomandibular dysfunction (TMD) involves pain, motor impairment and psychological distress, often sustained by maladaptive central neuroplasticity. Transcranial direct current stimulation (tDCS) can modulate cortical excitability, enhance descending inhibitory control, and improve function, making it a promising adjunct to multimodal rehabilitation.
Objective
To examine the effects of tDCS combined with multimodal rehabilitation on pain, motor performance and psychosocial outcomes in TMD and to explore associated neurophysiological mechanism.
Methods
In this randomized, assessor-blinded trial, participants received either active tDCS plus rehabilitation or Sham tDCS plus rehabilitation. Assessments occurred at baseline, post-intervention (8 weeks) and at 3 and 6-month follow-up. Primary outcomes were EEG Alpha Modulation Index (AMI), Pressure pain threshold (PPT) and Jaw functional limitation scale (JFLS); secondary outcomes included neck disability index (NDI), patient global impression of change (PGIC) data were analyzed via repeated-measures ANOVA with intention-to-treat principles.
Results
Active tDCS with rehabilitation produced greater improvements than sham in all outcomes (p < 0.001). EEG Alpha Modulation Index increased (η2 = 0.24), indicating enhanced cortical excitability. PPT improved (η2 = 0.22) showed significant and sustained functional gains. PGIC scores indicated large perceived improvement (r = 0.72), maintained at 6 months. No serious adverse events were reported. Minor events (headaches, tingling, skin irritation) occurred in <10 % of sessions and were transient.
Conclusion
tDCS combined with therapeutic exercise safely enhances cortical excitability, pain modulation, function and patient outcomes in TMD, supporting Multimodal rehabilitation. Further research should refine protocals and confirm long-term benefits across populations.
{"title":"Modulating cortical excitability through transcranial direct current stimulation combined with therapeutic exercise for craniofacial myofascial pain: Randomized controlled trial","authors":"Ramesh Chandra Patra, Deepti Agrawal Garg, A. Yashudas","doi":"10.1016/j.jobcr.2025.10.005","DOIUrl":"10.1016/j.jobcr.2025.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Temporomandibular dysfunction (TMD) involves pain, motor impairment and psychological distress, often sustained by maladaptive central neuroplasticity. Transcranial direct current stimulation (tDCS) can modulate cortical excitability, enhance descending inhibitory control, and improve function, making it a promising adjunct to multimodal rehabilitation.</div></div><div><h3>Objective</h3><div>To examine the effects of tDCS combined with multimodal rehabilitation on pain, motor performance and psychosocial outcomes in TMD and to explore associated neurophysiological mechanism.</div></div><div><h3>Methods</h3><div>In this randomized, assessor-blinded trial, participants received either active tDCS plus rehabilitation or Sham tDCS plus rehabilitation. Assessments occurred at baseline, post-intervention (8 weeks) and at 3 and 6-month follow-up. Primary outcomes were EEG Alpha Modulation Index (AMI), Pressure pain threshold (PPT) and Jaw functional limitation scale (JFLS); secondary outcomes included neck disability index (NDI), patient global impression of change (PGIC) data were analyzed via repeated-measures ANOVA with intention-to-treat principles.</div></div><div><h3>Results</h3><div>Active tDCS with rehabilitation produced greater improvements than sham in all outcomes (p < 0.001). EEG Alpha Modulation Index increased (<em>η</em><sup>2</sup> = 0.24), indicating enhanced cortical excitability. PPT improved (<em>η</em><sup>2</sup> = 0.22) showed significant and sustained functional gains. PGIC scores indicated large perceived improvement (r = 0.72), maintained at 6 months. No serious adverse events were reported. Minor events (headaches, tingling, skin irritation) occurred in <10 % of sessions and were transient.</div></div><div><h3>Conclusion</h3><div>tDCS combined with therapeutic exercise safely enhances cortical excitability, pain modulation, function and patient outcomes in TMD, supporting Multimodal rehabilitation. Further research should refine protocals and confirm long-term benefits across populations.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1731-1741"},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Limited mouth opening can impact oral function and hygiene, necessitating surgical intervention. Adjunctive appliance therapy has been shown to improve postoperative outcomes. At The Hospital for Sick Children (SickKids), a customized Mandibular Opening Appliance (MOA) was developed to enhance jaw mobility post-surgery.
Methods
A retrospective chart review was conducted for seven patients who completed MOA therapy at our orthodontic clinic between 2021 and 2024, using data from patients' charts. Maximum incisal opening (MIO) was recorded pre-surgery, post-surgery, following MOA use, and follow-up.
Results
Pre-surgical MIO ranged from 5 to 17 mm, with a mean of 8.8 ± 5.2 mm. Among the five patients with good to excellent compliance, final MIO ranged from 18 to 42 mm, representing a mean increase of 23.2 ± 9.2 mm (range: 13–36 mm). In contrast, two patients with poor compliance showed only minimal improvement (2 mm and 4 mm).
Conclusions
These findings demonstrate the efficiency of the MOA in improving MIO in compliant pediatric patients. Incorporating such appliances post-surgery shows potential for improving mandibular mobility and supporting long-term outcomes. Although a larger sample size is needed to strengthen the evidence, current results remain compelling and support refining appliance protocols for this patient population.
{"title":"A custom-made appliance for mandibular mobilization in children with limited mouth opening","authors":"Mahdis Maleki, Sally Elshennawy, Paniz Haghighi, Taras Masnyi, Kyle Stevens","doi":"10.1016/j.jobcr.2025.10.010","DOIUrl":"10.1016/j.jobcr.2025.10.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Limited mouth opening can impact oral function and hygiene, necessitating surgical intervention. Adjunctive appliance therapy has been shown to improve postoperative outcomes. At The Hospital for Sick Children (SickKids), a customized Mandibular Opening Appliance (MOA) was developed to enhance jaw mobility post-surgery.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted for seven patients who completed MOA therapy at our orthodontic clinic between 2021 and 2024, using data from patients' charts. Maximum incisal opening (MIO) was recorded pre-surgery, post-surgery, following MOA use, and follow-up.</div></div><div><h3>Results</h3><div>Pre-surgical MIO ranged from 5 to 17 mm, with a mean of 8.8 ± 5.2 mm. Among the five patients with good to excellent compliance, final MIO ranged from 18 to 42 mm, representing a mean increase of 23.2 ± 9.2 mm (range: 13–36 mm). In contrast, two patients with poor compliance showed only minimal improvement (2 mm and 4 mm).</div></div><div><h3>Conclusions</h3><div>These findings demonstrate the efficiency of the MOA in improving MIO in compliant pediatric patients. Incorporating such appliances post-surgery shows potential for improving mandibular mobility and supporting long-term outcomes. Although a larger sample size is needed to strengthen the evidence, current results remain compelling and support refining appliance protocols for this patient population.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1742-1748"},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-16DOI: 10.1016/j.jobcr.2025.10.012
Deepak Agrawal, Sabah Zaheer, Vilas Newaskar
Introduction
Dental extractions in patients on antiplatelet therapy pose a bleeding risk. Current guidelines support continuing antiplatelet therapy during surgery, but effective local hemostasis is crucial. Chitosan, a biopolymer with haemostatic, antimicrobial, and wound-healing properties, may offer advantages over cotton gauze. This study evaluated chitosan dressing vs. standard gauze during dental extractions in patients on antiplatelet therapy.
Methodology
A prospective randomized study was conducted over 18 months at the Department of Oral and Maxillofacial Surgery, Government College of Dentistry, Indore, with 100 patients on antiplatelet therapy. Extraction sites were randomly assigned to Group A (chitosan) or Group B (cotton gauze). The primary outcome was time to hemostasis, with secondary outcomes including pain (VAS), Landry healing index, postoperative bleeding, and complications. Data were analyzed using SPSS v25.0.
Results
Group A showed significantly faster hemostasis (median 0.67 min) compared to Group B (median 4.5 min; p < 0.001). Bleeding ceased within 3 min in all Group A sockets vs. 11 % in Group B (p < 0.001). Group A also had lower pain scores and higher healing index values at Day 7 (both p < 0.001). Dry socket incidence was low and similar between groups.
Conclusion
Chitosan dressing appears to be a promising adjunct for achieving rapid hemostasis, reducing postoperative discomfort, and improving early healing following dental extractions in patients on antiplatelet therapy. Larger multicenter studies with longer follow-up are recommended to confirm these findings and explore broader clinical applications.
{"title":"Efficacy of chitosan dressing as a local haemostatic agent in the management of dental extractions in patients on antiplatelet therapy. A prospective randomized study","authors":"Deepak Agrawal, Sabah Zaheer, Vilas Newaskar","doi":"10.1016/j.jobcr.2025.10.012","DOIUrl":"10.1016/j.jobcr.2025.10.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Dental extractions in patients on antiplatelet therapy pose a bleeding risk. Current guidelines support continuing antiplatelet therapy during surgery, but effective local hemostasis is crucial. Chitosan, a biopolymer with haemostatic, antimicrobial, and wound-healing properties, may offer advantages over cotton gauze. This study evaluated chitosan dressing vs. standard gauze during dental extractions in patients on antiplatelet therapy.</div></div><div><h3>Methodology</h3><div>A prospective randomized study was conducted over 18 months at the Department of Oral and Maxillofacial Surgery, Government College of Dentistry, Indore, with 100 patients on antiplatelet therapy. Extraction sites were randomly assigned to Group A (chitosan) or Group B (cotton gauze). The primary outcome was time to hemostasis, with secondary outcomes including pain (VAS), Landry healing index, postoperative bleeding, and complications. Data were analyzed using SPSS v25.0.</div></div><div><h3>Results</h3><div>Group A showed significantly faster hemostasis (median 0.67 min) compared to Group B (median 4.5 min; p < 0.001). Bleeding ceased within 3 min in all Group A sockets vs. 11 % in Group B (p < 0.001). Group A also had lower pain scores and higher healing index values at Day 7 (both p < 0.001). Dry socket incidence was low and similar between groups.</div></div><div><h3>Conclusion</h3><div>Chitosan dressing appears to be a promising adjunct for achieving rapid hemostasis, reducing postoperative discomfort, and improving early healing following dental extractions in patients on antiplatelet therapy. Larger multicenter studies with longer follow-up are recommended to confirm these findings and explore broader clinical applications.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1715-1720"},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive and antiangiogenic therapies. Identifying its incidence and risk factors is vital for prevention and management.
Objective
To identify clinical and pharmacological factors associated with healing outcomes in patients with MRONJ who receiving antiresorptive or antiangiogenic therapy treated at a single center over one-year analysis period. Additionally, we examined the healing outcome and its association with MRONJ stage and anatomical location.
Methods
This single-center cohort study, combining retrospective baseline data collection with prospective longitudinal follow-up over one year in Northern Thailand. Patient demographics, medication history, clinical features, and treatment outcomes were analyzed.
Results
Seventy-four patients (79.73 % female; mean age 72.07 ± 10.78 years) with 205 sites were analyzed. The overall MRONJ prevalence was 22.44 %, highest among patients with bone metastasis (85.71 %) and multiple myeloma (23.53 %). One-year incidence reached 23.46 %, with cancer patients showing the highest incidence (100 %). Tooth extraction was the leading local risk factor (71.74 %). Overall healing rate was 67.39 %, with better outcomes in stage 1 (77.78 %) and stage 2 (68.00 %) compared to stage 3 (0 %). In stages 1 and 2, univariable analysis showed stage 1 had higher odds of healing (OR: 1.84; 95 % CI: 0.53–6.41), and multivariable analysis confirmed this trend (adjusted OR: 3.51; 95 % CI: 0.16–76.4), though neither was statistically significant.
Conclusion
MRONJ prevalence and incidence remain substantial in high-risk populations. Better healing was observed in early-stage lesions, emphasizing the importance of early detection and timely intervention to improve clinical outcomes.
{"title":"Medication-related osteonecrosis of the jaw in Northern Thailand: A one-year cohort study of risk factors, incidence, and healing outcomes","authors":"Sutthida Pakdeemeechai , Jirapha Kammai , Nattakan Chaipattanawan , Napatsorn Imerb","doi":"10.1016/j.jobcr.2025.10.008","DOIUrl":"10.1016/j.jobcr.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive and antiangiogenic therapies. Identifying its incidence and risk factors is vital for prevention and management.</div></div><div><h3>Objective</h3><div>To identify clinical and pharmacological factors associated with healing outcomes in patients with MRONJ who receiving antiresorptive or antiangiogenic therapy treated at a single center over one-year analysis period. Additionally, we examined the healing outcome and its association with MRONJ stage and anatomical location.</div></div><div><h3>Methods</h3><div>This single-center cohort study, combining retrospective baseline data collection with prospective longitudinal follow-up over one year in Northern Thailand. Patient demographics, medication history, clinical features, and treatment outcomes were analyzed.</div></div><div><h3>Results</h3><div>Seventy-four patients (79.73 % female; mean age 72.07 ± 10.78 years) with 205 sites were analyzed. The overall MRONJ prevalence was 22.44 %, highest among patients with bone metastasis (85.71 %) and multiple myeloma (23.53 %). One-year incidence reached 23.46 %, with cancer patients showing the highest incidence (100 %). Tooth extraction was the leading local risk factor (71.74 %). Overall healing rate was 67.39 %, with better outcomes in stage 1 (77.78 %) and stage 2 (68.00 %) compared to stage 3 (0 %). In stages 1 and 2, univariable analysis showed stage 1 had higher odds of healing (OR: 1.84; 95 % CI: 0.53–6.41), and multivariable analysis confirmed this trend (adjusted OR: 3.51; 95 % CI: 0.16–76.4), though neither was statistically significant.</div></div><div><h3>Conclusion</h3><div>MRONJ prevalence and incidence remain substantial in high-risk populations. Better healing was observed in early-stage lesions, emphasizing the importance of early detection and timely intervention to improve clinical outcomes.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1721-1730"},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-15DOI: 10.1016/j.jobcr.2025.10.007
Divyansh Sinha, Suresh Venugopalan, Vijay Anand
Introduction
Full mouth rehabilitation (FMR) addresses complex dental issues like tooth wear, cosmetic concerns, and loss of occlusal stability, enhancing both function and aesthetics. This study aimed to evaluate the success and survival of tooth-supported FMR treatments and identify common causes of treatment failure.
Methodology
A retrospective analysis of 60 patients who underwent FMR between 2019 and 2021 was conducted. Data were collected from the Dental Information Archiving Software (DIAS) and analyzed using modified USPHS criteria, covering parameters like postoperative sensitivity, anatomical form, and marginal adaptation, marginal discoloration, surface texture and recurrent caries. Additional aesthetic and functional discrepancies were also documented.
Results
At cementation, all parameters scored 100 % alpha. At 3-year follow-up, slight declines were observed in sensitivity (99.17 % alpha), anatomic form (99.17 % alpha), marginal discoloration (98.88 % alpha), and recurrent caries (99.17 % alpha), with no statistical significance. Marginal adaptation (97.22 % alpha, p = 0.004) and surface texture (97.5 % alpha, p = 0.006) showed significant differences. Aesthetic issues included midline disparities (34 %) and ceramic chipping (30 %), while functional issues included absence of incisal guidance (23 %) and occlusal plane discrepancies (16 %).
Discussion
Findings suggest that successful FMR relies on a multidisciplinary approach and advanced CAD/CAM technology, which enhances accuracy and reduces treatment time. However, common aesthetic issues, such as gingival zenith variations, highlight areas for further improvement.
全口康复（FMR）解决复杂的牙齿问题，如牙齿磨损、美容问题和咬合稳定性丧失，增强功能和美观。本研究旨在评估牙支持FMR治疗的成功和生存，并确定治疗失败的常见原因。方法回顾性分析2019 - 2021年间60例FMR患者。从牙科信息存档软件（DIAS）中收集数据，并使用改进的USPHS标准进行分析，包括术后敏感性、解剖形态、边缘适应、边缘变色、表面纹理和复发性龋病等参数。还记录了其他美学和功能差异。结果胶结时，各项指标α评分均为100%。3年随访，敏感性（99.17% α）、解剖形态（99.17% α）、边缘变色（98.88% α）、龋齿复发（99.17% α）略有下降，差异无统计学意义。边缘适应性（97.22% α, p = 0.004）和表面纹理（97.5% α, p = 0.006）差异有统计学意义。美学问题包括中线差异（34%）和陶瓷碎片（30%），而功能问题包括缺切引导（23%）和咬合平面差异（16%）。研究结果表明，成功的FMR依赖于多学科方法和先进的CAD/CAM技术，这可以提高准确性并缩短治疗时间。然而，常见的美学问题，如牙龈天顶变化，突出了需要进一步改善的领域。
{"title":"Assessment of the success and survival of full mouth rehabilitations: a 3 year follow up study","authors":"Divyansh Sinha, Suresh Venugopalan, Vijay Anand","doi":"10.1016/j.jobcr.2025.10.007","DOIUrl":"10.1016/j.jobcr.2025.10.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Full mouth rehabilitation (FMR) addresses complex dental issues like tooth wear, cosmetic concerns, and loss of occlusal stability, enhancing both function and aesthetics. This study aimed to evaluate the success and survival of tooth-supported FMR treatments and identify common causes of treatment failure.</div></div><div><h3>Methodology</h3><div>A retrospective analysis of 60 patients who underwent FMR between 2019 and 2021 was conducted. Data were collected from the Dental Information Archiving Software (DIAS) and analyzed using modified USPHS criteria, covering parameters like postoperative sensitivity, anatomical form, and marginal adaptation, marginal discoloration, surface texture and recurrent caries. Additional aesthetic and functional discrepancies were also documented.</div></div><div><h3>Results</h3><div>At cementation, all parameters scored 100 % alpha. At 3-year follow-up, slight declines were observed in sensitivity (99.17 % alpha), anatomic form (99.17 % alpha), marginal discoloration (98.88 % alpha), and recurrent caries (99.17 % alpha), with no statistical significance. Marginal adaptation (97.22 % alpha, <em>p</em> = 0.004) and surface texture (97.5 % alpha, <em>p</em> = 0.006) showed significant differences. Aesthetic issues included midline disparities (34 %) and ceramic chipping (30 %), while functional issues included absence of incisal guidance (23 %) and occlusal plane discrepancies (16 %).</div></div><div><h3>Discussion</h3><div>Findings suggest that successful FMR relies on a multidisciplinary approach and advanced CAD/CAM technology, which enhances accuracy and reduces treatment time. However, common aesthetic issues, such as gingival zenith variations, highlight areas for further improvement.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1710-1714"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-15DOI: 10.1016/j.jobcr.2025.10.004
Mohamed Hamdy Helal , Aya Anwar Alsherif , Yasmin Hamdy , Malak Yousef Mohamed Shoukheba , Khaled M. Ali , Mohamed Yehia Abdelfattah , Moustafa Nabil Aboushelib
Objectives
There is an increasing demand for innovative biomaterials, scaffolds and techniques in dental practices to improve regenerative therapies. Researchers studied periodontium regeneration using biologically compatible scaffolds to repair periodontal and bony defects. The present study aimed to evaluate the effect of β-tricalcium phosphate/gelatin composite scaffolds incorporated with gentamycin-loaded chitosan microspheres for periodontal regeneration in two-wall intra bony defects in Dogs.
Design
12 bilateral intrabony defects (total 24 defects), 5 mm height, and 3 mm depth, were surgically created on the mesial surface of second mandibular premolars and allowed to become chronically healed in 12 mongrel male dogs. Dogs were randomly divided into three groups: Group I (8 defects) received β-tricalcium phosphate/gelatin composite scaffolds incorporated with gentamycin-loaded chitosan microspheres. Group II (8 defects) received the same scaffolds without gentamycin. Group III (8 defects) received open flap debridement (OFD) as a control. The animals were sacrificed at 8 weeks post-operatively for histological and histomorphometry analysis (n = 8, α = 0.05).
Results
In comparison to the control, both test groups exhibited the highest percentage of newly formed bone height, newly formed bone area, newly formed cementum, and newly formed periodontal tissues, indicating a substantial (P < 0.001) increase in new regenerative tissue. However, in the control group, epithelial downgrowth predominated.
Conclusions
Within the limitations of this study, the novel treatment approach using β-TCP/Gelatin Scaffolds with Gentamicin-Loaded Chitosan improved periodontal regeneration and wound healing in two-wall intra bony defects in Dogs.
{"title":"A novel approach utilizing Β-tricalcium phosphate/gelatin composite scaffolds incorporated with gentamycin- loaded chitosan microspheres for periodontal regeneration in two-wall intra bony defects","authors":"Mohamed Hamdy Helal , Aya Anwar Alsherif , Yasmin Hamdy , Malak Yousef Mohamed Shoukheba , Khaled M. Ali , Mohamed Yehia Abdelfattah , Moustafa Nabil Aboushelib","doi":"10.1016/j.jobcr.2025.10.004","DOIUrl":"10.1016/j.jobcr.2025.10.004","url":null,"abstract":"<div><h3>Objectives</h3><div>There is an increasing demand for innovative biomaterials, scaffolds and techniques in dental practices to improve regenerative therapies. Researchers studied periodontium regeneration using biologically compatible scaffolds to repair periodontal and bony defects. The present study aimed to evaluate the effect of β-tricalcium phosphate/gelatin composite scaffolds incorporated with gentamycin-loaded chitosan microspheres for periodontal regeneration in two-wall intra bony defects in Dogs.</div></div><div><h3>Design</h3><div>12 bilateral intrabony defects (total 24 defects), 5 mm height, and 3 mm depth, were surgically created on the mesial surface of second mandibular premolars and allowed to become chronically healed in 12 mongrel male dogs. Dogs were randomly divided into three groups: Group I (8 defects) received β-tricalcium phosphate/gelatin composite scaffolds incorporated with gentamycin-loaded chitosan microspheres. Group II (8 defects) received the same scaffolds without gentamycin. Group III (8 defects) received open flap debridement (OFD) as a control. The animals were sacrificed at 8 weeks post-operatively for histological and histomorphometry analysis (n = 8, α = 0.05).</div></div><div><h3>Results</h3><div>In comparison to the control, both test groups exhibited the highest percentage of newly formed bone height, newly formed bone area, newly formed cementum, and newly formed periodontal tissues, indicating a substantial (P < 0.001) increase in new regenerative tissue. However, in the control group, epithelial downgrowth predominated.</div></div><div><h3>Conclusions</h3><div>Within the limitations of this study, the novel treatment approach using β-TCP/Gelatin Scaffolds with Gentamicin-Loaded Chitosan improved periodontal regeneration and wound healing in two-wall intra bony defects in Dogs.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1696-1709"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-14DOI: 10.1016/j.jobcr.2025.10.001
Siva Shankar Dev , Ramya Ramadoss , K. Nitya , Sandhya Sundar , Suganya Panneer Selvam , K. Hema Shree
Background
Radix entomolaris (RE), a distolingual supernumerary root in mandibular first molars, presents significant challenges in endodontic treatment due to its complex and variable anatomy. Conventional radiographic techniques often fail to detect such intricacies, increasing the risk of missed canals and treatment failure.
Objective
This study aimed to characterize the morphometric complexity of RE using cone-beam computed tomography (CBCT) and to develop machine learning (ML) models for classifying root canal morphotypes and predicting anatomical bifurcation.
Methods
One hundred extracted mandibular first molars with confirmed RE were scanned using high-resolution CBCT. Morphometric parameters—including canal curvature, cross-sectional area, roundness index (a circularity metric), volumetric size, and root fusion status (fused vs. separate roots)—were extracted at multiple apical levels. These features were used to train supervised and unsupervised ML models. A decision tree classifier predicted bifurcation presence using four anatomical features, while K-means clustering (k = 2) stratified morphotypes.
Results
The decision tree classifier achieved an F1-score of 0.87, with a sensitivity of 85.7 % and specificity of 89.4 %. Volumetric canal size was the strongest predictor of bifurcation (AUC = 0.81). K-means clustering identified two morphotypes: simple (round, single orifice) and complex (irregular, bifurcated, or C-shaped canals). Notably, roundness index decreased coronally, and 27 % of samples exhibited mid-root bifurcation.
Conclusion
CBCT-derived features, particularly canal volume and curvature, effectively predict RE complexity. The integration of these features into machine learning models provides a clinically valuable framework for morphotype classification and personalized endodontic planning. These findings support the adoption of AI-assisted diagnostics in managing anatomically complex root canal systems.
{"title":"Morphotype stratification of radix entomolaris in mandibular molars","authors":"Siva Shankar Dev , Ramya Ramadoss , K. Nitya , Sandhya Sundar , Suganya Panneer Selvam , K. Hema Shree","doi":"10.1016/j.jobcr.2025.10.001","DOIUrl":"10.1016/j.jobcr.2025.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Radix entomolaris (RE), a distolingual supernumerary root in mandibular first molars, presents significant challenges in endodontic treatment due to its complex and variable anatomy. Conventional radiographic techniques often fail to detect such intricacies, increasing the risk of missed canals and treatment failure.</div></div><div><h3>Objective</h3><div>This study aimed to characterize the morphometric complexity of RE using cone-beam computed tomography (CBCT) and to develop machine learning (ML) models for classifying root canal morphotypes and predicting anatomical bifurcation.</div></div><div><h3>Methods</h3><div>One hundred extracted mandibular first molars with confirmed RE were scanned using high-resolution CBCT. Morphometric parameters—including canal curvature, cross-sectional area, roundness index (a circularity metric), volumetric size, and root fusion status (fused vs. separate roots)—were extracted at multiple apical levels. These features were used to train supervised and unsupervised ML models. A decision tree classifier predicted bifurcation presence using four anatomical features, while K-means clustering (k = 2) stratified morphotypes.</div></div><div><h3>Results</h3><div>The decision tree classifier achieved an F1-score of 0.87, with a sensitivity of 85.7 % and specificity of 89.4 %. Volumetric canal size was the strongest predictor of bifurcation (AUC = 0.81). K-means clustering identified two morphotypes: simple (round, single orifice) and complex (irregular, bifurcated, or C-shaped canals). Notably, roundness index decreased coronally, and 27 % of samples exhibited mid-root bifurcation.</div></div><div><h3>Conclusion</h3><div>CBCT-derived features, particularly canal volume and curvature, effectively predict RE complexity. The integration of these features into machine learning models provides a clinically valuable framework for morphotype classification and personalized endodontic planning. These findings support the adoption of AI-assisted diagnostics in managing anatomically complex root canal systems.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1681-1689"},"PeriodicalIF":0.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-14DOI: 10.1016/j.jobcr.2025.09.026
Sibi Charan, Ramya Ramadoss, Nitya Krishnasamy, Sandhya Sundar, Suganya Panneer Selvam, K. Hema Shree
Background
Age-related attrition in dentin is associated with gradual mineral loss and collagen degradation, affecting its structural and functional integrity. However, there remains a need for standardized, quantitative indices to assess these degenerative changes.
Objective
This study aimed to evaluate the structural, chemical, and elemental changes in healthy versus attrited dentin using a multimodal analytical approach and to introduce novel quantitative indices for assessing dentin degradation.
Methods
Human teeth exhibiting signs of attrition were collected, processed, and analyzed using X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), inductively coupled plasma mass spectrometry (ICP-MS). Four novel indices—Crystallinity Loss Index (CLI), Mineral Integrity Index (MII), Collagen Degradation Ratio (CDR), and Structural Degradation Index (SDI)—were developed and applied.
Results
Attrited dentin showed significantly reduced crystallinity (CLI = 25.2 %), decreased mineral integrity (MII = 0.38), and marked collagen loss (CDR = 0.60) compared to healthy samples. Elemental analysis revealed a decreased Ca/P ratio and lower concentrations of Zn and Sr, with elevated Fe and Cu levels in aged dentin. The SDI (0.237) provided a composite representation of overall dentin degradation.
Conclusion
The combined use of spectroscopic and elemental analyses, along with the application of novel quantitative indices, enables a robust evaluation of dentin degradation associated with attrition. These metrics hold potential in clinical diagnosis, forensic dentistry, and restorative treatment planning.
{"title":"Quantitative evaluation of spatial heterogeneity in dentin attrition using combined spectroscopic and elemental profiling","authors":"Sibi Charan, Ramya Ramadoss, Nitya Krishnasamy, Sandhya Sundar, Suganya Panneer Selvam, K. Hema Shree","doi":"10.1016/j.jobcr.2025.09.026","DOIUrl":"10.1016/j.jobcr.2025.09.026","url":null,"abstract":"<div><h3>Background</h3><div>Age-related attrition in dentin is associated with gradual mineral loss and collagen degradation, affecting its structural and functional integrity. However, there remains a need for standardized, quantitative indices to assess these degenerative changes.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the structural, chemical, and elemental changes in healthy versus attrited dentin using a multimodal analytical approach and to introduce novel quantitative indices for assessing dentin degradation.</div></div><div><h3>Methods</h3><div>Human teeth exhibiting signs of attrition were collected, processed, and analyzed using X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), inductively coupled plasma mass spectrometry (ICP-MS). Four novel indices—Crystallinity Loss Index (CLI), Mineral Integrity Index (MII), Collagen Degradation Ratio (CDR), and Structural Degradation Index (SDI)—were developed and applied.</div></div><div><h3>Results</h3><div>Attrited dentin showed significantly reduced crystallinity (CLI = 25.2 %), decreased mineral integrity (MII = 0.38), and marked collagen loss (CDR = 0.60) compared to healthy samples. Elemental analysis revealed a decreased Ca/P ratio and lower concentrations of Zn and Sr, with elevated Fe and Cu levels in aged dentin. The SDI (0.237) provided a composite representation of overall dentin degradation.</div></div><div><h3>Conclusion</h3><div>The combined use of spectroscopic and elemental analyses, along with the application of novel quantitative indices, enables a robust evaluation of dentin degradation associated with attrition. These metrics hold potential in clinical diagnosis, forensic dentistry, and restorative treatment planning.</div></div>","PeriodicalId":16609,"journal":{"name":"Journal of oral biology and craniofacial research","volume":"15 6","pages":"Pages 1690-1695"},"PeriodicalIF":0.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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