International Dental Journal[JOURNAL]
Sun
200 papers
Network Analysis of Sleep, Mental Health, and Stress in Korean Dentists.
Yuh C, Song IS, Lee HJ … +2 more , Lee YM, Cho CH
Int Dent J · 2026 Jun · PMID 42341599 · Full text
INTRODUCTION AND AIMS: Dentists are vulnerable to occupational stress, poor sleep, and related mental health problems. However, prior studies have treated sleep quality as a single aggregate score, obscuring which specif...
INTRODUCTION AND AIMS: Dentists are vulnerable to occupational stress, poor sleep, and related mental health problems. However, prior studies have treated sleep quality as a single aggregate score, obscuring which specific sleep dimensions are most closely connected with mental health and occupational stress. This study applied psychological network analysis to examine the interrelationships among individual sleep quality components, mental health indicators, and occupational stress in Korean dentists. METHODS: A cross-sectional online survey of 229 Korean dentists was conducted in 2016. Six Pittsburgh Sleep Quality Index (PSQI) components, the Center for Epidemiologic Studies Depression Scale (CES-D), State-Trait Anxiety Inventory (STAI), Brief Encounter Psychosocial Instrument-Korean (BEPSI-K), Physician Job Stress (PJS), and Dentist Job Stress (DJS) scales were analysed. A Gaussian Graphical Model was estimated using EBICglasso (gamma = 0.5) following nonparanormal transformation. Centrality indices, bridge centrality, and bootstrap stability were computed. RESULTS: The network revealed 31 non-zero edges among 11 nodes. The strongest edges were depression-anxiety (partial r = 0.60), physician-dentist job stress (0.42), and subjective sleep quality-daytime dysfunction (0.35). Depression showed the highest strength centrality (z = 1.65). Bridge centrality analysis identified daytime dysfunction (bridge strength = 0.385) and sleep latency (0.224) as the primary sleep-domain nodes connecting to mental health and stress domains. The network demonstrated excellent stability (CS-coefficient = 0.70). CONCLUSION: Daytime dysfunction and sleep latency emerged as prominent bridge nodes linking sleep quality with mental health and occupational stress in dentists. These findings highlight specific sleep-related domains that may warrant attention in future screening and intervention studies. CLINICAL RELEVANCE: Rather than treating poor sleep as a single construct, dental workforce well-being programmes could target daytime dysfunction and sleep latency as specific domains for screening and support. Early identification of depressive symptoms, which occupied a central position in the network, may help prevent broader deterioration of occupational functioning.
BMP9-Smad1/5/9 Signalling Mediates Osteogenic Differentiation and Alveolar Bone Remodelling in hPDLFs.
Hu J, An N, Chang S … +3 more , Zhao S, Su R, Huang J
Int Dent J · 2026 Jun · PMID 42341598 · Full text
OBJECTIVES: This study aimed to investigate the role of BMP9-Smad1/5/9 in the osteogenic differentiation and alveolar bone remodelling of Human periodontal ligament fibroblasts (hPDLFs) under the action of cyclic tensile...
OBJECTIVES: This study aimed to investigate the role of BMP9-Smad1/5/9 in the osteogenic differentiation and alveolar bone remodelling of Human periodontal ligament fibroblasts (hPDLFs) under the action of cyclic tensile stress (CTS). METHODS: An orthodontic tooth movement (OTM) model was established in Sprague-Dawley (SD) rats, the expression status of OCN and BMP9 was measured using immunohistochemistry. hPDLFs were subjected to CTS treatment (10% elongation, 0.5 Hz) to simulate the mechanical microenvironment during orthodontic treatment. The activity of ALP was detected by colorimetric assay and azo coupling staining, respectively. Mineralized nodules were visualized by Alizarin red staining. The expression levels of osteogenesis-related genes including RUNX2, ALP, and OCN were evaluated. To determine the role of BMP9-Smad1/5/9 in CTS-induced osteogenic differentiation, BMP9-Smad1/5/9 signalling was diminished by small RNA against BMP9 and the inhibitor of Smad signalling, the potential of osteogenic differentiation was assessed. RESULTS: BMP9 expression was upregulated in the tension-side periodontal ligament tissues of SD rats, as well as in hPDLFs stimulated by CTS. hPDLFs exhibited increased osteogenic differentiation potential under CTS induction, as evidenced by increased ALP activity, upregulated expression of osteogenesis-related genes, increased mineralized nodule formation and ALP staining. Mechanistically, CTS elevated the phosphorylation levels of Smad1/5/9. Silencing BMP9 attenuated CTS-induced osteogenic differentiation and reduced Smad1/5/9 phosphorylation. Moreover, inhibition of BMP9-Smad1/5/9 signalling pathway suppressed the osteogenic potential of hPDLFs. CONCLUSIONS: CTS increased the osteogenic potential of hPDLFs. Silencing of BMP9 and inhibition of the BMP9-Smad1/5/9 signalling inhibited the osteogenic differentiation of hPDLFs induced by CTS. CLINICAL RELEVANCE: These findings provide mechanistic insights into periodontal tissue remodelling and may contribute to the development of strategies to accelerate orthodontic tooth movement in clinical practice.
Predicting Perceived Profile Attractiveness From Cephalometric Measurements Using Machine Learning.
Pirayesh Z, Sohrabniya F, Ourang SA … +6 more , Mohammad-Rahimi H, Esmaeili S, Khosravani S, Motamedian SR, Schwendicke F, Tichy A
Int Dent J · 2026 Jun · PMID 42341597 · Full text
OBJECTIVES: Orthodontic treatment planning requires careful consideration of facial aesthetics. This study aimed to compare machine learning (ML) models to predict perceived attractiveness based on lateral cephalometric...
OBJECTIVES: Orthodontic treatment planning requires careful consideration of facial aesthetics. This study aimed to compare machine learning (ML) models to predict perceived attractiveness based on lateral cephalometric measurements and to identify parameters that significantly impact perceived attractiveness. METHODS: Lateral cephalometric radiographs and corresponding facial photographs of 400 patients were utilized in this study. Twenty-six raters, including 20 laypeople and 6 domain experts (art, maxillofacial surgery, and orthodontics), evaluated each photograph using a 1 to 5 Visual Analogue Scale (VAS), and cephalometric analyses using the Dolphin software served as the reference standard. Five ML models, linear regression, Support Vector Machine, XGBoost Regressor, Random Forest, and artificial neural network, were trained to predict attractiveness scores based on the reference standard, and their performance on a test set (n = 59) was evaluated using root mean square error (RMSE). Subsequently, feature importance analysis was conducted to identify cephalometric indices that had the largest impact on VAS scores. RESULTS: Experts consistently rated facial attractiveness higher than laypeople, especially in age groups >15 years. Furthermore, female raters rated female profiles significantly higher and male profiles significantly lower than male raters, with differences evident in >15 age groups. Among the 5 ML models, Random Forest demonstrated the best performance (RMSE = 0.50). The feature importance analysis revealed that soft tissue parameters, especially those related to facial convexity, maxillary and mandibular prognathism, and vertical proportions, were most predictive of attractiveness scores. CONCLUSION: ML models showed promising results in predicting facial attractiveness based on cephalometric measurements and highlighted the correlation of facial aesthetics with soft tissue parameters. The proposed ML-based approach can aid clinicians in the objective assessment of treatment outcomes.
Three-Dimensional Radiographic and Morphological Features of Ameloblastoma and Odontogenic Keratocyst: A Comparative Cone Beam Computed Tomography Study Using Automatic Segmentation.
Li L, Huang S, Zhang X … +6 more , Liu X, Cheng Y, Yang K, Zhang L, He H, Huang Z
Int Dent J · 2026 Jun · PMID 42335754 · Full text
OBJECTIVES: We aimed to compare the three-dimensional (3D) radiographic and morphological features, and explore their associations in ameloblastoma (AM) and odontogenic keratocyst (OKC) on CBCT scans, to facilitate clini...
OBJECTIVES: We aimed to compare the three-dimensional (3D) radiographic and morphological features, and explore their associations in ameloblastoma (AM) and odontogenic keratocyst (OKC) on CBCT scans, to facilitate clinicians in the preoperative differential diagnosis between the two lesions. METHODS: CBCT scans of 151 AMs and 164 OKCs were retrospectively collected. The morphological features (volume, length, width, height) of lesions were obtained by OCL-Net automatically, an algorithm established for odontogenic cystic lesion (OCL) segmentation. Meanwhile, the radiographic features of lesions including shape, border, buccolingual expansion, cortical bone destruction, lesion-tooth relationship, root resorption and tooth displacement were assessed by maxillofacial radiologists. Differences in morphological and radiographic features between AM and OKC were identified. Additionally, associations between morphological and radiographic features were analyzed separately in AM and OKC cases. RESULTS: AM showed significantly greater volume (p = 0.002), length (p = 0.009), length-to-width (p = 0.014), and length-to-height (p = 0.022) ratios compared with OKC. Additionally, scalloped borders (p = 0.003), buccolingual expansion (p < 0.001), cortical bone destruction (p = 0.035), root resorption (p < 0.001) and tooth displacement (p = 0.014), were more commonly observed in AMs than in OKCs. Moreover, OKCs with cortical bone destruction (p < 0.001) and tooth displacement (p < 0.01) were significantly larger than those without, while these radiographic features were not associated with lesion volume in AMs. CONCLUSION: OKCs generally show smaller lesion volumes, less extensive invasion along the frontal axis, and less aggressive radiographic features on CBCT than AMs. In addition, small lesions that cause destruction of the surrounding tissues are more likely to be AMs rather than OKCs. CLINICAL RELEVANCE: Our findings may aid clinicians in the preoperative differentiation of AM and OKC, while our proposed OCL-Net may facilitate the future development of a fully automated diagnostic system and provide a novel perspective for the differential diagnosis of a broader spectrum of jaw space-occupying lesions.
Root Canal Location Accuracy: Dynamic Navigation Verses Freehand in Extracted Human Molars - A Randomized In Vitro Study.
Chen F, Han T, Guo H … +11 more , Wang G, Qiu L, Tang J, Li J, Dong L, Huang Y, Wang L, Luo Q, He H, Li H, Xue P
Int Dent J · 2026 Jun · PMID 42335753 · Full text
OBJECTIVES: To compare the accuracy, instrumentation time, and success rate of three dynamic navigation systems (DNSs)-infrared-active (IA), infrared-passive (IP), and visible light-passive (VP)-with freehand (FH) operat...
OBJECTIVES: To compare the accuracy, instrumentation time, and success rate of three dynamic navigation systems (DNSs)-infrared-active (IA), infrared-passive (IP), and visible light-passive (VP)-with freehand (FH) operation in locating root canals of maxillary and mandibular molars, providing a basis for technique selection in complex endodontic treatments. METHODS: Ninety-six extracted human mandibular molars were randomly assigned to four groups (n = 24/group): IA-DNS, IP-DNS, VP-DNS, and FH (control). Specimens were embedded in plaster and scanned with CBCT (0.3 mm slice thickness). In DNS groups, fiducial markers enabled real-time tracking of the bur position. The FH group used a microscope with CBCT reference. Recorded parameters included: angular deviation (°), three-dimensional deviations at entry and target points (mm), instrumentation time (s), tooth structure loss (mm³), and success rate of canal location. Data were analysed using ANOVA and chi-square tests (α = 0.05). RESULTS: DNS demonstrated significantly higher accuracy than FH. Angular deviations in DNS groups (IA: 0.64° ± 0.34°, IP: 0.59° ± 0.32°, VP: 0.63° ± 0.24°) were 94.3% to 94.7% lower than FH (11.03° ± 4.70°) (P < .001). Three-dimensional deviations at entry (0.57-0.70 mm) and target (0.59-0.80 mm) were significantly smaller than FH (1.64 mm and 1.26 mm, respectively; P < .001). Tooth structure loss in DNS groups (9.79-11.03 mm³) was reduced by 26.8% to 34.6% compared to FH (14.98 mm³; P < .001). No significant difference in operative time was observed among groups (176-183 s, P > .05). Success rate was significantly higher in DNS groups (99.54%, 215/216) than FH (93.06%, 67/72; P = .004). No significant differences were observed among the three DNS types for any parameter. CONCLUSION: DNS significantly enhanced accuracy of root canal location in molars, reducing angular deviation by >94%, minimizing tooth structure loss by >26%, and increasing success rate to 99.5%. Performance was consistent across different optical principles and signal mechanisms, supporting DNS as a viable option for precise management of calcified canals and other nonsurgical endodontic procedures.
When Artificial Intelligence Agrees Too Easily: The Emerging Risk of Artificial Intelligence Sycophancy in Dentistry.
Turky M, Dummer PMH
Int Dent J · 2026 Jun · PMID 42335752 · Full text
Abstract loading — click title to view on PubMed.
Federated Learning in Endodontics: A Framework for Privacy-Preserving Multicentre Artificial Intelligence.
Turky M, Samaranayake L, Osathanon T … +1 more , Dummer PMH
Int Dent J · 2026 Jun · PMID 42330717 · Full text
INTRODUCTION AND AIM: High-quality artificial intelligence (AI) models in endodontics require access to diverse, well-annotated datasets. This review introduces federated learning (FL) as a privacy-preserving framework f...
INTRODUCTION AND AIM: High-quality artificial intelligence (AI) models in endodontics require access to diverse, well-annotated datasets. This review introduces federated learning (FL) as a privacy-preserving framework for collaborative AI in endodontics. METHODS: In this narrative review, a comprehensive literature search was conducted across databases, encompassing studies published up to April 2026. The search strategy was intentionally broad to facilitate a thorough exploration of the evolution of the relevant concepts. However, to ensure consistency in comprehension and analysis, the review was limited to publications in English. Studies describing the fundamentals and applications of FL were reviewed and comparatively analysed. The narrative review served as the framework for outlining implementation pathways, challenges, and research priorities for its application to diagnostic and decision-support tasks. RESULTS: Traditional centralised training methods face legal and ethical challenges due to data protection regulations. FL allows institutions to retain local patient data while contributing model updates to a central server or decentralised network, thus providing a viable alternative. The article explores FL principles, privacy and security mechanisms, architectures, technical challenges, and adversarial risks. Regulatory and ethical considerations hinge on a mix of advanced technical measures and robust organisational practices. A proposed roadmap for implementing FL includes pilot studies, standardised data processes, clinical validation, and regulatory engagement. FL promises to enhance AI development in endodontics while safeguarding patient privacy, with potential benefits in diagnostics and personalised care. CONCLUSION: FL could advance AI integration in endodontics, prioritising the protection of patient privacy. This initiative holds the potential to improve diagnostic processes and facilitate personalised treatment approaches. CLINICAL RELEVANCE: FL enables the development of multicentre AI models without sharing patient data. By leveraging diverse clinical datasets, this approach may improve the accuracy and generalisability of AI systems for endodontic diagnosis, treatment planning, and outcome prediction while preserving patient privacy.
The Efficacy of Mesenchymal Stem Cell-Based Therapy for Sjögren's Syndrome: A Systematic Review and Meta-Analysis of Preclinical Studies.
Yang X, Shi C, Wu Z … +5 more , Hu J, Yao A, Luo S, Fu B, Yu Y
Int Dent J · 2026 Jun · PMID 42330716 · Full text
BACKGROUND: Sjögren's syndrome (SjS) is a chronic autoimmune disease primarily characterized by xerostomia, often accompanied by xerophthalmia, cutaneous dryness, arthralgia, and stiffness. Mesenchymal stem cell (MSC)-ba...
BACKGROUND: Sjögren's syndrome (SjS) is a chronic autoimmune disease primarily characterized by xerostomia, often accompanied by xerophthalmia, cutaneous dryness, arthralgia, and stiffness. Mesenchymal stem cell (MSC)-based therapies have shown promising immunomodulatory potential in autoimmune diseases, yet their efficacy in SjS remains uncertain. Before advancing to clinical application, a systematic evaluation of preclinical evidence is essential to clarify their therapeutic impact and experimental consistency. METHODS: This systematic review and meta-analysis were registered in PROSPERO (CRD42023471348) and conducted in accordance with PRISMA guidelines. Comprehensive searches were performed in PubMed, Embase, Scopus, Cochrane Library, and Web of Science up to 1 May 2025. Random-effects meta-analyses were conducted to assess changes in salivary flow rate (SFR), inflammatory infiltration, and cytokine expression. RESULTS: A total of 25 studies met the inclusion criteria. Pooled analyses demonstrated that MSCs, MSC-derived exosomes, and MSC-conditioned medium significantly improved stimulated SFR (standardized mean difference = 3.19, 95% confidence interval 2.50-3.88, P < .001) and reduced inflammatory infiltration (standardized mean difference = -2.04, 95% confidence interval -2.66 to -1.43, P < .001). MSC-based therapies decreased serum levels of proinflammatory cytokines (interleukin-6 [IL-6] and interferon-gamma) and increased IL-10. Exploration of heterogeneity indicated that MSC type and dosage influenced SFR outcomes, MSC intervention type affected inflammatory infiltration and serum IL-6 levels, and MSC dosage influenced serum IL-10 levels. CONCLUSION: MSC-based therapies show potential for treating SjS in animal models, improving salivary secretion, reducing inflammation, and modulating immune cytokines. Substantial heterogeneity across studies highlights the need for standardized protocols regarding MSC source, dosage, and treatment duration before clinical translation.
Study on a Novel Dental Composite Resin with Fluorinated Polyurethane Monomer and Modified Polyether Ether Ketone Fillers.
Liu Z, Hong G, Yang Z … +3 more , Lin Q, Shi Z, Zhu S
Int Dent J · 2026 Jun · PMID 42330715 · Full text
INTRODUCTION AND AIMS: Traditional dental composite resins faced persistent challenges regarding biofilm accumulation and hydrolytic degradation. This study aimed to develop a novel resin monomer fluorinated polyurethane...
INTRODUCTION AND AIMS: Traditional dental composite resins faced persistent challenges regarding biofilm accumulation and hydrolytic degradation. This study aimed to develop a novel resin monomer fluorinated polyurethane dimethacrylate (FPUDMA) and surface-modified polyether ether ketone (PEEK) fillers to enhance the comprehensive performance of composite resins. METHODS: FPUDMA was synthesized via solution polymerization, while PEEK was hydroxylated and grafted with KH570 to introduce C=C bonds. Experimental composite resins were formulated with varying concentrations of PEEK-C=C at 0%, 2.5%, 5%, and 7.5% by weight. Key properties evaluated included degree of conversion, depth of curing, water sorption/solubility, mechanical properties (before/after aging), polishability, initial bacterial adhesion, and cytocompatibility. RESULTS: FPUDMA and PEEK-C=C were confirmed by FTIR, NMR, and XPS. Increasing PEEK-C=C content reduced the degree of conversion and curing depth, but all values met ISO standards. There was no significant difference in water absorption/solubility among the groups. As the increase of PEEK-C=C content, the flexural strength, elastic modulus, and surface hardness significantly increased, but decreased at 7.5% group, whether before or after aging (P<0.05). All groups exhibited favorable polishing performance and cytocompatibility (cell viability >90%). The FPUDMA monomer could still maintain anti-bacterial adhesion properties when incorporated into the resin. CONCLUSION: The novel composite resin with FPUDMA and 5 wt% PEEK-C=C fillers demonstrated optimized mechanical properties, acceptable polymerization characteristics, resistance to bacterial adhesion, and favorable biocompatibility. CLINICAL RELEVANCE: These improvements are expected to mitigate degradation at the tooth-restoration interface, thereby reducing the risk of secondary caries and restoration fracture. Consequently, the novel resin represents a clinically viable option for durable dental restorations.
Computational Analysis of Antimicrobial Peptides Targeting Agglutinin-Like Protein 3 (Als3) and β-Glucan Synthase in Denture-Associated Candidiasis.
Saini RS, Dermawan D, Chopra S … +4 more , Binduhayyim RIH, Mosaddad SA, Alarcón-Sánchez MA, Heboyan A
Int Dent J · 2026 Jun · PMID 42330714 · Full text
BACKGROUND: Candida albicans adhesion and biofilm formation on prosthetic surfaces drive denture-associated candidiasis and are unaffected by traditional fungicidal treatments. Pre-emptive prevention of fungal attachment...
BACKGROUND: Candida albicans adhesion and biofilm formation on prosthetic surfaces drive denture-associated candidiasis and are unaffected by traditional fungicidal treatments. Pre-emptive prevention of fungal attachment to prosthetic devices is a rational strategy to avoid recurrent infections. METHODS: We utilized a mechanism-based computational pipeline to screen peptides with activity centred on inhibiting fungal adhesion instead of viability. We chose two colonization-relevant targets: agglutinin-like protein 3 (Als3), involved in surface attachment, and 1,3-β-glucan synthase (GS), involved in glucan-dependent biofilm-support processes. Peptides were ranked using protein-peptide docking, 100-ns molecular dynamics simulations, and MM/PBSA binding free energy calculations to determine metrics of interface coverage, interaction persistence, and dynamic energetic favourability. RESULTS: We found that tachystatin consistently and stably occupied the highest proportion of adhesion-related interfaces on both Als3 and GS. Tachystatin dynamics demonstrated lower residue-level fluctuations in functionally relevant residues and preservation of hydrogen bonds throughout the simulation. MM/PBSA assessments revealed favourable and consistent binding energetics facilitated by van der Waals forces. These findings suggest that the peptide may comparatively maintain interface occupancy consistent with a potential steric hindrance effect at adhesion-relevant regions. The selected control peptides failed to occupy the predicted interfaces and demonstrated inadequate stabilities. CONCLUSIONS: Targeting Als3-mediated adhesion together with GS-associated biofilm-support processes represent a promising preventive strategy for denture-associated candidiasis. Tachystatin emerged as the most promising peptide within this comparative computational screen and may warrant further evaluation as a candidate for reducing biofilm formation on dental prosthetics Overall, this interaction- and simulation-based framework may support antimicrobial peptide selection focused on biofilm prevention.
Career Status and Mental Health Among Female Dentists in China: A Nationwide Cross-Sectional Survey.
Dong T, Yang Y, Liu L … +7 more , Ouyang N, Yuan L, Xu S, Li T, Xia L, Ye N, Fang B
Int Dent J · 2026 Jun · PMID 42322688 · Full text
INTRODUCTION AND AIMS: Female dentists make up a large proportion in China and often face heavy workloads and occupational pressure. This study aims to conduct a comprehensive analysis of the current situation, challenge...
INTRODUCTION AND AIMS: Female dentists make up a large proportion in China and often face heavy workloads and occupational pressure. This study aims to conduct a comprehensive analysis of the current situation, challenges and mental health conditions of female dentists in China. METHODS: A cross-sectional survey among female dentists in China was conducted using a structured questionnaire. The survey collected information on demographic characteristics, workload, income satisfaction, psychological status, occupational stress, and occupational attitudes. Logistic regression was used to analyse factors associated with income satisfaction, anxiety symptoms, depressive emotions, and professional commitment. RESULTS: A total of 3,504 valid responses from female dentists across China were collected. 27.22% participants reported income dissatisfaction, with 55.5% perceiving income not proportional to their effort and 45.32% believing they earned less than male colleagues of the same level. Age, practice status, clinical specialty, annual income and workload all affect income satisfaction. Family responsibilities substantially impacted careers, with 44.06% having given up opportunities for advancement due to family reasons. Mental health burdens were substantial, with 97.6% reporting occasional or frequent anxiety and 86.24% experiencing depressive moods. Work-family imbalance is the strongest positive predictor of anxiety and depression. A total of 78.48% participants expressed love for their profession, though only 40.83% would actively recommend it to others. Dissatisfaction with income, work intensity and promotion speed and work-family imbalance significantly reduces professional commitment. CONCLUSIONS: Female dentists in China constitute a highly qualified group yet facing multifaceted professional obstacles. Income satisfaction, psychological well-being, and occupational enthusiasm among female dentists are influenced by multiple factors. Systemic interventions are urgently needed to address pay equity, provide support for work-family balance and mental health to ensure a sustainable and healthy future for the dental workforce. CLINICAL RELEVANCE: This survey provides important insights into the current career landscape of female dentists in China and may inform strategies aimed at improving porfessional development and workforce equity.
Comparing Deep Learning Models for Identifying Maxillary Transverse Deficiency from Intraoral Photographs.
Li J, Wang R, Yi Z … +3 more , Ni J, Zuo Z, Wang Y
Int Dent J · 2026 Jun · PMID 42320262 · Full text
INTRODUCTION AND AIMS: Maxillary transverse deficiency (MTD) is conventionally evaluated using cone-beam computed tomography (CBCT), which entails increased radiation exposure, cost, and clinical workload. Frontal intrao...
INTRODUCTION AND AIMS: Maxillary transverse deficiency (MTD) is conventionally evaluated using cone-beam computed tomography (CBCT), which entails increased radiation exposure, cost, and clinical workload. Frontal intraoral photographs are routinely obtained in orthodontic practice. Using CBCT-derived transverse measurements as reference standards, we developed, validated, and compared multiple deep learning (DL) models to assess the feasibility of identifying MTD from frontal intraoral photographs. METHODS: This study included 826 internal and 192 external patients who underwent paired frontal intraoral photographs and CBCT. MTD was determined based on the University of Pennsylvania analysis (UPA) and Yonsei transverse analysis (YTA) labels. DenseNet 121, ResNet 18, EfficientNet B0/B3, and MobileNetV3 Small/Large were trained separately on photographs using UPA- and YTA-based labels. Five-fold cross-validation was employed, and performance was evaluated on the internal and external test sets using accuracy, precision, recall, and F1 scores, along with confusion matrices and areas under the receiver operating characteristic curves. DeLong's test assessed the differences between the models. RESULTS: In the external test set under the UPA labelling scheme, ResNet 18 achieved the highest accuracy (90.62%). Under the YTA labelling scheme, DenseNet 121 and ResNet 18 achieved the highest accuracy (96.88%). Across all internal and external test sets using both labelling schemes, DenseNet 121 and ResNet 18 yielded the best overall performance, and no statistically significant difference was observed between the two models (P > .05). CONCLUSIONS: The DL models demonstrated strong potential for analysing frontal intraoral photographs to detect MTD. These findings provide initial insights into the use of DL models to identify MTD from frontal intraoral photographs for orthodontic purposes. CLINICAL RELEVANCE: This study demonstrates the feasibility of using DL-based recognition of frontal intraoral photographs to identify MTD. As a cost-effective adjunctive tool, the proposed approach may assist clinicians in identifying MTD and help improve case selection for CBCT imaging.
The Impact of Dental Prostheses in Patients With Cardiovascular Disease: A Scoping Review With Exploratory Analysis.
Werdiningsih M, Weng EC, Hasegawa Y … +4 more , Maria MTS, Hori K, Nagasawa Y, Shinmura K
Int Dent J · 2026 Jun · PMID 42320261 · Full text
Dental prostheses not only restore oral function but may also impact systemic health outcomes. This scoping review sought to synthesize evidence on the association between dental prostheses, hypertension, and physical fu...
Dental prostheses not only restore oral function but may also impact systemic health outcomes. This scoping review sought to synthesize evidence on the association between dental prostheses, hypertension, and physical function, including frailty, in adults with established cardiovascular disease (CVD) or elevated cardiovascular risk. This review was conducted following the PRISMA-ScR guidelines and Joanna Briggs Institute methodology. Literature searches were performed in PubMed and Google Scholar up to November 10, 2024. Eligible studies were observational investigations involving adults with established CVD or elevated cardiovascular risk who used dental prostheses. An exploratory quantitative approach was used to summarize the direction and patterns of association. Seven studies met the inclusion criteria: 5 assessed hypertension and 2 examined physical function. Exploratory pooled analysis based on unadjusted data indicated that individuals with dental prostheses had a lower odds of hypertension (odds ratio = 0.69; 95% confidence interval, 0.52-0.91), although substantial heterogeneity (I² = 95%) and the use of unadjusted estimates imply a high risk of residual confounding. Limited evidence suggests that dental prosthesis use may help preserve mobility and mitigate frailty in patients with CVD; however, differences in frailty definitions and limited adjustment for confounding factors reduce comparability and indicate that these findings should be interpreted as exploratory and hypothesis-generating. Current evidence suggests that dental prosthesis use may offer benefits beyond oral rehabilitation, potentially linked to better hypertension-related outcomes and physical function in adults with CVD or elevated cardiovascular risk, but certainty is limited by the small number of studies and methodological heterogeneity. These exploratory, hypothesis-generating findings highlight the need for well-designed longitudinal studies to clarify potential associations and underlying mechanisms. Beyond restoring oral function, prosthodontic rehabilitation may have broader systemic implications, contributing to better cardiovascular-related outcomes in aging populations.
Mapping Indonesian Public Discourse on Oral Health: A Content Analysis of Social Media Using Latent Dirichlet Allocation Topic Modelling.
Amalia R, Dewanto I, Wirasto A … +1 more , Sandy LPA
Int Dent J · 2026 Jun · PMID 42314277 · Full text
BACKGROUND: The potential of social media that offers public health insights in middle-income countries remains underexplored. This study examines patterns of oral health discourse on Indonesian social media and highligh...
BACKGROUND: The potential of social media that offers public health insights in middle-income countries remains underexplored. This study examines patterns of oral health discourse on Indonesian social media and highlighting such insights into promotive and preventive oral health strategies. METHODS: A discourse and content analysis was conducted on user-generated posts from Quora and Threads over an 18-month period (July 1, 2023-January 31, 2025). Posts were retrieved through automated data extraction and computational text retrieval based on keyword searches and coded into 19 predefined categories. Latent Dirichlet allocation (LDA) was applied to identify underlying thematic structures. Associations between platforms and discussion topics were tested using chi-square and Monte Carlo simulations. Comparative analyses examined platform-specific trends, thematic frequencies and inquiry types, with findings cross-referenced against national survey data. RESULTS: A total of 858 posts (541 from Quora, 317 from Threads) were analysed. The most frequently discussed issues were mouth ulcers and toothache. LDA revealed 10 dominant themes, including oral hygiene practices, children's dental visits, gum swelling and postsurgical recovery. Quora discussions were dominated by symptom-focused inquiries, whereas Threads contained more personal and emotionally expressive narratives. Statistical testing confirmed a significant association between platform type and topics discussed (P < .001). CONCLUSION: This study demonstrated the utility of automated data extraction and LDA-based thematic modelling in uncovering community-level oral health patterns. Social media provides an immediate context-relevant perspective for monitoring oral health needs, supporting targeted communication strategies and responsive public health interventions. CLINICAL RELEVANCE: This study introduces a complementary approach to conventional epidemiological monitoring. The findings can guide policymakers and practitioners in developing targeted preventive initiatives and public engagement strategies for improved oral health outcomes.
Beyond Explainability: The Trust Paradox of Conversational Artificial Intelligence in Endodontics.
Turky M, Dummer PM
Int Dent J · 2026 Jun · PMID 42314276 · Full text
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Spatial Discrepancies in CBCT-Based Localization of Impacted Mandibular Third Molars.
Li Z, Zou Y, Wang T … +4 more , Tang X, Huang J, Peng S, Zhao J
Int Dent J · 2026 Jun · PMID 42314275 · Full text
INTRODUCTION AND AIMS: To quantitatively evaluate the accuracy of cone-beam computed tomography (CBCT) in localizing impacted mandibular third molar (IMTM), using surgical guides as an image transfer modality. METHODS: P...
INTRODUCTION AND AIMS: To quantitatively evaluate the accuracy of cone-beam computed tomography (CBCT) in localizing impacted mandibular third molar (IMTM), using surgical guides as an image transfer modality. METHODS: Patients requiring extraction of low-level horizontally impacted mandibular third molars underwent standardized CBCT. For 10 deeply impaction cases (Pell & Gregory Class C), personalized guides were designed and printed based on CBCT models to demarcate crown boundaries. Intraoperative mesiodistal and vertical discrepancies between guide-indicated and actual crown positions were measured. For an additional 60 cases without guides, only the horizontal discrepancy between the IMTM and the adjacent second molar was measured. RESULTS: Actual IMTM positions extended mesially beyond the second molar distal surface (mean: 4.51 ± 1.52 mm), with significantly greater deviations in Class C than Class B (P < .05). Surgical guide-based measurements confirmed that actual crown positions were mesial and inferior to CBCT indications. Mean mesiodistal deviation was 4.94 ± 1.45 mm. Significant vertical discrepancies were also observed (mean superior: 5.21 ± 1.38 mm; mean inferior: 4.62 ± 0.95 mm). CONCLUSION: In the mandibular retromolar region, CBCT-based localization may deviate from actual anatomy by several millimeters in mesiodistal and vertical dimensions, with deeper impactions showing greater discrepancies. Heightened vigilance is warranted when planning surgeries based solely on CBCT for deeply impacted IMTMs or retromolar foreign bodies. CLINICAL RELEVANCE: During mandibular retromolar region imaging, CBCT demonstrates mesiodistal and vertical deviations, with these error increasing as the target approaches the mandibular angle and inferior mandibular border.
Periapical Lesion Grade and Sinus Mucosal Thickness in Severe Periodontitis.
Tang W, Chen F, Qin P … +6 more , Cui X, Xehesbek B, Wen Y, Wang J, Li A, Zhu C
Int Dent J · 2026 Jun · PMID 42314274 · Full text
INTRODUCTION AND AIMS: Severe periodontitis (Stage III-IV) frequently coexists with apical periodontitis, both of which can contribute to Schneiderian membrane thickening (SMT). This study quantifies the association betw...
INTRODUCTION AND AIMS: Severe periodontitis (Stage III-IV) frequently coexists with apical periodontitis, both of which can contribute to Schneiderian membrane thickening (SMT). This study quantifies the association between periapical lesion severity and SMT in a well-defined cohort of severe periodontitis, aiming to improve the preoperative risk assessment using cone-beam computed tomography (CBCT). METHODS: CBCT images from 330 patients diagnosed with Stage III-IV periodontitis complicated by apical periodontitis in maxillary posterior teeth were analysed. SMT was measured at standardised sites, and periapical lesion severity was graded using the CBCT periapical index (CBCT-PAI). Differences in SMT according to sex, periodontal stage and tooth position were evaluated, and correlations between CBCT-PAI and SMT were assessed using nonparametric tests and Spearman's rank correlation. RESULTS: Increased SMT was observed in both stage III and stage IV periodontitis, no significant difference between stages. SMT also exhibited a bilateral distribution pattern. Analysis of individual teeth revealed that the SMT showed a modest but statistically significant correlation with the severity of apical periodontitis (Stage III: ρ = 0.213, P < .001; Stage IV: ρ = 0.244, P < .001). Notably, SMT was particularly pronounced in the maxillary first molar (P < .001), which may reflect their close anatomical relationship with the sinus floor. CONCLUSION: In patients with severe periodontitis, SMT showed a modest association with the severity of coexisting apical periodontitis. Differences in SMT distribution were observed across different tooth positions; this may also be related to anatomical and functional factors. CLINICAL RELEVANCE: These findings provide supportive information for preoperative periodontal and dental assessments in patients requiring implant surgery, and may assist in preoperative risk assessment.
Beyond Algorithms: Embodied Artificial Intelligence and the Future of Dentistry.
Turky M, Dummer PMH
Int Dent J · 2026 Jun · PMID 42314273 · Full text
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Self-Efficacy, Psychological State, Oral Health Behaviour, and Oral Health-Related Quality of Life in Chinese Patients With Periodontal Disease.
Yu Y, Du S, Xu K … +5 more , Wang M, Duan X, Li J, Zi S, Si Y
Int Dent J · 2026 Jun · PMID 42308666 · Full text
INTRODUCTION AND AIMS: Periodontal disease, a major oral disease, includes various inflammatory diseases that affect the tooth support structure (gums, alveolar bone, and periodontal ligament) and can lead to tooth loss...
INTRODUCTION AND AIMS: Periodontal disease, a major oral disease, includes various inflammatory diseases that affect the tooth support structure (gums, alveolar bone, and periodontal ligament) and can lead to tooth loss and promote systemic inflammation, affecting more than 1 billion people worldwide. This study aimed to investigate the relationship between self-efficacy, psychological state, oral health behaviours, and oral health-related quality of life (OHRQoL) in patients with periodontal disease. METHODS: Convenience sampling was implemented to recruit participants diagnosed with periodontal disease. Data on demographic characteristics, tooth brushing frequency, and self-reported oral health status were collected using a structured questionnaire. Participants were assessed using the General Self-Efficacy Scale, 9-item Patient Health Questionnaire, Modified Dental Anxiety Scale, and Oral Health Impact Profile (OHIP-14). Finally, structural equation modelling (SEM) was used to identify associations. RESULTS: Of the 366 participants included in the study, 77.6% reported brushing their teeth at least twice daily, and 53.4% reported using dental floss at least once daily. The mean OHRQoL score (OHIP-14) was 24.7. The SEM showed a good fit. Depression was negatively correlated with self-efficacy (β = -0.235, P < .001), while self-efficacy was positively correlated with oral health behaviours (β = 0.176, P < .001). Furthermore, oral health status, socioeconomic status, depression, and anxiety were significant predictors of OHRQoL. CONCLUSION: Self-efficacy played an important role in establishing good oral health behaviours. CLINICAL RELEVANCE: Future interventions should prioritize enhancing self-efficacy and paying more attention to psychological factors (such as depression) to effectively promote oral health behaviours.
Melatonin Rescues Enamel Defects Induced by Maternal Circadian Disruption via Targeting the BMAL1-JNK3 Axis.
Wang X, Liu J, Bi M … +6 more , Li X, Yang X, Xu W, Chen Z, Wang Y, Ji F
Int Dent J · 2026 Jun · PMID 42308665 · Full text
INTRODUCTION AND AIMS: Developmental defects of enamel (DDE) are highly prevalent, yet effective preventive measures remain elusive. The process of amelogenesis exhibits intrinsic circadian rhythmicity. While the photope...
INTRODUCTION AND AIMS: Developmental defects of enamel (DDE) are highly prevalent, yet effective preventive measures remain elusive. The process of amelogenesis exhibits intrinsic circadian rhythmicity. While the photoperiod-regulated hormone melatonin is a recognized modulator of bone formation, its potential role in coordinating the circadian aspects of enamel biomineralization remains incompletely understood. This study aimed to decipher the impact of aberrant photoperiods on enamel development and to identify melatonin's regulatory targets. METHODS: We assessed the impact of maternal circadian disruption on offspring enamel mineralization using 3D X-ray microscopy (3DXRM), ATR-FTIR, SEM, Western blot, and qRT-PCR. Plasma melatonin concentration was measured by ELISA. Melatonin was administered to pregnant mice under circadian disruption to investigate its effects on enamel mineralization in their offspring. To investigate the molecular mechanisms downstream of BMAL1, we performed Bmal1 knockdown in ameloblast-lineage cells (ALCs) and used RNA sequencing and siRNA transfection. RESULTS: Circadian disruption impaired enamel mineralization (reduced thickness/density, increased CO₃²⁻/PO₄³⁻ ratio, rough surface with disorganized prisms), which was partially rescued by melatonin. Bmal1 knockdown in ALCs disrupted mitochondrial respiration, increased JNK3 phosphorylation, and reduced mineralization; melatonin restored mitochondrial function and suppressed JNK3 overactivation. CONCLUSION: Mechanistically, melatonin inhibits JNK3 phosphorylation to restore enamel mineralization. Bmal1 knockdown impairs the mitochondrial respiratory electron transport chain, while melatonin restores its function, thereby suppressing JNK3 overactivation and ultimately promoting mineralization. CLINICAL RELEVANCE: The BMAL1-JNK3 axis is a therapeutic target for enamel mineralization, providing a novel theoretical basis for perinatal circadian regulation.
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