Journal of Applied Dentistry and Oral Sciences

The single-incision connective tissue grafting (SICTG) represents an advancement in periodontal plastic surgery, designed to achieve primary wound closure, reduce donor-site morbidity, and promote improved early healing compared with traditional trapdoor and double-incision techniques.

To describe the biological rationale of the SICTG technique and propose a biologically driven modification based on accumulated clinical experience aimed at improving surgical handling and tissue preservation.

The proposed modification builds upon established SICTG principles while incorporating refinements and technical innovations intended to enhance graft harvesting, facilitate tissue preservation, and maintain favorable wound stability. The approach is derived from clinical observations and biological considerations related to wound healing and vascular supply.

The modified-SICTG may offer practical advantages in surgical handling and donor-site management. However, it should be regarded as a technical proposal rather than a validated clinical protocol. Further systematic clinical trials are required to evaluate its effectiveness, safety, and long-term stability through controlled clinical outcome studies.

The rapid expansion of digital technologies in dentistry has resulted in increased reliance on complex clinical and imaging data, creating opportunities for artificial intelligence (AI) to support diagnostic and treatment-related decision-making. While AI-based systems have demonstrated promising results, their clinical relevance and ethical implications require critical evaluation. This narrative review aims to evaluate the current evidence on AI applications in dentistry with particular emphasis on clinical utility, validation, and ethical considerations.

A narrative review of the literature was conducted using peer-reviewed studies focusing on AI applications across dental specialties, including dental imaging, orthodontics, endodontics, prosthodontics, implant dentistry, oral medicine, and oral pathology. Emphasis was placed on clinically relevant outcomes, validation approaches, and real-world applicability.

AI has shown substantial potential as a decision support tool in dentistry, particularly in diagnostic imaging, automated analysis, and treatment planning. Applications such as caries detection, cephalometric landmark identification, periapical pathology detection, and digital smile design demonstrate improved efficiency and consistency. However, most AI systems remain limited by retrospective study designs, lack of external validation, population bias, and restricted interpretability.

AI represents a valuable adjunct in modern dental practice when used to support, rather than replace, clinical judgment. Responsible integration of AI requires robust validation, ethical governance, clinician education, and regulatory clarity to ensure patient safety and equitable care.

To evaluate the diagnostic performance of an artificial intelligence (AI) system in detecting common dental diseases on panoramic radiographs and to compare its findings with expert manual interpretation.

AI has gained increasing attention in dental radiology as a potential tool for supporting image interpretation. Although several studies have reported promising results, the real-world diagnostic performance of AI systems across diverse dental pathologies remains insufficiently validated.

This retrospective diagnostic accuracy study analyzed 100 panoramic radiographs using the Second Dentists^® AI software (Velmeni Inc., USA). AI-generated binary outputs were compared with consensus diagnoses established by two experienced oral and maxillofacial radiologists blinded to AI results. Analysis was performed per radiograph, allowing multiple coexisting conditions. Diagnostic performance was assessed using sensitivity, specificity, precision, accuracy, F1-score, and agreement measures with 95% confidence intervals.

The AI system demonstrated high diagnostic performance for missing teeth (MT), fixed prosthesis (FiP), root stumps (RS), and dental caries (DC). Lower sensitivity was observed for periapical pathology (PP), which accounted for the majority of false-negative (FN) findings. Agreement between the AI and expert interpretation was high for most categories, although it was reduced for subtle lesions.

AI shows potential as an adjunctive tool for interpreting panoramic radiographs, particularly for well-defined dental conditions. However, reduced sensitivity for subtle pathologies, methodological constraints, and limited external validation highlight the need for cautious clinical implementation and further multicenter evaluation.

To evaluate and compare the perception of rotational discrepancies of the permanent maxillary right central incisor among dental professionals and laypersons using standardized three-dimensional (3D) digital models.

Participants assessed digital images of a 3D dental model via an online questionnaire. The model featured induced rotational discrepancies of tooth 11 at ±2.5°, ±5°, ±10°, and 0°. Participants were asked to indicate whether they detected a rotation. Accuracy rates were calculated, and chi-square tests were used to compare group differences (α = 0.05).

A total of 205 participants were included: 67 laypersons, 51 prosthodontists, 50 orthodontists, and 37 general dentists. Significant differences were found across groups in the detection of simulated rotations. Dental professionals showed higher accuracy in identifying rotational discrepancies, particularly at smaller angles. Orthodontists achieved the highest detection rates, accurately identifying rotations as small as ±2.5°, while laypersons typically failed to perceive discrepancies below ±10°. Statistically significant differences (p < .05) were observed between orthodontists and laypersons at most rotation levels. General dentists and prosthodontists also outperformed laypersons, although with less consistency at lower degrees of rotation.

Dental specialists, especially orthodontists, are significantly more accurate in identifying minor rotational discrepancies of anterior teeth. In contrast, laypersons are generally only able to perceive larger deviations (≥10°). These findings underscore the critical role of professional expertise in the diagnostic and esthetic evaluation processes during orthodontic and restorative treatment planning.

This in-vitro study aims to evaluate and compare the effects of remineralizing mouthwashes based on inorganic fluoride, organic fluoride, or zinc hydroxyapatite on the mechanical properties (yield strength (YS) and modulus of elasticity (ME)) of NiTi and CuNiTi archwires under loading and unloading.

A total of 200 samples of 0.016 × 0.022 NiTi and CuNiTi archwires were divided into four groups (n = 50 per group) and immersed in 5 mL of different remineralization agents. The samples were incubated at 37°C for 1.5 h, then rinsed and tested using a universal testing machine. A three-point bending test was conducted to determine the YS and ME of the wires.

Tukey’s post hoc test and one-way ANOVA were used to analyze differences between groups. The results showed that for NiTi wires, only the inorganic fluoridated mouthwash (Phos-Flur) significantly affected mechanical properties during loading. During unloading, both inorganic (Phos-Flur) and organic fluoridated (Amflor) mouthwashes had a significant effect. For CuNiTi wires, only the inorganic fluoridated mouthwash (Phos-Flur) showed a significant effect during unloading. The non-fluoridated zinc hydroxyapatite mouthwash did not affect either NiTi or CuNiTi wires during loading or unloading.

Non-fluoridated remineralizing zinc hydroxyapatite mouthwash did not affect the loading and unloading mechanical properties of both NiTi and CuNiTi wires when compared with fluoridated mouthwashes. Zinc hydroxyapatite-based mouthwashes may serve as a safer alternative without compromising remineralization effectiveness.

Myofascial pain dysfunction syndrome (MPDS) is a common musculoskeletal cause of orofacial pain and may occasionally mimic early neuropathic or neurological conditions, posing a diagnostic challenge for dental practitioners.

A 70-year-old edentulous female presented with right-sided orofacial pain and was initially diagnosed with MPDS based on clinical findings. Despite conservative management, she subsequently developed acute unilateral facial paralysis consistent with Bell’s palsy. Temporomandibular joint imaging was unremarkable; however, further evaluation with magnetic resonance imaging (MRI) and computed tomography (CT) of the brain revealed a well-defined calcified extra-axial lesion measuring 1.7 × 1.4 cm at the planum sphenoidale and left olfactory groove, suggestive of a calcified meningioma.

This case highlights the diagnostic challenge posed by overlapping musculoskeletal and neurological symptoms in orofacial pain conditions. The presence of neurological red flag signs such as progressive facial weakness, persistent or worsening pain, sensory disturbances, or inadequate response to conventional therapy should alert dental practitioners to the need for prompt neurological referral and advanced neuroimaging to exclude underlying intracranial pathology.

Fanconi anemia (FA) is an uncommon inherited disorder characterized by bone marrow failure, congenital anomalies, and increased susceptibility to malignancy. Early signs may appear in the oral cavity, making dental evaluation important for prompt detection in pediatric patients. This case highlights the importance of oral findings in early recognition of FA and the role of dentists in prompt referral and interdisciplinary management.

A 9-year-old girl presented with gingival bleeding for 1 month. Examination revealed severe gingival inflammation with intraoral petechiae. Routine blood tests revealed pancytopenia. Bone marrow biopsy revealed a hypocellular marrow, and FA was confirmed by cytogenetic analysis. Tooth #55 was extracted under hospital admission, following platelet transfusion and antibiotic prophylaxis. The patient subsequently underwent bone marrow transplantation (BMT) with immunosuppressive therapy and radiotherapy, resulting in complete resolution of gingival inflammation. She continues to be under regular follow-up with hematology and pediatric dental care.

Early identification of oral signs can aid dental professionals in suspecting systemic disorders such as FA, allowing timely referral, diagnosis, and multidisciplinary management.

Osteosarcoma of the jaws (OSJ) is a rare malignant bone tumor with variable clinical and radiographic presentations, often mimicking benign odontogenic or inflammatory lesions. This diagnostic uncertainty frequently leads to delayed recognition and treatment.

A 29-year-old female presented with a gradually enlarging, painful swelling in the left mandibular region that had been progressing over 3 months. The swelling was associated with tooth mobility. She had previously received treatment for a presumed periapical pathology elsewhere. On radiographic evaluation, including intraoral periapical and occlusal radiographs, orthopantomogram, and cone-beam computed tomography, an ill-defined mixed radiolucent–radiopaque lesion was observed, along with widening of the periodontal ligament space and a characteristic sunburst periosteal pattern. Histopathological analysis revealed a highly cellular malignant neoplasm composed of pleomorphic osteoblast-like cells producing disorganized woven bone, leading to a diagnosis of well-differentiated osteogenic sarcoma of the mandible.

OSJ presents significant diagnostic challenges due to its rarity and overlap with common dental conditions. Correlation of clinical features with advanced imaging and histopathology is essential for early diagnosis.

This case emphasizes the need for heightened clinical suspicion when evaluating atypical jaw lesions. Prompt multidisciplinary diagnosis and management are essential to improve outcomes in patients with OSJ.