Eleftherios G. Kaklamanos

Background: Achieving valid and reproducible facial attractiveness assessment in orthodontic practice remains challenging. Artificial intelligence (AI) has shown potential in orthodontics and may help reduce inconsistencies in the evaluation of facial and smile aesthetics. This study aimed to develop and internally validate an AI model for assessing facial attractiveness in a Caucasian population. Materials and methods: The study sample was derived from a subset of the SCUT-FBP5500 V2 dataset and included Caucasian subjects, comprising 750 males and 750 females with human-rated facial attractiveness scores on a 1–5 scale. The model was based on a ResNet-50 backbone pretrained on ImageNet. Training was performed using the Adam optimizer (learning rate 0.0001) and mean squared error loss for up to 100 epochs. Stratified data splits of 70% for training, 10% for validation, and 20% for testing were created according to facial attractiveness score and sex. During training, data augmentation techniques, including resizing, random horizontal flipping, rotation, colour jittering, and tensor conversion, was applied, whereas the validation and test sets underwent resizing only. All experiments were conducted on a Linux-based system with an NVIDIA RTX 2080 GPU, using Python 3.12 and PyTorch v2.9. Model performance was assessed using MAE and RMSE across the test set, by sex, and across facial attractiveness-score quintiles. Results: The model demonstrated predictive performance on the test set, with an MAE of 0.215 (95% CI: 0.196–0.234) and an RMSE of 0.276 (95% CI: 0.251–0.300). Sex-specific analysis showed marginally better performance in males, with an MAE of 0.201 (95% CI: 0.177–0.225), compared with 0.228 (95% CI: 0.198–0.264) in females (P = 0.662). The highest accuracy was observed in the densely represented segment of the dataset, where the MAE was 0.156 (95% CI: 0.119–0.199). Error metrics varied across attractiveness-score ranges and were highest in the (3.02–3.63] range. Conclusions: The proposed model closely approximated human ratings of facial attractiveness and demonstrated predictive accuracy. These findings support the potential of AI-based tools to provide more consistent aesthetic assessments in orthodontics. Future research should include diverse populations to improve generalizability and clinical applicability.

Aims: To evaluate whether minimally invasive non‐surgical therapy (MINST) with flapless application of enamel matrix derivative (EMD) achieves non‐inferior clinical and radiographic outcomes compared to minimally invasive surgical technique (MIST) + EMD, while improving patient‐reported outcome measures (PROMs). Materials and Methods: Following CONSORT guidelines, 40 patients with mandibular Grade II furcation defects were randomised to MINST ( n = 20) or MIST ( n = 20) with EMD. Probing pocket depth (PPD), clinical attachment level (CAL) and cone‐beam computed tomography (CBCT) horizontal/vertical bone loss were assessed at baseline and 9 months. PROMs (visual analogue score [VAS] and Oral Health Impact Profile [OHIP‐14]) were recorded longitudinally. Results: At 9 months, the mean PPD reduction was 2.20 ± 2.24 mm in the MIST group and 2.15 ± 1.76 mm in the MINST group. The adjusted mean difference was −0.22 mm (95% CI: −1.43 to 0.99 mm). The one‐sided non‐inferiority p ‐value was 0.025. As the upper bound of the confidence interval remained below the prespecified non‐inferiority margin, MINST was considered non‐inferior to MIST for the primary outcome. When evaluated against the strict +1.0 mm margin, MINST achieved statistical non‐inferiority for gingival recession ( p = 0.003) and vertical bone gain ( p = 0.015). However, non‐inferiority could not be formally established for CAL ( p = 0.067) or horizontal bone gain ( p = 0.157). PROMs revealed significantly lower root hypersensitivity and improved oral‐health‐related quality of life in the MINST group at 2 weeks; however, these differences were not sustained at later timepoints. Conclusions: Within the limitations of this randomised controlled trial, MINST with EMD showed clinical and radiographic outcomes generally comparable to MIST in mandibular Class II furcation defects. While non‐inferiority against a strict 1.0 mm margin was successfully established for the primary outcome (PPD) and specific secondary parameters, it could not be formally confirmed for CAL or horizontal bone gain. MINST was associated with significantly improved short‐term PROMs during the early healing phase. Trial Registration: ClinicalTrials.gov identifier: NCT05541614

Purpose: Molar–incisor hypomineralisation (MIH) is a qualitative enamel defect affecting first permanent molars and often incisors, and is associated with increased risks of caries, hypersensitivity, and poor restorative outcomes. Although global prevalence varies, data from Gulf Cooperation Council (GCC) countries remain limited. This systematic review and meta-analysis aimed to estimate the pooled prevalence of MIH among children in the GCC. Methods: A comprehensive search of five databases was conducted up to September 2025 and identified studies published between January 2000 and August 2025 reporting MIH prevalence among children in GCC countries with available data. Eligible studies were published in English or Arabic and included healthy children aged 6 years or older. Risk of bias was assessed using a validated prevalence tool. Meta-analysis was conducted using a random-effects model, and heterogeneity was assessed with I ² statistics. Results: Eighteen studies involving 15,417 children from Saudi Arabia, the United Arab Emirates, and Bahrain met the inclusion criteria, representing approximately 80% of the GCC population. The pooled MIH prevalence was 19.9% (95% CI [15.7–24.9%]), higher than the global average of 13.5%. Across studies, prevalence ranged from 7.57% to 58.46%, with substantial heterogeneity (I ² = 97.9%). Meta-analysis of 11 studies showed no statistically significant sex difference in MIH prevalence (pooled OR for females vs males = 0.79, 95% CI [0.59–1.06]; p = 0.12). Conclusions: MIH remains an important public health concern, with prevalence in the included GCC countries exceeding international averages in the included GCC countries. Standardised diagnostic criteria and national surveillance systems are strongly recommended to support earlier detection and improved management. Registration: INPLASY202390032.

Background: Body Dysmorphic Disorder (BDD) is characterized by an intense preoccupation with perceived flaws in physical appearance, which can influence choices related to aesthetically driven healthcare. In orthodontics, this may cause a mismatch between a person’s subjective concern about their appearance and the treatment need determined by established indices. Therefore, orthodontic treatment indices are crucial to ensure that interventions are clinically justified rather than primarily motivated by disproportionate appearance-related distress. Objective: To systematically review and appraise the existing evidence on the connection between BDD and orthodontic treatment need as assessed by established indices. Materials and Methods: A systematic search of five electronic databases was conducted for studies published up to March 2026 that examined the association between BDD and orthodontic treatment need. Eligible studies included individuals undergoing orthodontic treatment or seeking orthodontic care, in whom BDD was evaluated using validated instruments and treatment need was assessed using established orthodontic indices. Risk of bias was assessed using the ROBINS-E tool. Results: A total of 2743 records were identified, and four observational studies met the inclusion criteria. Due to heterogeneity in study design, assessment methods and outcomes, findings were synthesized narratively. Orthodontic treatment need was assessed using the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC), the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC), and the Index of Complexity, Outcome and Need (ICON). Two studies using IOTN-DHC reported a negative association between BDD and orthodontic treatment need, whereas studies using IOTN-AC and ICON found no significant relationship. Associations with sex, age, education, depression, and anxiety were inconsistent across studies. Conclusions: Current evidence suggests an inconsistent relationship between Body Dysmorphic Disorder and orthodontic treatment need, highlighting the relevance of personalized assessment in orthodontic decision-making. Given the limited number of studies and the high risk of bias, the findings should be considered preliminary, and further standardized studies are needed to clarify this association.

Purpose: This systematic review aimed to evaluate the clinical effectiveness of erbium laser therapy, either as monotherapy or as an adjunct to access flap surgery, on managing residual periodontal pockets in patients with periodontitis. Methods: This systematic review adhered to PRISMA guidelines and was registered in PROSPERO (CRD42024620788). A comprehensive literature search was conducted across PubMed, Cochrane, Scopus, and trial registries. Data synthesis was performed using random-effects meta-analysis, and the quality of evidence was assessed using GRADE. Finally, five RCTs involving 124 patients and 310 sites met the inclusion criteria. Results: Both erbium laser and conventional flap surgery groups demonstrated improvements in periodontal parameters. Differences favoring erbium lasers were observed in clinical attachment level (CAL) at 6 and 12 months (mean difference − 0.36 mm; p < 0.05). Other parameters, including probing pocket depth (PPD), gingival recession (GR), gingival inflammation (GI), and plaque index (PI) showed no significant differences. Results for bleeding on probing (BoP) and radiographic changes were inconsistent. Patient-reported outcomes were better in the erbium laser group. Conclusions: Erbium laser therapy may represent a promising minimally invasive approach with outcomes broadly comparable to conventional access flap surgery, with modest improvements in CAL and favorable patient-reported outcomes. However, the limited evidence base warrants cautious interpretation. Long-term RCTs are necessary to validate these findings and inform clinical practice.

This study analyzed the gingival crevicular fluid (GCF) proteome of 35 patients with Grade II furcation defects using the Olink Reveal platform. Comparison with non-periodontitis sites identified 227 differentially expressed proteins. A machine-learning pipeline prioritized a 34-protein signature (including GLIPR1, MME, and IRAG2) that accurately differentiated furcation defects from health (AUC = 0.887), reflecting a distinct profile of severe inflammation and neutrophil activation.

This review explores the vital role of orthodontic specialty and orthodontic records in forensic investigations, emphasizing their contribution to human identification. It synthesizes current literature on methodologies, advantages, limitations, and future perspectives, positioning orthodontics as a valuable adjunct within the forensic toolkit. Collaboration between orthodontists, forensic scientists, and AI technologies will further strengthen the reliability and speed of human identification, reinforcing justice and humanitarian efforts worldwide.

Background: Peri-implantitis, a condition characterized by inflammation and progressive bone loss around dental implants, presents a significant challenge in contemporary dentistry. Conventional non-surgical treatments often fail to fully eliminate bacterial biofilms, particularly on complex implant surfaces. Laser therapies have emerged as potential adjuncts due to their antimicrobial and bio-modulatory properties. However, their microbiological effectiveness and suitability for individualized patient treatment planning remain unclear. Objective: Τhis study aims to systematically assess and synthesize the microbiological effects of various laser-assisted non-surgical treatments for peri-implantitis compared to conventional mechanical debridement. Methods: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420251035354). Randomized controlled trials (RCTs) evaluating microbiological changes following laser-assisted non-surgical treatment of peri-implantitis, with a minimum follow-up of one month, were identified through searches in multiple databases and registries up to February 2025. The ncluded studies used lasers such as diode, Er: YAG, and photodynamic therapy (PDT) either alone or as adjuncts to mechanical debridement. Outcomes of interest included bacterial counts. Risk of bias was assessed using the RoB2 tool, and certainty of evidence was evaluated via GRADE. Quantitative synthesis used random-effects meta-analysis, with standardized mean differences (SMDs) calculated. Results: Eight RCTs involving 266 patients and 335 implants were included in the systematic review. Quantitative synthesis of three pathogens (counts of Fusobacterium nucleatum, P. gingivalis, T. denticola) across three studies displayed no statistically significant differences between laser and control groups at 3 and 6 months (p > 0.05 for all comparisons). When examining individual study findings, PDT, particularly in patients with diabetes or acute abscess, showed short-term reductions in red complex bacteria (e.g., Porphyromonas gingivalis and Treponema denticola). In contrast, diode and Er: YAG lasers demonstrated inconsistent or transient effects. The quality of evidence was rated as very low according to GRADE. Conclusions: Laser-assisted therapies, especially PDT, may provide targeted microbiological benefit in selected patient groups, supporting their adjunctive use within personalized treatment planning rather than as replacements for mechanical debridement, which remains the gold standard. Further high-quality RCTs incorporating well-defined patient risk profiles, such as systemic conditions and behavioral factors, and precision treatment algorithms are needed.