Mahmut Koparal

To compare the diagnostic performance of ChatGPT 5.5, Claude Opus 4.1, Gemini 3 Flash, and Grok 4 in International Classification of Orofacial Pain (ICOP)-based clinical scenarios. Thirty ICOP diagnoses were randomly selected, and corresponding clinical scenarios were manually developed. Each scenario was submitted to all models using standardized prompts in independent sessions. Two blinded evaluators assessed primary diagnosis accuracy, subclassification accuracy, clinical interpretation, and management recommendations. Overall performance differed significantly among models (p < .001). Grok 4 achieved the highest total score and outperformed the other models. No significant differences were found among ChatGPT 5.5, Gemini 3 Flash, and Claude Opus 4.1. Subclassification accuracy was consistently lower than primary diagnosis accuracy, while management recommendations did not differ significantly. LLM performance varied across ICOP-based scenarios. Although Grok 4 showed the highest diagnostic concordance, current LLMs should support, not replace, clinician judgment.

Background: Temporomandibular joint osteoarthritis (TMJ-OA) is a degenerative disease and manifests itself with pain and limitation of movement in the jaws. Arthrocentesis alone or in combination with intraarticular injections is one of the most commonly used treatment methods in these patients. The aim of the study is to examine the effectiveness of arthrocentesis plus tenoxicam injection and to compare it with arthrocentesis alone in patients with TMJ-OA. Methods: Thirty patients with TMJ-OA who were treated randomly with either arthrocentesis plus tenoxicam injection (TX group) or arthrocentesis alone (control group) were examined. Maximum mouth opening (MMO), visual analog scale (VAS) pain values, and joint sounds were the outcome variables, which were evaluated at pre-treatment and at 1, 4, 12, and 24 weeks after treatment. Statistical significance was set at p < 0.05. Results: The gender distribution and mean age were not significantly different between the two groups. Pain values (p < 0.001), MMO (p < 0.001), and joint sounds (p < 0.001) improved significantly in both groups. However, there was no significant difference between the groups in terms of outcome variables [pain (p = 0.085), MMO (p = 0.174), joint sounds (p = 0.131)]. Conclusions: Arthrocentesis plus tenoxicam injection showed no better outcomes in terms of MMO, pain, and joint sounds compared with arthrocentesis alone in patients with TMJ-OA. Trial registration: Injection of Tenoxicam Versus Arthrocentesis Alone in the Treatment of Temporomandibular Joint Osteoarthritis, NCT05497570. Registered 11 May 2022. Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000CD7A&selectaction=Edit&uid=U0006FC4&ts=6&cx=f3anuq

We aimed to compare the effectiveness of panoramic radiography (PR) and cone beam computed tomography (CBCT) in radiographic diagnosis of maxillary sinus (MS) diseases. MS diseases (mucosal thickening, mucus retention cyst, polyp sinusitis, mucocele and tumoral formations) was carried out on both PR and CBCT images belonging to 625 patients. Analyzes were performed separately for right and left maxillary sinus, and total of 1250 PR and CBCT images. While a diagnosis of disease was made in 42.96% of a total of 1250 MS according to CBCT. According to PR, diagnosis was made in 58.72%. The 537 diagnoses where lesion presence was determined on CBCT in our study were compared over PR, and it was observed that, there was the right diagnosis (true positive) in 106 (19.73%) of these including respectively mucus retention cyst (n = 88), polyp (n = 16), 1 sinusitis and 1 tumor, and there was an incorrect diagnosis (false positive) in 221 (41.15%). In 42.92% of the MS that were identified as healthy based on CBCT, the correct diagnosis was also made on PR (true negative). The use of CBCT instead of PR in the diagnosis of pathological or inflammatory diseases contributes to a more accurate radiographic differential diagnosis.

Objectives Dental follicle (DF) is made up of mesenchymal cells and fibers surrounding the enamel organ of a developing tooth. It has been shown that cystic and neoplastic lesions can develop from the pericoronal follicles of impacted third molars (ITMs). But the molecular transformation of DF tissues has not yet been uncovered and remains elusive. Accordingly, in the present study, we aimed to investigate the differential expression of lncRNA genes in DF tissues associated with asymptomatic impacted mandibular third molars (IMTMs) that do not show pathological pericoronal radiolucency in radiographic examination. Material and methods A total of 30 patients with unilateral mesioangular IMTMs were enrolled for the study. The expressions of lncRNA genes were determined in the DF and healthy gingival tissues obtained from study patients. For the determination of lncRNA expression levels, RNA was isolated from the obtained tissues, converted to cDNA samples, and analyzed by quantitative real-time PCR method. Results As a result, we found that the gene expression of MEG3 was increased about 10-fold in DF tissues compared to healthy gingival tissues (p < 0.0001). In addition, NORAD expression was found to be upregulated 4.2-fold (p = 0.0002) in DF tissues. Also, expression level of MALAT1 was found to be decreased 1.24-fold (p = 0.584) and TP73-AS1 increased 2.6-fold (p = 0.093) in DF tissues compared to healthy gingival tissues. Conclusions Consequently, present findings suggest that differentially expressed lncRNAs in DFs might be associated with the various levels of cellular events including osteogenic differentiation, DNA damage, and the transformation into odontogenic pathology. Clinical relevance Expression levels of MEG3 and NORAD lncRNA molecules may guide clinicians in the evaluation of asymptomatic ITM dental follicles that cannot be determined radiologically and during extraction of these teeth for prophylactic purposes.

Aim: This study aims to investigate the awareness and knowledge level of patients about the use of herbal products in dentistry.Materials and Methods: Present study was carried out on a total of 200 patients who applied to the Faculty of Dentistry Oral and Maxillofacial Surgery Clinic in 2020. Data were collected using questionnaires. Herbal product usage levels, attitudes towards phytotherapy and general opinions of the patients were evaluated.Results: Herbal products used for oral and dental health were found to be at lower levels than herbal products used in the prevention or treatment of other diseases. The patients preferred these products for halitosis and wounds. The most commonly used plants for oral health were mint, clove, thyme and black mulberry.Conclusion: The results of present study showed that patients are willing to use herbal products. This result suggests that it would be beneficial for dentists to integrate phytotherapy into treatment protocols.

To examine the effects of stress, bruxism, malocclusion, and oral habits on the incidence of temporomandibular disorders (TMDs) using a classification tree method (CTM). We obtained data from a total of 1.338 patients: 669 who had TMDs and 669 who but haven’t TMDs. We recorded interview data on stress and oral habits, and during oral examination, noted malocclusions, bruxism, and any sign of poor oral habits. All data were subjected to CTM analyses. The TMD rate was highest in stressed patients (96.8%), and significantly lower in stress-free patients (25.3%) (P < 0.001). TMD was evident in all patients exhibiting both stress and bruxism (100.0%). In stressed patients lacking bruxism, the effects of malocclusion on TMD were significant (P < 0.001). CTM analyses showed that the most significant factor affecting TMD was stress, followed by bruxism and malocclusion. This is the first report to use CTM to define factors affecting TMD.

Decision trees are data mining techniques for extracting hidden knowledge from large databases. This study was performed to establish the risk factors associated with halitosis by applying a decision tree model in a Turkish population and examining the interactions between these factors. We obtained data from a total of 1.290 patients, consisting of 645 patients with halitosis and 645 healthy controls. The subjects’ demographic characteristics, smoking status, alcohol intake, medical history and medications were assessed. The presence of potential intraoral causes of halitosis was determined by investigating perceived oral health problems such as caries, periodontal diseases, tongue coating, and oral cavity pathologies. Halitosis level was evaluated using an organoleptic scale. All data were subjected to classification tree analyses. Halitosis was significantly more common in patients with (80.9%) than without (20.7%) oral health problems (P < 0.001). Halitosis was significantly less common in non-smokers without oral health problems than in smokers with oral health problems (14.5%; P < .001). Halitosis was evident in all patients with oral health problems, smokers, and those with respiratory diseases (100%). The effects of systemic diseases on halitosis were significant in non-smokers without oral health problems (P < 0.05). Respiratory conditions showed significant effects on halitosis in smokers with oral health problems (P < 0.01). We developed a decision tree model to identify risk factors associated with halitosis. The classification tree method showed that the most significant factors affecting halitosis were oral health problems followed by smoking status.

Aims and Objective: Sleep bruxism is a complicated disease, and its cause remains controversial. If the etiology of bruxism is resolved, the treatment can be adjusted to the prevailing aetiological factor. Thus, the aim of this study was to evaluate the oxidative stress level and serum prolidase activity in patients with sleep bruxism.Materials and Methods: Seventy healthy subjects and 51 patients with sleep bruxism were included in this study, and blood samples from all patients were collected. Serum samples were analyzed for total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), and prolidase activity.Results: The prolidase, TOS, and OSI levels were significantly higher in patients with bruxism than in the healthy controls (p = 0.001, p = 0.001, p = 0.001, respectively). The TAS level was significantly lower in bruxism patients than in healthy controls (p = 0.003).Conclusion: The increased TOS, OSI, and prolidase levels and decreased TAS levels could be assumed to result in oxidative injury in patients with sleep bruxism. However, the study could not determine whether oxidative imbalance and increased serum prolidase levels could be a cause or a result of bruxism.