Krisztina Márton

Background/Objectives: Image-based teledentistry can support remote caries screening, but diagnostic performance varies. This systematic review evaluated its accuracy against in-person dental examination. Methods: PubMed, Embase and CENTRAL were searched again on 22 September 2026. Fifty-three reports were retained: 43 diagnostic-accuracy and ten agreement/AUC-only reports described separately. Separate logit-scale multilevel random-effects models included 32 outcomes from 20 reports per endpoint. Moderator models excluding age included 26 outcomes from 16 reports and assessed dentition, image-acquisition role, and device. Risk of bias was assessed using QUADAS-2 and a separate adapted framework for agreement reports. Results: Summary sensitivity was 85.50% (95% CI 79.57–89.92%) and specificity was 92.25% (84.77–96.22%), with substantial heterogeneity (both Q tests p < 0.0001). The moderator omnibus test was significant for sensitivity (p = 0.0015), but not specificity (p = 0.9632). Intraoral camera use was associated with higher sensitivity than smartphone use after Holm adjustment (p = 0.0011). Dentition and acquisition-role contrasts were not significant after adjustment. Conclusions: Image-based teledentistry may support screening and triage. Mixed diagnostic units, heterogeneous thresholds, overlapping outcomes, sparse moderator categories and source-data limitations require cautious interpretation and prevent universal device or user rankings.

Background: People with any form of dry mouth may have problems with eating, swallowing, speaking, taste perception, wearing dentures, and maintaining good oral health. Subsequently, it can have a major impact on the quality of life through its effects on the qualitative and quantitative parameters of nutrition. Nevertheless, little is known about the effects of different foods and nutrients on salivation and orofacial sicca symptoms. Despite this, the literature on the relationship between xerostomia (x), hyposalivation (h), Sjögren disease (SD), and nutrition is relatively sparse. Objective: The authors aimed to evaluate the dietary habits of middle-aged patients with newly diagnosed dry mouth and/or SD compared with healthy controls. Methods: A total of 128 participants (10 men and 118 women; mean age: 53 ± 13 years) enrolled in the study. A 35-question questionnaire containing a “computer-assisted personal interview”-type exploratory survey was used to record body mass index (BMI), possible food allergies, harmful habits, used sources of health-related information, and nutritional habits such as frequency and types of daily meals, for example, fruit, vegetable, meat, vitamin, and trace element consumption. Subjective sicca symptoms (xerostomia, xerophthalmia) were also assessed by guided questions, while the unstimulated whole saliva (UWS) flow rate was determined by the spitting method to confirm hyposalivation. SD was diagnosed based on the 2016 ACR-EULAR diagnostic criteria. Participants were divided into four groups: healthy controls (c), xerostomia (x), hyposalivation (h), and SD. Patients' data were compared with those of healthy controls. Results: The mean BMI of the participants did not show a significant difference from the normal BMI, although it was slightly elevated in all four patient groups (c: 24.7; x: 25.4; h: 26.2; SD: 25.2). The smoking percentage was high in the SD group: 49% vs. 18% in the c group ( p = 0.01), while it was 0 in both the x and h groups. The percentage of food allergy and/or intolerance (lactose, milk protein or gluten, floating, and bloating) was increased among all patients compared with healthy controls: 50% of patients with xerostomia and 44% and 68% with those with hyposalivation compared with only 16% of healthy controls ( p < 0.05, p < 0.05, p < 0.00001, respectively). Similarly, liquid consumption was between 1.9 and 2.2 L/day in all groups, and the interviewed participants preferred water ( approximately 78%) and diary milk products (more than 80%). Significantly less patients with xerostomia consumed alcohol (2.6 vs. 18%, p < 0.05) and vegetable milk regularly (2.6 vs. 18%, p < 0.05) compared with healthy controls; alcohol consumption was also low in the h (4.7%) and SD (6.4%) group of patients. There was no significant difference in the intake of different vitamins and trace elements between any patient group and the c group, except that of vitamin D3, which was consumed in a significantly higher frequency by the x group of patients ( p < 0.05). Extra sugar, processed food, snack, extra salt consumption, and grain and wheat types of preference were at similar levels in all the examined groups. It was observed that all four groups favored apple among all fruits, while patients with dry mouth did not prefer sour fruits like berries (hyposalivation p < 0.05) and citrus fruits (x and h; p < 0.05 and p < 0.05) or irritating agents like onions (h; p < 0.05), as these foods might deteriorate both the dryness feeling and the burning mucosal symptoms. Potato was less preferred by the other groups compared with the healthy control group and might cause swallowing problems in patients of the x group ( p < 0.05). Nevertheless, rice and tomato-paprika consumption was increased in the h group ( p < 0.05, p < 0.05). With regard to meat types, poultry (50%–88%), pork (40%–58%), and seafood (33%–50%) were the most popular, but possibly because of its less fat content, the x and SD group of patients consumed less poultry compared with the c group of patients (50 and 52% vs. 80%; p < 0.001, p < 0.05, respectively. It should also be noted that people today prefer the internet as a source for obtaining any diet or health awareness information (64%–92%) and less frequently consult their physicians or specialists (0%–6%). No significant differences were found between the patient and control groups in terms of oil and fat consumption; vegetable oils (82%–100%) and butter (22%–25%) were the most popular between the groups. Conclusions: As a primary outcome of this study, the nutrition of patients with dry mouth and/or SD generally does not differ from the diet of healthy persons, and it is determined by local traditions and availability. The number of daily meals and the pattern of fluid consumption do not vary significantly because of sicca symptoms or SD. A higher incidence of food allergy was reported in patients with dry mouth and/or SD. Affected patients tend to prefer easily swallowable, non-irritant, softer (rice), or high-water content foods such as tomato and paprika, or cold cuts. Patients with dry mouth and/or SD need conscious dietary advice from their family practitioners, dentists, or specialists to alleviate their symptoms, while trustworthy websites and social media may serve as important sources of health information.

Primary Sjögren disease (pSjD) is associated with a wide range of oral manifestations, including mucosal alterations such as oral ulcers, stomatitis, angular cheilitis, papillary atrophy, and tongue fissuration, as well as oral sequelae of sicca symptoms, including dysphagia, dysgeusia, and chewing difficulties. In addition to these oral findings, pSjD also presents with systemic manifestations such as arthritis, cutaneous vasculitis, and involvement of internal organs. This systematic review and meta-analysis aimed to assess the risk of oral disorders and differences in cariological and periodontal indices in pSjD patients compared with controls. The systematic search was conducted in PubMed, EMBASE, and CENTRAL on November 8, 2024 (PROSPERO: CRD42024608240). Studies meeting the eligibility criteria included adult patients with pSjD. Primary outcomes included the odds ratio (OR) and prevalence of oral disorders as well as the mean difference (MD) and single mean values of dental indices. Meta-analyses were performed using random-effects models to calculate pooled outcome measures and corresponding 95% confidence intervals (CIs). Seventy-five studies were included in the systematic review, with 49 eligible for meta-analysis. The following oral disorders showed increased risk: candidiasis (OR: 10.5; CI: 6.99 to 15.79), dysphagia (OR: 26.78; CI: 20.94 to 34.25), dysgeusia (OR: 17; CI: 4.52 to 63.96), stomatitis (OR: 2.65; CI: 2.17 to 3.23), angular cheilitis (OR: 6.31; CI: 1.94 to 20.53), papillary atrophy (OR: 6.68; CI: 1.12 to 42.16), and fissured tongue (OR: 11.72; CI: 3.42 to 40.18). Patients with pSjD were found to have fewer teeth (MD: −2.16; CI: −4.27 to −0.05) and a higher decayed, missing, filled teeth (MD: 4.72; CI: 3.01 to 6.43) and decayed, missing, filled surfaces (MD: 20.45; CI: 10.16 to 30.74) scores. Furthermore, periodontal parameters showed no significant differences. Patients with pSjD have up to a 30-fold higher risk of developing various oral disorders, emphasizing the need for preventive dental care and early recognition.

Introduction: Oral potentially malignant disorders (OPMDs) can lead to oral cancer, which is one of the most common cancers worldwide. Prevention is crucial in the avoidance of malignant transformations of OPMDs. Artificial intelligence (AI) provides a new and noninvasive tool for analyzing medical data, such as patient data, radiologic images, and clinical photographs. These AI-based tools can help in the decision-making process. However, histological examination is still the gold standard for diagnosing OPMDs. Objectives: This systematic review and meta-analysis aimed to investigate the diagnostic accuracy of artificial intelligence on intraoral photographs of patients with OPMDs. Methods: A systematic search was conducted on 5 major databases (MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science) on November 10, 2023. Included studies compared AI methods to histology examination as the reference. A quantitative analysis was carried out to assess sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic odds ratio (DOR), positive likelihood ratio (LR ⁺ ), and negative likelihood ratio (LR ⁻ ) calculated with 95% confidence intervals (CIs). Results: Six eligible articles were included, with 898 images out of 4,046 tested using AI-based architectures. Five studies investigated at least 2 AI models. The overall sensitivity, specificity, DOR, LR ⁺ , and LR ⁻ were 0.94 (95% CI, 0.88 to 0.95), 0.95 (95% CI, 0.85 to 0.98), 212.39 (95% CI, 56.39 to 800.00), 16.89 (95% CI, 5.72 to 48.68), and 0.08 (95% CI, 0.05 to 0.13) for the best-performing AI-based architectures in terms of sensitivity, respectively. Conclusion: AI-based diagnostic tools have high negative predictive value that could help identify OPMD lesions using intraoral photographs. Knowledge Transfer Statement: This systematic review on AI-based methods to diagnose oral potentially malignant disorders showed that although their high negative predictive value could reduce unnecessary specialist consultations, clinical judgment remains paramount. Further prospective studies are needed to evaluate the integration of AI diagnostics into routine care and screening and policies to enhance efficiency and support early detection and prevention of oral cancer.

Objective One-third of the Hungarian population suffers from xerostomia. Since there is no evidence of the actual prevalence of Sjogren's syndrome (SS) in Hungary, this study aimed to evaluate the same. Materials and Methods Data were collected from the Faculty of Dentistry, Semmelweis University from 2008 to 2015. A diagnosis of SS was established based on the American College of Rheumatology and European League Against Rheumatism criteria. Results Of the 1076 patients examined with sicca symptoms, 188 patients had confirmed SS. Primary SS (pSS) was diagnosed in 135 patients and secondary SS (sSS) was confirmed in 53 patients. According to the available statistical records of the public health service of Hungary, there were an average of 16 (0.0014%, 5-26) newly diagnosed SS cases in the entire population and 141 SS patient-practitioner consultations (49-232) per 100,000 inhabitants in the country over the past 10 years (based on the past 10 years: 2011-2020). Conclusion Results revealed that approximately 1/5th-1/6th of patients with sicca symptoms have SS, among whom 72% and 285 have pSS and sSS, respectively. Global Hungarian records simultaneously revealed that the number of both new diagnoses and doctor-SS patient encounters has significantly decreased (by 50%) yearly over the last decade.

This article explores terrorism against healthcare facilities and workers throughout the world since September 11, 2001 to assess trends in these attacks. Using five datasets, it examines the increased risk of terrorist attacks against healthcare facilities and workers, and analyzes when, where and how these largely soft targets have been attacked by terrorists. The article provides a quantitative and qualitative analysis about the types of attacks and concludes with recommendations for healthcare facilities to mitigate the risk of terrorist attacks as well as provides suggestions for further studies.

Tamas Demeter, Melinda Penzes, Alexandra Kovacs, Katalin Karolyhazy, Csilla Erdei, Vanda Roxana Nimigean, Victor Nimigean, Anna Dezsi, Melinda Szekely, Krisztina Marton - Smoking Related Major- and Minor Salivary Gland Flow Rates, Xerostomia and Other Sicca Symptoms in Hungary

Objective: The aim of this in vitro study was to evaluate the effects of substrate colors, different levels of ceramic thickness and translucency, and cement shades on the color difference from a reference color of lithium‐disilicate crowns.Materials and Methods: A premolar tooth preparation was made on a study model for 1.0 and 1.5 mm thick full‐ceramic crowns. Digital impressions were taken (3Shape TRIOS) and crowns designed in a CAD program (DentalDesigner). Shade A1 crowns were milled (Everest, Kavo) from high‐translucency (HT) and low‐translucency IPS e.max (Ivoclar Vivadent) blocks. Twelve substrates were made of different colors and materials (Natural Die Material, Co‐Cr, zirconia, and gold‐colored alloy). Three different shades of try‐in pastes were used to simulate the effect of cements (Variolink Esthetic try‐in paste; Ivoclar). Shade measurement was done three times for each crown by a spectrophotometer (VITA Easyshade Advance); averages were compared to a reference crown (A1, HT, 1.5 mm, ND2 abutment, neutral try‐in paste) with ΔE₀₀ (CIEDE2000, according to the CIE latest standard) calculated.Results: All the examined parameters influenced the ΔE₀₀ of the crowns. The weakest effect was exerted by the try‐in paste.Conclusions: All examined parameters influenced the final color of e.max CAD lithium‐disilicate ceramic crowns.Clinical Significance: Matching the shade of ceramic crowns to the natural tooth color is a great challenge in dentistry. To meet patients' increasing esthetical expectations, CAD/CAM methods are very popular for full‐ceramic crowns. However, several factors such as the shade of the abutment, luting cement color, ceramic thickness, and translucency may influence the final color. Our objective was to measure the optical effect of these factors on the final shade of CAD/CAM lithium‐disilicate ceramic crowns.