Anna Takács

Background/Objectives: Odontogenic cysts and ameloblastomas (AB) are mostly asymptomatic, often discovered later due to severe symptoms, and only histopathological examination provides definitive diagnosis. AI-assisted diagnostics offer a fast, noninvasive, painless diagnostic tool. To our knowledge, this is the first meta-analysis aiming to evaluate the classification, detection, and segmentation performance of artificial intelligence (AI) for odontogenic cysts and ABs as distinct entities and to determine if it can achieve clinically acceptable accuracy. Methods: Our systematic search was conducted on 11 January 2026, in Medline, EMBASE, and Cochrane Central Register of Controlled Trials without restrictions or filters. Studies comparing AI diagnostics with histopathological diagnostics for odontogenic cysts and ABs were included. Diagnostic parameters, including sensitivity, specificity, and accuracy, were extracted and analyzed; additionally, diagnostic odds ratios were calculated. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Recommendations of the GRADE workgroup were followed to determine the certainty of evidence. Results: Thirteen articles were found eligible, of which seven were included in our meta-analysis. The group with the highest sensitivity (Se) was the “no lesion” (N) group (0.9726, 95% CI 0.9284–1; I2 = 46%), followed by the radicular cyst (RC) (mean 0.9054, 95% CI 0.8051–1; I2 = 89%), dentigerous cyst (DC) (mean 0.8788, 95% CI 0.7828–0.9749; I2 = 93%), odontogenic keratocyst (OKC) (0.763, 95% CI 0.6999–0.8262; I2 = 14%) and AB (mean 0.4369, 95% CI 0.231–0.6429; I2 = 79%) groups. Results for AB, RC, and DC were statistically significant. The AB achieved the highest specificity (Sp) (mean 0.9889, 95% CI 0.9736–1; I2 = 0%), followed by RC (mean 0.9724, 95% CI 0.9431–1; I2 = 79%), DC (mean 0.9516, 95% CI 0.9116 0.9917; I2 = 90%), N (mean 0.9226, 95% CI 0.8385–1; I2 = 95%) and OKC (mean 0.8991, 95% CI 0.8683–0.9298; I2 = 8%) groups. DC, N, and RC had statistically significant results. Diagnostic odds ratios (DOR) showed that classification was better than chance for all lesion types. Conclusions: AI demonstrated high specificity, and is therefore effective in identifying healthy individuals. However, its sensitivity in detecting diseased patients remains suboptimal and requires further improvement.

Background: The purpose of this in vitro study was to compare the accuracy of implant placement in model surgeries according to the design of the drills (straight drills or step drills) used to finalize the implant bed during pilot-guided static computer-assisted implant surgery (sCAIS). Methods: Model surgeries were carried out on resin models randomly assigned to three study groups. Virtual planning software (coDiagnostiX 10.6, Dental Wings, Montreal, Canada) was used to plan the implant positions. In Groups 1 and 2, pilot-guided sCAIS was performed. Straight drills were used in Group 1, and step drills were used in Group 2 to finalize the implant beds. In Group 3, fully guided sCAIS was performed using a universal fully guided kit (RealGUIDE Full Surgical Kit 3DIEMME, RealGUIDE, Cantù, Como, Italy). A total of 90 dental implants (Callus Pro, Callus Implant Solutions GmbH, Nuremberg, Germany) were placed (six implants per model, five models per study group). The primary outcome variables (angular deviation, coronal global deviation, and apical global deviation) were calculated for all implants based on the comparison of the preoperative surgical plan with the postoperative scans. Results: Group 2 (coronal global deviation, 0.78 ± 0.29 mm; apical global deviation, 1.02 ± 0.56 mm) showed significantly lower values of both global deviation variables than Group 1 (coronal global deviation, 0.95 ± 0.20 mm; apical global deviation, 1.42 ± 0.49 mm). However, there was no significant difference in angular deviation between Groups 1 and 2 (7.56 ± 2.92° and 6.44 ± 2.84°). Group 3 produced significantly lower values of all three primary outcome variables (angular deviation, 2.36 ± 0.90°; coronal global deviation, 0.59 ± 0.28 mm; apical global deviation, 0.90 ± 0.29 mm) than Group 1 and significantly lower angular deviation and coronal global deviation values than Group 2. Conclusions: The design of the drills used to finalize implant osteotomies during pilot-guided sCAIS influences dental implant placement accuracy. Using step drills instead of straight drills for final osteotomies decreases deviation from the surgical plan. The fully guided approach performed better than the pilot-guided sCAIS.