Angela Tisci

Objective: Osteolytic jaw lesions are heterogeneous and share radiographic features. Radiomics from CBCT may provide quantitative biomarkers to aid differential diagnosis between developmental and inflammatory Odontogenic Cysts. Methods: A retrospective radiomic analysis was performed on CBCT scans of osteolytic jaw lesions from 52 patients; after quality control, 44 lesions were included (28 developmental and 16 inflammatory cysts). Lesions were segmented in 3D Slicer, and radiomic features were extracted with PyRadiomics. Unsupervised analyses used K‐means and principal component analysis (PCA). Group differences were tested with ANOVA. For supervised classification, Logistic Regression, Random Forest, SVM, Multilayer Perceptron, and a stacking model were trained using PCA‐based dimensionality reduction, mutual‐information feature selection, SMOTE oversampling, and repeated stratified 5‐fold cross‐validation. Results: One thousand four hundred and thirty‐seven features per lesion were extracted; univariate analysis identified 11 radiomic features showing differences between the two diagnostic groups ( p < 0.05). However, none remained statistically significant after false discovery rate (FDR) correction, indicating the exploratory nature of these findings. Random Forest showed the best performance (AUC 0.76, accuracy 0.74, specificity 0.81, sensitivity 0.61). Unsupervised clustering did not reveal separated groups. Conclusions: While individual radiomic features did not demonstrate significance, a multivariate machine learning approach may identify complex signatures with moderate discriminative performance.

Background: Histiocytoses are rare diseases and represent a heterogeneous group of pathologies with variable clinical features, determined by the tissue accumulation of cells of presumed dendritic or macrophage origin. Oral manifestations may constitute an early clinical sign and sometimes the only initial evidence of the pathology. The aim of this systematic review with meta-analysis was to investigate the prevalence of oral manifestations in patients affected by LCH, describing their clinical and histopathological characteristics. Methods: A systematic search was conducted on three major databases (PubMed, Scopus and ScienceDirect) and on Google Scholar grey literature. Relevant articles were selected based on inclusion and exclusion criteria, following the guidelines of the Cochrane handbook. The primary outcome was the prevalence of oral manifestations, calculated as the proportion of affected patients compared to the total cohort in each study. A fixed-effects meta-analysis was performed. A sensitivity analysis was also performed excluding studies with high heterogeneity and a correlation analysis between the mean age at diagnosis and the prevalence of oral lesions, weighted by sample size. Results: 16 studies were included for a total of 2,174 patients. The aggregate prevalence of oral manifestations was 14.86% (95% CI: 11.80–18.58%), reduced to 10.57% in sensitivity analysis. The most frequently involved sites were the mandible and the gums, with osteolytic, ulcerative or periodontal lesions. The weighted correlation analysis between age and prevalence showed a very weak and non-significant correlation (r = 0.007, p = 0.991; Spearman ρ = − 0.258, p = 0.734), confirmed even after the exclusion of outliers. Conclusions: Oral manifestations represent a relevant clinical component in LCH and may constitute an early diagnostic sign. However, the prevalence varies widely between studies. No significant correlation was observed between age at diagnosis and the presence of oral manifestations. However, the interpretation of these findings is limited by the predominance of retrospective studies and the overall moderate methodological quality of the available evidence. Therefore, further standardized prospective studies are needed to better clarify the clinical impact of oral lesions in LCH.

Background/Objectives: Peri-implantitis is a major complication in implant dentistry, and its radiographic diagnosis remains challenging because conventional assessment is operator-dependent and bone loss is often detected only after measurable changes occur. Artificial intelligence (AI) may support the detection, quantification, and prognostic assessment of peri-implant bone conditions. This review aimed to synthesize evidence on AI-based radiographic approaches for peri-implantitis detection, marginal bone loss measurement, and risk stratification. Methods: PubMed and Scopus were searched for original studies published between 2013 and 2025 that applied artificial intelligence (AI), including machine learning and deep learning, to peri-implantitis. Eligible studies focused on peri-implant bone assessment and reported quantitative performance metrics. Extracted data included imaging modality, AI model, task, dataset, reference standard, validation strategy, performance, and clinical relevance. A qualitative synthesis was performed. Results: Eleven studies met the eligibility criteria; however, one full text could not be retrieved, and ten studies were included. In most of the studies, peri-implant marginal bone loss detection or measurement was performed using periapical/intraoral radiographs, while only few studies used panoramic or combined imaging. Common architectures included YOLO variants, Faster R-CNN, Mask R-CNN, U-Net, ResNet, and AlexNet. Performance was generally encouraging for implant localization, bone loss detection, keypoint identification, and severity classification. Only one study addressed outcome prediction. All studies were retrospective and internally validated. Conclusions: AI may support radiographic detection and quantification of peri-implant bone loss as an adjunctive diagnostic tool. However, evidence is limited by retrospective designs, heterogeneous reference standards, lack of external validation, and limited clinical-data integration. Future studies should prioritize prospective multicenter validation, longitudinal imaging, and multimodal models.

Objectives: Given the growing use of resonance frequency analysis in clinical implantology and the inconsistent evidence regarding its prognostic value, this systematic review aimed to clarify the association between implant stability quotient (ISQ) with insertion torque (IT), marginal bone loss (MBL), and implant survival/success rate. Material and Methods: Following PRISMA guidelines, a comprehensive literature search was conducted across MEDLINE, Scopus, and Web of Science to answer the PIO question: “In systemically healthy patients undergoing implant placement, are ISQ values associated with intraoperative and postoperative surrogate parameters (IT and MBL) and clinical outcomes such as implant survival and success?” Risk of bias was assessed using design‐specific methodological tools. Results: Forty‐eight studies were included, and 20 were eligible for quantitative analysis of ISQ‐IT correlation. A moderate and statistically significant association was observed (pooled r = 0.44; 95% CI: 0.32–0.55, p < 0.001), with substantial heterogeneity ( I ² > 90%). Three studies assessed baseline ISQ values and implant survival. Although surviving implants showed higher ISQ values (mean difference = 10.22), the pooled estimate was not statistically significant and remained highly heterogeneous. Quantitative synthesis for MBL and implant success was not feasible due to inconsistent reporting and methodological variability. Conclusions: ISQ shows a moderate correlation with IT, supporting its role as a complementary indicator of primary implant stability. However, high heterogeneity and limited certainty of evidence restrict its clinical interpretability. Current evidence does not support baseline ISQ values as independent predictors of MBL or implant survival.

Objectives: To evaluate the effectiveness of spatial superimposition of cone‐beam computed tomography (CBCT) scans acquired at baseline and 6‐month follow‐up for monitoring bone healing in mandibular cystic lesions, aiming to reduce variability in conventional volumetric comparisons and enhance accuracy, reproducibility, and spatial fidelity of radiographic assessments. Materials and Methods: Two CBCT scans of a single patient (baseline, T0; follow‐up, T1) were imported into 3D Slicer v5.8.0. The mandible was isolated by manually cropping a region of interest, and the cystic lesion was segmented semi‐automatically using the Grow from Seeds tool. A rigid six‐degree‐of‐freedom registration aligned T1 to T0; the resulting transformation matrix was applied to the T1 segmentation to enable direct voxel‐wise comparison. Lesion volumes were measured, and spatial subtraction analysis quantified the resorbed area. Results: Lesion volume decreased from 1841.64 mm ³ at T0 to 1362.62 mm ³ at T1, corresponding to an absolute reduction of 479.02 mm ³ (26.0%). The subtraction mask accurately localized regressed voxels, confirming both the magnitude and spatial distribution of bone healing. Conclusions: Potential limitations related to CBCT artifacts and the need for operator‐dependent manual steps should be considered when interpreting the results. Overall, CBCT superimposition with semi‐automatic segmentation provides an objective, consistent, and anatomically precise approach for monitoring mandibular cyst regression and may represent a useful tool to support conservative management strategies.

Stacchi C, et al. J Periodontal Implant Sci. 2026 ;56:e42. https://doi.org/10.5051/jpis.2601980099

Objectives: The radiographic diagnosis of dental caries is often complicated by the presence of radiographic optical effects, such as the Mach band effect and triangular-shaped radiolucencies (TSR). These phenomena can give rise to false-positive diagnoses, especially in bite-wing radiographs, thus influencing clinical decision-making and possibly leading to overdiagnosis and overtreatment. The aim of this systematic review and meta-analysis was to clarify the real prevalence of these radiographic optical effects in dental radiographs and to quantify their influence on diagnostic errors in caries detection. Methods: This systematic literature review follow the PRISMA guidelines and registered in PROSPERO (CRD420251083823), prior to its execution. Electronic searches were conducted on PubMed, Scopus and the Cochrane Library, with the addition of Grey literature and references of the main reviews on the topic. Inclusion criteria included clinical, in vitro and ex vivo studies evaluating the impact of TSR and Mach band effects on intraoral radiographs (bitewing or periapical), reporting diagnostic performance, prevalence or misinterpretation rates. Data extraction and risk of bias assessment (AXIS, QUADAS-2) were performed independently by two reviewers. Meta-analyses were performed using random effects models. Results: Of 640 identified reports, only five studies were included. The overall prevalence of non-carious TSR on maxillary molars was 26.44%, 270/1021. The meta-analysis showed that effects (TSR or Mach band) led to false positive diagnoses of caries or fractures, in approximately 13% of observations (60/464). Heterogeneity was high (I² > 90%) and the certainty of the evidence was classified as low to very low due to the type of studies included and the consistency indices. Conclusions: Radiographic optical effects, especially TSR and Mach band effect, are highly prevalent in bitewing images and significantly increase the risk of false positive caries diagnoses, especially in children. Given the low certainty of the available evidence, clinicians should interpret radiographic findings with caution and always correlate them with a thorough clinical examination. Further high-quality research is needed to develop standardized diagnostic criteria and strategies to mitigate radiographic optical effects in dental practice.

This scoping review aims to examine and identify the potential clinical implications and future research directions concerning Hunter–Schreger bands (HSBs) through an analysis of the scientific medical literature. The scoping review was conducted following the PRISMA Extension for Scoping Reviews (PRISMA‐ScR) guidelines, utilising electronic databases such as PubMed, Scopus, the Cochrane Central Register of Trials and ScienceDirect, employing keyword combinations for database search. During the selection process, 327 records were identified, of which only 10 studies fully met the inclusion criteria and were included in the review. The extracted data were summarised in tables. Current evidence suggests that HSB play a crucial role in strengthening enamel by dissipating energy and preventing crack propagation. The use of imaging technologies, optical microscopy and diffraction studies has enabled a detailed characterisation of their structure, distribution and function, opening new avenues for future diagnostic and therapeutic applications in dentistry. However, the predominance of in vitro studies highlights the need for further in vivo clinical research to confirm and translate these findings into innovative dental practices.