Abstract in English:

Abstract Artificial intelligence (AI) has emerged as a promising tool to support or perform specific oral diagnostic tasks, particularly through advances in machine learning and deep learning. This comprehensive review aimed to synthesize current evidence and explore future directions for AI-driven or AI-supported oral diagnostic workflows across four target pathologies: odontogenic cysts, odontogenic tumors, oral potentially malignant disorders (OPMDs), and oral squamous cell carcinoma (OSCC). A structured search strategy combining MeSH terms and free-text keywords was applied, encompassing target conditions, AI methodologies, diagnostic performance metrics, and clinician comparator groups. Across all pathologies, AI models demonstrated encouraging performance, frequently approaching that of experienced clinicians, particularly in image-based detection and classification tasks. In some contexts, improved sensitivity was observed, suggesting potential value in early disease detection. However, findings were highly variable and often limited by methodological constraints, including retrospective study designs, small or curated datasets, lack of external validation, and heterogeneity in reporting metrics such as sensitivity, specificity, accuracy, and area under the curve. Importantly, no consistent evidence supports the superiority of AI over clinicians across all performance measures. Instead, current data suggest that AI may serve as a valuable adjunct to clinical decision-making, with potential to reduce diagnostic variability and support non-specialist practitioners. Future research should prioritize prospective, multicenter studies with standardized methodologies, robust external validation, and evaluation of real-world and patient-centered outcomes. While AI holds significant promise, its routine clinical implementation for oral diagnostic tasks remains premature, requiring further validation, transparency, and integration into clinical workflows.

Abstract in English:

Abstract This review synthesizes current literature on laser applications in dentistry, with particular emphasis on the biological mechanisms of photobiomodulation (PBM), dosimetric considerations, tissue interactions, and the clinical management of the most prevalent oral lesions. The oral disorders most frequently investigated for the therapeutic use of PBM were: a) oral pain conditions: trigeminal neuralgia, temporomandibular disorders, and burning mouth syndrome; b) oncology-related conditions: oral mucositis and hyposalivation; c) immune-mediated disorders: recurrent aphthous stomatitis and oral lichen planus; and d) viral infections: herpes labialis. A wide range of laser parameters has shown clinical benefits in the treatment of these disorders. These outcomes are attributed to the anti-inflammatory, analgesic, and tissue repair effects of PBM, which may occur immediately and cumulatively over repeated sessions. PBM therapy is a valuable therapeutic resource in contemporary dentistry and may be successfully applied in a wide range of clinical conditions. Clinical effectiveness of PBM depends on appropriate dosimetry and irradiation parameters according to the biological characteristics of each condition and therapeutic target. Therefore further well-designed randomized clinical trials and protocol standardization are still required to strengthen clinical recommendations and optimize reproducibility.

Abstract in English:

Abstract The concept of bioactivity in restorative dentistry has evolved beyond the traditional expectation of inert materials designed solely to replace lost tooth structure. Contemporary restorative systems are increasingly engineered to interact with the dentin-pulp complex by modulating mineral dynamics, matrix stability, and cellular responses. However, misconceptions remain regarding what restorative “bioactivity” can realistically achieve in clinical practice. This review critically discusses the biological basis and clinical relevance of bioactive materials in restorative dentistry, emphasizing dentin-pulp preservation and the distinction between validated bioactivity and laboratory observations. Bioactivity may arise through physicochemical mechanisms, such as ion release, pH modulation, and mineral precipitation, which may contribute to mineral recovery and dentin-pulp preservation, although many proposed effects remain insufficiently validated clinically. In parallel, biological mechanisms involve modulation of odontogenic signaling, pulp cell differentiation, and extracellular matrix dynamics. Strategies targeting collagen stability, including cross-linking, protease inhibition, and intrafibrillar mineralization, may also improve hybrid-layer durability and interfacial longevity. Beyond dentin-focused interventions, pulp-directed bioactivity includes clinically established vital pulp therapy materials and emerging scaffold-based regenerative systems that remain largely investigational. However, important translational questions remain regarding the clinical functionality of current materials. Clinically relevant restorative bioactivity should not be defined by ion release or surface mineral deposition alone, but by the ability of materials to preserve dentin-pulp homeostasis and long-term restorative stability. Moving beyond the “bioactive” label requires evidence-based strategies that sustain dentin-pulp homeostasis rather than merely replacing lost structure.

Abstract in English:

Abstract Clinical management of patients with molar incisor hypomineralization (MIH) requires a comprehensive and multidimensional assessment that integrates clinical, behavioral, radiographic, functional, and psychosocial parameters. This article discusses key aspects of MIH management, including diagnosis and severity grading; non-invasive strategies aimed at preventing enamel breakdown; restorative management of severely affected molars, including the role of timed extractions; esthetic treatment to mask opacities in anterior teeth; and desensitizing approaches for the management of hypersensitivity. The literature for this narrative review was identified through targeted searches in PubMed for classic and recent publications on the clinical management of MIH. Reference lists of relevant articles were also hand-searched to identify additional relevant studies. Finally, future perspectives and emerging directions in MIH management are discussed.

Abstract in English:

Abstract This narrative review critically examines common myths in dental bleaching that are often presented as strategies to improve efficacy or reduce adverse effects, despite limited, inconsistent, or context-dependent clinical support. The review integrates evidence from clinical trials and systematic reviews identified through searches, with priority given to higher-level clinical evidence when available. In addition, concepts from Evidence-Based Practice and Cognitive Psychology are used to contextualize why weakly supported protocols may persist in clinical decision-making. The analysis addressed frequently disseminated beliefs in clinical practice and led to the following conclusions: a) dietary restriction does not improve bleaching outcomes; b) preventive use of analgesics and/or anti-inflammatory drugs does not reduce tooth sensitivity (TS); c) higher peroxide concentrations may accelerate early bleaching but increase adverse effects and do not enhance final efficacy; d) prolonged gel exposure beyond recommended times does not produce perceptible additional color change and may increase TS; e) tray scalloping does not consistently reduce patient-perceived gingival irritation; f) increasing gel volume or contact area does not improve final bleaching efficacy and may increase biological cost; g) light-activation does not provide additional clinical benefit; h) gel agitation does not enhance bleaching outcomes; i) over-the-counter products do not replace professionally supervised bleaching in terms of predictability and magnitude of color change; and j) desensitizing toothpastes show inconsistent efficacy in preventing TS. Overall, bleaching protocols should be selected according to clinically meaningful benefits, adverse effects, patient-centered outcomes, and the strength and consistency of the available evidence, rather than tradition, intuition, or commercial appeal.

Abstract in English:

Abstract Regenerative endodontics has transformed the management of immature necrotic teeth by offering the potential to improve root structure rather than merely induce apical closure. Over the past two decades, considerable progress has been made in case selection, disinfection protocols, irrigation strategies, intracanal medicaments, scaffold design, and biologically based tissue engineering approaches. Despite these advances, key challenges remain, including protocol standardization, variability in clinical outcomes, limited high-quality clinical evidence, and the gap between promising laboratory findings and routine clinical implementation. This narrative review summarizes the recent literature on regenerative endodontics, focusing on contemporary clinical protocols and their limitations, prognostic factors, treatment outcomes, and emerging therapeutic strategies. Current evidence supports regenerative procedures that involve careful case selection, appropriate scaffold formation, well-sealed coronal restorations, and effective disinfection that preserves stem cell viability. While these protocols promote infection control, periapical healing, and tooth survival, continued root maturation remains variable, and existing therapies primarily result in tissue repair rather than true regeneration of a functional pulp-dentin complex. Additionally, there are several limitations to the widespread clinical adoption of advanced regenerative therapies, including outcome measures, alongside regulatory, manufacturing, and logistical challenges. Bridging the gap between innovation and clinical practice will require continued advances in tissue engineering, as well as more robust clinical evidence and standardized treatment protocols.

Abstract in English:

Abstract Cigarette smoking is a well-established risk factor for periodontitis, contributing to increased clinical attachment loss (CAL), alveolar bone loss, and impaired treatment response. As electronic cigarettes (ECs) are increasingly used as alternatives to combustible tobacco, questions remain regarding their adverse effects on oral and periodontal health. This critical review integrated evidence from experimental, cross-sectional, longitudinal and interventional studies to evaluate the relationship between EC use and periodontal health. Experimental and molecular studies supported biological plausibility for periodontal harm, indicating that aerosols can induce oxidative stress, upregulate pro-inflammatory mediators, and disrupt host-microbial interactions. Cross-sectional studies generally reported poorer periodontal conditions among EC users compared with never-smokers, including higher plaque index and periodontal probing depth, although results for CAL and alveolar bone loss were inconsistent. Comparisons between EC users and cigarette smokers often showed more favorable clinical parameters among EC users. Longitudinal evidence continued to be limited. The only prospective cohort study reported higher CAL among EC users than never-smokers and observed an increase in CAL over time exclusively in EC users. Interventional studies assessing response to periodontal therapy have yielded inconsistent results, with some suggesting a poorer treatment response among EC users and others finding no significant differences. Overall, there were Well-designed longitudinal studies with clearly defined exposure groups, standardized periodontal outcomes, and longer follow-up are needed to clarify whether EC use independently contributes to periodontal deterioration.

Abstract in English:

Abstract Peri-implantitis is a biofilm-related disease characterized by inflammation and tissue damage in the peri-implant mucosa, along with progressive loss of supporting bone. Although triggered by a polymicrobial biofilm, disease progression is influenced by factors beyond microbial buildup. This thorough review explores factors that may promote peri-implant disease progression, focusing on interactions among biofilm dynamics, local conditions, patient-related factors, and material-related characteristics. Evidence suggests that biofilm maturation, ecological imbalance, and ongoing inflammatory response are key drivers of disease progression. Locally, microbial shifts, iatrogenic conditions, and reduced cleanability seem to facilitate microbial buildup and hinder maintenance. Patient factors such as a history of periodontitis, smoking, and poorly controlled diabetes are most consistently linked to poorer peri-implant outcomes, while genetic susceptibility remains suggested but not confirmed. Material properties, including surface topography, roughness, chemistry, wettability, corrosion behavior, and particle release, may influence microbial colonization and host responses, though their independent clinical significance is less certain. Overall, current research points to a multifactorial model of peri-implant disease progression, though much of the evidence is based on observational studies with substantial heterogeneity, limiting the ability to draw definitive conclusions. A comprehensive understanding of microbial, biological, prosthetic, systemic, and material factors is crucial for accurate risk assessment, prevention, and personalized management of peri-implantitis.

Abstract in English:

Abstract This scoping review mapped the evidence on the clinical applicability and implications of digital workflows for fixed and removable full-arch rehabilitation in completely edentulous patients, focusing on workflow-related operational parameters and clinician-reported outcomes. This review was conducted in accordance with the PRISMA-ScR and was registered on the Open Science Framework. The research question was "What is the current evidence on digital workflows for full-arch rehabilitations and their implications for clinical practice?". A search was conducted in PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, and Embase, supplemented by grey literature and reference screening. The inclusion criteria were clinical studies and reviews focusing on the clinical implications of workflow-related performance indicators and the clinician's perceptions, considering the digital workflow. A descriptive analysis was conducted in terms of clinical application and key findings regarding accuracy, time-efficiency, cost-effectiveness, and clinician satisfaction. A total of 40 studies were included. The implant-level impressions demonstrated values for 3D linear deviations within clinically acceptable thresholds (up to 200 μm) and traditional methods remained feasible for tissue impressions due to the highest discrepancies found in the peripheral regions. The digital workflow was time- and cost-saving, ranging from 27.17% to 75.10% and 9.21% to 39.49%, respectively. The digital workflow was accurate for implant-level impressions. Evidence suggests limitations in peripheral and movable mucosa capture; however, certain protocols may improve reliability, and conventional methods remain important in specific clinical contexts. Moreover, it's time- and cost-efficient for interventions in completely edentulous patients, but the evidence remains scarce and inconclusive for clinician satisfaction.