PubMed · 6962961
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B J Heinenberg, S Heinenberg. 1982. [Basic knowledge: tooth conservation information (III)].. https://pubmed.ncbi.nlm.nih.gov/6962961/
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Artificial intelligence (AI) has been proposed as a tool to improve dental caries detection across imaging modalities; however, its clinical value remains uncertain. This umbrella review aimed to synthesize and critically appraise systematic reviews evaluating AI for caries detection and diagnosis. An umbrella review was conducted following PRIOR guidance (PROSPERO CRD420261340728). Searches were performed in MEDLINE, Embase, Scopus, Web of Science, and Google Scholar up to 15 March 2026. Methodological quality was assessed using AMSTAR 2, and overlap of primary studies was quantified using the corrected covered area (CCA). Seventeen systematic reviews were included, of which five reported diagnostic test accuracy meta-analyses using bivariate or HSROC models. Across these meta-analyses, pooled sensitivity ranged from 0.76 to 0.94 and specificity from 0.85 to 0.91. Most systems were based on deep learning models applied to bitewing radiographs and intraoral photographs. However, substantial heterogeneity was observed in imaging modalities, lesion thresholds, analytical tasks, and evaluation metrics. In addition, a high degree of overlap across reviews and recurrent methodological limitations, including reliance on retrospective datasets, limited external validation, and inconsistent reporting, substantially weaken the reliability of the evidence. Although AI models demonstrate high diagnostic performance under experimental conditions, current evidence does not support their use as stand-alone diagnostic tools. Their clinical applicability remains limited, and implementation should be restricted to decision-support contexts until robust prospective validation demonstrates meaningful impact on clinical decision-making and patient outcomes.
Due to their inertness and unsurpassed aesthetic properties, ceramic materials are increasingly used as inlay materials. Based on a questionnaire, the frequency and character of complications related to ceramic inlay therapy were assessed and some important pitfalls and clinical relevant factors discussed. A majority of the dentists performed between 1 and 10 ceramic inlays per month using several different ceramic materials. As many as 85% of the dentists had observed complications in connection with ceramic inlays. Most frequency reported was hypersensitivity of a transient nature (15%). The material revealed an overall inlay fracture frequency of 5%, but the individual variations were high. Tooth fracture, loss of retention and other complications such as secondary caries, endodontic envolvement, colour mismatch and a surface and edge deterioration occurred with a varying but lower frequency. Failure analysis revealed a large number of causative factors among which cavity and inlay design, bonding procedures, selection of luting material and proper case selection were regarded as the most important. Due consideration to the strength of remaining tooth substance was found to be important in reducing the problem of hypersensitivity and the risk of tooth and inlay fracture.
The successful prevention of caries in Sweden, as in many other countries, is an example of what might he obtained when a systematic and complete program is adopted. Fluoride programs, mechanical cleaning of the teeth, and improved nutrition and eating habits have been the most important fundamentals for the positive results. A diminished use of tobacco, with a reduced frequency of periodontitis as one of the consequences, has been successful in some groups in the population but less so in others. There is, however, evidence now in Sweden of a less active preventive approach concerning caries prophylaxis among some parents today than a generation ago. Thus, there are obvious reasons to continue with oral preventive programs, preferably integrated with general health programs. For acceptable quality in preventive programs to be obtained, concrete goals must be formulated. These should be based upon scientific findings. Those in the society who should be given priority in the program must be identified by epidemiological studies. Systems for follow-up of the preventive measures should be integrated into the programs when they are initiated. Total quality assurance programs should include parameters which describe the resources and the process needed to obtain the formulated goals. The qualifications of those involved in the process are among the most important resources for success.