PubMed · 9037967
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J A Bier. 1997. Controlling caries.. https://doi.org/10.14219/jada.archive.1997.0145
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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.
Glass-ionomer cements, both self-hardening and resin-modified, have been shown to increase the pH of lactic acid solutions in which they are stored. Similar results have been obtained for a zinc phosphate and a zinc polycarboxylate cement. The pH was increased over a period of 7 days by between 1.54 and 2.65 pH units from an initial value of pH of 2.60, depending on the cement. It is concluded that, as a result of this ability to neutralize surrounding aqueous solutions, these materials may have the beneficial effect in vivo of inhibiting caries development. In the case of glass-ionomers, this mechanism might complement that of fluoride release.
The effects of changes in horizontal X-ray beam angulation and different cavity shape on images of approximal cavities on bite-wing radiographs were examined using a laboratory model. Cylindrical-, rectangular- and cone-shaped bur cut cavities were prepared in the approximal surfaces of 108 teeth and their depth determined using silicone putty impressions. Spatial relationships were controlled by fixing specimens into perspex blocks. Standardized radiographs were taken at baseline (0 degree) and then using pre-angled wedges to imitate horizontal X-ray beam movements of 5, 10 and 15 degrees in both mesial and distal directions. Radiographic cavity depth to the nearest 0.1 mm was measured. Over the range of X-ray beam movements, more than 72% of cavities deepened compared to baseline. As bucco-lingual cavity width increased the magnitude of the depth change increased. For some cylindrical cavities increases equating to 200% over baseline were seen; in some rectangular cavities increases of up to 400% over baseline occurred. The present study suggests that changes in irradiation geometry from baseline are likely to result in a cavity appearing to deepen. In a clinical context over-treatment is therefore the most likely outcome.