Journal of Craniomaxillofacial Research

Exploring the Advancements of Forensic Odontology: A Review

2026-05-24T10:57:52+0430

Introduction: Forensic dentistry is essential for human identification, but traditional manual techniques are often time-intensive and prone to subjectivity. The integration of artificial intelligence (AI) presents a transformative opportunity to enhance accuracy and efficiency across various forensic odontology applications. This systematic review consolidates and analyzes the existing literature on AI applications in forensic dentistry.
Materials and Methods: A comprehensive literature search was conducted in the PubMed and Scopus databases following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies published up to August 2025 were considered for inclusion.
Results: A total of 116 studies were analyzed. The primary applications included age estimation (54 studies), gender estimation (33 studies), and human/dental identification (26 studies). Bite mark analysis (1 study) and facial reconstruction (2 studies) were identified as underexplored areas. Convolutional neural networks (CNNs) were the most frequently employed AI algorithm, utilized in 64% (74/116) of studies, while orthopantomograms (OPGs) were the predominant imaging modality in 72% (84/116) of investigations. Quantitative results demonstrated significant promise: age estimation models achieved a mean absolute error (MAE) as low as 0.0079 years and a peak classification accuracy of 99.98%; gender estimation models attained accuracies between 68% and 98%; and human identification models reached up to 100% accuracy in optimal conditions, though sensitivity dropped to 69% in complex postmortem cases. Emerging techniques, such as microbiome analysis and generative adversarial networks (GANs), were noted as innovative future directions.
Conclusion: AI demonstrates significant potential to improve accuracy and reduce processing time in core forensic dentistry tasks, particularly age and gender estimation. However, challenges related to data privacy, algorithmic bias, and legal admissibility persist. Future research should prioritize the development of explainable AI models, standardized and diverse datasets, and robust regulatory frameworks to ensure ethical and trustworthy integration into forensic practice.
Keywords: Artificial intelligence; Dental identification; Forensic dentistry; Forensic odontology.

Photobiomodulation Therapy for Facial Nerve Repair: Systematic Review

2026-05-24T10:57:53+0430

Introduction: Microsurgery interventions for direct nerve repair often lead to serious complications and limited success. Non-surgical methods, although somewhat effective, have limited benefits. Photobiomodulation therapy (PBMT) has emerged as a promising approach based on clinical and laboratory studies. The photobiomodulation may accelerate and improve nerve regeneration. This review explores various methodologies used in photobiomodulation for regenerating nerve sensitivity after surgical trauma involving nerve structures in the oral and perioral region.
Materials and Methods: Articles available in PubMed, Scopus, Web of Science, and Google Scholar databases with similar topics over the 20-year period from 2005 to 2025 were selected and reviewed based on inclusion and exclusion criteria. Articles were retrieved by searching for the keywords photobiomodulation, facial nerves and facial nerve injury.
Results: Seven studies related to Photobiomodulation treatment with 810 nm diode laser on facial nerves were selected and reviewed. Of the seven studies reviewed, 2 in 2022, 1 in 2021, 3 in 2017, and 1 in 2014.
Conclusion: Light modulation at 810 nm has a significant, rapid effect on improving visual analog scale (VAS) scores for general sensory perception and thermal discrimination. Notably, the use of photobiomodulation shows the possibility of accelerating the recovery of these sensory functions.
Keywords: Photobiomodulation therapy; Low-level laser light therapy; Complication; Trauma; Facial nerve injuries.

Can Artificial Intelligence Help to Prevent and Manage Oral Infections: A Review

2026-05-24T10:57:53+0430

Introduction: This study aimed to answer “Can artificial intelligence help to prevent and manage oral infections? How can it help us? What we know and what we do not know?”.
Materials and Methods: Artificial intelligence-driven Internet of Things systems enable real-time monitoring of the oral environment and early identification of cariogenic and inflammatory factors. In the present narrative review, the authors used keywords such as “Artificial Intelligence”, “Biofilms”, “Dental Caries”, “Internet of Things”, and “Periodontitis”. They conducted a literature search via Google Scholar and PubMed from January 2015 to November 2025.
Results: Artificial intelligence algorithms have shown high accuracy in diagnosing oral and periodontal diseases, predicting microbial resistance, and optimizing antimicrobial therapies. Integration of artificial intelligence with antimicrobial robots represents a promising approach for biofilm detection, degradation, and targeted removal. These technologies collectively enhance personalized dental care and support preventive, data-based decision-making in dentistry.
Conclusion: Artificial intelligence and Internet of Things integration offer transformative potential in oral healthcare by improving early detection, prevention, and management of oral infections. However, further clinical studies, data standardization, and ethical considerations are necessary for safe and effective implementation of these technologies in dental practice.
Keywords: Artificial intelligence; Biofilms; Dental caries; Internet of things; Periodontitis.

Patient-Reported Outcomes Following Surgical Management of Oral Cancer

2026-05-24T10:57:53+0430

Introduction: Oral cavity cancers are a significant public health issue, particularly in South-Central Asia. While treatment efficacy has improved, the long-term impact on patients’ quality of life (QoL) requires further investigation. This exploratory study aimed to assess the long-term QoL of patients with oral cancer following surgical treatment in a single-center Iranian cohort.
Materials and Methods: This retrospective, single-center cohort study involved 40 patients who underwent oral cancer surgery at Shariati Hospital, Tehran, between 2013 and 2023. Data were collected via structured telephone interviews using the validated Persian version of the University of Washington Quality of Life questionnaire (UW-QOL v4.0). Descriptive statistics were prioritized, with exploratory analyses to examine potential associations with demographic/clinical variables.
Results: The mean age was 55.2 years (±10.8), and 60% were female. The buccal mucosa (52.5%) and tongue (30%) were the most common primary sites, with most patients (75%) diagnosed at advanced stages (III/IV). Pain was the most severely affected domain (mean score: 59.4), reported as a “significant problem” by 55% (22/40) of patients. Appearance, anxiety, and mood were also notably impaired. Shoulder function and saliva production were the best-preserved domains. Exploratory statistical analyses did not reveal significant associations between QoL scores and variables such as gender, disease stage, or age, though the study was underpowered for such comparisons (see Supplementary Tables S1–S6).
Conclusion: In this exploratory cohort, patients reported considerable long-term detriment in QoL after oral cancer surgery, particularly regarding pain and psychosocial domains. The findings, while limited by sample size, underscore the necessity for comprehensive, multidisciplinary survivorship care focused on pain management, psychological support, and functional rehabilitation. Larger, multi-center studies are needed to identify reliable predictors of QoL in this population.
Keywords: Oral cancer; Quality of life; Uw-qol questionnaire; Surgery; Post-treatment care; Survivorship.

In Vitro Comparative Analysis of Antioxidant Activities in Ethanolic Extracts of Centella Asiatica Linn., Ocimum Basilicum, Ocimum Sanctum, and Camellia Sinensis

2026-05-24T10:57:53+0430

Introduction: To comparatively evaluate the antioxidant potential of ethanolic extracts of Centella asiatica Linn. (CA), Ocimum basilicum Linn. (OB), Ocimum sanctum (OS), and Camellia sinensis (CS) using multiple in vitro assays.
Materials and Methods: Ethanolic extracts of CA, OB, OS, and CS were prepared and subjected to in vitro antioxidant analysis, including total antioxidant capacity, DPPH radical scavenging, nitric oxide radical scavenging, reducing power, and superoxide anion radical scavenging assays using UV spectrophotometry. Antioxidant activities were recorded at concentrations up to 1000 µg/ml. All assays were performed across a concentration range of 10–1000 µg/ml using serial dilutions.
Results: Total antioxidant activity (109.40 ± 0.15 % inhibition), DPPH scavenging (107.88 ± 9.32 % inhibition), nitric oxide scavenging (98.27 ± 9.48 % inhibition), reducing power (absorbance: 93.12 ± 9.12 at 700 nm), and superoxide scavenging (88.93 ± 8.14 % inhibition). The differences between groups were statistically significant (p < 0.001).
Conclusion: CA demonstrated superior antioxidant activity compared to OB, OS, and CS. Its high antioxidant potential suggests its promise as a natural therapeutic agent for preventing oxidative stress–related diseases.
Keywords: Antioxidants; Centella asiatica; Camellia sinensis; Ocimum basilicum; Ocimum sanctum; Oxidative stress.

Socio-Demographic and Clinical Patterns of Cleft Lip and Palate Patients

2026-05-24T10:57:53+0430

Introduction: Cleft lip and palate (CLP) is among the most common congenital craniofacial anomalies worldwide, with multifactorial aetiology influenced by genetic, environmental, and socioeconomic factors. Despite its significant public health burden in India, region-specific epidemiological data from tertiary care centres remain limited.
Materials and Methods: A cross-sectional, prospective observational study was conducted over one year at the Cleft Outpatient Department of PGIMS Rohtak, Haryana. All consenting patients diagnosed with cleft lip, cleft palate, or cleft lip and palate were included. Demographic details, parental characteristics, socioeconomic background, habits, family history, cleft type, laterality, and diagnostic grouping based on the Nagpur classification were recorded using a standardized proforma. Descriptive statistics were applied, and associations between diagnostic groups and selected variables were analysed using the Chi-square test at a 5% significance level.
Results: A total of 48 patients were evaluated, with equal gender distribution (50% males, 50% females). The mean paternal and maternal ages were 33.4 and 28.2 years, respectively. Most fathers were labourers or unemployed, while 91.7% of mothers were homemakers, reflecting a predominantly low socioeconomic background. Deleterious parental habits were present in 18.8% of cases, and a positive family history was observed in 8.1%. Left-sided cleft involvement was most common (64.3%). Chi-square analysis revealed no statistically significant association between diagnostic group and sex (p = 0.801), deleterious habits (p = 0.604), or family history (p = 0.576).
Conclusion: This study defines the local epidemiological and clinical profile of CLP patients at PGIMS Rohtak, demonstrating equal sex distribution, socioeconomic vulnerability, and predominance of left-sided clefts, with diagnostic patterns independent of major demographic and behavioural confounders.
Keywords: Cleft lip; Cleft palate; Congenital abnormalities; Cross-sectional studies; Epidemiology.

Comparison of the Effect of Drug Therapy and Physical Therapy on Myofascial Pain and Dysfunction

2026-05-24T10:57:54+0430

Introduction: Myofascial Pain Disorder (MPD), a prevalent subtype of Temporomandibular Disorders, presents with localized pain and functional limitations. While pharmacotherapy and transcutaneous electrical nerve stimulation (TENS) are common interventions, their comparative effectiveness remains underexplored, particularly in regional contexts like Bojnourd, Iran, during 2020–2021.
Materials and Methods: In this randomized controlled trial, 30 patients with MPD were randomized into two groups (n = 15 each): Group 1 received active TENS (100 Hz, 25mA, 30 minutes weekly for 4 weeks) plus placebo capsules; Group 2 received active medication (Naproxen 500mg and Diazepam 2mg twice daily for 10 days) plus sham TENS. Pain intensity (Visual Analog Scale, 0–10) and maximum pain-free mouth opening (mm) were assessed at baseline, day 10, and 4 weeks. Data were analyzed using repeated-measures ANCOVA (α = 0.05).
Results: TENS significantly outperformed pharmacotherapy in pain reduction (p < 0.001), with Group 1 achieving a 67.5% VAS reduction by day 10 versus 28.3% in Group 2. Both groups showed comparable improvements in mouth opening (p = 0.727). No adverse events were reported.
Conclusion: High-frequency TENS provides faster and more substantial pain relief than pharmacotherapy in acute MPD, with equivalent functional outcomes. These findings support TENS as a first-line, non-invasive therapy for MPD, informing evidence-based practice in regional and global contexts.
Keywords: Myofascial pain syndromes; Transcutaneous electric nerve stimulation; Temporomandibular joint disorders.

The Frequency of Intraosseous Lesions of Jaws of Patients Referred to the Pathologic Centers of Zanjan from 2013 to 2024

2026-05-24T10:57:54+0430

Introduction: The jaw bones are susceptible to a variety of lesions. Understanding the prevalence and distribution of these lesions is crucial for informing preventative strategies within healthcare settings. This study aimed to evaluate the prevalence of intraosseous jaw lesions in a population referred to diagnostic and therapeutic centers in Zanjan, Iran, between 2013 and 2024.
Materials and Methods: This study employed a cross-sectional descriptive analytical design. This cross-sectional study, conducted in Zanjan in 2023, utilized structured data sheets to collect information on patients with intraosseous lesions. The collected data included demographic details (age, gender), lesion location, radiographic characteristics, and histopathological diagnosis. We applied Chi-square and Monte Carlo tests for statistical analysis.
Results: A total of 325 intraosseous lesions were reported in our study. A total of 214 intraosseous lesions were reported in this study. The most common group of lesions was inflammatory periapical lesions (49.5%), and the most common lesion was radicular cyst (26.6%). The mandible was the most common site of involvement (51.9%), and the most common clinical presentation was asymptomatic (83.2%). In both jaws, the most common group of lesions was inflammatory periapical lesions (61.2% in the maxilla and 38.7% in the mandible). No significant differences were observed in the distribution of lesion frequency based on gender or age group (p > 0.05).
Conclusion: This study contributes valuable data on the prevalence and distribution of intraosseous lesions within an Iranian population. These findings establish baseline information that can inform the development and implementation of preventative therapeutic protocols within healthcare facilities at the community level.
Keywords: Jaw; Odontogenic cyst; Bone lesions; Periapical granuloma; Radicular cyst.

Knowledge, Attitude, and Self-Reported Practice Regarding Fissure Sealants among Senior Dental Students in Tehran University of Medical Sciences

2026-05-24T10:57:54+0430

Introduction: Dental caries is a prevalent oral disease, and fissure sealants are effective preventive measures. Dental students play a crucial role in influencing public acceptance of this treatment. This study aimed to assess the knowledge, attitude, and self-reported practice regarding fissure sealants among senior dental students at Tehran University of Medical Sciences (TUMS).
Materials and Methods: This cross-sectional study was conducted in 2023. A census sampling method was employed to recruit all eligible senior dental students (N = 163). The participants included fifth- and sixth-year dental students from both campuses of the School of Dentistry, TUMS. Data were collected using a validated, anonymous questionnaire comprising four sections: demographics, knowledge (11 questions), attitude (8 questions), and self-reported practice (14 questions). Statistical analysis was performed using SPSS version 26 via the Mann-Whitney test, Spearman’s correlation, and multiple linear regression analysis.
Results: Out of 163 distributed questionnaires, 117 were completed (response rate: 72%). The participants included 61 (52.1%) males and 56 (47.9%) females. The mean scores were 8.4±1.7 (out of 11) for knowledge, 28.8±3.5 (out of 40) for attitude, and 9.9±1.7 (out of 14) for self-reported practice. Male students showed significantly higher knowledge scores compared to females (P = 0.02). Fifth-year students also scored significantly higher in knowledge than sixth-year students (P = 0.04). A significant positive correlation was found between self-reported practice and both knowledge (P = 0.02) and attitude (P = 0.003).
Conclusion: Senior dental students demonstrated an acceptable level of theoretical knowledge regarding fissure sealants. However, their attitude and self-reported practice fell short of expected standards, highlighting the need for educational reinforcement and practical training in the dental curriculum.
Keywords: Knowledge; Attitude; Dental caries; Pit and fissure sealants; Dental students.

Potential of IP-10, EGFR, CK17 and ANXA1 as Non-Invasive Biomarkers for the Diagnosis of Oral Squamous Cell Carcinoma

2026-05-24T10:57:54+0430

Introduction: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity. Early diagnosis and the identification of non-invasive biomarkers for disease monitoring are essential. This study aimed to evaluate the expression of genes involved in inflammation (IP-10), cellular proliferation (EGFR), epithelial differentiation (CK17), and cellular regulation (ANXA1) in the peripheral blood of OSCC patients compared with healthy individuals.
Materials and Methods: In this case–control study, peripheral blood samples were collected from 30 OSCC patients and 30 healthy controls. Total RNA was extracted and reverse-transcribed into cDNA. Relative expression levels of IP-10 (CXCL10), EGFR, CK17, and ANXA1 were quantified using real-time polymerase chain reaction (Real-Time PCR). Statistical analyses were performed using SPSS software.
Results: The expression levels of EGFR and CK17 were significantly increased in OSCC patients compared with controls (p < 0.001). Similarly, IP-10 expression was significantly upregulated in the patient group (p < 0.001). In contrast, ANXA1expression was significantly downregulated in OSCC patients (p < 0.001).
Conclusion: The altered expression patterns of IP-10, EGFR, CK17, and ANXA1 in the peripheral blood of OSCC patients indicate the potential of these markers as non-invasive molecular diagnostic biomarkers. The concurrent upregulation of EGFR and CK17 may play a critical role in tumor progression, while the downregulation of ANXA1 may reflect impaired anti-inflammatory and apoptotic processes. These findings support the future application of PCR-based blood tests for OSCC screening or monitoring; however, further confirmatory studies are recommended.
Keywords: Oral squamous cell carcinoma; Peripheral blood; Gene expression; EGFR; CK17; IP-10; ANXA1; Real-time PCR.

Management of Odontogenic Keratocyst by Decompression: A Case Report

2026-05-24T10:57:54+0430

Odontogenic keratocyst (OKC) is a locally aggressive intrabony cyst of odontogenic origin and one of the most debated jaw pathologies because of its high recurrence potential and variable treatment strategies. This report presents the long-term outcome of a mandibular OKC treated by decompression alone. A 31-year-old woman presented with painless right mandibular swelling. Imaging showed a well-defined unilocular radiolucency from the mandibular angle to the distal root of the first molar, associated with an impacted third molar and external root resorption of the second molar. Decompression was performed by creating a buccal bone window, evacuating the cyst, extracting tooth 48, and placing an acrylic plug. Histopathology confirmed an odontogenic keratocyst. Serial panoramic and cone-beam computed tomography scans demonstrated progressive bone fill, so secondary enucleation and curettage were not undertaken. At 7-year follow-up, complete radiographic healing and no recurrence were observed. This case demonstrates that, in carefully selected mandibular OKCs, decompression alone followed by strict and prolonged radiographic surveillance can achieve complete resolution while avoiding the morbidity of more aggressive procedures. Conservative treatment with decompression may therefore be considered a viable option in selected patients.
Keywords: Conservative treatment; Curettage; Decompression; Surgical; Jaw cysts; Odontogenic keratocyst.

Diagnostic Challenge of a Primary Laryngeal Lymphoma Mimicking Laryngeal Inflammation with No Sign of Malignancy: A Case Report

2026-05-24T10:57:54+0430

Laryngeal lymphoma is an extremely rare condition. Symptoms are nonspecific and include hoarseness, dysphagia, and respiratory difficulty or airway obstruction. The initial presentation often mimics benign conditions such as inflammation or infection. Early diagnosis is crucial for optimal treatment. A 63-year-old man was admitted with a 1-month history of dysphonia, persistent hoarseness, odynophagia, and mild dyspnea. The patient did not report any fever, weight loss, or night sweats. Complete examination included: general physical examination, comprehensive ENT examination, oral cavity examination, neck examination, stroboscopy, flexible fibrolaryngoscopy, CT scan, MRI, and chest X-ray. Biopsy and IHC confirmed a diagnosis of diffuse large B-cell lymphoma (DLBCL). The patient underwent chemotherapy with the R-CHOP scheme, followed by involved-site radiotherapy (ISRT). After a 2-year follow-up, the patient remained in complete remission. This case emphasizes the importance of considering rare malignancies in patients with nonspecific laryngeal symptoms and the crucial role of a comprehensive diagnostic workup, even when symptoms are more commonly associated with benign conditions such as inflammation, and there is no sign of malignancy. Time is a critical factor for the management of laryngeal lymphoma, as Early diagnosis with appropriate treatment may significantly improve patients’ prognosis.
Keywords: Laryngeal lymphoma; Inflammation; Malignancy.

Intentional Replantation of a Hopeless Mandibular Molar with a Combined Periodontal–Endodontic Lesion: A Case Report

2026-05-24T10:57:54+0430

Intentional replantation (IR) is traditionally considered a last-resort procedure for teeth with an otherwise hopeless prognosis. Although advances in biomaterials have improved clinical outcomes, long-term evidence in teeth with combined periodontal–endodontic lesions (CPEL) and severe mobility remains limited. This case report describes a 12-year outcome of IR in a mandibular molar with a large CPEL, Grade III mobility, and persistent infection despite previous root canal therapy (RCT). A 45-year-old female presented with persistent pain and a draining sinus tract associated with tooth #36 one month after an RCT performed elsewhere. Clinical examination revealed Grade III mobility, probing depths >6 mm, bleeding on probing, and Class III furcation involvement. Radiography showed extensive periradicular and furcal radiolucency (PAI = 5). After obtaining written informed consent, an IR was performed. Atraumatic extraction was followed by root-end resection, retro-preparation using Gates-Glidden burs, and placement of calcium-enriched mixture (CEM) cement as a root-end filling material. The tooth was replanted within 9 minutes. No splinting was used. At two weeks, the infection had resolved, and mobility decreased to Grade II. Complete radiographic healing was observed at 3 years (PAI = 1). Probing depths normalized (<3 mm), mobility resolved (Grade 0), and no root resorption or ankylosis occurred. Follow-ups at 4, 5, 6, and 12 years confirmed long-term stability. At 12 years, recurrent coronal caries was restored with an amalgam crown featuring intra-orifice barriers. Periapical health, periodontal architecture, and function remained intact. This 12-year follow-up demonstrates that, when executed with strict biological principles and biomaterial selection, IR can achieve long-lasting success even in teeth with multiple negative prognostic indicators. The result highlights CEM cement as a biocompatible, bioactive root-end filling material that may promote periradicular healing in compromised conditions.
Keywords: Intentional replantation; Calcium silicate; Periodontal-endodontic lesion; Apical periodontitis; Root-end filling; Mineral trioxide aggregate; Long-term outcome.

Concurrent Mandibular Pyogenic Granuloma and Acute Osteomyelitis Following SARS-CoV-2 Infection: A Case Report

2026-05-24T10:57:54+0430

This report details a complex oral manifestation of SARS-CoV-2 infection in a 50-year-old female recovering from moderate COVID-19. The patient presented with severe mandibular pain, which upon comprehensive clinical, radiographic, and histopathological evaluation was diagnosed as concurrent advanced pyogenic granuloma and acute osteomyelitis with sequestration in the same jaw quadrant, accompanied by severe bilateral facial paresthesia. The diagnostic process was protracted, with osteomyelitis only confirmed following a subsequent presentation with exposed bone. Management necessitated sequential surgical debridement, targeted antibiotic therapy, and neuropathic pain control with Gabapentin, culminating in eventual resolution. This singular co-occurrence of a reactive vascular lesion and an invasive bony infection suggests a unified pathophysiological model wherein SARS-CoV-2-induced endotheliopathy, cytokine dysregulation, and immune dysfunction collectively establish a permissive local environment for both aberrant angiogenic proliferation and bacterial invasion of bone. The case underscores the imperative for heightened clinical suspicion of complex, co-existing maxillofacial pathologies in post-COVID patients and illuminates the potential therapeutic dilemmas inherent in managing such intertwined inflammatory and infectious sequelae.
Keywords: COVID-19; Osteomyelitis; Pyogenic granuloma; Oral manifestations.

Oral Mandibular Peripheral Osteoma: A Case Report

2026-05-24T10:57:54+0430

Peripheral osteomas of the mandible are rare, benign osteogenic tumors characterized by slow-growing cortical or cancellous bone proliferation. This report presents a case of a peripheral osteoma in the mandibular angle and reviews potential etiological factors. A 72-year-old woman presented with a painless, asymptomatic mandibular bone asymmetry and was referred to the oral and maxillofacial department of Isfahan University of Medical Sciences with no visible asymmetric changes in facial soft tissue. The lesion was a 4 cm pedunculated radiopaque mass located on the buccal surface of the left posterior mandible, as confirmed by computed tomography. Surgical excision revealed histopathological features characteristic of lamellar bone admixed with some woven bone, consistent with a diagnosis of peripheral osteoma. Postoperative recovery was smooth, and there was no evidence of recurrence at 1-year follow-up. Peripheral osteomas frequently occur in the mandible and can lead to functional disruptions or cosmetic concerns. Trauma and chronic muscle tension can contribute to their formation, but many cases arise without a clear cause. Typically asymptomatic, surgical removal is the most effective treatment with low recurrence rates. A thorough radiographic assessment is essential; more research is needed to understand their molecular mechanisms.
Keywords: Peripheral osteoma; Mandible; Benign bone tumor; Case report; Risk factors.