Oral leukoplakia (OL) is the most common oral potentially malignant disorder and carries a risk of malignant transformation. Cryotherapy is a minimally invasive treatment option for OL, but its efficacy and optimal dose-response remain inconsistent among various studies. This systematic review evaluated the clinical efficacy and safety of cryotherapy for OL lesions and explored whether the characteristics of the lesions and treatment parameters influenced clinical outcomes. Electronic searches were performed in Embase, PubMed, and the Cochrane Central Register of Controlled Trials according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Seven studies reporting original clinical outcomes of cryotherapy for OL lesions were included. Data on cryotherapy dose, number and frequency of sessions, complete regression rates, and recurrence rates were extracted. Seven studies comprised 357 patients and approximately 360 OL lesions. Complete regression rates ranged from 77.8% to 100%. Cryogun cryotherapy needed a mean of 3.1 ± 1.3 treatment sessions to achieve complete regression of the OL lesions, compared to 6.3 sessions by cotton-swab cryotherapy. OL lesions smaller than 2 cm2, located outside the tongue, with epithelial dysplasia, or with a surface keratin layer <55 μm required significantly fewer cryotherapy sessions to achieve a complete regression. Reported recurrence rates were 8-34%, and continued tobacco use was the most consistent risk factor for recurrence. Malignant transformation was observed in 6.6% of OL patients in a long-term cohort. We conclude that cryotherapy is a simple, safe, and effective treatment for OL. Cryogun cryotherapy is more efficient than cotton-swab cryotherapy.
Alveolar ridge remodeling following tooth extraction remains a clinical challenge in implant dentistry, particularly in the esthetic zone where dimensional stability of hard and soft tissues is critical for subsequent implant placement. This short communication describes a simplified clinical workflow for socket regeneration using a composite regenerative matrix (CRM) composed of concentrated growth factor (CGF), autologous fibrinogen glue (AFG), and freeze-dried bone allograft (FDBA). The technique was applied following atraumatic extraction in a single maxillary esthetic-zone case. Clinical and radiographic observations were documented for up to 5 years. Healing was uneventful, and cone-beam computed tomography performed at 3 months demonstrated qualitative socket fill and preservation of ridge contour. Implant placement was subsequently performed using a digitally guided approach. Radiographic follow-up at 1 and 5 years demonstrated stable peri-implant bone levels and maintained buccal plate morphology. The results suggest that CRM provides a simplified, biologically integrated, and predictable workflow for socket regeneration, particularly suitable for esthetic-zone applications requiring long-term dimensional stability.
This narrative review explores the "Leeuwenhoek Paradox," a metaphorical and conceptual challenge that arises when artificial intelligence (AI) detects subtle periapical radiological changes that are not visible to human observers. Drawing on evidence from studies using two-dimensional and cone-beam computed tomography (CBCT) imaging, this review critically examined the limitations of human-centered reference standards and recurrent discrepancies in AI-based periapical detection. The literature shows that AI systems frequently detect more periapical alterations than human experts. These findings may reflect early bone changes, as indicated by CBCT-based analyses of bone density and longitudinal observations. The paradox arises because AI identifies subclinical radiographic changes (AI-SRCs) that fall below the threshold of human visual perception, leading to their classification as false positives by humans owing to the limitations of human vision. Framed within the Leeuwenhoek Paradox, this article highlighted the constraints of equating diagnostic truth exclusively with human visual perception. Finally, the review outlined conceptual pathways for validating AISRCs, including longitudinal clinical studies, standardized visualization tools such as heatmaps, and the definition of new diagnostic thresholds, with the aim of supporting the safe integration of AI into dental diagnostics while mitigating the risks of overdiagnosis.
