IntroductionThis ex vivo study evaluated the diagnostic performance of different MRI sequences for postoperative imaging of simulated mandibular fractures stabilized with titanium and bioresorbable osteosynthesis materials.MethodsSix porcine mandibles with standardized fractures of the mandibular angle, body, and parasymphysis were stabilized using titanium microplates, titanium reconstruction plates, or bioresorbable systems. All specimens underwent photon-counting computed tomography (CT) as a reference and 3 Tesla MRI, including five sequences: T1-weighted turbo spin echo (T1-TSE), DIXON-based imaging (DIXON), T1-TSE with vendor-specific artifact reduction techniques (WARP), ultrashort echo time (UTE), and slice encoding for metal artifact correction (SEMAC). Three blinded observers rated general image interpretability, fracture visibility, artifact extent, and soft- as well as hard-tissue interpretability using five-point Likert scales. Quantitative analysis included signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and two-dimensional artifact measurements.ResultsAdvanced artifact-reduction sequences outperformed conventional T1-TSE and DIXON (p < 0.001). UTE and WARP achieved the highest general image interpretability (median 5) and excellent fracture line visibility, alongside SEMAC. WARP provided the best soft-tissue interpretability (median 5), highest muscle SNR (median 207.9 vs. 74.4 for SEMAC and 51.9 for UTE; p ≤ 0.013), and highest CNR (median 184.8 vs. 59.6 for SEMAC and 23.5 for UTE; p ≤ 0.043), while UTE demonstrated superior hard-tissue SNR (median 30.0 vs. 13.2 for SEMAC; p < 0.001). SEMAC showed the greatest reduction in artifact extent (135% relative to CT vs. 209% for WARP and 220% for UTE; p ≤ 0.004). There was good inter-reader agreement (α = 0.76).ConclusionAdvanced MRI sequences, such as SEMAC, UTE and WARP, substantially improved postoperative image interpretability and reduced implant-related artifacts. A tailored MRI protocol may complement CT in selected postoperative scenarios.

OBJECTIVE:To evaluate the feasibility of an optimized high-resolution three-dimensional (3D) double-echo steady-state (DESS) magnetic resonance imaging (MRI) sequence, combined with a dedicated 15-channel mandibular coil, on 3T MRI for visualization of the mandibular nerve and its six peripheral branches in healthy volunteers. STUDY DESIGN:Images from 21 participants were assessed by three readers with varying levels of experience and medical specialties. Overall image quality, artifact presence, and nerve continuity across the proximal and distal segments of the masseteric, buccal, auriculotemporal, lingual, inferior alveolar, and mylohyoid nerves were evaluated using 5-point visual rating scales (5 = best, 1 = worst). Descriptive statistics and inter-reader agreement using Krippendorff's alpha (α) were calculated. RESULTS:Image quality was consistently rated as excellent with minimal artifacts (median 5, IQR 5-5) and high inter-reader agreement (α = 0.87-0.92). Continuous visualization of proximal and distal segments was achieved for most branches, particularly the inferior alveolar and lingual nerves (median 5, IQR 5-5). Visualization of thinner branches, including the masseteric, mylohyoid, and buccal nerves, was more challenging (median 4-4.5). Overall inter-reader agreement for nerve continuity assessment ranged from good to perfect (α = 0.79-1.0). CONCLUSIONS:An optimized high-resolution 3D-DESS sequence, combined with a dedicated mandibular coil, enables reliable and reproducible visualization of the mandibular nerve and its peripheral branches.

Introduction This ex vivo study aimed to determine the optimal energy level for virtual monoenergetic imaging (VMI) using photon-counting detector computed tomography (PCD-CT) and to evaluate the effectiveness of iterative metal artifact reduction (iMAR) in assessing simulated endodontic challenges and complications. Methods Sixteen extracted third molars were simulated with one of eight distinct endodontic diagnostic challenges and imaged using PCD-CT at radiation doses equivalent to standard-dose cone-beam CT. VMIs were reconstructed from 70-190 keV at 10 keV increments, both with and without iMAR. Diagnostic accuracy, depiction quality of endodontic challenges, artifact severity, and visualization of key endodontic anatomical structures were independently assessed by 2 observers using a 5-point visual analogue scale (1 = least favourable, 5 = most favourable). Descriptive statistics were calculated, and inter-reader agreement was analysed using Krippendorff’s alpha coefficient. Results VMIs achieved excellent diagnostic accuracy (97%) and high-quality visualization of endodontic challenges (median: 5, IQRs: 4-5 or 4.25-5; α = 0.63-1.00) across the entire reconstructed energy spectrum (70-190 keV), with minimal artifacts, particularly at ≥ 110 keV (α = 1.0). Task-specific analysis demonstrated optimal visualization of caries at 70-80 keV and fractured files at 70-100 keV. For other pathologies, VMI at ≥100 keV effectively reduced artifacts without compromising anatomical detail. IMAR did not improve image quality and consistently reduced diagnostic performance. Conclusions VMI from PCD-CT provides high-quality imaging with minimal artifacts, well-suited for indication-specific endodontic diagnostics. Clinical Relevance PCD-CT supports novel, indication-specific workflows in endodontic imaging, potentially enhancing diagnostic precision and long-term treatment follow-up.

Abstract Objective To determine optimal reconstruction parameters for dental implant imaging using photon-counting detector CT (PCD-CT), including ultra-high-resolution (UHR) images, virtual monoenergetic images (VMI), and iterative metal artifact reduction (iMAR). Materials and methods In this ex vivo study, six pig mandibles were prepared with two titanium-based implants and imaged on a PCD-CT. Scans were reconstructed as UHR images and VMI from 70–190 keV at 10 keV increments with and without iMAR. Two independent readers qualitatively evaluated image quality and artifact severity using five-point visual rating scales (5 = excellent, no or minimal artifacts; and 1 = very poor, non-diagnostic, severe artifacts). Two readers quantified artifact severity, defined as the standard deviations in attenuation in regions of interest adjacent to the implants. Results UHR images without iMAR yielded high image quality (median 5 for both readers) with minor artifact severity (median 4 for both), whereas iMAR reduced image quality (median 3 for both). VMI without iMAR showed decreasing artifacts at higher energy levels. VMI at 120–130 keV achieved optimal image quality (median 5 for both readers at 120 keV, and medians 4 and 5 at 130 keV) with minimal artifacts (median 5 for both), whereas iMAR reduced quality. Quantitative artifact burden decreased with higher energy levels (from 200 HU at 70 keV to 113 HU at 190 keV), and no improvement was observed using iMAR. Conclusions PCD-CT effectively reduces metal-induced artifacts in dental implant imaging, with UHR images and VMI at 120–130 keV providing optimal image quality, while reconstructions with iMAR offered no further benefit. Relevance statement PCD-CT provides excellent dental implant visualization while minimizing the impact of metal artifacts. Key Points In this ex vivo study, ultra-high-resolution images and virtual monoenergetic images at 120–130 keV from PCD-CT effectively reduce metal artifacts from dental implants. Effective artifact reduction offers excellent visualization of the bone-implant interface. Iterative metal artifact reduction (iMAR) did not provide additional benefit for visualization of the bone-implant interface. Graphical Abstract

To assess the diagnostic performance of photon-counting detector computed tomography (PCD-CT) and cone-beam computed tomography (CBCT) at dose-matched radiation levels (high, standard, and low) for detecting and evaluating simulated endodontic conditions, treatments, and associated complications. Sixteen extracted third molars with eight endodontic tasks were imaged using PCD-CT and CBCT. Qualitative (image quality, artifact susceptibility, diagnostic interpretability) and quantitative (endodontic working length) parameters were assessed by two observers using a five-point Likert scale. Descriptive statistics and weighted kappa (κ) were used for data analysis. High- and standard-dose PCD-CT demonstrated superior image quality and anatomical visualization compared to CBCT (median 5, IQR 5–5; κ = 1.0; all p < 0.001). Low-dose PCD-CT remained diagnostically robust, outperforming CBCT, except in root canal visualization, where both performed similarly. Diagnostic accuracy of pathologies and complications was slightly higher with PCD-CT (80–88

To assess, in a prospective pilot study, five magnetic resonance imaging (MRI) artifact reduction protocols (UTE, SEMAC, Dark Bone, DESS, and STIR) using a 15-channel dentomaxillofacial coil in trauma patients undergoing cranio-maxillofacial and oral reconstruction. Eighteen patients (15 M/3 F, 37.9 ± 17.5 years) underwent MRI within 48 h after surgery. Image quality, artifact extent, and visualization of peri-osteosynthesis tissues were qualitatively evaluated on a 5-point scale (5 = best, 1 = worst). Quantitative analysis assessed protocol-specific artifact-induced signal voids in relation to the dimensions of manufacturer-specific implants. Descriptive statistics and inter- and intra-observer reliability were evaluated using weighted kappa statistics. UTE and SEMAC consistently demonstrated highest image quality and minimal artifacts, accurately depicting peri-osteosynthesis tissues, with mean artifact deviations below 2 mm relative to ground-truth implant dimensions. STIR showed intermediate performance, providing robust fat suppression and soft-tissue contrast, whereas Dark Bone and DESS exhibited higher artifact prevalence and lower diagnostic confidence. Subgroup analysis confirmed these trends across fracture location and implant type. Inter- and intra-observer agreement ranged from substantial to perfect (κ = 0.71-1.0, p < 0.001). Modern MRI techniques like UTE and SEMAC with specialized coils improve postoperative imaging by balancing artifact suppression, image quality, and diagnostic confidence, potentially enhancing assessment of perioperative complications, reconstructive outcomes, and oncological follow-up in cranio-maxillofacial surgery.

Burning Mouth Syndrome (BMS) is a multifactorial condition characterized by persistent oral burning in the absence of visible clinical abnormalities. This systematic review aimed to evaluate the prevalence, allergen spectrum, and clinical relevance of hypersensitivity to dental materials in patients with BMS, and to assess symptom outcomes following allergen removal or avoidance. A systematic search of PubMed, ScienceDirect, and the Cochrane Library identified 27 eligible studies from 357 identified records, consisting primarily of observational studies, case series, and case reports. Common allergens included nickel, gold, mercury, palladium, cobalt, and acrylate-based materials. Patch test positivity rates ranged from approximately 13

Tonsilloliths are calcifications commonly formed within the palatine tonsils, with a prevalence ranging from 10% to 40%. While typically asymptomatic, tonsilloliths can occasionally lead to complications. This case report presents a 50-year-old male with incidental bilateral radiopacity in the mandibular angle region detected on an orthopantomogram with no clinical symptoms. Advanced imaging modalities, including 3-T magnetic resonance imaging (MRI), cone-beam computed tomography (CBCT), and MR-based cinematic rendering (CR), were employed for differential diagnosis of the observed radiopacity and preprocedural planning of extractions and implant placement in the context of the patient's dental pathology. The consistent visualization of tonsilloliths across various imaging modalities highlights the unique strengths of each technique in diagnosing, visualizing, and differentiating these calcifications. This multimodal approach can provide valuable insights for accurate diagnosis, effective surgical planning, and improved diagnostic confidence, even in asymptomatic patients with incidental findings.

Segmental Odontomaxillary Dysplasia (SOD) is a rare, non-hereditary developmental disorder affecting one side of the maxilla, impacting hard and soft tissue as well as dentition in the affected area. The condition is often associated with enlargement of soft and hard tissue on the affected area and dental anomalies, with occasional cutaneous manifestation. SOD is a non-progressive developmental disorder. Annual clinical and radiological follow-ups are recommended to monitor dentoalveolar development. Orthodontic treatments and dentoalveolar interventions are considered successful treatment options. We present the case of a patient suffering from SOD and discuss the dentist's role in early detection and the importance of the follow-up care of affected patients.

This case study highlights the use of cinematic rendering (CR) in preoperative planning for the excision of a cyst in the oral and maxillofacial region of a 60-year-old man. The patient presented with a firm, non-tender mass in the right cheek, clinically suspected to be an epidermoid cyst. Conventional imaging, including dental magnetic resonance imaging (MRI) protocols, confirmed the lesion’s size, location, and benign nature. CR reconstructions, combining advanced algorithms and novel skin presets, allow for the generation of highly realistic, three-dimensional visualizations from conventional imaging datasets. CR provided an enhanced, detailed depiction of the lesion within its anatomical context, significantly improving spatial understanding for surgical planning. The surgical excision was performed without complications, and histological analysis confirmed the diagnosis of a benign epidermoid cyst with no evidence of dysplasia or malignancy. This case demonstrates the potential of CR to refine preoperative planning, especially in complex anatomical regions such as the face and jaw, by offering superior visualization of superficial and deep structures. Thus, the integration of CR into clinical workflows has the potential to lead to improved diagnostic accuracy and better surgical outcomes.

Purpose:This ex vivo study was performed to determine the optimal energy level for virtual monoenergetic images (VMIs) generated with photon-counting detector computed tomography (PCD-CT) to minimize metal artifacts from dental implants. Materials and Methods:Twelve implants from various manufacturers were placed in 6 pig mandibles and scanned with PCD-CT. VMIs were reconstructed at energy levels from 70 keV to 150 keV in 20-keV increments. Three readers with varying experience qualitatively assessed the image quality, artifact burden, and diagnostic interpretability of peri-implant soft and hard tissues using a 5-point discrete visual scale. Objective analyses included quantitative line profile analysis of implant-induced artifacts. Descriptive statistics were calculated, and inter-reader agreement was assessed using percentage agreement and the Krippendorff alpha coefficient. Results:Qualitative analysis demonstrated excellent image quality for VMIs at ≥110 keV (median=5), with minimal artifacts observed at 130-150 keV. In contrast, lower-energy VMIs (70-90 keV) showed inferior performance due to artifact-related limitations in diagnostic interpretability. Inter-reader agreement ranged from moderate to perfect, with perfect reliability (α=1) for VMIs ≥110 keV. Quantitative line-profile analysis confirmed reduced artifact burden at higher energy levels, particularly for VMIs ≥110 keV. Conclusion:VMI at energy levels ≥110 keV on PCD-CT reduced dental implant-related metal artifacts and offered excellent image quality, including assessment of both peri-implant soft and hard tissues. These findings suggest that optimized PCD-CT VMI may enhance postoperative follow-up imaging. Future in vivo studies are warranted to validate these findings in clinical practice.

Objectives This observational study evaluated the effectiveness of an Automated Face Coding (AFC) software in identifying facial expressions related to dental pain. Methods Fifty-seven participants (49.8 ± 17.1 years) with symptoms of dental pain were recruited. Participants self-reported their pain using a Visual Analog Scale (VAS) score and their faces were filmed using a smartphone. The video clips were exported to an AFC software, which analyzed the facial expressions. The analysis focused on detecting changes in facial expressions and emotional states. The analysis was performed at two timepoints, at baseline (on the first visit), and at post treatment recall when pain was alleviated (self-reported). Non-parametric tests were used for statistical analysis (p < 0.05). Results Significant reduction in pain levels was observed between the first visit and at the post treatment recall visit (mean VAS: baseline = 5.65 ± 2.08, recall = 0.40 ± 0.80; p < 0.001). No significant gender differences were observed in pain scores (p > 0.05). Significant differences in facial expressions between the two time points was not detected by the software (p > 0.05). Emotional parameters remained stable. Conclusion The findings of this study concluded that the current capability of the AFC software to detect changes in facial expressions specific to pain alleviation is limited, even though it can provide detailed analysis of facial muscle movements. Further research is needed to enhance the software's sensitivity to pain-related expressions and explore its integration with other diagnostic tools for improved patient care and treatment outcomes. Clinical Significance Statement The study explored the potential of AFC software in analyzing facial expressions for applications in screening and diagnosis of dental problems especially in non-communicative geriatric patients. While effective in monitoring facial movements, the software's current limitations in detecting pain-specific changes underscore the need for further advancements.

ABSTRACT Objectives The aim of this ex vivo study was to assess the performance of photon‐counting detector computed tomography (PCD‐CT) compared with cone‐beam computed tomography (CBCT) at equivalent radiation doses for detecting and evaluating mandibular and dental anatomical structures in porcine cadavers. Material and Methods This intermodal comparative study evaluated imaging protocols at three radiation dose levels (high: 360 μSv, standard: 145 μSv, low: 20 μSv) in six porcine cadaver heads, analyzing 12 CBCT and 18 PCD‐CT volumes. Two blinded observers assessed image quality, artifact susceptibility, and diagnostic interpretability using a 5‐point Likert scale (5 = highest, 1 = lowest). Statistical analysis included descriptive statistics and interobserver reliability, assessed by weighted kappa (κ) analysis. Results PCD‐CT either matched or outperformed CBCT at standard‐ and low‐dose protocols, demonstrating superior anatomy coverage, density, contrast, and less artifact susceptibility. High‐ and standard‐dose protocols achieved perfect scores 5 (SD = 0). At low‐dose levels, PCD‐CT showed slightly lower scores but still outperformed CBCT. PCD‐CT showed minimal artifacts, with no significant artifacts in high and standard doses. Inter‐ and intra‐reader reliability was higher for PCD‐CT (κ: 0.694–1; p < 0.001) compared to CBCT (0.55–0.916; p < 0.001), with the difference being largest at low doses. Conclusion PCD‐CT outperforms CBCT in diagnostic interpretability and artifact reduction across various radiation dose levels, offering a promising alternative for dentomaxillofacial imaging that aligns with the ALADAIP principle.

This study compared cone-beam computed tomography (CBCT) and photon-counting detector computed tomography (PCD-CT) for detecting simulated mandibular osseous lesions, emphasizing lesion detectability, quantitative accuracy, and inter-reader reliability at equivalent radiation doses. Three types of simulated osseous lesions (sequestrum/fracture, cystic lesion, and extended periodontal gap) were evaluated by two readers, across three radiation dose levels: high (360 μSv), standard (122 μSv), and low (20 μSv). Image quality, artifact presence, and lesion detectability were qualitatively evaluated using a 5-point Likert scale (5 = highest to 1 = lowest rating). Lesion dimensions were quantitatively measured. Statistical analysis included descriptive statistics and weighted kappa for interobserver reliability. High-dose PCD-CT consistently provided the highest image quality, lesion detectability, and minimal artifacts across all lesion types (5 ± 0), achieving perfect inter-reader agreement (100 %). PCD-CT outperformed CBCT in lesion detectability, with the greatest difference at lower doses (3.87 ± 0.35 to 4.83 ± 0.39 vs. 3.13 ± 0.53 to 4.5 ± 0.52). PCD-CT demonstrated superior inter-reader reliability, with perfect agreement for high-dose (κ = 1.0; p < 0.001) and good agreement for standard- and low-dose protocols (κ = 0.909 and κ = 0.744; p < 0.001). Quantitative measurements showed minimal intermodal differences ranging from 0.15 to 0.34 mm, confirming PCD-CT's clinical precision even at low-dose protocols. These findings highlight PCD-CT's potential in dentomaxillofacial imaging, enhancing diagnostic capabilities and reducing radiation exposure.

To compare the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) for surgically relevant parameters in mandibular trauma, evaluating five in-house-optimized MRI protocols with a dedicated 15-channel mandibular coil. Fifteen patients with 30 acute mandibular fractures underwent 3T MRI using five optimized protocols: UTE, StarVIBE, Dark Bone, DESS, and STIR. Three independent observers qualitatively rated image quality, fracture line visibility, cortical delineation, and bone-to-soft-tissue contrast on a five-point visual analog scale (5 = best, 1 = lowest). Quantitative analysis included measurement of the maximum distance of the fracture gap. Descriptive statistics and inter-observer agreement (Krippendorff’s α) were calculated. CT enabled rapid and accurate fracture detection in all cases. Among MRI protocols, UTE (85

A 14-year old boy with pronounced facial asymmetry was referred for [ 99m Tc]Tc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) single-photon emission computed tomography / computed tomography (SPECT/CT) of the jaw. The initial clinical suspicion of causative fibrous dysplasia in the retromolar region was ruled out through both imaging and bone biopsy. Instead, [ 99m Tc]Tc-DPD-SPECT/CT confirmed the presence of hemimandibular hyperplasia. Cinematic rendering provided photorealistic images, effectively visualizing the asymmetry of the mandible and teeth, and the underlying increased condylar bone turnover.

To compare cone-beam computed tomography (CBCT) with photon-counting detector computed tomography (PCD-CT) at equivalent radiation doses, focusing on qualitative and quantitative parameters relevant to dental implant surgery. This ex vivo comparative study of porcine specimens assessed five imaging protocols with both CBCT and PCD-CT at three effective radiation dose levels (high: 360µSv, standard: 145µSv, low: 20µSv) to evaluate image quality, artifact burden, metal artifact susceptibility, and quantitative bone measurements in the mandibular region. Three blinded readers analyzed the data using a 5-point Likert scale (5 = highest to 1 = lowest rating) and performed linear bone measurements at implant planning sites. Statistical analysis included descriptive statistics and inter-reader reliability assessment using intraclass correlation coefficients (ICC). Each reader evaluated 30 data sets (12 CBCT, 18 PCD-CT), with 24 implant planning sites per imaging protocol. High-dose PCD-CT demonstrated the best image quality and diagnostic interpretability (4.89 ± 0.27), followed by standard-dose PCD-CT and CBCT (4.50 ± 0.73; 4.33 ± 0.61), with low-dose protocols showing intermediate quality with higher artifact burden. In comparison to CBCT, PCD-CT demonstrated superior performance in reducing implant-induced artifacts across all protocols. Quantitative bone measurements showed minimal variability, meeting clinical precision requirements for computer-assisted implant surgery. Both qualitative (ICCs:0.70–0.89; p < 0.001) and quantitative (ICCs:0.79–1; p < 0.001) analyses demonstrated high reliability, regardless of the reader’s experience. PCD-CT demonstrated superior image quality and reduced artifacts compared with CBCT at all radiation dose levels. These findings highlight PCD-CT’s potential to enhance implant planning and improve clinical outcomes with reduced radiation exposure while maintaining diagnostic accuracy.

Background:Visualization technology is enhancing interactive learning by merging digital content with real-world environments, offering immersive experiences through augmented reality (AR) in fields like medical education. AR is being increasingly used in medicine and dental education to improve student learning, particularly in understanding complex concepts such as bone remodeling. Active learning strategies, supported by AR, boost student autonomy, reduce cognitive load, and improve learning outcomes across various disciplines. AR is gaining popularity in higher education as it enhances active learning, reduces cognitive load, and improves cognitive, meta-cognitive, and affective outcomes, particularly in medical and nursing education. The effectiveness of immersive AR in enhancing understanding of complex physiological processes is still unclear, with a lack of rigorous studies on its impact and how to effectively convert academic content into AR. Objective:We assess the capacity of AR-enhanced content for learning medical knowledge with a state-of-the-art AR game published along with a modern cell atlas of the oral cavity. To assess AR-enhanced content for learning, we formulated hypotheses on the general impact on learning (H1), specific improvements in learning (H2), and long-term retention (H3). Methods:An AR serious game was developed to represent current knowledge on osteoclasts for classroom use. The game was evaluated in an unblinded face-to-face vignette experiment (39 participants). Learning outcomes on "Osteoclasts" were compared between the AR game (17 participants) and a textbook-only option (20 participants) conveying the same content. Participants were randomly assigned and learning success was measured at three time-points, immediately after the experiment session, 1 week later, and 1 month later, via web-based surveys. Results:The AR serious game elicited strong interest in the topic (perceived relevance in Attention, Relevance, Confidence, and Satisfaction [ARCS], W=10,417; P<.001) and motivated students by increasing self-efficacy (confidence in ARCS, W=11,882.5; P=.02) and satisfaction (in ARCS, W=4561; P<.001). The learning outcomes were comparable to text-based self-learning (t=2.0103; PBonferroni=.095). Furthermore, curious students benefited more from interactive learning methods compared with text-only methods and had higher learning success (t=-2.518; P=.02). Conclusions:Introducing new technology such as AR into teaching requires technological investment, updated curricula, and careful application of learning paradigms. We found support for improved motivation (H1) and some evidence of AR's baseline effectiveness (H2a). While we could not confirm AR's impact on visual tasks overall (H2b), we noted an interesting interaction between curiosity and visual task outcomes (H2c), as well as how game design influences student perception of the material (H2d). Due to attrition, long-term learning outcomes (H3) could not be assessed. AR-based learning may particularly benefit curious students, who often struggle with text-heavy methods. As students are increasingly accustomed to brief, engaging content, teaching approaches must adapt.

This systematic review evaluates the current literature on state-of-the-art radiation-free MRI techniques for managing dental, oral, and maxillofacial trauma, comparing their diagnostic performance to conventional X-ray-based imaging. Two reviewers conducted an investigation using the PICOS search strategy across multiple databases, including MEDLINE, EMBASE, BIOSIS, Web of Science, Cochrane Library, LILACS, and BBO Dentistry. Twenty-nine studies were included: 12 on orbital trauma, 10 on condylar, subcondylar, or TMJ trauma, five on mandibular fractures, and one each on temporal bone and dental trauma. MRI was performed at post-traumatic, postoperative, or both stages. Despite variability in scan parameters, field strengths, and coil configurations, the results highlight MRI's growing potential in trauma assessment. CT-like and Black Bone MRI sequences enable simultaneous visualization of hard and soft tissues at trauma sites, providing diagnostic insights comparable to X-ray-based techniques. However, despite their superior soft-tissue assessment, they remain less effective at depicting intricate bony pathoanatomical conditions. This diagnostic approach can improve the long-term benefit-to-risk ratio, particularly for younger, radio-sensitive patients requiring repeated imaging and long-term follow-up. However, a modality- and protocol-oriented approach is essential to balance clinical conditions, radiation exposure, and diagnostic accuracy and efficiency, to ensure optimal patient outcomes in comprehensive trauma management.

The dental pulp is a highly vascularized and innervated connective tissue composed of various cell types, including fibroblasts, odontoblasts, mesenchymal stem cells, neuronal, and endothelial cells. The interplay between these diverse cell populations is pivotal for dental pulp tissue homeostasis and regeneration after carious infections and traumatic tooth lesions. Despite the great clinical need, comprehensive in vitro models that accurately recapitulate the complexity of the dental pulp are still missing, hampering the development of novel, faster, and more effective therapies. In this study, an innovative "tooth-on-chip" microfluidic device is presented to emulate the composition and three-dimensional structure of the dental pulp tissue in vitro. Co-culture of human dental pulp stem cells, odontoblast-like cells, endothelial cells, and trigeminal neurones in this miniaturized system successfully reproduced the structural organization and physiology of the dental pulp. The microfluidic device integrated various compartments that allowed the generation of complex vascular and neuronal networks, the formation of stem cell perivascular niches, and the formation of an odontoblast/dentine interface. The "tooth-on-chip" device represents a conceptual leap in replicating dental pulp physiology in vitro, offering a state-of-the-art platform to study dental pulp physiology and pathology and serving as a benchmark to create more advanced tooth simulation systems.