Search Results (272)

Background: Exercise rehabilitation (ER) has become an important treatment regimen during the recovery phase of acute ischemic stroke (AIS). Optimal exercise prescriptions for post-stroke motor recovery remain controversial. Methods: PubMed, Embase, the Cochrane Library, and Web of Science were systematically searched through November 2025. The Cochrane risk-of-bias (RoB 1) assessment tool was utilized to assess the risk of bias in the original studies. Results: This study included 66 trials comprising 3675 patients. For balance, whole-body tilting postural training (WTPT), unilateral strength training (UST) and robot-assisted unilateral gait training (RAUGT) showed high SUCRA rankings. Activities of daily living likely improved most with robot-assisted Tai Chi training (RATCT), home rehabilitation guidance (HRG) and robot-assisted gait training (RAGT). Fugl-Meyer Assessment (FMA) gains appeared greatest following robot-assisted hand training with electrical stimulation (RAHT + ES), neural inhibition therapy (NIT) and graded motor imagery with electrical stimulation (GMI + ES). Walking endurance seemed most responsive to visual feedback training (VFT), UST and visual aids training (VAT), while functional mobility showed greatest improvement with tilt sensor-assisted gait training with electrical stimulation (TAGT + ES), gait training (GT) and virtual reality therapy with motor imagery (VRT + MI). Conclusions: This study provides the first comprehensive evidence synthesis evaluating the comparative effectiveness of specific exercise modalities across distinct recovery domains after AIS. Rather than supporting generic interventions, the findings highlight the distinct comparative advantages of various emerging technologies and traditional practices. These results offer an evidence-based framework for clinicians to optimize post-stroke rehabilitation protocols and highlight priority areas for future research on dose–response and long-term outcomes. Full article

Background/Objectives: Cognitive impairment and well-being have become increasingly connected in aging research, yet the intellectual structure, collaboration patterns, and thematic evolution of this interdisciplinary field remain insufficiently mapped. This study aimed to provide a bibliometric overview of research on cognitive impairment and well-being. Methods: A total of 1355 publications published between 1985 and 2026 were retrieved from the Web of Science Core Collection. Bibliometric analyses were conducted using VOSviewer and CiteSpace to examine publication trends, journal distribution, collaboration networks, disciplinary evolution, keyword clusters, burst keywords, and document co-citation patterns. Results: The field showed a clear pattern of accelerated growth, especially during the past decade. The knowledge structure was organized around two core themes: caregiver well-being and the psychosocial well-being of people with cognitive impairment. Non-pharmacological interventions, long-term care contexts, and methodological research formed connecting clusters around these themes. Caregiver burden emerged as the earliest major research line and has recently moved toward evidence-based intervention development. Non-pharmacological interventions showed a three-stage evolution, from single-modality explorations such as music therapy, to meta-analysis-driven evidence synthesis, and then to technology-enabled approaches such as virtual reality. Collaboration network analysis showed that the USA acted as a scale hub, the United Kingdom as a bridging hub, and China as a high-output but low-connectivity participant. Bridging authors, including Orrell and Bennett, occupied structural hole positions. Conclusions: This study provides a four-decade knowledge map of cognitive impairment and well-being research and offers a reference framework for theoretical integration and future research planning. Full article

Background: Invasive coronary angiography has historically been the reference standard for coronary, valvular, and structural heart disease. Over the past decade, coronary computed tomography angiography (CCTA), CT-derived fractional flow reserve (CT-FFR), photon-counting detector computed tomography (PCCT), and cardiac magnetic resonance (CMR) have expanded the range of clinical questions answerable without an intra-arterial catheter, but this shift has been uneven across clinical domains. Methods: We performed a narrative review and synthesis of randomized trials, registries, society guidelines, and consensus documents (2009–2026) identified through PubMed and major cardiovascular guideline databases, written from a joint cardiology and cardiac-surgical standpoint. Results: The boundary has shifted asymmetrically, by which we mean a domain-dependent rather than uniform displacement of invasive angiography. Non-invasive imaging is now established as the first-line approach for stable chest pain at low-to-moderate pretest probability, for pre-transcatheter aortic valve replacement (TAVR) and structural procedural planning, and for aortic disease. It remains contested for stable multivessel disease and pre-coronary artery bypass grafting (CABG) planning, where CCTA- or CT-FFR-only planning is still investigational. Invasive angiography stays first-line for ST-elevation myocardial infarction (STEMI), cardiogenic shock, and complex percutaneous coronary intervention (PCI), where diagnosis and therapy are inseparable. Conclusions: Invasive and non-invasive modalities are complementary rather than competing. The appropriate first-line investigation depends on the disease domain, pretest probability, anatomical complexity, imaging quality, and whether diagnosis and treatment can be separated. We propose a complexity-stratified, heart-team framework and identify the surgical research gaps that remain. Full article

Background: Critically ill children with cancer are vulnerable to sepsis and septic shock, secondary hemophagocytic lymphohistiocytosis (HLH), cytokine release syndrome, delayed chemotherapy clearance, and multiorgan dysfunction. Although hemoadsorption can remove inflammatory mediators and selected toxins, evidence in pediatric oncology remains limited and heterogeneous. Objective: To systematically review the indications, technical application, biomarker and physiologic findings, safety reporting, and clinical outcomes of hemoadsorption in critically ill pediatric oncology and hemato-oncology patients. Methods: We conducted a PRISMA-guided systematic review of PubMed, Scopus, and Web of Science from January 2017 to 1 June 2026, supplemented by reference screening. The search strategy was expanded to capture cartridge-based hemoadsorption and related extracorporeal blood purification modalities, including albumin dialysis systems, but direct synthesis was restricted to cartridge-based hemoadsorption. Evidence was stratified as direct pediatric oncology evidence, supportive hemato-oncology/transplant evidence, or contextual mixed pediatric critical-care evidence. Because included reports were small, uncontrolled, and clinically heterogeneous, synthesis followed a structured narrative approach without meta-analysis. Results: Twelve reports met the inclusion criteria; most were case reports, case series or retrospective observational studies. Hemoadsorption was most often described for septic shock, sepsis-like hyperinflammation, or secondary HLH, with smaller experience in delayed methotrexate clearance, CAR-T-cell-associated cytokine release syndrome, and post-transplant hyperbilirubinemia. Reported devices included CytoSorb, Jafron HA330, and HA230. Direct pediatric oncology reports described before–after reductions in IL-6, IL-10, C-reactive protein, procalcitonin, or ferritin, together with changes in oxygenation, vasoactive support, or organ dysfunction scores. However, all findings were vulnerable to confounding by concurrent antimicrobials, immunomodulation, kidney replacement therapy, source control, and natural recovery. Mortality outcomes were reported using non-equivalent horizons and were summarized narratively. Conclusions: Hemoadsorption has been attempted as adjunctive rescue support in selected critically ill pediatric oncology and hemato-oncology patients. Current evidence is insufficient to determine treatment effect, survival benefit, optimal timing, device selection, anticoagulation strategy, or pharmacokinetic safety. Full article

Background: Sickle cell disease (SCD) is the most common inherited blood disorder globally, affecting approximately 300,000 newborns annually. Cardiac remodeling, resulting from chronic anemia, vascular obstruction, and endothelial dysfunction, substantially contributes to morbidity and mortality in patients with SCD. Therefore, characterizing these patterns is essential to clinical management and outcome improvement in pediatric patients. However, a comprehensive synthesis of cardiac remodeling patterns in pediatric and adolescent patients with SCD and their associations with genotype and clinical severity is lacking. Methods: We conducted a systematic review in accordance with the PRISMA 2020 guidelines and searched five databases for studies published from January 1978 to December 2024. Of 1131 retrieved studies, 37 met the inclusion criteria; of these, 31 focused exclusively on children (Group A), while six included both children and adults (Group B). We analyzed cardiac remodeling patterns, genotype-specific findings, associations with disease severity, and imaging modalities. The 37 studies included approximately 4253 patients from 12 countries, representing diverse populations and imaging techniques. Results: Left ventricular (LV) dilation was the most frequently reported finding, noted in 33 of 37 studies (89.2%; representing study-level reporting frequency, not patient-level prevalence), followed by diastolic dysfunction (reported in 18 of 37 studies; 48.6%); elevated TRV (≥2.5 m/s) as an echocardiographic screening marker for pulmonary hypertension (PH) risk was found in 14 of 37 studies (37.8%; TRV ≥ 2.5 m/s is a screening criterion, not confirmed hemodynamic PH); myocardial fibrosis was found in three studies (8.1%, exclusively from mixed-age cohorts); and QTc prolongation/arrhythmia was found in one study (2.7%). The HbSS genotype was associated with the most severe cardiac changes. Studies that did not stratify by genotype subtype (HbS/β⁰ vs. HbS/β⁺) may underestimate cardiac severity in mixed-genotype cohorts. Markers of disease severity, such as elevated lactate dehydrogenase (LDH) expression, frequent acute chest syndrome (ACS), and increased hospitalizations, were associated with more pronounced cardiac remodeling in individual studies, but the cross-study consistency of this association varied. Study designs and imaging modalities also varied, underscoring the need for standardized assessment protocols to enhance comparability and clinical translation. This review presents a narrative synthesis; individual study statistics are reported as originally published, without formal pooled estimates. Conclusions: Cardiac abnormalities in SCD were reported from early childhood, with more advanced phenotypes being more frequently described in older adolescents and mixed-age cohorts, suggesting possible age-related progression requiring prospective confirmation. Principal limitations include retrospective PROSPERO registration (CRD420261435382), the predominance of cross-sectional study designs, the inconsistent z-score normalization of cardiac dimensions, the incomplete reporting of treatment exposure, the disproportionate contribution of mixed-age cohorts to advanced imaging findings, and inter-study heterogeneity in echocardiographic protocols. Full article

Objectives: The facial nerve (FN) possesses one of the most intricate anatomical courses in the head and neck, traversing the brainstem, temporal bone, and parotid gland before terminating within the muscles of facial expression. Owing to its complex anatomy, marked anatomical variability, and frequent distortion by adjacent pathology, preservation of FN integrity remains a fundamental challenge in skull base, otologic, and head and neck surgery. This review aims to provide a comprehensive synthesis of the contemporary literature regarding the clinical anatomy of the FN and to examine how anatomical variation, pathology-induced distortion, surgical strategy, and emerging technologies influence nerve preservation and functional outcomes. Methods: A comprehensive narrative review of the literature was conducted using PubMed, Scopus, and Google Scholar. Publications from 1983 through 2026 were searched using combinations of keywords, including “facial nerve,” “facial nerve anatomy,” “anatomical variation,” “vestibular schwannoma,” “hemifacial spasm,” “parotid surgery,” “facial nerve injury,” “facial nerve reconstruction,” “facial reanimation,” “diffusion tensor imaging,” “intraoperative neurophysiological monitoring,” and “artificial intelligence.” Peer-reviewed anatomical, radiological, clinical, and review articles published in English were included, while conference abstracts and studies lacking direct anatomical or surgical relevance were excluded. Particular emphasis was placed on surgically relevant anatomical variations, pathology-related anatomical distortion, advanced imaging modalities, intraoperative neurophysiological monitoring, reconstructive techniques, and predictors of postoperative facial nerve function. Results: Facial nerve preservation was found to depend on the interplay between individual anatomical variability, disease-related anatomical distortion, and operative strategy. In vestibular schwannoma surgery, nerve displacement, capsular adhesion, and cystic tumor degeneration were consistently associated with increased surgical complexity and less favorable postoperative facial function. In hemifacial spasm, successful microvascular decompression relied on precise identification of neurovascular conflict at the root exit zone. Within the parotid gland, substantial variability in branching architecture and surgical landmarks contributed to an increased risk of iatrogenic injury. Advanced imaging techniques, particularly diffusion tensor imaging tractography, improved preoperative prediction of FN location, while intraoperative neurophysiological monitoring enabled real-time assessment of neural integrity and functional preservation. Emerging artificial intelligence-based predictive models demonstrated potential to enhance patient-specific surgical planning and prognostication. Conclusions: Contemporary facial nerve surgery has evolved toward an individualized, anatomy-driven, and function-preserving paradigm supported by advanced imaging, intraoperative monitoring, and reconstructive strategies. Detailed understanding of both normal FN anatomy and pathology-induced anatomical distortion remains essential for optimizing surgical decision-making, maximizing nerve preservation, and improving long-term functional outcomes. Future developments integrating multimodal imaging, predictive analytics, and artificial intelligence may further refine patient-specific management and enhance postoperative facial function. Full article

Background: Obesity is a chronic condition that compromises health and quality of life, with physical exercise representing a relevant therapeutic strategy in its management. Functional training (FT) has been adopted as a modality that integrates neuromuscular and cardiorespiratory stimuli, promoting both physical and psychosocial benefits. However, gaps remain in the literature regarding the effects of FT on body composition in individuals with excess weight. In this context, a systematic review was conducted to analyze the current state of scientific knowledge on this approach. Methods: Randomized controlled clinical trials investigating FT were selected, including interventions classified as high-intensity functional training (HIIT-F), multicomponent programs, and CrossFit-like interventions when they fulfilled the predefined FT eligibility criteria. Participants were required to be between 18 and 65 years of age, physically independent, and in generally good health. The systematic search was conducted in the PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, PEDro, and LILACS databases. The risk of bias (RoB 2.0) and the certainty of the evidence (GRADE) were assessed. Results: A total of 2,972 records were identified. Seven studies met the eligibility criteria, comprising 296 participants. Two randomized controlled trials (61 participants) were eligible for meta-analysis. The pooled analysis demonstrated a significant reduction in body fat percentage (%BF) in favor of FT/HIIT-F compared with non-exercising controls (mean difference = −4.44 percentage points; 95% confidence interval −7.08 to −1.80; p = 0.001). Risk of bias assessment showed moderate methodological limitations across studies. None were classified as low risk. Three had high risk due to missing outcome data and deviations from intended interventions, whereas four showed some concerns related to allocation concealment and analysis reporting. Bias in outcome measurement was consistently low. Conclusions: Current evidence suggests that FT/HIIT-F may be associated with reductions in %BF among adults with overweight or obesity. However, these findings should be interpreted with caution because the certainty of the evidence was rated as very low according to the GRADE approach, the quantitative synthesis included only two studies, and important methodological limitations were identified. As the available data are predominantly derived from female participants, the applicability of these findings to men remains uncertain. Full article

Background/Objectives: Perinatal loss is a profoundly distressing life event associated with grief, depression, anxiety, post-traumatic stress symptoms, and long-term psychosocial challenges among bereaved parents who experience miscarriage, stillbirth, or neonatal death. Although psychotherapeutic interventions are increasingly used to address these adverse outcomes, there is limited synthesis on how characteristics consistent with a patient-centered care perspective are reflected in such interventions and how they may relate to psychosocial well-being. This umbrella review aimed to synthesize evidence on psychotherapeutic interventions following perinatal loss and to examine patient-centered care–related dimensions reported across the included reviews, including therapeutic communication, patient engagement, therapeutic relationships, emotional validation, and meaning-making processes. Methods: An umbrella review was conducted in accordance with the Joanna Briggs Institute methodological guidance. Systematic reviews and meta-analyses published between 2019 and 2025 were identified through searches of PubMed, CINAHL, PsycINFO, and the Cochrane Library from database inception to 31 May 2026. Eligible reviews examined psychotherapeutic, psychosocial, and psychological support interventions designed to improve grief, depression, anxiety, post-traumatic stress symptoms, psychological distress, coping, and psychosocial well-being among bereaved parents following perinatal loss. In accordance with the predefined secondary exploratory objective, a secondary interpretive synthesis examined patient-centered care–related dimensions described within the included reviews. Results: Five systematic reviews and meta-analyses met the inclusion criteria. Interventions included cognitive behavioral therapy, mindfulness-based approaches, bereavement counseling, psychosocial support programs, narrative interventions, supportive counseling, and digitally delivered psychological therapies. Across reviews, psychotherapeutic interventions were generally associated with beneficial effects on grief, depression, anxiety, post-traumatic stress symptoms, and broader indicators of psychosocial well-being. Communication-, support-, and engagement-related characteristics consistent with a patient-centered care perspective, including empathy, therapeutic alliance, individualized support, emotional validation, and continuity of communication, were identified through secondary interpretive synthesis as recurring features of beneficial interventions. Digital modalities, such as internet-based cognitive behavioral therapy and telephone-delivered counseling, were consistently described as supporting accessibility, engagement, and continuity of care. Conclusions: Psychotherapeutic interventions following perinatal loss appear to improve a range of psychosocial outcomes. A patient-centered care perspective may help interpret how communication, emotional validation, patient engagement, and supportive therapeutic relationships are described in relation to psychological adaptation after loss. These dimensions should be understood as interpretive characteristics identified across the included reviews rather than as directly measured mechanisms of intervention effectiveness. Future research should examine communication processes, therapeutic alliance, and patient engagement using validated measures, assess how these factors relate to intervention effectiveness, and support the development of integrated, patient-centered models of perinatal bereavement care. Full article

Introduction: Hepatic infarction is an uncommon but clinically important cause of focal ischemic liver injury. In internal medicine, it usually emerges in acutely ill or complex hospitalized adults with sepsis, shock, malignancy, thrombosis, vasculitis, transplantation, or recent hepatobiliary or interventional procedures who develop a new focal hepatic lesion and abnormal liver tests. Aims: This review aims to provide internists with a practical diagnostic and management pathway for recognizing hepatic infarction, distinguishing it from abscess and malignancy, selecting appropriate imaging, identifying vascular complications, and avoiding unnecessary biopsy or drainage when conservative management is safer. Methods: We performed a structured narrative review of adult hepatic infarction and related ischemic liver entities using targeted searches in PubMed/MEDLINE and Scopus. The search strategy, screening process, and evidence limitations are reported explicitly. Because the available evidence is dominated by case reports, small series, radiology reviews, and guidance on related vascular liver diseases, the synthesis is qualitative and the proposed pathway is conceptual rather than prospectively validated. Results: Hepatic infarction is most often recognized when systemic hypoperfusion, splanchnic vasoconstriction, microvascular dysfunction, or local macrovascular compromise coexist. Multiphasic computed tomography (CT) is usually the first-line acute-care modality, while MRI, contrast-enhanced ultrasound, Doppler ultrasound, CT angiography, or vascular imaging should be selected according to diagnostic uncertainty and suspected arterial or portal venous complications. The main diagnostic pitfalls are misclassification as abscess, malignancy, hematoma, or postoperative collection. Conclusions: In the appropriate clinical context, a wedge-shaped or geographic non-enhancing hepatic lesion should trigger vascular-ischemic reasoning before being labeled as abscess or tumor. The proposed internist-led pathway is intended as a pragmatic conceptual framework for diagnostic reasoning and multidisciplinary communication, not as a validated guideline or evidence-based algorithm. Full article

Artificial intelligence (AI) has emerged as a transformative tool for plant health monitoring, offering new opportunities for scalable, timely, and data-driven pest and disease management in agriculture. This review provides a comprehensive synthesis of AI-based methods for pest and plant disease detection, systematically organizing existing literature across sensing modalities, learning paradigms, and deployment scales. We distinguish between population-level pest monitoring, plant-centric visual inspection, and field-scale surveillance, as well as between post-symptomatic disease recognition and pre-symptomatic detection enabled by spectral imaging technologies. Beyond summarizing recent advances, this work places strong emphasis on critical analysis, discussing fundamental limitations related to data scarcity, domain shift, generalization under field conditions, and the challenge of disentangling biotic from abiotic stress factors. The review further examines the distinction between correlation-driven AI predictions and causal disease understanding, positioning AI as a complementary decision-support tool alongside established diagnostic methods. Building on these insights, we outline key future research directions, including multimodal sensor fusion, explainable and trustworthy AI, edge-based deployment for real-time monitoring, and the development of foundation models for unified agricultural intelligence. This review aims to serve as both an accessible entry point and a critical reference for advancing AI-driven plant health management. Full article

Background: Natriuretic peptides, including B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), are established biomarkers of myocardial stress and circulatory overload. Although originally validated for diagnosis and exclusion of heart failure, their diagnostic and prognostic applications have expanded significantly in the context of critical illness. However, interpretation in critically ill patients is complicated by confounding factors such as systemic inflammation and renal dysfunction. Objective: This review synthesizes current evidence on the diagnostic, monitoring, and prognostic applications of natriuretic peptides in critically ill adults. It further outlines practical considerations, confounding variables, and emerging complementary biomarkers pertinent to clinical decision-making. Methods: A structured search of PubMed, Embase, and the Cochrane Library (January 2000 to October 2025) identified studies evaluating BNP, NT-proBNP, and atrial natriuretic peptide (ANP) in intensive care unit (ICU) patients. Eligible studies and review articles assessed diagnostic utility, volume status, hemodynamic monitoring, and prognostic performance. Narrative synthesis was employed using information obtained from eligible studies. Results: Twenty-four studies met the inclusion criteria. BNP and NT-proBNP facilitate differentiation between cardiogenic and noncardiogenic respiratory failure, identification of mixed shock states, and assessment of volume status when used in association with other modalities such as echocardiography and ultrasonography. Elevated natriuretic peptide concentrations consistently predict mortality, acute kidney injury, prolonged mechanical ventilation, and adverse outcomes in several disease states, including sepsis, acute respiratory distress syndrome [ARDS], postoperative cardiac dysfunction, and COVID-19-related critical illness. However, interpretation remains limited by confounders, including renal impairment, age, systemic inflammation, brain injury, mechanical ventilation, and right-ventricular strain/dysfunction. Conclusions: Natriuretic peptides serve as valuable adjuncts for diagnostic assessment, hemodynamic monitoring, and risk stratification in the ICU. When interpreted with attention to biological kinetics and clinical context, these biomarkers enhance multimodal monitoring and support individualized management. Future research should refine ICU-specific cutoffs and assess natriuretic peptide–guided therapeutic strategies in prospective multicenter trials. Full article

Background: Wrist-hand radiographic skeletal maturation methods are widely used for forensic age estimation of living individuals, remaining among the most widely accepted imaging modalities in forensic practice despite limited evidence supporting their use at the legally relevant 18-year threshold. This systematic review aims to provide a quantitative synthesis of the widely recognized but previously unsynthesized body of evidence regarding their diagnostic accuracy (sensitivity, specificity, AUC-curve, mean absolute error-MAE) for forensic adult age estimation. Methods: Six databases (Scopus, PubMed, Google Scholar, Embase, Cochrane, Clarivate) between 1980 and 2026 were searched. Studies evaluating wrist-hand skeletal maturation for forensic age estimation in individuals ≥16 years with verified chronological age were included. Two reviewers independently screened studies and extracted data. Quality was assessed using QUADAS-2. DerSimonian-Laird random-effects model estimated the sensitivity and specificity of the wrist-hand bones maturation at the age of 18 years, and pooled MAE. GRADE assessed the certainty of evidence. Results: From 747 records, 23 studies (11,425 participants, 15 countries, 2003–2025) were included. Pooled MAE was 0. 537 years (95% CI: 0.387–0.686; 95% PI: 0.33–0.79 years), but obtained from 3 Italian studies conducted on clinical populations, and all characterized by high risk of bias. At the 18-year threshold, pooled sensitivity was 69.5% (95% CI: 61.6–77.3%; 95% PI: 35.3–100%) and specificity 85.56% (95% CI: 83.53–87.60%; 95% PI: 77.2–93.9%). Nevertheless, the heterogeneity was extreme (I² > 98%) for all diagnostic measures, and calculated prediction intervals confirm that individual study results are expected to vary widely. QUADAS-2 assessment revealed 82.6% of studies with high/unclear patient selection bias. GRADE-certainty was VERY LOW for both outcomes due to serious risk of bias, very serious inconsistency, and serious indirectness. Conclusions: Wrist-hand skeletal maturation shows low accuracy and high rates of misclassification for age estimation at the 18-year threshold. The wide prediction intervals (sensitivity 35–100%, specificity 77–94%, MAE 0.33–0.79 years) indicate that performance in a new study population may differ substantially from the pooled estimates. Very low certainty evidence, extreme heterogeneity, and substantial methodological limitations preclude confident application. Results should be interpreted with caution in forensic contexts, preferably combining multiple age indicators, in particular dental evidence. Full article

Background/Objectives: Peri-implantitis is a major complication in implant dentistry, and its radiographic diagnosis remains challenging because conventional assessment is operator-dependent and bone loss is often detected only after measurable changes occur. Artificial intelligence (AI) may support the detection, quantification, and prognostic assessment of peri-implant bone conditions. This review aimed to synthesize evidence on AI-based radiographic approaches for peri-implantitis detection, marginal bone loss measurement, and risk stratification. Methods: PubMed and Scopus were searched for original studies published between 2013 and 2025 that applied artificial intelligence (AI), including machine learning and deep learning, to peri-implantitis. Eligible studies focused on peri-implant bone assessment and reported quantitative performance metrics. Extracted data included imaging modality, AI model, task, dataset, reference standard, validation strategy, performance, and clinical relevance. A qualitative synthesis was performed. Results: Eleven studies met the eligibility criteria; however, one full text could not be retrieved, and ten studies were included. In most of the studies, peri-implant marginal bone loss detection or measurement was performed using periapical/intraoral radiographs, while only few studies used panoramic or combined imaging. Common architectures included YOLO variants, Faster R-CNN, Mask R-CNN, U-Net, ResNet, and AlexNet. Performance was generally encouraging for implant localization, bone loss detection, keypoint identification, and severity classification. Only one study addressed outcome prediction. All studies were retrospective and internally validated. Conclusions: AI may support radiographic detection and quantification of peri-implant bone loss as an adjunctive diagnostic tool. However, evidence is limited by retrospective designs, heterogeneous reference standards, lack of external validation, and limited clinical-data integration. Future studies should prioritize prospective multicenter validation, longitudinal imaging, and multimodal models. Full article

Background: The sphenoid sinus occupies a strategically central position at the base of the skull, in close proximity to critical neurovascular structures including the pituitary gland, optic nerves, internal carotid arteries, and the cavernous sinus. Its complex anatomical configuration and pronounced individual variability render it a structure of paramount clinical importance in transsphenoidal approaches to the sellar and parasellar regions. Methods: A narrative review of the literature was conducted in accordance with the SANRA (Scale for the Assessment of Narrative Review Articles) guidelines for narrative reviews. A comprehensive search was performed across four electronic databases—PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar—covering publications from January 2000 through March 2026, with the final search update completed in March 2026. An initial pool of 826 articles was identified. Following title and abstract screening, 421 articles were retained for full-text assessment; of these, 307 contributed to the conceptual synthesis, and 100 are directly cited in the manuscript. The literature selection process followed a structured flow diagram consistent with PRISMA reporting principles for identification and screening stages. Results: We synthesise current evidence on the embryological development, macroscopic and microscopic anatomy, morphological classifications, and epidemiological distribution of anatomical variations in the sphenoid sinus, with emphasis on radiological assessment and surgical relevance. The spectrum of pneumatization patterns—from the conchal type through presellar and sellar variants to the postsellar, clival, and lateral types—is reviewed alongside population-level prevalence data. Common and rare variations are examined, including intrasinus septation, Onodi cells, and bony dehiscences overlying the internal carotid artery and optic nerve. The comparative diagnostic capabilities of computed tomography and magnetic resonance imaging are evaluated, alongside emerging modalities such as three-dimensional reconstruction, virtual reality, and augmented reality. Conclusions: Detailed morphological knowledge of the sphenoid sinus plays an important role in surgical strategy, instrument selection, and risk mitigation in skull base surgery. Individualised preoperative imaging—integrating CT, MRI, and, where available, immersive digital technologies—is essential for safe transsphenoidal planning and cannot be replaced by standard anatomical templates. Full article

Background/Objectives: Artificial intelligence is increasingly applied to dental imaging, yet favorable internal performance does not necessarily indicate clinical transferability. This systematic review evaluated whether imaging-based dental artificial intelligence models have progressed beyond internal algorithmic development toward external validation, generalizability, reproducibility, privacy-preserving learning, and clinical implementation readiness. Methods: Searches were conducted in PubMed/MEDLINE, Scopus, and Embase up to May 2026. Eligible studies were primary empirical investigations based on human dental or oral imaging data that assessed at least one translational-validation dimension beyond internal development, including external testing, multicenter or multi-device validation, cross-dataset reproducibility, or privacy-preserving learning. Evidence was synthesized using a structured narrative synthesis reported according to the Synthesis Without Meta-analysis framework. Results: Fifteen studies published between 2023 and 2026 were included. They addressed caries detection, periodontal bone loss, gingival inflammation, root morphology, palatal radicular grooves, radiographic quality control, tooth-width estimation, and dental-structure segmentation. Translational-readiness domains included external validation, generalizability, reproducibility, privacy-preserving learning, transparency, and workflow relevance. Validation varied across cohorts, repositories, centers, devices, cross-dataset benchmarks, and federated-learning settings. Reproducibility, annotation harmonization, uncertainty reporting, explainability, workflow evaluation, and code or model availability were inconsistent. Quantitative pooling was not performed because tasks, modalities, units of analysis, reference standards, validation designs, and metrics were highly heterogeneous. Conclusions: Within this selected subset of externally tested studies, translational progress is emerging but remains uneven. Implementation readiness requires stronger reproducibility, clinically meaningful validation, workflow evaluation, and attention to regulatory, organizational, and human-factor barriers. Full article