Abstract Purpose The aim was to evaluate the ability of four large language models (LLMs) (OpenAI's ChatGPT‐3.5, Microsoft 365 Copilot, DeepSeek‐R1, and Google Gemini 2.5 Pro) to develop treatment options when presented with clinical cases published in the maxillofacial prosthodontics literature. Materials and Methods Six maxillofacial case reports were fed to the LLMs following a prompt that requested prosthodontic treatment options from the perspective of a prosthodontist. Expert evaluators scored the relevance, clarity, depth, focus, and coherence of the responses. Statistical analyses, including descriptive statistics, two‐way analysis of variance (ANOVA), post hoc Tukey tests, Pearson correlation analyses, and intraclass correlation coefficients (ICCs), were performed ( α < 0.05). Results There were significant differences among the total mean relevance ( p = 0.003), clarity ( p = 0.006), depth ( p < 0.001), focus ( p < 0.001), and coherence ( p < 0.001) scores of chatbots. Copilot consistently scored the lowest, and Gemini or DeepSeek scored the highest for all five factors. Depth ( p = 0.006), focus ( p = 0.024), and coherence ( p = 0.013) scores of senior prosthodontists were slightly higher than those of junior prosthodontists. Pearson correlation analysis revealed positive correlations between the total mean scores for all five factors ( p < 0.001). Conclusions The study demonstrates the ability of LLMs to develop maxillofacial prosthetic treatment plans tailored to specific clinical scenarios. There were significant differences between the abilities of the LLMs evaluated in this study. Copilot scored the lowest for all factors evaluated, and Gemini and/or DeepSeek scored the highest.
Fabrication of custom oral positioning devices in head and neck proton radiotherapy
AbstractWith complex head and neck diseases that closely approximate crucial organs or have advanced spread and cannot be surgically resected, intensity modulated proton beam radiotherapy is favored due to its superior dose targeting through magnetic manipulation of the proton energy. A radiation mask and an oral positioning device immobilize craniofacial, cervical, and oral structures for accurate and reliable radiation delivery. Widely available prefabricated thermoplastic oral positioning devices are manufactured in standardized forms and materials that unpredictably affect the proton beams’ pathways and range. This technique article showcases a workflow that combines analog and digital dental techniques to produce a customized 3D‐printed oral positioning device within 2 appointments.
The Effect of Patient Specific Factors on Occlusal Forces Generated: Best Evidence Consensus Statement
AbstractPurposeThe purpose of this Best Evidence Consensus Statement was to search the literature to determine if there is a relationship between patient specific factors and occlusal force.Materials and MethodsA literature review was conducted in the following databases: Evidence‐Based Medicine Reviews (EBMR), Cochrane Database of Systematic Reviews, Embase, and Ovid MEDLINE(R) and Epub Ahead of Print. Articles on patient factors and occlusal force were compiled by using a combination of the key words: “bite force,” “occlusal force,” “partial and complete edentulism,” “bruxism,” and “orthognathic class.” Inclusion criteria included meta‐analyses, systematic reviews, randomized controlled trials, case series, and journal articles. Exclusion criteria were case reports, studies in children, animals, and bench studies.ResultsOf the 1502 articles that met the initial search criteria, 97 related to patient‐specific factors affecting occlusal forces. These articles were evaluated, rated, and organized into appropriate categories addressing questions of foci.ConclusionsThe range of occlusal force is highly variable among subjects correlated to patient specific factors such as age, gender, partial and complete edentulism, the presence of a maxillofacial defect, location of edentulous area, orthognathic profile, and magnitude of occlusal vertical dimension. Tooth replacement therapies targeted at increasing occlusal contact seem to have a positive effect on increasing occlusal force. Bruxism does not necessarily demonstrate higher occlusal powering but may have greater tooth contact time. Occlusal force is not clearly affected by the type of dental restoration or restorative material used. The clinical significance of the changes in occlusal forces is yet to be determined.
Prosthetic Rehabilitation with Amyloidosis of the Tongue
AbstractAmyloidosis of the tongue can result in significant and irreversible alterations of tooth position and function due to prolonged application of imbalanced force on the teeth by the enlarged tongue. Due to the rarity of this oral form of systemic disease, little has been elucidated on management of the resulting impaired oral function. While surgery can address the size of the tongue, it carries significant morbidities, enlargement can recur, and does not address adverse tooth positioning. Prosthetic rehabilitation can more aptly restore oral function but it also needs to be tailored based on the patient's expectations and goals as well as biologic and mechanical parameters of treatment. This report discusses an effective and noninvasive application of a tooth‐supported, removable prosthesis with an onlay occlusal design to restore occlusion, speech, and esthetics in a patient with tongue‐based amyloidosis.