Large AI Models in Dental Healthcare: From General-Purpose Systems to Domain-Specific Foundation Models

Background: Oral diseases affect nearly 3.5 billion people worldwide, yet the comparative clinical potential of large-scale AI models in dentistry remains poorly understood. Three distinct model categories have emerged: language-generative models, discriminative vision foundation models, and dental-specific foundation models, with no unified review examining their relationships and collective limitations. Methods: Following PRISMA-ScR guidelines, we systematically searched four databases (PubMed, Google Scholar, Scopus, arXiv), screened independently by two reviewers. After applying inclusion/exclusion criteria, 97 studies (2020-2026) were included. We propose a two-dimensional classification framework organizing models by architectural paradigm and dental specialization degree. Results: Language-generative models excel at text-based tasks (clinical reasoning, licensing exams, patient communication) but show inconsistent performance on image-dependent diagnostics. Adapted SAM and CLIP variants achieve strong tooth segmentation and lesion detection results. Dental-specific models (DentVFM, DentVLM, OralGPT) demonstrate strongest performance on complex multimodal tasks. Integrated pipelines consistently outperform single-model approaches. A data asymmetry is observed: dental-specific pretraining concentrates almost entirely in the vision domain, reflecting scarce large-scale dental text corpora. Conclusions: General-purpose and dental-specific models play complementary roles; the most effective systems combine both within structured pipelines. Safe autonomous deployment requires resolving three persistent barriers: hallucination in generative models, limited annotated dental datasets, and absent standardized clinical evaluation benchmarks.

Self-CephaloNet: A Two-stage Novel Framework using Operational Neural Network for Cephalometric Analysis

Cephalometric analysis is essential for the diagnosis and treatment planning of orthodontics. In lateral cephalograms, however, the manual detection of anatomical landmarks is a time-consuming procedure. Deep learning solutions hold the potential to address the time constraints associated with certain tasks; however, concerns regarding their performance have been observed. To address this critical issue, we proposed an end-to-end cascaded deep learning framework (Self-CepahloNet) for the task, which demonstrated benchmark performance over the ISBI 2015 dataset in predicting 19 dental landmarks. Due to their adaptive nodal capabilities, Self-ONN (self-operational neural networks) demonstrate superior learning performance for complex feature spaces over conventional convolutional neural networks. To leverage this attribute, we introduced a novel self-bottleneck in the HRNetV2 (High Resolution Network) backbone, which has exhibited benchmark performance on the ISBI 2015 dataset for the dental landmark detection task. Our first-stage results surpassed previous studies, showcasing the efficacy of our singular end-to-end deep learning model, which achieved a remarkable 70.95% success rate in detecting cephalometric landmarks within a 2mm range for the Test1 and Test2 datasets. Moreover, the second stage significantly improved overall performance, yielding an impressive 82.25% average success rate for the datasets above within the same 2mm distance. Furthermore, external validation was conducted using the PKU cephalogram dataset. Our model demonstrated a commendable success rate of 75.95% within the 2mm range.