An interdisciplinary framework for artificial intelligence, precision medicine, and ethical governance in periodontal care: a systematic review 

Abstract

Periodontal disease represents a significant global health challenge, affecting nearly one billion people worldwide. The integration of artificial intelligence (AI), precision medicine, and ethical governance frameworks offers transformative potential for revolutionizing periodontal care through personalized approaches and enhanced diagnostic capabilities. A systematic search of electronic databases including PubMed/MEDLINE, Web of Science, Scopus, and IEEE Xplore were conducted for literature published from 2020 onward. The study selection process identified publications focusing on AI, precision medicine, or ethical governance in periodontal care. Inclusion criteria encompassed studies involving human subjects or human-derived data, published in English from 2020 onward. Data extraction captured study characteristics, AI performance metrics, precision medicine applications, and ethical considerations. A narrative synthesis approach was employed to analyze and organize the findings into three domains: AI applications, precision medicine approaches, and ethical governance frameworks. A total of 326 records were identified from databases, with 63 studies meeting inclusion criteria. The analysis revealed that AI algorithms, particularly convolutional neural networks, achieved exceptional diagnostic performance with area under the curve (AUC) values frequently exceeding 0.85 for automated detection of periodontal bone loss and disease classification. Precision medicine approaches demonstrated significant advances through genetic susceptibility profiling, salivary biomarker identification, and personalized treatment protocols. However, critical ethical challenges emerged, including data privacy concerns, algorithmic bias in underrepresented populations, and regulatory gaps in dental AI applications. The convergence of AI and precision medicine represents a paradigm shift in periodontal care, enabling unprecedented personalization of diagnosis and treatment. Successful implementation requires developing robust ethical governance frameworks, standardized validation protocols, and comprehensive educational programs to ensure equitable access and maintain clinical excellence while harnessing technological innovation.

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