Objective: This systematic review aimed to evaluate the validity of artificial intelligence (AI)-based models applied to orthodontic diagnosis. Materials and Methods: A comprehensive electronic search was conducted in five databases—PubMed, ScienceDirect, Google Scholar, Web of Science, and the Cochrane Library—using the MeSH terms artificial intelligence, orthodontics, orthodontic diagnosis, neural networks, and machine learning. After applying predefined inclusion and exclusion criteria, nine studies were selected for full-text review and critical appraisal. Results: The initial search identified 325 studies related to AI in orthodontic diagnosis, and after screening titles and abstracts, 52 full-text articles were assessed for eligibility, of which eleven met the inclusion criteria. The included studies evaluated various AI algorithms for their diagnostic accuracy and clinical applicability. Conclusion: The evidence suggests that AI can enhance diagnostic accuracy and efficiency in orthodontics, offering significant potential to improve diagnosis, decision-making, treatment monitoring, and prediction of treatment outcomes. However, further research with standardized methodologies and larger clinical datasets is needed to validate the reliability and generalizability of AI-based diagnostic models in orthodontic practice.
Cite this paper
Khamlich, K. and Bourzgui, F. (2026). Validity of Artificial Intelligence Models in Orthodontic Diagnosis: A Systematic Review. Open Access Library Journal, 13, e15172. doi: http://dx.doi.org/10.4236/oalib.1115172.
Schwendicke, F., Samek, W. and Krois, J. (2020) Artificial Intelligence in Dentis-try: Chances and Challenges. Journal of Dental Research, 99, 769-774. https://doi.org/10.1177/0022034520915714
Chen, Y.W., Stanley, K. and Att, W. (2020) Artificial Intelligence in Dentistry: Current Applications and Future Perspectives. Quintessence International, 51, 248-257.
Wang, H., Minnema, J., Batenburg, K.J., Forouzanfar, T., Hu, F.J. and Wu, G. (2021) Mul-ticlass CBCT Image Segmentation for Orthodontics with Deep Learning. Journal of Dental Research, 100, 943-949. https://doi.org/10.1177/00220345211005338
Gao, S., Wang, X., Xia, Z., Zhang, H., Yu, J. and Yang, F. (2025) Artifi-cial Intelligence in Dentistry: A Narrative Review of Diagnostic and Therapeutic Applications. Medical Science Monitor, 31, e946676. https://doi.org/10.12659/msm.946676
Moher, D., Liberati, A., Tetzlaff, J. and Altman, D.G. (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Annals of Internal Medicine, 151, 264-269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
Jung, S.K. and Kim, T.W. (2016) New Approach for the Diagnosis of Extractions with Neural Network Machine Learning. Ameri-can Journal of Orthodontics and Dentofacial Orthopedics, 149, 127-133. https://doi.org/10.1016/j.ajodo.2015.07.030
Thanathornwong, B. (2018) Bayesian-Based Decision Support System for Assessing the Needs for Orthodontic Treatment. Healthcare Informatics Research, 24, 22-28. https://doi.org/10.4258/hir.2018.24.1.22
Choi, H., Jung, S., Baek, S., Lim, W.H., Ahn, S., Yang, I., et al. (2019) Artificial Intelligent Model with Neural Network Machine Learning for the Diagnosis of Orthognathic Surgery. Journal of Craniofacial Surgery, 30, 1986-1989. https://doi.org/10.1097/scs.0000000000005650
Kök, H., Acilar, A.M. and İzgi, M.S. (2019) Usage and Comparison of Artificial Intelligence Algorithms for Determination of Growth and Development by Cervical Vertebrae Stages in Orthodontics. Progress in Orthodontics, 20, Article No. 41. https://doi.org/10.1186/s40510-019-0295-8
Li, P., Kong, D., Tang, T., Su, D., Yang, P., Wang, H., et al. (2019) Orthodontic Treatment Planning Based on Artificial Neural Networks. Scientific Reports, 9, Article No. 2370. https://doi.org/10.1038/s41598-018-38439-w
Patcas, R., Bernini, D.A.J., Volokitin, A., Agustsson, E., Rothe, R. and Timofte, R. (2019) Applying Artificial Intelligence to Assess the Impact of Orthognathic Treatment on Facial Attractiveness and Estimated Age. International Journal of Oral and Maxillofa-cial Surgery, 48, 77-83. https://doi.org/10.1016/j.ijom.2018.07.010
Hwang, H.W., Park, J.H., Moon, J.H., et al. (2020) Automated Identification of Cephalometric Landmarks: Part 2—Might It Be Better than Human? The Angle Orthodontist, 90, 69-76. https://doi.org/10.2319/022019-129.1
Kunz, F., Stellzig-Eisenhauer, A., Zeman, F. and Boldt, J. (2020) Artificial Intelligence in Orthodontics: Evaluation of a Fully Automated Cephalometric Analysis Using a Customized Convolutional Neural Network. The Journal of Orofacial Orthopedics, 81, 52-68.
Wood, T., Anigbo, J.O., Eckert, G., Stewart, K.T., Dundar, M.M. and Turkkahraman, H. (2023) Prediction of the Post-Pubertal Mandibular Length and Y Axis of Growth by Using Various Machine Learning Techniques: A Retrospective Longi-tudinal Study. Diagnostics, 13, Article 1553. https://doi.org/10.3390/diagnostics13091553
Noeldeke, B., Vassis, S., Sefidroodi, M., Pauwels, R. and Stoustrup, P. (2024) Comparison of Deep Learning Models to Detect Crossbites on 2D Intraoral Photographs. Head & Face Medicine, 20, Article No. 45. https://doi.org/10.1186/s13005-024-00448-8
Ziaei, S., Samani, D., Behjati, M., Ravari, A.O., Salimi, Y., Ahmadi, S., et al. (2025) Accuracy of Artifi-cial Intelligence in Orthodontic Extraction Treatment Planning: A Systematic Re-view and Meta Analysis. BMC Oral Health, 25, Article No. 1576. https://doi.org/10.1186/s12903-025-06880-9
Brickley, M.R., Shepherd, J.P. and Armstrong, R.A. (1998) Neural Networks: A New Technique for Devel-opment of Decision Support Systems in Dentistry. Journal of Dentistry, 26, 305-309. https://doi.org/10.1016/s0300-5712(97)00027-4
Lu, C., Ko, E.W. and Liu, L. (2009) Improving the Video Imaging Prediction of Postsurgical Facial Profiles with an Artificial Neural Network. Journal of Dental Sciences, 4, 118-129. https://doi.org/10.1016/s1991-7902(09)60017-9
Takada, K., Yagi, M. and Horiguchi, E. (2009) Computational Formulation of Orthodontic Tooth-Extraction Decisions. Part I: To Extract or Not to Extract. The Angle Or-thodontist, 79, 885-891. https://doi.org/10.2319/081908-436.1
Litsas, G. and Ari-Demirkaya, A. (2010) Growth Indicators in Orthodontic Patients. Part 1: Comparison of Cervical Vertebral Maturation and Hand-Wrist Skeletal Maturation. European Journal of Paediatric Dentistry, 11, 171-175.
Kim, H.J., Kim, K.D. and Kim, D.H. (2022) Deep Convolutional Neural Network-Based Skeletal Classification of Cephalometric Image Compared with Automat-ed-Tracing Software. Scientific Reports, 12, Article No. 11659. https://doi.org/10.1038/s41598-022-15856-6
Uysal, T., Ramoglu, S.I., Basciftci, F.A. and Sari, Z. (2006) Chronologic Age and Skeletal Maturation of the Cervical Vertebrae and Hand-Wrist: Is There a Relationship? American Journal of Orthodontics and Dentofacial Orthopedics, 130, 622-628. https://doi.org/10.1016/j.ajodo.2005.01.031
Buschang, P.H., Tanguay, R., LaPalme, L. and Demirjian, A. (1990) Mandibular Growth Prediction: Mean Growth Increments versus Mathematical Models. The European Journal of Or-thodontics, 12, 290-296. https://doi.org/10.1093/ejo/12.3.290
Pitta-yapat, P., Limchaichana-Bolstad, N., Willems, G. and Jacobs, R. (2014) Three-Dimensional Cephalometric Analysis in Orthodontics: A Systematic Re-view. Orthodontics & Craniofacial Research, 17, 69-91. https://doi.org/10.1111/ocr.12034
Arik, S.Ö., Ibragimov, B. and Xing, L. (2017) Fully Automated Quantitative Cephalometry Using Convolutional Neural Networks. Journal of Medical Imaging, 4, Article 014501. https://doi.org/10.1117/1.jmi.4.1.014501
Ed-Dhahraouy, M., Riri, H., Ezzahmouly, M., Bourzgui, F. and El Moutaoukkil, A. (2018) A New Methodolo-gy for Automatic Detection of Reference Points in 3D Cephalometry: A Pilot Study. International Orthodontics, 16, 328-337. https://doi.org/10.1016/j.ortho.2018.03.013
Larson, B.E. (2014) Or-thodontic Preparation for Orthognathic Surgery. Oral and Maxillofacial Surgery Clinics of North America, 26, 441-458. https://doi.org/10.1016/j.coms.2014.08.002
Baumrind, S., Korn, E.L., Boyd, R.L. and Maxwell, R. (1996) The Decision to Extract: Part II. Analysis of Clinicians’ Stated Reasons for Extraction. American Journal of Orthodontics and Dentofacial Orthopedics, 109, 393-402. https://doi.org/10.1016/s0889-5406(96)70121-x