{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T05:44:26Z","timestamp":1792129466725,"version":"4.4.0"},"reference-count":53,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014840","name":"Gemeinsame Bundesausschuss","doi-asserted-by":"publisher","award":["01VSF22025 (KIDS)"],"award-info":[{"award-number":["01VSF22025 (KIDS)"]}],"id":[{"id":"10.13039\/501100014840","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian Dental Journal"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Managing oral mucosal lesions in general dental practice is challenging, as visually similar conditions may require very different treatments. We developed an AI\u2010based triage system connecting intraoral image analysis with guideline\u2010based treatment recommendations, tested it externally, and compared its performance with clinicians' recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>YOLOv8 and YOLOv11 were trained on 4079 intraoral photographs to classify 11 oral mucosal lesion types. These were mapped into five treatment tiers defined by urgency and management aim: T1 specialist referral for malignant and high\u2010risk lesions, T2 interdisciplinary referral for specialist\u2010led non\u2010cancer management, T3 risk\u2010adapted surveillance, T4 dental treatment with reassessment, and T5 no treatment. Model performance was compared with two general dentists and four specialists on an internal test set. YOLOv11 was additionally tested on an external dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>YOLOv11 outperformed YOLOv8 in macro\u2010averaged precision, recall, and F1 score, achieving 0.72, 0.74, and 0.73 respectively. However, 25% of T1 high\u2010risk cases were under\u2010triaged. YOLOv11 significantly outperformed all clinicians, whose F1 scores ranged from 0.33 to 0.69. External performance decreased markedly (F1 score: 0.58), consistent with domain shift.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Guideline\u2010oriented AI triage is feasible but requires multicentre training for improved generalizability, as well as safety\u2010focused optimization, and prospective user evaluation before clinical use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/adj.70079","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:54:01Z","timestamp":1792126441000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Diagnosis to Decision\u2010Making:\n                    <scp>AI<\/scp>\n                    \u2010Driven Triage of Oral Mucosal Lesions Detected on Intraoral Photographs"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9304-2954","authenticated-orcid":false,"given":"Julia","family":"Schw\u00e4rzler","sequence":"first","affiliation":[{"name":"Clinic for Conservative Dentistry, Periodontology and Digital Dentistry LMU Medizin, LMU University Hospital, Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen  Munich Germany"},{"name":"ITU\/WHO\/WIPO Global Initiative on Artificial Intelligence for Health, Topic Group Oral Health  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8893-2683","authenticated-orcid":false,"given":"Ekaterina","family":"Tolstaya","sequence":"additional","affiliation":[{"name":"Clinic for Conservative Dentistry, Periodontology and Digital Dentistry LMU Medizin, LMU University Hospital, Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen  Munich Germany"},{"name":"ITU\/WHO\/WIPO Global Initiative on Artificial Intelligence for Health, Topic Group Oral Health  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6260-9992","authenticated-orcid":false,"given":"Antonin","family":"Tichy","sequence":"additional","affiliation":[{"name":"Clinic for Conservative Dentistry, Periodontology and Digital Dentistry LMU Medizin, LMU University Hospital, Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen  Munich Germany"},{"name":"ITU\/WHO\/WIPO Global Initiative on Artificial Intelligence for Health, Topic Group Oral Health  Geneva Switzerland"},{"name":"Institute of Dental Medicine First Faculty of Medicine of the Charles University and General University Hospital  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8412-1114","authenticated-orcid":false,"given":"Tami","family":"Yap","sequence":"additional","affiliation":[{"name":"Melbourne Dental School The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7829-4684","authenticated-orcid":false,"given":"Michael","family":"McCullough","sequence":"additional","affiliation":[{"name":"Melbourne Dental School The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoana","family":"Malenova","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery LMU Medizin, LMU University Hospital, Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3885-6659","authenticated-orcid":false,"given":"David","family":"Steybe","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery LMU Medizin, LMU University Hospital, Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Otto","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery LMU Medizin, LMU University Hospital, Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Paris","sequence":"additional","affiliation":[{"name":"Department of Operative, Preventive and Pediatric Dentistry Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1223-1669","authenticated-orcid":false,"given":"Falk","family":"Schwendicke","sequence":"additional","affiliation":[{"name":"Clinic for Conservative Dentistry, Periodontology and Digital Dentistry LMU Medizin, LMU University Hospital, 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