{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T12:16:37Z","timestamp":1771848997721,"version":"3.50.1"},"reference-count":32,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Early detection of dental caries is essential for effective oral health management. Current diagnostic workflows rely heavily on radiographic imaging, which involves infrastructure requirements, workflow coordination, and resource considerations that may limit frequent use in high-throughput or resource-constrained settings. These contextual factors motivate exploration of adjunct screening concepts that could support front-end triage decisions within existing care pathways. This study evaluates, in simulation, whether modeled tooth-percussion response signals contain sufficient discriminative information to justify further translational and managerial investigation. Implementation costs, workflow optimization, and economic outcomes are not evaluated directly; rather, the objective is to assess whether the technical preconditions for a potentially scalable screening concept are satisfied under controlled in silico conditions. Methods: An in silico model of tooth percussion was developed in which enamel, dentin, and pulp\/root structures were represented as a simplified layered mechanical system. Impulse responses generated from simulated tapping were used to compute the modeled surface-vibration response (enamel-layer displacement), which served as a proxy for a measurable percussion-related signal (e.g., contact vibration), rather than a recorded acoustic waveform. Carious conditions were simulated through depth-dependent reductions in stiffness and effective mass and increases in damping to represent enamel and dentin demineralization. A synthetic dataset of labeled simulated signals was generated under varying structural parameters and measurement-noise assumptions. Machine-learning models using Mel-frequency cepstral coefficient (MFCC) features were trained to classify healthy teeth, enamel caries, and dentin caries at a screening (triage) level. Results: Under baseline simulation conditions, the classifier achieved an overall accuracy of 0.97 with balanced macro-averaged F1-score (0.97). Misclassifications occurred primarily between healthy and enamel-caries categories, whereas dentin-caries cases were most consistently identified. When measurement noise and structural variability were increased, performance declined gradually, reaching approximately 0.90 accuracy under the most challenging simulated scenario. These results indicate that discriminative information is present within the modeled signals at a screening (triage) level, meaning that higher-risk categories can be distinguished probabilistically rather than with definitive diagnostic certainty. Sensitivity and specificity trade-offs were not optimized in this study, as the objective was to assess separability rather than to define clinical decision thresholds. Conclusions: Within the constraints of the in silico model, simulated tooth-percussion response signals demonstrated discriminative patterns between healthy, enamel caries, and dentin caries categories at a screening (triage) level. These findings establish technical plausibility under controlled simulation conditions and support further investigation of percussion-based screening as a potential adjunct to clinical assessment. From a healthcare management perspective, the present results address a prerequisite question\u2014whether such signals contain sufficient information to justify translational research, rather than demonstrating workflow optimization, cost reduction, or system-level impact. Clinical validation, threshold optimization, and implementation studies are required before managerial or operational benefits can be evaluated.<\/jats:p>","DOI":"10.3390\/diagnostics16040638","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T11:39:10Z","timestamp":1771846750000},"page":"638","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Managerial Feasibility of an AI-Based Tooth-Percussion Signal Screening Concept for Dental Caries: An In Silico Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Stefan Lucian","family":"Burlea","sequence":"first","affiliation":[{"name":"Dentoalveolar Surgery, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2791-3400","authenticated-orcid":false,"given":"C\u0103lin Gheorghe","family":"Buzea","sequence":"additional","affiliation":[{"name":"National Institute of Research and Development for Technical Physics, IFT Ia\u0219i, 700050 Iasi, Romania"},{"name":"\u201cProf. Dr. Nicolae Oblu\u201d Clinical Emergency Hospital Ia\u0219i, 700309 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Nica","sequence":"additional","affiliation":[{"name":"Department of Odontology-Periodontology, Fixed Prosthesis, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3863-6904","authenticated-orcid":false,"given":"Florin","family":"Nedeff","sequence":"additional","affiliation":[{"name":"Department of Environmental Engineering, Mechanical Engineering and Agritourism, Faculty of Engineering, \u201cVasile Alecsandri\u201d University of Bacau, 600115 Bacau, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0922-740X","authenticated-orcid":false,"given":"Diana","family":"Mirila","sequence":"additional","affiliation":[{"name":"Department of Environmental Engineering, Mechanical Engineering and Agritourism, Faculty of Engineering, \u201cVasile Alecsandri\u201d University of Bacau, 600115 Bacau, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentin","family":"Nedeff","sequence":"additional","affiliation":[{"name":"Department of Environmental Engineering, Mechanical Engineering and Agritourism, Faculty of Engineering, \u201cVasile Alecsandri\u201d University of Bacau, 600115 Bacau, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6447-0958","authenticated-orcid":false,"given":"Lacramioara","family":"Ochiuz","sequence":"additional","affiliation":[{"name":"Department of Odontology-Periodontology, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucian","family":"Dobreci","sequence":"additional","affiliation":[{"name":"Department of Physical and Occupational Therapy, \u201cVasileAlecsandri\u201d University of Bacau, 600115 Bacau, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maricel","family":"Agop","sequence":"additional","affiliation":[{"name":"Department of Environmental Engineering, Mechanical Engineering and Agritourism, Faculty of Engineering, \u201cVasile Alecsandri\u201d University of Bacau, 600115 Bacau, Romania"},{"name":"Academy of Romanian Scientists, 3 Ilfov, 050044 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana","family":"Rudnic","sequence":"additional","affiliation":[{"name":"Department of Odontology-Periodontology, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.1600-0757.2011.00425.x","article-title":"The global burden of periodontal disease and dental caries","volume":"60","author":"Petersen","year":"2012","journal-title":"Periodontology"},{"key":"ref_2","unstructured":"Fejerskov, O., Nyvad, B., and Kidd, E. (2015). Dental Caries: The Disease and Its Clinical Management, Wiley Blackwell. 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