Can artificial intelligence in orthopantomography advance dental diagnostics through automated image analysis?

Artificial Intelligence (AI) is rapidly transforming dental education and clinical practice, as deep learning-especially convolutional neural networks-brings unprecedented accuracy to interpreting orthopantomograms (OPGs). This review illuminates the cutting-edge frontiers of AI-driven dental imaging, tracing how recent breakthroughs are transforming the detection, classification, and segmentation of complex dental anatomy and pathology. Notably, state-of-the-art AI models have reached remarkably high accuracy in tooth identification, while commercial solutions demonstrate promising-though variable-performance in diagnosing complex conditions, such as the adequacy of endodontic procedures. Yet, bringing AI into routine dental care remains fraught with obstacles - demanding vast annotated datasets, coping with population variability, and confronting persistent medicolegal and trust concerns. Growing collaborations between regulators and professional bodies in the United States and European Union are now shaping ethical and legal frameworks to guide its safe use. This narrative review goes beyond summarizing technological progress in AI-driven dental radiology - it uniquely integrates diagnostic breakthroughs with the rapidly evolving regulatory and ethical landscape. By bridging innovation with implementation, it offers educators, practitioners, and learners a forward-looking roadmap that positions AI not as a distant promise, but as a transformative force already reshaping the future of dental diagnostics and training.