Artificial Intelligence in Orofacial Pain: Diagnostic and Predictive Performance Across Machine Learning and Deep Learning Models.

Orofacial pain (OFP) includes a broad spectrum of odontogenic and non-odontogenic conditions with overlapping clinical features that often limit diagnostic accuracy, driving increasing interest in artificial intelligence (AI) as a tool to enhance diagnostic precision and support clinical decision-making. A narrative review was conducted using PubMed/MEDLINE, Scopus, and Web of Science to identify studies (2016-2026) applying AI to the diagnosis, classification, or prediction of OFP in adults. Eligible studies reported at least two diagnostic performance metrics and were thematically grouped into odontogenic and non-odontogenic categories, the latter including musculoskeletal, neurovascular, and neuropathic pain. Twenty studies were included. Neurovascular pain, particularly migraine, showed the most consistent and highest diagnostic performance, likely due to the greater availability of structured clinical data and standardized diagnostic criteria. Musculoskeletal pain, especially temporomandibular disorders, also demonstrated high and reproducible performance. In contrast, odontogenic pain showed lower and more heterogeneous performance, with better results mainly in imaging-based models, while signal- and behavior-based approaches were less robust. Neuropathic pain exhibited moderate to high performance in selected radiomics studies, but overall results remained inconsistent due to phenotypic variability and limited objective biomarkers. Currently, AI shows promising potential in OFP diagnosis, especially for neurovascular and musculoskeletal pain, but clinical translation is limited by data heterogeneity and lack of validation. Progress in clinical practice depends on multimodal datasets and multicenter studies to ensure robust, generalizable tools.