Artificial Intelligence–Driven Dentistry: A Systematic Review of Ethical and Legal Challenges

Background: Artificial intelligence (AI) is unraveling new paths for dentistry by improving diagnostic accuracy. This is streamlining treatment planning and optimizing clinical workflows. Yet, its integration brings forth crucial ethical, legal, and regulatory challenges, which range from safeguarding patient autonomy and data privacy to addressing algorithmic bias, ensuring transparency, and maintaining professional accountability. Objective: This systematic review brings together existing evidence on the ethical and legal aspects of technology-driven dentistry. Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, five electronic databases, along with official sources (FDA, EU Commission, and FDI) published from 2019 to August 2025. Eligible studies focused on the ethical, legal, or regulatory dimensions of digital technologies in dentistry. Data were extracted and thematically organized into five domains: patient autonomy and informed consent, data privacy and security, bias and fairness, transparency and accountability, and regulatory/legal frameworks. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the risk of bias. Results: A total of 16 records met the inclusion criteria, and the findings emphasize the need to protect patient rights, ensure clinician readiness, and align with international and regional regulations (EU AI Act, FDA, and FDI). Policy frameworks offered reliable guidance, while surveys and commentaries carried moderate bias. Conclusion: The use of digital technologies in dentistry requires a balanced approach with clear frameworks, global guidelines, and targeted clinician training that are essential to ensure patient-centered, fair, and legally compliant adoption in modern dental care.