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مقالهها، منابع و پژوهشهای تازه حوزه جراحی دهان، فک و صورت
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شواهد دندانپزشکی
PubMed2026
[THE ROLE OF SOCIAL HYGIENIC FACTORS AND SANITARY CULTURE OF POPULATION IN FORMATION OF STOMATOLOGICAL STATUS OF RURAL RESIDENTS OF THE REPUBLIC OF DAGESTAN].
The diseases of oral cavity belong to the most widespread non-communicable pathologies, significantly affecting quality of life and the economy. In Russia, the prevalence of dental caries and periodontal diseases remains high, especially in the rural population, where availability of stomatological care is limited. In the Republic of Dagestan, the situation is complicated by natural climatic, cultural and linguistic characteristics, that determine the necessity of local evaluation of factors of stomatological health.
PubMed2026
Adverse reactions and safety of nebulized budesonide in elderly patients with inflammatory airway diseases.
BACKGROUND: Budesonide suspension is a first-line inhaled corticosteroid for elderly patients with inflammatory airway diseases, but existing research lacks targeted safety data for the very elderly (≥80 years), systematic analysis of adverse reaction (ADR) temporal distribution and quantitative evidence for modifiable clinical risk factors. OBJECTIVE: To investigate the safety profile, ADR temporal patterns and independent modifiable risk factors of nebulized budesonide suspension in elderly patients, with a focus on ≥80 years. METHODS: A retrospective analysis of 128 elderly patients (39 ≥80 years) treated with budesonide suspension (2 ml:1 mg) from January 2023 to June 2025 was conducted. ADRs were identified via medical record cross-check and verified by an expert team, with causality assessed using the WHO-UMC system. ADR incidence, type and temporal distribution were observed; univariate and multivariate logistic regression analyses were used to screen independent risk factors. RESULTS: The overall incidence of mild ADRs was 17.97%, with local ADRs (78.26%, predominantly oropharyngeal candidiasis) and systemic ADRs (21.74%). ADRs peaked at 8-14 days (39.13%). Age ≥80 years (OR=3.245, p=0.030), treatment duration >14 days (OR=2.897, p=0.048) and inadequate mouth rinsing (OR=4.126, p=0.008) were independent risk factors. ADR incidence was higher in patients with ≥3 underlying diseases (25.00% vs. 11.76%). CONCLUSION: Nebulized budesonide suspension is well tolerated in elderly patients, with no severe ADRs. This study clarifies temporal patterns of ADRs and identifies inadequate mouth rinsing as a key modifiable risk factor, providing targeted safety data for the very elderly. Standardized mouth rinsing and short-course medication are recommended for high-risk groups to reduce ADR risk. Notably, this study is limited by its single-center, retrospective design, which may introduce selection and information bias and the findings require validation in prospective multi-center studies with larger sample sizes.
PubMed2026
Biological and Molecular Biomarkers in Oral Potentially Malignant Disorders and Oral Cavity Squamous Cell Carcinoma-Innovation and Insights.
Oral cavity squamous cell carcinoma (OCSCC) represents the 16th most prevalent cancer worldwide accounting for greater than 389,000 cases annually. Most examples of OCSCC are preceded by a diverse group of lesions exhibiting variable risk of transformation to cancer, collectively termed oral potentially malignant disorders (OPMDs). The identification of salivary, serologic, and/or tumor tissue biomarkers holds substantial promise for improving detection, prognosis, and treatment of OPMDs and OCSCC. Although certain biomarkers have become standard of care in the management of patients, continued robust validation and stringent protocol standardization efforts are critical to ensure both diagnostic accuracy and widespread utilization.
PubMed2026
Chronic Oral Complications of Oral Cancer Therapy.
Head and neck cancer (HNC) patients are uniquely susceptible to adverse oral health outcomes following head and neck radiation therapy (RT). Various risk factors for these oral health outcomes post-RT were identified in the OraRad study, which followed HNC patients from pre-RT to 2 y post-RT. Chronic oral complications include hyposalivation, trismus, dental caries, periodontal disease, tooth loss, exposed bone, and osteoradionecrosis of the jaw. Results from OraRad provide a framework for oral health care providers both in preparing patients for RT and in managing sequelae of RT for best outcomes for the HNC patient population.
PubMed2026
Diagnostic Adjuncts and Biopsy Techniques for Oral Potentially Malignant Disorders and Oral Cavity Squamous Cell Carcinoma.
Diagnostic adjuncts for oral potentially malignant disorders such as leukoplakia or erythroplakia can aid the clinician in triaging abnormal lesions and facilitate both biopsy site selection and surgical management. No adjuncts replace gold standard biopsy and histopathological examination, and their optimal use requires training and experience. This article covers the potential applications, both in primary and expert settings, of adjuncts, such as tissue autofluorescence, toluidine blues staining, and cytopathology. It covers new and emerging adjuncts such as confocal microscopy, liquid biopsy, oral microbiome testing, and the role of artificial intelligence. Incisional biopsy site selection and techniques will also be discussed.
PubMed2026
Oral Potentially Malignant Disorders: Current Knowledge and Future Directions.
Oral potentially malignant disorders (OPMDs) include a range of oral mucosal lesions and conditions that carry an increased risk of progressing to oral squamous cell carcinoma. This review compiles current knowledge on the changing definition and terminology of OPMDs. It also examines the factors associated with malignant transformation, the usefulness of diagnostic adjuncts for general dental practitioners, and current and emerging management strategies. This study draws from consensus reports, clinical reviews, recent findings, and future directions to provide a comprehensive understanding of OPMDs, aiming to assist both specialists and general practitioners in effectively identifying, diagnosing, and managing these conditions.
PubMed2026
Periodontitis and Oral Cancer Risk.
An association between periodontitis and oral cancer risk and progression has been suggested. It seems most likely that periodontitis plays an indirect role in oral cancer risk and progression in which its contribution to a chronic inflammatory state characterized by the persistent release of pro-inflammatory cytokines contributes to oxidative stress and DNA damage, potentially favoring carcinogenic processes. Periodontal health status of an individual may serve as a surrogate for general health as those factors which contribute to good general health, environment, lifestyle, and access to care are also determinants of oral health and impact cancer risk.
PubMed2026
Proliferative Leukoplakia.
Proliferative leukoplakia (PL) is an uncommon yet aggressive variant of oral leukoplakia characterized by its high rates of malignant transformation and recurrence. Primarily affecting older, non-smoking females, PL can present as homogenous, verrucous, or erythroleukoplakia lesions. PL is associated with high DNA aneuploidy, alterations in tumor suppressor genes (TP53, CDKN2A), and exhibits immune evasion markers, such as PD-L1. Histopathologically, lesions may demonstrate architectural or cytologic dysplasia. Treatment of PL remains challenging with limited options. Recent findings support further research into molecular and immune-based therapies. There are current inconsistencies in terminology and diagnostic criteria for PL which emphasize the need for an international consensus to support standardized reporting, timely management, and conduct of clinical trials.
PubMed2026
Staging and Outcome of Oral Cavity Cancer: Early Stage and Late Stage Disease.
Oral cavity carcinoma management always requires the involvement of a multidisciplinary team. Surgery is the mainstay of treatment, although other therapeutic modalities such as chemotherapy and radiotherapy are often needed in a multimodal treatment approach. Accurate staging is of great importance to better define the best therapeutic strategy, in addition to specific pathologic characteristics, tumor location, and patient-specific considerations. Guidelines help the clinicians in defining the best treatment plan. These guidelines define 2 major groups of patients, early stage and late stage disease, for which they provide specific algorithms/flow charts for an updated evidence-based decision-making process.
PubMed2026
Staging and Outcome of Oral Cavity Cancer: Reconstruction, Recurrent Disease, and Specific Treatment Considerations.
Specific considerations must be made in the treatment course of oral cavity carcinoma (OCC). Given the role of oral cavity in important functions such as speaking, eating, and esthetics, the choice of the optimal reconstructive option is of utmost importance. For small residual defects local flaps provide an acceptable solution, while for larger defects the adoption of the more complex revascularized free flaps is considered the gold standard. Another challenge is the management of recurrent OCC, which is characterized by a dismal prognosis. In this case, surgery is the first treatment option, when feasible, sometimes integrated with radiotherapy or chemotherapy.
PubMed2026
Supportive Care for Oral Cancer Survivors: A Rehabilitation Approach.
Oral cancer survivors are at an increased risk for developing physical impairments that can adversely affect physical function and quality of life due to the cancer location and treatment that includes surgery and chemoradiation therapy. Many of these impairments can present long after completion of treatment. Surveillance, screening, and treatment of these impairments require a multidisciplinary rehabilitative team that is an integral part of the care of this fragile population. This review article addresses the assessment and treatment of physical impairments commonly encountered during and after completion of oral cancer treatment.
PubMed2026
Facial nerve palsy and hypertension; unusual presentation of apparent mineralocorticoid excess (AME) syndrome in a paediatric patient.
We report a rare case of a monogenic form of hypertension where a boy in early childhood presented with a 2-day history of right-sided facial palsy. Severe hypertension was evident with signs of end-organ damage. This report aims to highlight the diagnostic process when a common presentation, such as facial palsy, uncovers a serious and rare underlying condition that demands urgent multidisciplinary care. Further workup revealed that the patient had hypokalaemic metabolic alkalosis with low serum renin and aldosterone levels. His urinary steroid profile was suggestive of Apparent Mineralocorticoid Excess. A homozygous autosomal recessive variant in the hydroxysteroid 11-beta dehydrogenase 2 gene confirmed a diagnosis of 11β-hydroxysteroid dehydrogenase type 2 deficiency. The syndrome has fewer than one hundred cases documented to date, with reversal of the mineralocorticoid effect as the primary treatment. This case highlights the importance of a step-by-step approach to paediatric hypertension and the need for an early urinary steroid profile.
PubMed2026
Interpreting the S1BF-ACC-LHb pathway in trigeminal neuralgia-associated affective behavior.
The study by Wang and colleagues proposes that three connected brain areas link facial nerve injury to pain and depression-like behavior in mice. The experiments are ambitious and potentially important. However, the nerve-injury model differs from the defining pattern of human trigeminal neuralgia, several behavioral and drug controls leave alternative explanations open, and measurements from many cells were not clearly separated from the animals that supplied them. Clarifying these issues, and distinguishing results from whole tissue from results specific to neurons, would make the causal and clinical implications more secure.
PubMed2026
Soil-plant-animal properties and microbial reassembly distinguish cattle oral disease prevalence across converted Amazon pasture systems.
Forest-to-pasture conversion can alter soil properties, forage composition, and microbial communities, but whether these changes are associated with bovine periodontitis remains unclear. We compared eight pasture systems in the Western Brazilian Amazon classified by high or low herd-level prevalence of periodontal lesions. Soil physicochemical properties, forage composition, microbial communities in soil, forage, and bovine subgingival biofilms, and the relative abundance of the streptomycin biosynthesis gene strB1 were evaluated. Although the systems had similar deforestation histories, low-prevalence pastures had finer-textured soils, greater soil Cu and forage Zn, and greater representation of Bacilli and Gammaproteobacteria. High-prevalence pastures had sandier soils, greater soil C:N ratios, lower micronutrient availability, and greater representation of Actinobacteria and Bacteroidetes. Microbial communities differed between prevalence classes in all three compartments, with higher alpha and gamma diversity and more compartmentalized co-occurrence networks in high-prevalence systems. Tax4Fun predicted greater representation of pathways related to carbohydrate metabolism and glycan biosynthesis in these systems, while qPCR showed higher strB1 abundance normalized to bacterial 16S rRNA gene abundance in soil and forage. These concurrent differences in soil properties, forage composition, and microbial communities were associated with bovine periodontitis prevalence. They do not demonstrate microbial transfer or causality but support the hypothesis that soil and forage conditions may influence environmental exposures related to oral microbiome dysbiosis.
PubMed2026
The effect of different CAD/CAM materials and thickness on the immediate load-bearing capacity of occlusal veneers.
OBJECTIVES: Minimally invasive occlusal veneers fabricated from ceramic and resin-based materials have gained increasing popularity in recent years. The aim of this study was to evaluate the effect of different CAD/CAM materials and restoration thicknesses on the immediate load-bearing capacity of occlusal veneers. MATERIALS AND METHODS: A total of 100 human mandibular molars were prepared for occlusal veneers with a 1-mm circumferential rounded chamfer finish line. A preparation height of 1.5 mm extending from the preparation margin to the occlusal plane was created. The teeth were divided into 10 groups (n = 10), and occlusal veneers were fabricated in two different thicknesses (0.6 and 1.5 mm) using four CAD/CAM block materials: lithium disilicate glass ceramic (IPS e.max), nanoceramic composite (Lava Ultimate and Cerasmart 270), hybrid ceramic (Enamic), and an experimental short fiber-reinforced composite (SFRC CAD). The tested thickness of 0.6 mm is below the minimum thickness recommended by all manufacturers. Restorations were designed using Cerec software. After adhesive cementation, all specimens were stored in water at 37 °C for 2 days, followed by quasi-static loading testing. Data were analyzed using 2-way ANOVA (´restorative material´ and ´restoration thickness`) and Tukey's post hoc test (α <0.05). RESULTS: The two-way ANOVA demonstrated significant main effects of both restorative material and restoration thickness on fracture load (p < 0.001), whereas the material-thickness interaction was not significant (p = 0.200). SFRC CAD exhibited the highest fracture load (SFRC 0.6 mm = 2560.2 ± 424.5N and SFRC 1.5 mm = 2799.0 ± 655.9N) while IPS e.max (IPS e.max 0.6 mm = 1224.2 ± 363.4N and IPS e.max 1.5 mm = 1799.9 ± 436.8N) showed the lowest. Increasing restoration thickness from 0.6 mm to 1.5 mm significantly resulted in higher fracture load regardless of the restorative material. CONCLUSION: Both restorative material and restoration thickness play important roles in the mechanical performance of occlusal veneers. Among the evaluated CAD/CAM materials, the experimental short fiber-reinforced composite demonstrated the highest load-bearing capacity, whereas ceramic and resin-based CAD/CAM materials showed lower values. However, the higher incidence of catastrophic failures involving both restoration and tooth structure in the SFRC CAD groups indicates that fracture load alone should not be considered the only factor for material selection. These findings suggest that ultrathin occlusal veneers may have potential for minimally invasive restorative applications; however, their long-term clinical performance and failure behavior should be further investigated before clinical recommendations can be established. CLINICAL RELEVANCE: Occlusal veneers with a thickness of 0.6 mm, minimum thickness recommended by manufacturers, exhibited promising immediate load-bearing capacity, supporting their potential use in minimally invasive restorative. Furthermore, the experimental short fiber-reinforced composite CAD/CAM material demonstrated superior load-bearing capacity compared with the other CAD/CAM materials evaluated in this study.
PubMed2026
The efficacy of surgical interventions for trigeminal neuralgia in multiple sclerosis: A systematic review.
Trigeminal neuralgia affects approximately 3% of patients with multiple sclerosis - a far higher prevalence than in the general population. The associated pain often proves refractory to medication, prompting consideration of neurosurgical intervention. The variable efficacy, tolerability, and durability of available procedures, compounded by factors such as multiple sclerosis subtype and neuroimaging findings, require evidence to guide personalised surgical decision-making. This systematic review evaluates surgical interventions for trigeminal neuralgia in multiple sclerosis, analysing how patient and disease-specific variables influence outcomes. A systematic review with narrative synthesis was performed. Following PRISMA guidelines, Embase, PubMed, and Scopus were searched (January 2000 - April 2026). Studies assessing pain relief from surgical procedures for trigeminal neuralgia in multiple sclerosis using the Barrow Neurological Institute Pain Scale were included. Risk of bias was assessed using the Newcastle-Ottawa Scale. Thirty-two studies, encompassing 1617 patients, met the inclusion criteria. Microvascular decompression in cases with demonstrable neurovascular conflict provided durable outcomes offset by higher risks of serious complications (including one fatality), despite inherent diagnostic uncertainty regarding whether pain was specifically driven by multiple sclerosis. Partial sensory rhizotomy displayed favourable pain relief (initial success range: 95.3-100%) and durability (recurrence ranging from 20.1 to 79 months). Whilst some studies noted a lack of major complications, some cases of severe trigeminal dysfunction including anaesthesia dolorosa were reported (n = 3; 7.5%). Percutaneous ablative procedures (initial success ranging from 58 to 100%) and gamma knife radiosurgery (initial success ranging from 52.7 to 97.3%) achieved comparable pain control rates to classical trigeminal neuralgia cohorts. They also featured a mild complication profile, though durability was suboptimal (recurrence ranging from 7.4 to 74.5 months for gamma knife radiosurgery and 8-60 months for percutaneous procedures) and repeat procedures were typically tolerable. Differing gamma knife radiosurgery dosages (</>80 Gy) were not associated with significant differences in pain control. Preliminary outcomes of arachnoid-trigeminal nerve release from a 2025 study highlighted promising results with 75% of patients achieving Barrow Neurological Institute Pain Scale I at final follow-up. Gamma knife radiosurgery and percutaneous ablative procedures represent well-tolerated surgical options with comparable outcomes to primary trigeminal neuralgia cohorts regardless of plaque burden. Partial sensory rhizotomy demonstrated notable efficacy and durability in refractory multiple sclerosis-associated trigeminal neuralgia, particularly in the absence of neurovascular conflict, and warrants earlier consideration in the surgical pathway. Microvascular decompression may offer long-term durability where neurovascular conflict is demonstrated. However, its higher procedural risk and the diagnostic uncertainty inherent in multiple sclerosis-associated trigeminal neuralgia cases with concurrent neurovascular conflict necessitate cautious patient selection. High-resolution preoperative imaging is therefore recommended to guide personalised modality selection. Prospective studies are needed to further validate surgical decision-making and establish standardised outcome reporting in this population.
PubMed2026
Torque expression in directly printed and thermoformed clear aligners: a controlled in vitro biomechanical comparison of power ridge effects.
BACKGROUND: Torque control of anterior teeth remains a major challenge in clear aligner therapy. Power ridges have been introduced to improve buccolingual root control; however, their biomechanical performance in directly printed aligners remains insufficiently investigated. The aim of this study was to compare the torque efficiency of power ridges in thermoformed and directly printed aligners. METHODOLOGY: A controlled in-vitro study was conducted using a standardised maxillary model requiring incisor torque correction. Four aligner groups were evaluated: Zendura Flex thermoformed aligners (Bay Materials LLC, USA) with (ZF-PR) and without (ZF-C) power ridges, and two directly printed aligners with power ridges fabricated from TA-28 (Graphy Inc., Seoul, South Korea) and DCA (LuxCreo Inc., Bellevue, WA, USA) resin materials. Power ridges were digitally positioned on the labial gingival third of the maxillary central incisors. Biomechanical testing was performed using the Orthodontic Measurement and Simulation System (OMSS) to assess torque expression, root displacement, and force-moment systems under controlled temperatures (25 °C and 37 °C). RESULTS: Torque expression demonstrated a clear material-dependent pattern. ZF-C, used as the baseline, showed moderate and consistent torque expression (38-39% of the programmed torque) across temperatures, with no significant temperature-dependent differences. DCA exhibited the highest torque expression, reaching 62% at 25 °C and 47% at 37 °C. ZF-PR showed intermediate performance (32-42%) with moderate temperature-related variation. TA-28 demonstrated the lowest torque expression (10-17%) with no significant temperature effect. Secondary outcomes supported these findings, with moment generation and displacement patterns correlating with torque expression, whereas force magnitude did not. CONCLUSIONS: Torque expression in clear aligner systems is primarily governed by material properties and thermomechanical behaviour. Design features alone cannot fully compensate for limitations in material performance. Effective torque delivery depends on the generation and transmission of an appropriate force-moment system rather than on force magnitude alone.
PubMed2026
Chitosan Nanoparticles Combined With Titanium-Prepared Platelet-Rich Fibrin for Socket Preservation in Postextraction Sites: Protocol for a Single-Arm Clinical, Radiographic, and Histomorphometric Study.
BACKGROUND: Alveolar ridge resorption following tooth extraction can compromise subsequent implant placement. Socket preservation techniques aim to minimize dimensional changes and promote favorable bone healing. Chitosan nanoparticles combined with titanium-prepared platelet-rich fibrin represent a biologically active approach to ridge preservation. OBJECTIVE: This study aims to evaluate longitudinal changes in alveolar ridge dimensions and bone quality following socket preservation using chitosan nanoparticles combined with titanium-prepared platelet-rich fibrin. METHODS: This is a single-arm prospective clinical study involving systemically healthy participants requiring tooth extraction. Clinical, radiographic, and histomorphometric assessments will be performed at baseline and at follow-up visits at 3 and 6 months. Statistical analysis will be conducted using within-subject repeated-measures approaches. RESULTS: No external funding was received for this research. The manuscript was submitted before recruitment of participants had started and no clinical data had been collected or analyzed. Clinical, radiographic, and histomorphometric outcomes will be evaluated to assess changes in the dimensions of the alveolar ridge, bone density, and quality of regenerated bone during the postextraction healing period. Clinical and radiographic evaluation will be performed at baseline, 3 months, and 6 months. Histomorphometric analysis will be performed on bone core biopsy samples taken at the time of implant placement. The results of the study will be reported after data collection and analysis. CONCLUSIONS: This protocol outlines a standardized approach to evaluating the clinical, radiographic, and histomorphometric outcomes of socket preservation using chitosan nanoparticles combined with titanium-prepared platelet-rich fibrin. The findings from this study may inform the design of future controlled clinical trials. TRIAL REGISTRATION: Clinical Trials Registry of India CTRI/2025/06/089715; https://tinyurl.com/4u6698xs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/79532.
PubMed2026
Dicer-independent miR-451a is upregulated in periodontitis and potentiates inflammation by impairing macrophage polarization and SOCS activity.
BACKGROUND: Periodontitis (PD) is characterized by localized inflammatory tissue destruction, yet the lesion-associated microRNA (miRNA)networks that regulate host immune responses remain incompletely defined. In this study, we aimed to identify and characterize dysregulated gingivalmiRNAs in PD that modulate inflammatory responses. METHODS: Using a split-mouth design, miRNA expression was profiled in gingival biopsies fromperiodontal lesions and clinically healthy sites. Differentially expressed miRNAs were identified by microarray analysis, and selected candidates werevalidated by RT-qPCR. The responses of candidate miRNAs to periodontal bacterial challenge were evaluated, followed by functional studies ofmacrophage polarization, phagocytosis, inflammatory cytokine production, and target-gene regulation. RESULTS: Microarray analysis identified 48differentially expressed miRNAs, including several upregulated non-canonical miRNAs. Among these, the Dicer-independent miRNAs miR-451a andmiR-1228 showed dose- and time-dependent induction following periodontal bacterial challenge. miR-451a, but not miR-1228, promoted a pro-inflammatory M1-like macrophage phenotype, characterized by increased HLA-DR and CD32 and reduced CD206 and CD163 expression. miR-451adirectly targeted multiple genes associated with M2 macrophage polarization, and its expression in inflamed gingival tissues inversely correlated with M2markers. miR-451a overexpression also reduced macrophage phagocytosis of E. coli and P. gingivalis while increasing pro-inflammatory cytokineproduction. Mechanistically, miR-451a directly suppressed SOCS3 and SOCS5, key negative regulators of JAK/STAT signaling, in TLR4-stimulated cells.The antagonistic expression patterns of miR-451a, SOCS3, and SOCS5 in PD further supported the functional relevance of this regulatory axis. CONCLUSION: miR-451a is a pathogen-responsive, PD-associated miRNA that promotes pro-inflammatory macrophage polarization, impairs bacterialphagocytosis, and amplifies inflammation through suppression of SOCS-mediated immune regulation. These findings identify the miR-451a-SOCS3/SOCS5 axis as a potential mechanism linking bacterial challenge to dysregulated macrophage responses in PD.
PubMed2026
Immune-related colitis following head and neck reconstructive surgery in a patient receiving long-term nivolumab.
Immune checkpoint inhibitors (ICIs) are increasingly incorporated into perioperative cancer treatment, raising challenges in distinguishing immune-related adverse events (irAEs) from postoperative complications. We report a case of postoperative immune-related colitis following head and neck reconstructive surgery in a patient receiving long-term nivolumab. A man receiving nivolumab for gastric cancer, who was maintained on prednisolone for prior immune-related myositis, underwent subtotal glossectomy for advanced tongue cancer. Despite perioperative steroid coverage, he developed grade 3 diarrhoea on postoperative day 4. After infectious causes were excluded and CT revealed diffuse colitis, empirical corticosteroid therapy was initiated, with rapid symptom resolution; colonoscopy and biopsy supported a diagnosis of immune-related colitis. This case illustrates that irAE colitis should remain in the differential diagnosis of postoperative diarrhoea in patients with prior ICI exposure. As perioperative use of ICIs expands, clinicians should maintain a high index of suspicion for irAEs in patients presenting with postoperative diarrhoea.
PubMed2026
Integrating Histological and Molecular Findings for Practical Salivary Gland Diagnostics.
PURPOSE: The purpose of this review paper is to provide an integrative algorithmic approach to the diagnosis of salivary gland tumors, including pertinent histologic features, immunohistochemical patterns and molecular driver mutations and/or fusions. METHODS: Review of the literature was performed to provide an up-to-date synopsis of salivary gland tumors, in a concise and summarized format. RESULTS: Diagnostic workflow algorithms are created and included to complement the histomorphologic subgroups, to provide a user-friendly tool when approaching salivary gland tumors in routine surgical pathology. CONCLUSION: Histomorphologic features and immunophenotype of majority of salivary gland tumors, including select molecular surrogate immunohistochemical stains, are the most important starting point in diagnostic interpretation. Molecular data can provide an additional data point for further supporting evidence and/or to aid in challenging cases.
PubMed2026
Neutrophil-derived oncostatin m contributes to endothelial cell dysfunction during Treponema denticola interaction.
Periodontitis (PD) is a common chronic inflammatory condition and a risk factor for cardiovascular diseases (CVD), yet underlying linking mechanisms remain unclear. The cytokine Oncostatin M(OSM) is elevated in both PD and CVD and has emerged as a potential mediator linking oral inflammation to vascular dysfunction. Neutrophils represent a prominent source of OSM during PD and OSM production is elevated by the periodontal pathobiont Treponema denticola (Td). This study investigated the role of exogenous and neutrophil-derived OSM in endothelial cell (EC) dysfunction and the contribution of heterogenous oral Treponema species in OSM production. Human aortic endothelial cells (HAoEC) were used to evaluate the effects of exogenous purified OSM and neutrophil-derived OSM on endothelial cell function. Endothelial permeability, neutrophil transmigration, cytokine production, cell activation and junctional integrity were assessed using transwell assays, ELISA, real-time PCR, immunoblotting and immunofluorescence microscopy. Exogenous OSM significantly increased HAoEC permeability, neutrophil transmigration and promoted endothelial activation; characterized by increased E-selectin, ICAM-1 and IL-6 expression. Mechanistically, OSM activated OSMR-STAT3 signaling and altered organization of VE-cadherin in adherens junctions and decreased expression of occludin in tight-junctions. Heterogeneous oral Treponema species promote OSM transcription and production from mouse and human neutrophils in vitro and in vivo using a mouse air pouch model of infection. T. denticola most robustly induced OSM release, likely independent of prominent virulence factors dentilisin and Msp. Co-culture model experiments revealed conditioned media from T. denticola-stimulated neutrophils promoted endothelial cell permeability and IL-6 while reducing endothelial nitric oxide synthase (eNOS) production. These effects were abolished by antibody neutralization of OSM, supporting a casual role of neutrophil-derived OSM. Overall, these findings provide mechanistic insight into putative links between PD and adverse cardiovascular events and identify OSM signaling as critical mediator in inflammation-driven endothelial dysfunction.
PubMed2026
Predicting orthodontic appointment adherence in adolescents and parents using an extended behavioral model.
BACKGROUND: Poor adherence in orthodontic care is a complex issue involving both children and their parents. The study aimed to expand the theory of planned behavior (TPB) by integrating sense of coherence (SOC) to predict appointment attendance in adolescent orthodontic patients. MATERIALS AND METHODS: This prospective cohort study recruited adolescents from the University of Alberta Graduate Orthodontic Clinic. Baseline questionnaires captured sociodemographic data, TPB constructs, and SOC. Appointment attendance and oral hygiene were monitored over 1 year. Structural equation modeling (SEM) was used to examine relationships between TPB constructs and appointment adherence, with model fit assessed using χ2, chi-square/degrees of freedom ratio (CMIN/DF), root mean square error of approximation (RMSEA), and comparative fit index (CFI). RESULTS: A total of 168 adolescent-parent pairs participated, and 57% of participants missed at least one appointment during the first year of treatment. SEM demonstrated moderate model fit (CMIN/DF = 1.74; RMSEA = 0.06; CFI = 0.84). Within the TPB constructs, only perceived behavioral control (PBC) significantly predicted intention (P < 0.05), whereas attitude and subjective norm were not significant predictors. SOC did not significantly predict intention, TPB constructs, or appointment adherence in either the adolescent or parent models. Intention also failed to significantly predict actual attendance. CONCLUSION: Within the expanded TPB-SOC framework, PBC was the sole psychosocial predictor of orthodontic appointment-adherence intention. However, neither intention nor SOC translates into actual clinical attendance. The moderate model fit indicates that psychosocial constructs alone are insufficient to fully explain orthodontic appointment adherence. To build more effective adherence models, future research and clinical strategies must look beyond psychology and account for structural, logistical, and environmental barriers.
PubMed2026
Surgical and orthodontic management of class III malocclusion in monozygotic twins using bilateral sagittal split osteotomy.
This case report discusses the genetic influence and treatment of class III malocclusion in identical twin sisters, in their early 20s, who presented with mandibular prognathism. Both exhibited concave profiles with hypodivergent growth patterns, but Sister A had a more pronounced concavity. Diagnosis revealed skeletal class III malocclusion with mandibular prognathism and negative overjet (9 mm in Sister A, 6 mm in Sister B). Treatment involved pre-surgical orthodontics, bilateral sagittal split osteotomy (BSSO) with mandibular setbacks (7 mm for Sister A, 5 mm for Sister B), followed by post-surgical orthodontics and retention. Both sisters achieved improved facial aesthetics, class I occlusion and functional stability. However, Sister B experienced transient paraesthesia and a bad split, leading to temporary splinting of the second molar. The case highlights the genetic basis of mandibular prognathism, the effectiveness of BSSO and the importance of meticulous surgical planning and interdisciplinary management for optimal long-term results.
PubMed2026
A review on laser-assisted veneer debonding.
This literature review examines the advancements in laser technology that have enhanced the veneer debonding process, offering insights into the proper implementation of these techniques in clinical practice with emphasis on laser parameters, debonding efficiency, thermal effects, and preservation of tooth structure. A systematic literature search was conducted on PubMed,Web of Science, Scopus and Cochrane Library. The review was structured according to the PICO framework. The search was performed independently by two reviewers on laser-assisted debonding of ceramic veneers using Er:YAG or Er,Cr:YSGG lasers.Based on a comprehensive evaluation of existing studies, the review presents different types of prosthetic restorations, materials, and laser parameters, and how they interact with each other. The benefits of laser precision, including improved control, workflow efficiency, fewer procedural steps, and reduced tissue impact, are emphasised to help dental practitioners enhance the standard of care in veneer debonding. Across the twenty nine studies that were obtained, laser debonding facilitated removal while pulpal temperature increases remained below commonly cited critical values. Both Er:YAG and Er,Cr:YSGG systems demonstrated effective veneer removal. Thinner veneers nedeed less irradiation time and lower energy. Limited enamel alterations occured when appropriate parameters were used. Current studies suggest that Er:YAG and Er, Cr: YSGG lasers offer clinical advantages in terms of efficiency, safety, and patient comfort. Studies demonstrate that optimized laser settings reduce debonding time and minimize the risk of thermal damage to underlying tooth structure and surrounding tissues. Debonding efficiency was influenced by veneer thickness, ceramic type, cement composition, laser power, pulse duration and cooling protocols Er:YAG and Er,Cr:YSGG lasers are promising tools for ceramic veneer debonding. However, results obtained in these studies cannot be directly associated to patient-centered issuses, further standardized clinical studies are required before definitive clinical recommendations can be made.
PubMed2026
Biofluid based biochemical and clinicopathological profiling for the detection and stratification of oral potentially malignant disorders.
OBJECTIVES: To assess the clinical applicability of Raman spectroscopy using serum and saliva for the identification and stratification of oral potentially malignant disorders (OPMDs) and to differentiate Oral Leukoplakia and Oral Submucous Fibrosis from tobacco habit controls. MATERIALS AND METHODS: This case control study was conducted on 60 patients divided into three groups: leukoplakia (L), Oral submucous Fibrosis (OSMF), and tobacco controls (TC). Serum and saliva samples were collected and analyzed using a confocal Raman spectroscope. Multivariate analysis using principal component analysis (PCA) and linear discriminant analysis (LDA) was performed to generate classification models. RESULTS: Spectral variations were observed among the groups in both serum and saliva, particularly in protein, lipid, nucleic acid related bands. Serum-based models demonstrated higher classification accuracy (~ 87.5%) compared to saliva (~ 80%) in 2-Class analyses. Combined 3-Class models showed accuracies of 70% and 60% in serum and saliva respectively. Class-specific sensitivity, specificity and predictive values for the three-class serum and saliva models are reported. CONCLUSION: In this exploratory case-control study, Raman spectroscopy of serum and saliva distinguished tobacco controls from patients with Oral Leukoplakia or OSMF with moderate-to-good classification accuracy, and serum-based models outperformed saliva-based models. These preliminary findings suggest that RS warrants further investigation as a minimally invasive adjunct for classification of OPMDs; validation in larger, prospective, multicentre cohorts with longitudinal follow-up is required before any early-detection or screening role can be established. CLINICAL RELEVANCE: Raman spectroscopy-based classification might eventually support risk-based triage for biopsy in high-burden settings. The present cross-sectional case-control design demonstrates group discrimination only, and does not by itself establish a screening, early-detection, or longitudinal-monitoring role.
PubMed2026
Biological effects of dental resin composites on human gingival fibroblasts: a systematic review of in vitro evidence.
OBJECTIVE: This systematic review summarized and synthesized the in vitro biological effects of resin composites (RCs) on human gingival fibroblasts (HGFs) to clarify their isolated cellular biocompatibility. MATERIALS AND METHODS: A systematic search was conducted in the MEDLINE/PubMed database using a PECOS framework to identify in vitro studies evaluating HGF responses to RCs. Two independent reviewers screened literature, extracted data, and assessed methodological quality (QUIN tool) and certainty of the evidence (GRADE framework). RESULTS: Thirty-eight studies comprising 185 distinct experiments across eight outcome measures were included. Marked heterogeneity was observed regarding RC composition (7 categories), specimen geometry, cell lines, and experimental durations. When evaluating cellular survival and damage independently, 27% of cytotoxicity experiments reported significant cell damage/death, while 45% of cell viability assays demonstrated a decreased metabolic activity. DNA damage was prominent, with 50% of 18 experiments reporting significant alterations. Significant increases occurred in reactive oxygen species production (71%) and inflammatory mediator release (62%). Conversely, 85% of morphology experiments showed no significant alterations. The overall certainty of evidence was graded as low to moderate. CONCLUSION: Dental resin composites can induce notable, independent adverse biological responses in human gingival fibroblasts in vitro, characterized by oxidative stress, inflammatory mediator release, DNA damage, and compromised viability. While highlighting a clear potential for toxicity, the low-to-moderate certainty and lack of physiological simulations leave their direct clinical significance open to further investigation. CLINICAL RELEVANCE: Synthesized evidence indicates that dental RCs exert moderate in vitro biological effects on gingival fibroblasts, including DNA-damage and inflammatory responses.
PubMed2026
Comprehensive dental management of odontogenic infection and ankyloglossia under general anaesthesia in a medically complex child with intellectual disability.
Children with intellectual disability often experience difficulties in accessing routine dental care because behavioural limitations and associated medical conditions make treatment challenging. Untreated dental infections in such patients may pose significant health risks, particularly when systemic conditions are present. A child in middle childhood with moderate intellectual disability presented with pain and progressive swelling in the right posterior mandibular region. The patient was non-verbal and had underlying cardiac dysfunction and encephalopathy, which further complicated clinical management. Clinical and radiographic examination revealed a grossly carious mandibular first permanent molar associated with a periapical cyst, along with severe ankyloglossia. Due to limited cooperation and medical complexity, comprehensive dental management was performed under general anaesthesia, including extraction, cyst enucleation, diode laser-assisted frenectomy and preventive care. Recovery was uneventful, and the patient was referred for speech therapy. This case highlights the importance of coordinated multidisciplinary management for medically complex children requiring comprehensive dental rehabilitation.
PubMed2026
Glymphatic dysfunction as a potential mechanistic link to cognitive ımpairment in Behçet's disease: a hypothesis.
Behçet's disease (BD) is a chronic multisystem inflammatory disease in which cognitive impairment is increasingly recognized but remains incompletely understood. Although cognitive dysfunction is more common in patients with Neuro-Behçet's disease (NBD), it has also been reported in patients without clinically apparent neurological involvement, suggesting that mechanisms beyond focal inflammatory lesions may contribute to cognitive impairment. The glymphatic system is a brain-wide perivascular clearance pathway that maintains cerebral homeostasis by facilitating the exchange of cerebrospinal and interstitial fluid and the removal of inflammatory mediators and metabolic waste products. Previous neuroimaging studies have demonstrated white matter microstructural abnormalities in both NBD and neurologically asymptomatic BD, with more extensive alterations in NBD. Furthermore, studies in systemic lupus erythematosus have identified an increased burden of enlarged perivascular spaces, choroid plexus enlargement, and lower diffusion tensor imaging along the perivascular space (DTI-ALPS) indices, providing preliminary imaging evidence of alterations putatively related to glymphatic function in systemic inflammation and neuropsychiatric involvement. However, the relationship between glymphatic dysfunction and cognitive impairment has not yet been directly investigated in BD. We hypothesize that chronic neuroinflammation, endothelial dysfunction, blood-brain barrier disruption, vascular inflammation, and sleep disturbance may impair glymphatic clearance in BD, leading to persistent neuroinflammation, white matter injury, and cognitive dysfunction. This proposed relationship has not yet been directly tested in BD. We further propose that glymphatic dysfunction may occur not only in patients with NBD but also in a subset of BD patients without overt neurological involvement, although it is likely to be more pronounced in NBD. If validated, this hypothesis could provide a novel mechanistic framework for cognitive impairment in BD and support the development of imaging biomarkers and adjunctive therapeutic strategies targeting glymphatic function.
PubMed2026
Neuroimaging signatures of facial onset sensory and motor neuronopathy (FOSMN).
Facial onset sensory and motor neuronopathy (FOSMN) is an exceptionally rare condition characterized by progressive facial paresthesia and the subsequent appearance of bulbar symptoms with rostro-caudal motor and sensory deficits sometimes extending to the hand muscles. The pathophysiological understanding of this disorder is very limited. In order to identify patterns of neuroanatomical involvement within the brain, we applied advanced magnetic resonance imaging-based techniques to a group of six patients with the diagnosis of FOSMN, using unbiased analysis techniques with atlas-based volumetry of volume-rendering T1-weighted data and whole brain-based spatial statistics of diffusion tensor imaging (DTI). The volumetric data showed significant global atrophy with prominent involvement of the medulla oblongata, while DTI demonstrated significant decreases in the right-hemispheric frontal lobe and bilaterally along the superior and inferior longitudinal fasciculi. In summary, this application of volumetry and DTI to a group of FOSMN patients demonstrated, beyond global brain atrophy as a correlate of a systemic disease process, regional atrophy in the brainstem/medulla oblongata, together with tract alterations of polymodal frontotemporoparietal interconnections. Future neuroimaging studies in larger patient groups of FOSMN are needed for detailed phenotype-neuroimaging correlations.