OBJECTIVES: To identify factors associated with local recurrence of oral squamous cell carcinoma, with particular attention to the margin-to-depth-of-invasion ratio. METHODS: We performed a retrospective cohort study of...OBJECTIVES: To identify factors associated with local recurrence of oral squamous cell carcinoma, with particular attention to the margin-to-depth-of-invasion ratio. METHODS: We performed a retrospective cohort study of 98 patients with pathological T1 or T2 oral squamous cell carcinoma treated between 2013 and 2021. The prognostic relevance of clinicopathological variables-including resection-margin distance and the margin-to-depth-of-invasion ratio-was evaluated. RESULTS: The margin-to-depth-of-invasion ratio was significantly associated with local recurrence (cutoff = 0.945, p = 0.014) and with disease-free survival (ratio < 0.945: 60.1%; ratio ≥ 0.945: 83.6%; p = 0.010); similar findings were observed for the close-margin subgroup (ratio < 0.945: 60.2%; ratio ≥ 0.945: 100%; p = 0.016). Close margins alone were not predictive of local recurrence (p = 0.258). In addition, no significant difference in disease-free survival was detected between cases with close margins and a ratio ≥ 0.945 and those with clear margins (100% vs. 80.2%; p = 0.094). CONCLUSIONS: The margin-to-depth-of-invasion ratio may serve as a practical criterion for determining the minimum resection distance and the need for postoperative adjuvant therapy in patients with close margins.
INTRODUCTION: The oral phageome, comprising bacteriophages inhabiting the oral cavity, has been proposed as a potential modulator of periodontal health and disease. This systematic review synthesizes current evidence on...INTRODUCTION: The oral phageome, comprising bacteriophages inhabiting the oral cavity, has been proposed as a potential modulator of periodontal health and disease. This systematic review synthesizes current evidence on interactions between bacteriophages, key periodontal bacteria, and the host in periodontitis. METHODS: The review followed PRISMA guidelines and was registered in PROSPERO (CRD420250653631). A systematic search of the literature was conducted from January 2025 up to March 2025. Two independent PECOS strategies were applied to include clinical/observational and ex vivo studies. Risk of bias was assessed using the Newcastle-Ottawa Scale, Joanna Briggs Institute Checklist, and a modified SYRCLE's tool. RESULTS: Of 965 records identified, 17 studies, comprising 623 patients, met the inclusion criteria. Clinical studies suggest alterations in the oral phageome in periodontitis, with increased abundance and activity of lytic phages, whereas temperate phages appear more prevalent in periodontal health. Ex vivo studies demonstrate that bacteriophages can interact with major periodontopathogens, influencing bacterial virulence, biofilm behavior, and horizontal gene transfer. CONCLUSION: Current evidence does not establish a causal role for bacteriophages in periodontitis. Nevertheless, phages may function as contextual modulators of periodontal dysbiosis, particularly in A. actinomycetemcomitans-associated disease. Further longitudinal and functional multi-omics studies are needed to clarify their clinical relevance. TRAIL REGISTRATION:PROSPERO ID: CRD420250653631.
BACKGROUND: Oral appliance (OA) therapy has gained wide acceptance for the management of obstructive sleep apnea (OSA). Although various types of OAs have been developed, the efficacy of the newer devices in patients wit...BACKGROUND: Oral appliance (OA) therapy has gained wide acceptance for the management of obstructive sleep apnea (OSA). Although various types of OAs have been developed, the efficacy of the newer devices in patients with mild to moderate OSA remains unclear. OBJECTIVE: This systematic review aimed to evaluate the clinical efficacy of customized titratable OAs in improving sleep in adults with mild-to-moderate OSA. METHODS: A comprehensive literature search of the Medline, Embase, Scopus, the Cochrane Library, and Web of Science databases for relevant randomized controlled trials (RCTs), published between 2000 and 2025, was performed. The primary outcomes were the apnea-hypopnea index (AHI), oxygen desaturation index (ODI), Epworth Sleepiness Scale (ESS) score, and mean oxygen saturation (SpO). The secondary outcomes included sleep efficiency and the percentage of total sleep time. RESULTS: Of the 1316 articles retrieved in the literature search, 122 fulfilled the inclusion criteria, including 32 RCTs that compared OAs with control interventions. Most studies reported significant improvements in AHI, with mandibular advancement devices demonstrating consistent efficacy across multiple trials. Improvements in the ESS, ODI, and SpO were also observed in several studies. CONCLUSION: Customized, titratable OAs are effective in reducing AHI and improving sleep-related outcomes in patients with mild-to-moderate OSA.
BACKGROUND: Alveolar bone resorption is typically associated with aging or chronic inflammation, while flavonols intake is known for its extensive anti-aging and anti-inflammatory properties. However, the relationship be...BACKGROUND: Alveolar bone resorption is typically associated with aging or chronic inflammation, while flavonols intake is known for its extensive anti-aging and anti-inflammatory properties. However, the relationship between them remains unclear. OBJECTIVE: This study aimed to examine the association between dietary flavonol intake and alveolar bone loss. METHODS: Using 2009-2010 NHANES data, this cross-sectional study analyzed 2-day dietary recalls of flavonols (isorhamnetin, quercetin, and kaempferol) and alveolar bone loss-defined as teeth with bone loss exceeding 5 mm. Analyses included descriptive statistics, multivariable logistic regression, smooth curve fitting, and threshold analysis, all adjusted for confounders. RESULTS: Among 1616 participants, severe alveolar bone loss was more common in older males and associated with lower quercetin or isorhamnetin intake and lower education levels. Quercetin and isorhamnetin consistently showed an inverse relationship with severe bone loss across regression and subgroup analyses. Kaempferol intake exhibited a U-shaped association with alveolar bone loss, which was more pronounced in males. CONCLUSION: Higher intake of isorhamnetin or quercetin was associated with lower levels of alveolar bone loss, whereas the association for kaempferol was more complex and requires consideration of intake dose.
OBJECTIVE: This review aims to elucidate the biological significance of Type H vessels, a specialized bone marrow vascular subtype characterized by high expression of endothelial mucin (Emcn) and PECAM-1/CD31, and their...OBJECTIVE: This review aims to elucidate the biological significance of Type H vessels, a specialized bone marrow vascular subtype characterized by high expression of endothelial mucin (Emcn) and PECAM-1/CD31, and their critical role in coupling angiogenesis with osteogenesis. We also discuss their therapeutic potential in craniomaxillofacial trauma and alveolar bone loss. METHODS: This is a narrative review. we identified relevant studies by searching PubMed (MEDLINE) and Web of Science using combinations of keywords related to CD31/Endomucin (Type H Vessels), angiogenic-osteogenic coupling, and oral/craniofacial conditions, and by screening reference lists of key articles. RESULTS: The central role of Type H Vessels in skeletal biology underscores therapeutic promise for mitigating bone loss in periodontitis and other oral pathologies. CONCLUSIONS: Type H Vessels are emerging regulators of angiogenic-osteogenic coupling in skeletal tissues. Although bone and craniofacial tissues are similar and craniofacial evidence is growing, It remains less extensive than long-bone mechanistic studies; therefore, translational strategies in oral medicine should be interpreted in light of this evidence gap. This review consolidates mechanistic and clinical evidence, proposing novel strategies to harness the angiogenic-osteogenic coupling for oral rehabilitation of bone-destructive diseases. Future research should explore precise modulation of Type H Vessels to optimize therapeutic outcomes.
OBJECTIVES: To develop India-specific consensus guidelines for accurate and uniform OLP diagnosis by integrating clinical and histopathological criteria, addressing regional disease burden, reducing diagnostic variabilit...OBJECTIVES: To develop India-specific consensus guidelines for accurate and uniform OLP diagnosis by integrating clinical and histopathological criteria, addressing regional disease burden, reducing diagnostic variability, and supporting early detection and improved patient outcomes. METHODS: The Indian Consensus on diagnosis and management of ORal Lichen Planus (INCORP) used a modified Delphi methodology involving 11 multidisciplinary experts. Three iterative rounds were conducted to review and refine diagnostic statements, with ≥ 80% agreement required for consensus. RESULTS: After three rounds of a modified Delphi process, consensus (≥ 80% agreement) was achieved for 40 out of 41 statements. ORal lichen planus (OLP) was defined as a chronic, immune-mediated mucosal disorder with bilateral, symmetrical reticular, atrophic, erosive, or plaque-like lesions. Consensus was reached on epidemiology, pathogenesis, clinical variants, investigations, and malignant transformation risk. OLP was recognised as potentially malignant. Biopsy with histopathological evaluation was recommended for all suspected cases, supported by adjunctive immunofluorescence and cytological smears in selected presentations. CONCLUSION: This first Indian consensus provides a clinicopathological framework for accurate OLP diagnosis, early malignancy detection, and improved epidemiological reporting, ensuring uniformity in clinical practice and enhancing patient outcomes.
BACKGROUND: Periodontitis is a chronic inflammatory disorder characterized by tissue degradation and bone loss. Lipopolysaccharide (LPS) accelerates disease progression by host immune activation, inducing localized infla...BACKGROUND: Periodontitis is a chronic inflammatory disorder characterized by tissue degradation and bone loss. Lipopolysaccharide (LPS) accelerates disease progression by host immune activation, inducing localized inflammatory infiltration and osteoclastogenesis, and disrupting bone metabolic homeostasis. Adipose-derived mesenchymal stem cells (ADSCs) exert anti-inflammatory, anti-apoptotic, and regenerative effects via paracrine signaling. METHODS: ADSCs were isolated using collagenase digestion and characterized by flow cytometry for surface markers and multilineage differentiation potential (assessed by Oil Red O and Alizarin Red S staining). ADSC-Exos were isolated via size-exclusion chromatography and ultrafiltration and characterized by transmission electron microscopy, nanoparticle tracking analysis, and immunoblotting. In a Pg-LPS-induced in vitro periodontitis model, PKH26-labeled ADSC-Exos were internalized by cells, as shown by confocal microscopy. Their effects on osteoclastic markers (TRAP, MMP-9, and COX-2) and signaling mediators (RANK and TRAF6) were evaluated using real-time PCR and western blotting. RESULTS: ADSCs-Exos suppressed early osteoclast differentiation in Pg-LPS-induced in vitro periodontitis model. Mechanistic studies revealed that ADSCs-Exos mitigated inflammation by modulating the COX-2/TRAF6/RANK signaling axis. CONCLUSIONS: This study investigated the effects of ADSCs-Exos on the early proliferation and differentiation of osteoclasts. Furthermore, in a periodontitis cell model, ADSCs-Exos regulate bone resorption by downregulating the mRNA and protein expression levels of COX-2, RANK, and TRAF6.
Maia-Lima MP, Ferreira LM, Cunha ZA
… +14 more, da Silva TA, Bergo BR, Kaminagakura E, Bonan PRF, Ramos JLF, Villarroel-Dorrego M, Anaya-Saavedra G, Vega CPP, Jiménez AR, Reiván-Ortiz P, Terán DAT, de Andrade BAB, Gilligan GM, Martelli-Júnior H
OBJECTIVE: To evaluate the perceptions of undergraduate dental students regarding the teaching of Oral Pathology and Oral Medicine (OP/OM) in Latin American countries. METHODS: This study included 364 undergraduate denta...OBJECTIVE: To evaluate the perceptions of undergraduate dental students regarding the teaching of Oral Pathology and Oral Medicine (OP/OM) in Latin American countries. METHODS: This study included 364 undergraduate dental students from seven Latin American countries. Data were collected through a questionnaire about the teaching of OP/OM in relation to the participants' perception and satisfaction. Comparisons between disciplines and between countries were performed using Pearson's chi-square, Wilcoxon, and Kruskal-Wallis tests, with post hoc pairwise comparisons conducted using the Dunn test with Bonferroni correction. A significance level of 5% was adopted. RESULTS: Significant differences between countries were observed in most OM domains (p < 0.05), with Argentina presenting higher overall satisfaction compared to all other countries, while differences in OP were limited to teaching quality and availability of materials and resources, with no significant difference in overall satisfaction across countries (p < 0.05). OM was associated with higher evaluations than OP in teaching quality, clinical usefulness, availability of resources, motivation, and overall satisfaction (p < 0.05). CONCLUSION: Perceptions of OP/OM teaching among Latin American dental students were generally positive, with OM receiving more favorable evaluations than OP across select domains. Satisfaction with OM varied significantly between countries, while OP showed greater homogeneity across the region.
OBJECTIVES: To examine the determinants of acute pain following tooth extraction, within a set of factors belonging to different domains: biometry, dental nosology and anatomy, psychology toward pain and surgery, and sur...OBJECTIVES: To examine the determinants of acute pain following tooth extraction, within a set of factors belonging to different domains: biometry, dental nosology and anatomy, psychology toward pain and surgery, and surgical procedure. METHODS: Participants were recruited in two centres in France and Lebanon. A 'simple extraction' (161 patients) and a 'wisdom teeth/tooth' group (at least mandibular) (115 patients) were studied separately. Postoperative pain and total analgesic drug intake (over 5 days) were both expressed as a composite score. Both scores were ranked within each surgery group, and their sum was the primary outcome, which was analysed by multivariable linear mixed models after a factor selection. RESULTS: In the simple extraction group, the primary outcome was predicted positively by preoperative fearfulness (defined by a composite of various phobias) and preoperative dental pain, and negatively by age (≥ 60) and a previous tooth extraction. In the wisdom teeth/tooth group, it was predicted positively by preoperative fearfulness and pain catastrophising, and negatively by a local inflammatory context and preoperative dental pain. CONCLUSIONS: Whereas postoperative pain was constantly favoured by psychological distress, age and other dental factors had different influences on postoperative pain depending on the type of extraction. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05405088.
OBJECTIVE: To investigate the role of mastication on the salivary nitrate transport and elucidate the underlying mechanisms. METHODS: Systemic nitrate levels were clinically compared between individuals with masticatory...OBJECTIVE: To investigate the role of mastication on the salivary nitrate transport and elucidate the underlying mechanisms. METHODS: Systemic nitrate levels were clinically compared between individuals with masticatory dysfunction and healthy individuals. Behavioral assessments were performed in mice with reduced masticatory activity to examine the impact on anxiety-like behavior. Mechanical stimulation was applied to salivary gland epithelial cells and tissues to explore the expression, localization, and translocation mechanisms of Sialin, a nitrate transporter encoded by the Slc17a5. RESULTS: Individuals with impaired mastication exhibited significantly lower systemic nitrate levels compared to healthy controls. In mice, decreased masticatory activity was associated with increased anxiety-like behavior. In vitro, mechanical force stimulated the upregulation and apical translocation of Sialin in human salivary gland epithelial cells (HSGs). Sialin was predominantly localized within lipid rafts, and its force-induced translocation was mediated by activation of the Piezo1 channel, which facilitated the movement of lipid rafts to the apical membrane, thereby enhancing nitrate secretion. CONCLUSION: Mastication sustains nitrate homeostasis and mitigates anxiety-like behavior in mice by mechanically activating the Piezo1 channel, thus facilitating the lipid raft-mediated translocation of Sialin to the apical membrane in salivary gland cells.
OBJECTIVE: To pilot the feasibility, diagnostic accuracy, and repeatability of the Takano NBI-based IPCL classification when applied by novice raters after short formal training. METHODS: Ten dental students classified 9...OBJECTIVE: To pilot the feasibility, diagnostic accuracy, and repeatability of the Takano NBI-based IPCL classification when applied by novice raters after short formal training. METHODS: Ten dental students classified 90 oral lesions shown as paired white-light and NBI images in two sessions, 4 weeks apart. Scores were recorded on an ordinal scale (0-4), where category 0 denoted hyperplasia or clinically normal mucosa, while categories 1-4 represented increasing degrees of epithelial dysplasia or invasive disease. Histopathology served as the reference standard. RESULTS: The 90 lesions comprised 38 hyperplastic/normal, 29 dysplastic, and 23 invasive carcinomas. Mean agreement with histology was 18.8% at T1 and 21.0% at T2, with weighted kappa values of 0.080 and 0.093, respectively. Agreement with the expert rater was 22.2% at T1 and 20.4% at T2, with weighted kappa values of 0.170 and 0.127. CONCLUSION: A short lecture-based training is insufficient for reliable NBI interpretation by novice raters. These findings support the necessity for structured, competency-based training and supervised case libraries before Takano-based NBI assessment can be recommended in clinical practice for inexperienced practitioners.
OBJECTIVE: Eosinophilic sialodochitis is an uncommon, chronic inflammatory disorder of the major salivary glands characterized by intermittent pain, swelling, and mucous plugging containing eosinophils. Despite increasin...OBJECTIVE: Eosinophilic sialodochitis is an uncommon, chronic inflammatory disorder of the major salivary glands characterized by intermittent pain, swelling, and mucous plugging containing eosinophils. Despite increasing reports, optimal diagnostic criteria and management remain unclear. METHODS: PubMed, ScienceDirect, Google Scholar, and Ovid databases were searched to August 2025. Data were collected from eligible studies published after 2000 in English, noting that some significant reviews also summarize the Japanese literature. RESULTS: Twenty-four studies (n = 309 patients) were included. The mean age was 39 years, with a male: female ratio of 1:2.5. The parotid gland was most often affected (50.8%), with bilateral involvement in 43.4% of cases. Most patients (87.4%) had atopy, particularly allergic rhinitis (75.4%). Swelling (94.5%), mucous plugs (46.0%), and pain (24.6%) were the most common symptoms. IgE was elevated in 66.3%, peripheral eosinophilia in 36.0%, and both in 6.5%. Imaging revealed ductal ectasia and stenosis, while histopathology demonstrated periductal fibrosis and eosinophilic infiltration. Endoscopy-assisted ductal irrigation and dilation were the most effective treatments, followed by conservative surgical excision. Medical treatments such as antihistamines, corticosteroids, and leukotriene receptor antagonists achieved variable treatment success. CONCLUSIONS: Future multicenter studies may eventually establish a definitive diagnostic algorithm based on combinations of clinical findings, IgE/eosinophils, and imaging.
OBJECTIVE: Squamous odontogenic tumor is a rare benign epithelial odontogenic neoplasm whose overlapping features with other odontogenic lesions may hinder diagnosis and management. This systematic review analyzed clinic...OBJECTIVE: Squamous odontogenic tumor is a rare benign epithelial odontogenic neoplasm whose overlapping features with other odontogenic lesions may hinder diagnosis and management. This systematic review analyzed clinical, radiographic, histopathological characteristics and treatment outcomes of SOT. METHODS: Comprehensive search was conducted in April 2025 across PubMed, Web of Science, Scopus, Embase, Cochrane Library, Livivo, BVS, SciELO, ProQuest, OpenGrey, IBICT/BDTD, and Google Scholar. Two independent reviewers performed study selection, data extraction, and risk-of-bias assessment. Only cases fulfilling diagnostic criteria established by the WHO Classification of Head and Neck Tumors (2024) were included. Cases descriptions and images were assessed by an experienced oral pathologist to confirm diagnostic consistency. RESULTS: A total of 65 SOT lesions were identified, including 59 intraosseous and 6 peripheral cases. Intraosseous lesions occurred across a wide age range with slight male predominance. Most lesions were solitary and located in the maxilla or posterior jaw regions. Radiographically, intraosseous lesions were predominantly unilocular, with triangular configuration most frequently reported. Most lesions were treated with conservative surgery, particularly surgical excision, and recurrence occurred in a minority of intraosseous cases. Peripheral lesions were solitary and showed a benign course without recurrence. CONCLUSION: SOT generally presents as a benign lesion with a favorable prognosis.
BACKGROUND: The early detection and diagnosis of head and neck squamous cell carcinoma (HNSCC) pose significant challenges. OBJECTIVES: This study explores the diagnostic and prognostic role of PANoptosis-related genes (...BACKGROUND: The early detection and diagnosis of head and neck squamous cell carcinoma (HNSCC) pose significant challenges. OBJECTIVES: This study explores the diagnostic and prognostic role of PANoptosis-related genes (PANRGs) in HNSCC. METHODS: In this study, machine learning was used to identify PANoptosis-related biomarkers in HNSCC, and a corresponding prognostic risk model was constructed. RESULTS: This study identified ZBP1, RIPK1, FADD, and RNF31 as biomarkers for HNSCC, among which ZBP1, RIPK1, and RNF31 served as protective factors, while FADD functioned as a risk factor. Based on the median Risk Score of the biomarkers, the validation set was categorized into high-risk and low-risk groups. NOBOX, SOX14, GBX1, and NKX2-4 were identified as hub genes playing critical roles in distinguishing the high-risk and low-risk groups, and these hub genes were significantly negatively enriched in the PPAR signaling pathway. Furthermore, immune infiltration analysis revealed that the abundance of immune cells in the low-risk group was significantly higher than that in the high-risk group. CONCLUSION: This study identified four PANoptosis-related biomarkers in HNSCC, with ZBP1, RIPK1, and RNF31 as protective factors and FADD as a risk factor. These findings provide new references for improving the prognosis of HNSCC patients and developing novel therapeutic strategies.