OBJECTIVE: To evaluate the quality and readability of large language models (LLMs) when responding to Frequently Asked Questions (FAQs) about oral lichen planus (OLP). METHODS: We evaluated the responses of three LLMs (C...OBJECTIVE: To evaluate the quality and readability of large language models (LLMs) when responding to Frequently Asked Questions (FAQs) about oral lichen planus (OLP). METHODS: We evaluated the responses of three LLMs (ChatGPT-4o, Gemini 2.0 Flash Experimental, and Copilot) to 13 patient-centered FAQs about OLP. Questions were identified using query tools, and answers were assessed by 14 oral medicine experts using the Quality Assessment of Medical Artificial Intelligence (QAMAI) tool. Readability was analyzed with the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKG) tools. RESULTS: All LLMs provided generally accurate and relevant responses, with median QAMAI scores indicating "good" to "very good" quality. ChatGPT achieved slightly higher completeness, particularly for questions on OLP definition and treatment. The reference provision was inconsistent across all chatbots. Readability analysis revealed that most responses required college-level literacy, with ChatGPT producing the most complex texts, Gemini occasionally achieving more accessible outputs, and Copilot situated in an intermediate position. CONCLUSIONS: LLMs may have potential as adjunctive tools for patient education in OLP, although they remain limited by incomplete information, inconsistent references, and suboptimal readability. Future research should incorporate longitudinal LLMs evaluations and training to develop models delivering accurate, accessible information, tailored to users' literacy levels.
OBJECTIVE: After reviewing the various interventions to evaluate their impact on guiding patients towards plaque control, their effects on periodontitis stabilisation, and the behavioural changes reported by patients. ME...OBJECTIVE: After reviewing the various interventions to evaluate their impact on guiding patients towards plaque control, their effects on periodontitis stabilisation, and the behavioural changes reported by patients. METHODS: This PROSPERO-registered systematic review followed PRISMA guidelines. Randomised controlled trials in adults with periodontitis assessing interventions to improve motivation for plaque control were included. Primary outcome was plaque index; secondary outcomes were other periodontal parameters and patient-reported behaviours. Study selection in different databases, data extraction, and risk-of-bias assessment were performed independently by two reviewers. RESULTS: Eight trials were included, with four different motivational interventions. Motivational Interviewing showed positive trends but no significant differences versus control (motivation-method described in the latest recommendations). Behavioural Interventions demonstrated plaque index and probing depth improvements, along with stronger tooth-brushing adherence. Patients included in Individually Tailored Oral Health Educational Programmes showed significantly greater plaque index improvement and maintenance of interdental cleaning versus controls. The Self-Care Commitment Model enhanced plaque control and self-care behaviours, though between-group differences were limited. These last three interventions were multi-sessional. The level of evidence was generally low-to-moderate. CONCLUSIONS: Multi-session motivational interventions seemed to have a positive effect for guiding patients towards behavioural changes. Larger and longer-term studies are needed to confirm these findings. TRIAL REGISTRATION: PROSPERO registration number: CRD42024551991.
OBJECTIVES: This study evaluated the efficacy of photobiomodulation (PBM) at acupuncture points for managing xerostomia in patients with Sjögren's Disease. MATERIAL AND METHODS: In this randomized, double-blind clinical...OBJECTIVES: This study evaluated the efficacy of photobiomodulation (PBM) at acupuncture points for managing xerostomia in patients with Sjögren's Disease. MATERIAL AND METHODS: In this randomized, double-blind clinical trial, 50 patients were assigned to PBM group (n = 22) or sham-PBM group (n = 28). The primary outcome was xerostomia symptoms assessed using a visual analogue scale (VAS). Secondary outcomes included Xerostomia Inventory, resting salivary flow rate (RSFR), and EULAR Sjögren's Syndrome Patient Reported Index score. Participants received weekly PBM sessions for four consecutive weeks, and evaluations were conducted at baseline, week 8 and 12. RESULTS: PBM showed a marginal tendency toward improvement on VAS (p = 0.0974) (OR = 1.929 95% CI 0.8939-4.525) and in the RSFR (p = 0.09996) (OR = +infinity 95% CI 0.9363-infinity) at week 8 compared with sham-PBM. However, no statistically significant differences were observed between groups at week 12 for any of the assessed outcomes. CONCLUSION: PBM at acupuncture points demonstrated a slight short-term benefit at week 8 in improving xerostomia symptoms and RSFR, although these effects did not persist at 12 weeks. These preliminary results suggest a potential role for PBM at acupuncture points as a safe, noninvasive adjunctive therapy for xerostomia in patients with SjD, warranting further validation in larger, long-term trials. TRIAL REGISTRATION: This study was registered in The Brazilian Registry of Clinical Trials (U1111-1298-9891).
OBJECTIVE: This study aimed to clarify the association between periodontitis and prostate-specific antigen and to guide the early prostate-specific antigen screening of periodontitis patients. MATERIALS AND METHODS: 1409...OBJECTIVE: This study aimed to clarify the association between periodontitis and prostate-specific antigen and to guide the early prostate-specific antigen screening of periodontitis patients. MATERIALS AND METHODS: 1409 participants who visited West China Hospital of Sichuan University during 2021 and 2022 were included. Measurements were taken for blood pressure, fasting blood glucose, total cholesterol, triglycerides, C-reactive protein, carcinoembryonic antigen, and prostate-specific antigen. Participants went through periodontal examinations and were grouped into non-periodontitis individuals, mild periodontitis, moderate periodontitis, and severe periodontitis. Logistic regression was used to explore the potential associations. RESULTS: Patients with severe periodontitis had significantly higher serum prostate-specific antigen compared to non-periodontitis individuals. No significant association between periodontitis and prostate-specific antigen was found in participants aged 20-40. In patients aged 41-80, regression models showed a significant association between elevated prostate-specific antigen and severe periodontitis, which was not significant in patients with mild and moderate periodontitis. CONCLUSION: In Chinese men aged 20-80 years, serum prostate-specific antigen was significantly higher in patients with severe periodontitis than in non-periodontitis patients. Severe periodontitis was significantly associated with elevated PSA levels among elder patients.
OBJECTIVE: To analyze the nuclear abnormalities of cytotoxicity-karyorrhexis (KR), karyolysis (KL), and pyknosis (PN)-and genotoxicity-micronucleus (MN) in exfoliated cells from different sites of the oral mucosa in pati...OBJECTIVE: To analyze the nuclear abnormalities of cytotoxicity-karyorrhexis (KR), karyolysis (KL), and pyknosis (PN)-and genotoxicity-micronucleus (MN) in exfoliated cells from different sites of the oral mucosa in patients with Epidermolysis Bullosa (EB) and a control group. MATERIALS AND METHODS: This cross-sectional observational study collected sociodemographic and clinical data through physical examination and a standardized questionnaire. Cells from the buccal, labial, and lingual mucosa were obtained via exfoliative cytology and evaluated for MN, KR, KL, and PN frequencies. Mann-Whitney and Kruskal-Wallis tests were applied. RESULTS: A total of 20 EB individuals were selected. The control group (n = 20) was matched for sex and age with EB. Males (40%) and females (60%) demonstrated a similar distribution and individuals aged ≤ 19 years represented the majority (65%). An increase in KR and KL was detected in EB, with a greater prevalence in the buccal (p = 0.0002 and p < 0.0001) and labial mucosa (p = 0.0005 and p = 0.0240). EB patients showed a higher frequency of MN in the buccal mucosa (p = 0.0083). CONCLUSION: An increase in nuclear abnormalities at different sites of the oral mucosa demonstrated the genetic instability associated with EB. Exfoliative cytology represents a potential tool for oral biomonitoring in these patients.
OBJECTIVE: To compare the adjunctive efficacy of a hyaluronic acid (HA) gel with 0.20% chlorhexidine (CHX) during nonsurgical periodontal therapy in periodontal patients over 6 months. METHODS: A single-blind, randomized...OBJECTIVE: To compare the adjunctive efficacy of a hyaluronic acid (HA) gel with 0.20% chlorhexidine (CHX) during nonsurgical periodontal therapy in periodontal patients over 6 months. METHODS: A single-blind, randomized, controlled trial included 40 healthy, nonsmoking adults with periodontitis. After supra- and subgingival debridement, patients used either HA gel (Aftoral; hyaluronic acid with glycerophosphoinositol and xylitol) or CHX mouthwash (Unidea; 0.20% chlorhexidine digluconate) once daily for 15 days at each time recall appointment. Clinical parameters-probing pocket depth (PPD, primary outcome), plaque control record (PCR), bleeding on probing (BoP), gingival recession (GR), tooth mobility (TM), clinical attachment level (CAL), and satisfaction (VAS)-were measured at baseline, 1, 3, and 6 months by a blinded examiner. Nonparametric tests were applied with significance at p < 0.05. RESULTS: HA showed greater PPD reduction than CHX at 3 and 6 months (-0.44 mm vs. -0.26 mm; p < 0.01). PCR and BoP decreased more in the HA group (p < 0.05), while CAL gain was higher (-0.43 mm vs. -0.21 mm; p < 0.05). GR, TM, and VAS showed no differences. No adverse events occurred. CONCLUSIONS: Adjunctive HA gel improved PPD, PCR, BoP, and CAL compared with CHX, confirming safety, and clinical benefit.
OBJECTIVE: To investigate the distribution, lineage fate, and reparative function of Thy1 lineage cells in the mouse mandible. METHODS: Single-cell transcriptomic analysis was used to identify osteogenic subpopulations w...OBJECTIVE: To investigate the distribution, lineage fate, and reparative function of Thy1 lineage cells in the mouse mandible. METHODS: Single-cell transcriptomic analysis was used to identify osteogenic subpopulations within mandibular mesenchymal stem cells. Lineage tracing in Thy1-CreERT2;Rosa26-tdTomato mice was employed to map the localization and osteogenic contribution of Thy1 lineage cells, while a critical-sized mandibular defect model was established to assess their reparative dynamics. Loss- and gain-of-function experiments were performed using Thy1-CreERT2;Rosa26-DTR mice and transplantation of purified tdTomato periosteal cells within hydrogel scaffolds. RESULTS: Single-cell analysis identified a Thy1-enriched osteoprogenitor subpopulation preferentially localized to the periosteum. Lineage tracing revealed that Thy1-lineage cells constituted a major proportion of periosteal osteogenic cells and exhibited clonogenic expansion and ectopic bone formation. Following mandibular injury, tdTomato cells progressively accumulated within the callus and represented the predominant osteogenic cell population at later stages. Genetic ablation of Thy1-lineage cells markedly impaired bone repair, whereas transplantation of purified tdTomato periosteal cells enhanced bone formation within the defect. CONCLUSIONS: Thy1 lineage periosteal cells represent a functionally important osteoprogenitor population in mandibular bone regeneration, providing a cellular framework for future mechanistic and translational studies.
OBJECTIVE: To compare the effectiveness of a formulated 5% thyme mouthwash with 0.2% aqueous chlorhexidine solution for improving oral health in ventilator-dependent intensive care unit (ICU) patients. METHODS: This pros...OBJECTIVE: To compare the effectiveness of a formulated 5% thyme mouthwash with 0.2% aqueous chlorhexidine solution for improving oral health in ventilator-dependent intensive care unit (ICU) patients. METHODS: This prospective, triple-blinded, randomized controlled trial (RCT) allocated 46 mechanically ventilated patients to the thyme (n = 23) or 0.2% aqueous chlorhexidine solution (n = 23) groups. Oral health indices, including the Oral Health Assessment Tool (OHAT), were evaluated at baseline and re-evaluated 5 days (Day 5) after the intervention commenced. RESULTS: Baseline characteristics were comparable. Both mouthwashes significantly improved oral health indicators from baseline (p < 0.001). However, on Day 5, the thyme group showed a statistically greater improvement in key OHAT components compared to the 0.2% aqueous chlorhexidine solution group (e.g., Oral Hygiene score, p = 0.004). Importantly, no adverse reactions or tolerability issues were reported in either group. CONCLUSION: The 5% thyme mouthwash demonstrated comparable effectiveness to the 0.2% aqueous chlorhexidine solution by Day 5. This positions the thyme-based mouthwash as a viable, well-tolerated alternative to conventional 0.2% aqueous chlorhexidine solution for oral care in invasively ventilated ICU patients.
OBJECTIVE: To synthesize evidence on spirituality in patients with head and neck cancer (HNC), focusing on its dimensions, assessment strategies, and impact on health outcomes. METHODS: A comprehensive search of PubMed,...OBJECTIVE: To synthesize evidence on spirituality in patients with head and neck cancer (HNC), focusing on its dimensions, assessment strategies, and impact on health outcomes. METHODS: A comprehensive search of PubMed, Embase, LILACS, Web of Science, Scopus, and gray literature identified qualitative and quantitative studies explicitly addressing spirituality in HNC. Eligible sources were narratively synthesized. RESULTS: Twenty-one studies met inclusion criteria. Core spiritual dimensions included the search for meaning, inner peace, religious faith, and a positive outlook. Six studies reported associations between spirituality and improved quality of life (QoL), while three described enhanced coping capacity and emotional resilience. Religious faith, irrespective of denomination, was associated with better pain management, fewer treatment-related side effects, lower existential distress, and, in some studies, improved survival outcomes. The Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale was the most frequently applied instrument, assessing beliefs, meaning, and inner peace. CONCLUSION: Spirituality was frequently associated with coping capacity, psychological adjustment, and QoL in patients with HNC. Integrating spiritual care into holistic oncology practice may enhance treatment adherence, resilience, and patient well-being.
BACKGROUND: This study investigates the association between single-nucleotide polymorphisms (SNPs) in the MMP-1, MMP-8, and MMP-13 genes and the risk of oral mucositis development in paediatric patients with leukaemia an...BACKGROUND: This study investigates the association between single-nucleotide polymorphisms (SNPs) in the MMP-1, MMP-8, and MMP-13 genes and the risk of oral mucositis development in paediatric patients with leukaemia and lymphoma who are undergoing methotrexate (MTX) treatment. MTX is associated with inflammatory effects and oxidative stress, which activate MMPs, enzymes responsible for degrading the extracellular matrix. This study aimed to investigate the association between MMPs polymorphisms (rs1799750, rs3025058, and rs2252070) with OM in the oncopediatric patients treated with MTX. METHODS: Genomic DNA from 100 patients was extracted from saliva and genotypes were obtained by PCR-RFLP. Genotype data were measured using the Chi-square test. Haplotype estimation, Hardy-Weinberg equilibrium, linkage disequilibrium, multiple logistic regression analyses was conducted using SNPStats and with R. MCA performed with the packages FactoMineR and factoextra. RESULTS: The results show that the MMP-1 g.-1607 G>GG, MMP-8 g.-799 C>T, and MMP-13 g.-77 A>G polymorphisms are associated with the occurrence of oral mucositis. The MMP-8 g.-799 C>T polymorphism was also associated with greater disease severity. CONCLUSIONS: The study highlights the importance of these MMPs polymorphisms as potential markers for predicting susceptibility to oral mucositis, suggesting that these data could help tailor treatments to minimise the occurrence and severity of mucositis.
OBJECTIVE: Oral squamous cell carcinoma (OSCC) is an aggressive malignancy with poor therapeutic outcomes and high recurrence rates. This review aims to summarize the structural, molecular, and analytical mechanisms unde...OBJECTIVE: Oral squamous cell carcinoma (OSCC) is an aggressive malignancy with poor therapeutic outcomes and high recurrence rates. This review aims to summarize the structural, molecular, and analytical mechanisms underlying the anticancer effects of key phytochemicals, including curcumin, resveratrol, and anthocyanins, and other phytochemicals in OSCC. METHODS: A narrative review was performed based on a structured literature search of PubMed, Scopus, and Web of Science using predefined keywords related to OSCC, phytochemicals, molecular signaling pathways, and analytical characterization. Relevant preclinical and mechanistic studies were critically evaluated. RESULTS: Phytochemicals exert anticancer effects in OSCC by modulating major signaling pathways such as PI3K/Akt/mTOR, VEGF, IL-6, Bax/Bcl-2, and MMP2/9, resulting in the regulation of apoptosis, cell proliferation, angiogenesis, and metastasis. Chromatographic and spectroscopic techniques play a pivotal role in the extraction, characterization, quantification, and structural elucidation of phytochemicals, supporting pharmacological standardization. Furthermore, several phytochemicals demonstrate synergistic effects with conventional chemotherapeutic agents and may reduce treatment-associated toxicity. CONCLUSION: This review integrates molecular, structural, and analytical evidence to provide a comparative framework for the role of phytochemicals in OSCC management. Although preclinical data strongly support their therapeutic potential, further analytical refinement and well-designed clinical studies are necessary to translate these findings into effective OSCC treatments.
OBJECTIVE: This study compared the clinical outcomes of ultrasound-guided temporomandibular joint lavage and intra-articular injection with traditional methods for treating temporomandibular disorders (TMD), aiming to of...OBJECTIVE: This study compared the clinical outcomes of ultrasound-guided temporomandibular joint lavage and intra-articular injection with traditional methods for treating temporomandibular disorders (TMD), aiming to offer valuable insights for clinical. MATERIALS AND METHODS: Forty TMD patients (20 per group) were randomly assigned to receive either traditional temporomandibular joint lavage and intra-articular injection or an ultrasound-guided approach. Immediate postoperative MRI assessed the joint cavity. RESULTS: Ultrasound guidance significantly reduced the number of needle attempts compared to the traditional approach (p < 0.01). Immediate post-procedure MRI showed no significant difference in superior joint cavity injection success between groups. However, the ultrasound-guided group had a significantly better success rate for the inferior joint cavity (p < 0.05). Three days post-procedure, the ultrasound-guided group demonstrated significantly better pain relief and maximum mouth opening (p < 0.05). At seven days post-procedure, there were no significant differences in pain levels or maximum mouth opening between the two groups (p > 0.05). The occurrence of postoperative complications was similar in both groups (p > 0.05). CONCLUSION: Ultrasound-guided treatment is a precise and minimally invasive method for treating TMD, offering better outcomes in terms of pain relief and joint function.
de Santana Barros AKO, Gomes-Filho IS, da Cruz SS
… +13 more, Trindade SC, Miranda SS, Figueiredo ACMG, Carneiro DO, Dos Santos MCAM, de Souza Sacramento I, de Moraes Marcílio Cerqueira E, Batista JET, Hintz AM, Seymour GJ, Scannapieco FA, Loomer PM, de Santana Passos-Soares J
OBJECTIVES: This study assessed oral health-related quality of life in individuals with and without obesity, and investigated its association with socioeconomic-demographic characteristics, lifestyle habits, health condi...OBJECTIVES: This study assessed oral health-related quality of life in individuals with and without obesity, and investigated its association with socioeconomic-demographic characteristics, lifestyle habits, health conditions, and clinical care. METHODS: A cross-sectional study was conducted with 250 individuals (≥ 18 years) in Salvador-Brazil. Data were collected using structured questionnaires, anthropometric assessments, and clinical oral examinations. Oral health-related quality of life was measured using the Oral Health Impact Profile-14. Obesity was classified by waist circumference. Sequential blockwise multiple regression models were employed for data analysis. RESULTS: Impaired oral health-related quality of life was reported by 56.7% of the overall sample. Obese individuals showed worse Oral Health Impact Profile-14 scores compared to non-obese individuals, with greater impairment in physical pain, and physical, psychological, and social disability domains. In final multivariate models, female sex, cardiovascular disease, and the decayed, missing, and filled teeth index were associated with impaired oral health-related quality of life among obese individuals. CONCLUSIONS: Obese individuals showed lower oral health-related quality of life scores than non-obese individuals, linked to poor oral health. Female sex, cardiovascular disease, and high decayed, missing, and filled teeth index scores emerged as significant factors associated with worse outcomes.
BACKGROUND: Periodontitis is characterized by periodontal ligament and alveolar bone destruction. Bone morphogenetic protein 9 (BMP9) is essential for periodontal tissue regeneration. This study investigates the impact a...BACKGROUND: Periodontitis is characterized by periodontal ligament and alveolar bone destruction. Bone morphogenetic protein 9 (BMP9) is essential for periodontal tissue regeneration. This study investigates the impact and underlying mechanism of BMP9 on osteogenic differentiation. METHODS: Periodontal ligament stem cells (PDLSCs) were treated with lipopolysaccharide (LPS) to simulate an inflammatory environment in vitro. Osteogenic differentiation was subsequently assessed. We further examined how sodium lactate (NaLa) and 2-deoxy-D-glucose (2-DG) modulated histone lactylation and BMP9 expression. For the in vivo study, experimental periodontitis was induced in rats, followed by local administration of NaLa or BMP9 inhibition. After 30 days, the maxillae were collected and analyzed by micro-computed tomography (micro-CT) and histological staining. RESULTS: LPS treatment significantly downregulated BMP9 expression and impaired osteogenic differentiation in PDLSCs. NaLa enhanced H3K18 lactylation at the BMP9 promoter, increasing BMP9 expression and improving osteogenic differentiation. Conversely, 2-DG inhibited glycolysis, reducing H3K18 lactylation and BMP9 expression. BMP9 overexpression partially restored osteogenic differentiation in LPS-treated PDLSCs. In vivo, we found that inhibition of BMP9 could effectively induce alveolar bone loss in rats with experimental periodontitis. CONCLUSIONS: Modulating lactate metabolism to enhance H3K18la levels and BMP9 expression could be a novel therapeutic strategy for promoting periodontal tissue regeneration in inflammatory conditions.
OBJECTIVE: To investigate the senescence/apoptosis phenotype of PD-L1 macrophages in gingival tissues with periodontitis and their relationship with the PI3K/AKT pathway. METHODS: Immunohistochemistry and multiplex immun...OBJECTIVE: To investigate the senescence/apoptosis phenotype of PD-L1 macrophages in gingival tissues with periodontitis and their relationship with the PI3K/AKT pathway. METHODS: Immunohistochemistry and multiplex immunofluorescence were used to assess PD-L1 expression and its colocalization with CD68/CD163 and p21 in human periodontitis gingival tissues. Public single-cell and bulk transcriptomic datasets were integrated to characterize PD-L1 macrophages. RAW264.7 senescence models were induced separately with Porphyromonas gingivalis LPS or HO, followed by lentiviral shRNA knockdown of PD-L1 to evaluate SASP, apoptosis-related markers, and PI3K/AKT signaling. RESULTS: PD-L1 was markedly upregulated in periodontitis gingiva and enriched in p21 macrophages. Single-cell and bulk analyses showed expansion of PD-L1 macrophages accompanied by upregulation of CDKN1A/CDKN2A and SASP factors such as IL-6 and IL-1β, increased expression of BCL2 family members, and activation of PI3K/AKT signaling. In the in vitro senescence model, PD-L1, p-PI3K, and p-AKT were elevated, and cells exhibited resistance to apoptosis. PD-L1 knockdown reduced PI3K/AKT activity, alleviated senescence and SASP, and promoted apoptosis. CONCLUSION: In periodontitis, PD-L1 senescent macrophages maintain inflammatory amplification and resistance to apoptosis through activation of the PI3K/AKT pathway. The PD-L1/PI3K/AKT axis may represent a potential immunomodulatory target for periodontitis treatment.
Brailo V, Lopez-Pintor RM, Harte M
… +21 more, Rogulj AA, Juras DV, Škrinjar I, Freitas MD, Posse JL, Monteiro L, Silva LM, Fricain JC, Naveau A, Lodi G, Lombardi N, Varoni E, López JL, Moreno SE, Ariyaratnam R, Alqarni AA, Ríordáin RN, Addison O, Li Y, Tamimi F, Albuquerque R
AIM: Optimal wound healing is a primary objective in oral surgical procedures. This study evaluated the effects of chlorhexidine + anti-discoloration system (CHX + ADS) with or without hyaluronic acid (HA) mouth rinse co...AIM: Optimal wound healing is a primary objective in oral surgical procedures. This study evaluated the effects of chlorhexidine + anti-discoloration system (CHX + ADS) with or without hyaluronic acid (HA) mouth rinse compared to placebo (PLCB) in promoting wound healing following third molar surgery. METHODS: Healthy subjects with indication to third molar extraction were included in this single center, randomized, placebo-controlled clinical trial. Following surgery, the patients were randomly assigned to three treatment groups, namely CHX + ADS + HA, CHX + ADS, or PLCB. Wound healing was assessed at 3, 7 and 14 days postoperatively using the Early Healing Index (EHI) ranging between Score 1 (complete wound healing in the absence of fibrin line) and 5 (incomplete wound healing with necrotic tissue). RESULTS: Fifty-four patients (18 per group) were included in the analysis. At 3 and 7 days, EHI scores were lower in both CHX + ADS- groups compared to PLCB (p < 0.01 for CHX + ADS + HA, p < 0.05 for CHX + ADS). Improved healing at Days 3 and 7 was observed in the CHX + ADS + HA compared to CHX + ADS (p < 0.05). At 14 days, no differences were noted among groups. CONCLUSION: CHX + ADS-based mouth rinses promoted early wound healing compared to placebo. The adjunct of HA improved wound closure, especially in the first postoperative week. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05414253.
OBJECTIVES: Oncological treatments can have adverse effects on oral health and cause long-term complications such as osteonecrosis. This retrospective study investigated the oral health of head and neck cancer patients b...OBJECTIVES: Oncological treatments can have adverse effects on oral health and cause long-term complications such as osteonecrosis. This retrospective study investigated the oral health of head and neck cancer patients before radiotherapy and patients with multiple myeloma, breast, prostate, lung, and kidney cancers before antiresorptive therapy. MATERIALS AND METHODS: Altogether 154 patients referred to dental screening before initiation of these therapies at Helsinki University Hospital in 2021 were included. Under the Helsinki protocol, the aim was to assess and treat the patients in a single day, progressing from examination to counseling and, if needed, to extractions. RESULTS: Before oncological treatment, 61.7% of the patients required at least one tooth extraction due to infection foci. Among antiresorptive therapy patients, multiple myeloma patients had less need for extraction (p = 0.006). Head and neck cancer patients smoked and used alcohol more than antiresorptive therapy patients. Smoking was associated with the need for extractions (p = 0.001). CONCLUSION: The Helsinki protocol enables efficient oral health evaluation without delaying cancer treatment. Head and neck cancer patients and antiresorptive therapy patients need dental evaluation before oncological treatment. Over half of patients had infection foci requiring extraction. Multiple myeloma patients showed a lower extraction need than other antiresorptive therapy patients.
OBJECTIVE: This study evaluated the CD4 T-cell role in mediating post-Rituximab Pemphigus vulgaris (PV) relapse, comparing CD4 count and CD4/CD20 ratio between patients who achieved remission and those who relapsed. METH...OBJECTIVE: This study evaluated the CD4 T-cell role in mediating post-Rituximab Pemphigus vulgaris (PV) relapse, comparing CD4 count and CD4/CD20 ratio between patients who achieved remission and those who relapsed. METHODS: The clinical course of 27 PV patients treated with Rituximab was evaluated after a 32-month median follow-up. CD4 and CD20 counts and CD4/CD20 ratio were longitudinally collected at treatment start date (T0), at 2-month intervals after Rituximab, until B-cell repopulation, at B-cell repopulation, at 6-, 12-, and 24-month intervals after repopulation, and at the end of follow-up or at relapse. RESULTS: Patients were administered Rituximab as adjuvant therapy: 16 (59%) relapsed while 11 (41%) achieved clinical remission. Higher CD4 count (p = 0.02*) and CD4/CD20 ratio (p = 0.004**) were found at B-cell repopulation in patients experiencing remission. Moreover, a significant difference (p = 0.002**) in post-repopulation CD4 T-cell course was found between groups, with patients in clinical remission reporting a mean decrease of 233.5 cells/μL during follow-up and relapsing patients experiencing a mean increase of 539.4 cells/μL and reaching the maximum CD4 value at relapse. CONCLUSIONS: Lower CD4 T-cell value at repopulation and increasing post-repopulation CD4 T-cell count were predictive of disease relapse suggesting a time-dependent role of CD4 T cells in post-Rituximab PV reactivation.