The objective of this systematic review was to synthesize evidence on the early clinical exposure (ECE) and its effectiveness, student experiences, and outcomes in undergraduate dental education. In August 2025, the systematic search was carried out in PubMed, Scopus, and Web of Science. The quantitative, qualitative, and/or mixed-methods peer-reviewed studies evaluating ECE to undergraduate dental students were included. Summary synthesis of included studies was carried out. The risk of bias and quality assessment was assessed with Cochrane Risk of Bias 2, ROBINS-I tool, Joanna Briggs Institute, and Critical Appraisal Skills programme. Nine studies (2007- August 2025) from a range of countries were included. ECE interventions were chairside demonstration, peer-assisted shadowing, simulation, clinical/community placements, and hybrid models. There is evidence of effectiveness of ECE in knowledge, psychomotor skills, and affective domains. In addition, student experiences were reported as positive and significant increases in satisfaction, confidence, motivation, clinical reasoning and other learning gains such as professional identity, empathy, and communication. Six out of nine included studies were non-randomized studies. All the non-randomized studies were reported methodological biases, including small single-center samples, self-report measures, short follow-up periods, and rated as some concern and high risk of bias. ECE in undergraduate dental education promising contribution to the cognitive, psychomotor, and affective domains and reduces transition stress to clinical training. However, presence of methodological bias in included studies undermines the evidence. Future studies with robust objective performance measures, multicentre designs, and longitudinal follow-up should be carried out to better establish the educational and clinical impact of ECE in dental education.
Early distinction between oral squamous cell carcinoma (OSCC) and possibly malignant disorders (PMDs) has been one of the most important diagnostic issues that may involve invasive biopsies. Therefore, it is of interest to assess the usefulness of salivary lactate dehydrogenase (LDH) and matrix metalloproteinase-9 (MMP-9) as non-invasive biomarkers of early detection. Spectrophotometry and ELISA were used in analyzing saliva samples of 135 participants (50 OSCC, 45 PMDs, 40 controls). The level of LDH and MMP-9 was much greater in OSCC than in PMDs and controls and demonstrated very high diagnostic accuracy (AUC > 0.89). Simultaneous biomarker measurement had better sensitivity and specificity indicating their possible use as well-grounded, non-invasive measures of screening oral cancer in its early stages.
Background Porphyromonas gingivalis (P. gingivalis) is a key pathogen in chronic periodontitis that drives dysbiosis and tissue destruction. Anaerobic culture often underestimates fastidious bacteria, whereas real-time polymerase chain reaction (RT-PCR) can provide higher sensitivity and accurate quantification. This study compared both methods for detecting and quantifying P. gingivalis in subgingival plaque from patients with chronic periodontitis and healthy controls. Methodology In total, 32 participants (16 with chronic periodontitis and 16 healthy) were included. Pooled subgingival plaque samples were analyzed by anaerobic culture on selective media and by RT-PCR targeting the 16S rRNA gene with a TaqMan probe and standard curve quantification. Clinical parameters were recorded (probing depth (PD), clinical attachment loss (CAL), and gingival index (GI)), and data were analyzed using t-tests, chi-square tests, Pearson's correlation, and diagnostic metrics. Results Participants with chronic periodontitis had significantly higher clinical parameters (PD = 6.38 ± 0.96 mm, CAL = 3.63 ± 1.09 mm, GI = 2.50 ± 0.22; all p = 0.001) and P. gingivalis loads (culture = 82.13 ± 54.26 CFU/mL, p = 0.031; RT-PCR = 97.44 ± 59.02 CFU equivalents/mL, p = 0.039) than controls. Bacterial load showed moderate positive correlations with clinical parameters (r = 0.35-0.42, p < 0.05). RT-PCR detected P. gingivalis in 59.4% of samples versus 50% by culture, achieving 100% sensitivity and 90.6% accuracy. Conclusions RT-PCR is more sensitive than culture for P. gingivalis detection, supporting its use for improved periodontal diagnosis and risk assessment.
Oral squamous cell carcinoma (OSCC) is a predominant form of cancer that affects the oral cavity of the mucosal epithelium layer. Withanolides are a structurally related family of natural products extracted from the herbal plant (Withania genus). Many active members of this family play a major role in the prevention and cure of OSCC, while some also show potent activity as anticancer agents. The data covered by this review were collected from different databases, including PubMed, Scopus, and Web of Science, focusing on studies relevant to withanolides and their applications against oral squamous cell carcinoma from 2020 to 2025. The core structure of withanolides consists of a steroidal ring system along with a lactone moiety. Presently, more than 1200 withanolides with different lactones and an array of different functional groups have been identified. This article focuses on several key derivatives, elucidating their targets and signalling molecular pathways that modulate cellular survival, proliferation, invasion, and metastasis. As an example, withaferin A (WA) is a well-studied withanolide that exhibits potent anticancer effects in oral squamous cell carcinoma. WA has been shown to modulate key signalling pathways such as NF-κB, PI3K/Akt, and heat shock protein regulation, leading to apoptosis, autophagy, and cell cycle arrest. The classification of this large family of withanolides is presented, based on structural differences correlated with their anticancer effects, molecular targets, and signalling pathways. Additionally, the potential of these derivatives in enhancing therapeutic strategies and overcoming resistance to conventional treatments is described and summarized. By understanding the intricate mechanisms through which withanolides exert their effects, future research can develop novel cancer therapies that leverage the efficacy of these natural compounds.
Oral health plays a significant role in an individual's well-being. Poor oral health is manifested as tooth loss, dental caries, periodontal diseases, and oral cancer. Early stages are often asymptomatic, but advanced stages of dental caries may lead to pain, infections, abscesses, and even sepsis. Any disease that could interfere with the activities of daily life may have an adverse effect on the general quality of life. The concept of oral health-related quality of life (OHRQoL) brings a new perspective to clinical care and research. It shifts the focus of clinicians and researchers from the oral cavity alone to the patient as a whole. Therefore, the notion of OHRQoL is the product of many observations and studies on the impact of oral diseases on various aspects of life. A thorough analysis of current studies was conducted to explore the impact of dental caries on OHRQoL in individuals aged 18 to 40. This process involved an extensive search through electronic databases, including Cochrane Central, Ovid, Web of Science, and PubMed. Studies that met the inclusion criteria, specifically those detailing cross-sectional research on the influence of dental caries on OHRQoL, were chosen. These studies were then evaluated for potential bias using the AXIS (Appraisal Tool for Cross-Sectional Studies) tool. The database search resulted in 9,058 unique records, with 8,893 deemed irrelevant. After an initial title screening, unrelated articles were eliminated. Of the 165 articles reviewed, 75 were removed due to duplication. Consequently, 90 articles underwent further scrutiny: 60 were excluded after reviewing their titles and abstracts, and 30 were subjected to a full-text review. Of these, 17 did not satisfy all the selection criteria and were excluded. The final review included 13 studies. Among these, eight used the Oral Health Impact Profile (OHIP)-14 questionnaire, while five used the Oral Impact on Daily Performances (OIDP) questionnaire, with all studies showing a significant connection between dental caries and OHRQoL. In all 13 studies, a significant association was observed between age groups (both young adults and adults) and OHRQoL due to untreated dental caries. Dental caries affected the OHRQoL in both young adults and adults. The findings provide evidence of increased impairment in OHRQoL with the greater severity and extent of untreated dental caries.
