Although MMP-8, IL-1β, and IL-6 have been implicated in peri-implantitis, their diagnostic accuracy for detecting peri-implantitis has not been systematically quantified. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of matrix metalloproteinase-8 (MMP-8), interleukin-1β (IL-1β), and interleukin-6 (IL-6) for the detection of peri-implantitis, and to compare their levels between peri-implantitis patients and healthy controls. A comprehensive literature search was conducted across English and Chinese Database up to May 1st, 2026. Studies reporting diagnostic accuracy data or biomarker concentrations for MMP-8, IL-1β, or IL-6 were included. Pooled standardized mean differences (SMD) with 95
Despite the recognized biological relevance of the PD-1/PD-L1 axis in immune evasion, the prognostic significance of PD-L1 expression in surgically treated oral squamous cell cancer (OSCC) patients remains largely unclear. To investigate the prognostic significance of PD-L1 expression in a large cohort of OSCC patients primarily treated surgically in a single center. This analysis included 156 consecutive OSCC patients treated with curative-intent surgery with their clinicopathologic variables, treatment details and clinical treatment outcomes. PD-L1 expression was categorized using the Combined Positive Score (CPS), defining PD-L1 positivity as CPS ≥ 10. Sensitivity analyses were repeated at the alternative thresholds CPS ≥ 1 and CPS ≥ 20. Survival and recurrence endpoints (OS, DFS, LRCR, NCR) were evaluated using Kaplan–Meier/log-rank methods and Cox regression with multivariable adjustment for key confounders. Of 156 consecutive OSCC patients, 120 (76.9
Minimizing pain during dental injections is essential for enhancing patient comfort and reducing anxiety-driven treatment avoidance. To evaluate a novel, engineered bilayer mucoadhesive patch designed to optimize drug bioavailability and reduce injection pain compared to a benzocaine gel. Split-mouth randomized clinical trial at Mashhad University of Medical Sciences involving 36 healthy patients requiring bilateral maxillary dental extractions. The primary predictor was the delivery format of the topical anesthetic agent. The novel 20
Orthognathic surgery is known to induce measurable alterations in nasal morphology. This study retrospectively assessed pre- and postoperative three-dimensional (3D) surface models (SMs) to evaluate nasal soft-tissue changes associated with clockwise (CW) and counterclockwise (CCW) Le Fort I movements combined with bilateral sagittal split osteotomy (BSSO). Fifty-six patients (23 CW, 33 CCW) who underwent Le Fort I osteotomy with BSSO between January 2016 and February 2020 were included. 3D SMs were obtained 1 day preoperatively and 6 weeks postoperatively using the Vectra M5 stereophotogrammetry system (Canfield Scientific, USA). Seventeen anthropometric nasal parameters were measured with OnyxCeph3 (Image Instruments, Germany). In the overall cohort, 8 of 17 nasal parameters showed significant postoperative changes. Most notably, transverse nasal dimensions increased, while nasal height and nasal dorsum length decreased. Subgroup analyses revealed that, after Holm–Bonferroni adjustment, 2 parameters remained significant in the CW group and 6 in the CCW group. However, direct between-group comparisons revealed no significant differences in the magnitude of postoperative changes. Le Fort I osteotomy combined with BSSO consistently alters nasal morphology, particularly by widening the alar and subalare regions and reducing nasal height. While both CW and CCW rotations produced measurable anthropometric changes, direct between-group comparisons showed no significant differences in the magnitude of postoperative changes.
The present study aimed to identify novel risk factors that influence buccal and lingual split patterns by focusing on individual mandibular ramus patterns in sagittal split ramus osteotomy (SSRO) cases. This retrospective cohort study analyzed 658 splits from patients who underwent an SSRO with the Hunsuck technique. Predictor variables included demographic and mandibular anatomy factors, while split patterns were used as outcome variables. Posterior ramus length and buccal horizontal osteotomy (BHO)-buccal type showed significant correlations with buccal bad split patterns. A 1-mm decrease in posterior ramus length increased the risk by up to 25
According to the literature, in our country, the first choice for the reconstruction of extensive defects after the removal of locally advanced oral tumors is free flap reconstruction, which achieves the best functional outcome. We investigated whether the anterolateral thigh flap, which can be closed primarily at the donor site and is usually indicated for large or complex defects, can be adapted for thin defects, as well. Within the framework of a pilot study, 10 patients who underwent radical ablative surgery for oral squamous cell carcinoma were reconstructed with an anterolateral thigh flap harvested in the superficial fascia plane. We compared our results with those of 42 oral cavity radial forearm flap reconstruction procedures. Of the 10 patients who underwent reconstruction with a thinned anterolateral thigh flap seven underwent surgery for sublingual tumor and three for tongue tumors. All the flaps healed uneventfully. The average flap thickness was 9.25 mm and the average pedicle length was 11.7 cm, which was similar to that of the radial forearm flap (8.6 mm and 12.1 cm). No complications were observed at the donor site, and in every case, we were able to close the donor site primary. The anterolateral free thigh flap harvested in the superficial fascia plane could be an appropriate choice for functional preservation and closure of the oral cavity. Considering that it is similar to the radial forearm flap in terms of thickness and pedicle length but has a more favorable donor site morbidity, its wider use is recommended.
This prospective experimental study evaluated whether short-term post-centrifugation handling under different environmental temperature conditions influences the macroscopic characteristics of platelet-rich fibrin (PRF) during routine clinical preparation. Venous blood samples were obtained from 38 healthy volunteers and processed using a standardized centrifugation protocol (3000 rpm, 10 min). PRF clots were harvested immediately after centrifugation or following 3 min of storage at room temperature (+ 20–22 °C) or + 4 °C. Macroscopic parameters, including clot weight, clot volume, membrane surface area, and membrane volume, were measured and compared. No statistically significant differences were observed among the three handling conditions for any of the measured macroscopic parameters (p > 0.05). However, donor-related factors influenced PRF dimensions. Female participants exhibited significantly greater clot weight and clot volume than males under all conditions, while increasing age was positively correlated with clot weight and volume in the room-temperature and + 4 °C groups (p < 0.05). Short-term post-centrifugation storage of PRF at room temperature or + 4 °C was not associated with statistically significant differences in its measured macroscopic characteristics. Future studies evaluating cellular viability, growth-factor release, fibrin architecture, mechanical properties, and biological activity are needed to complement these macroscopic findings.
Sialadenoma papilliferum (SP) is a rare benign salivary gland tumor characterized by a distinctive biphasic architecture and clinical resemblance to other papillary lesions of the oral cavity. Although recent studies have identified alterations in the MAPK pathway, particularly BRAF V600E mutations, the molecular landscape of this rare lesion remains incompletely characterized. We report a case of SP arising in the floor of the mouth of a 25-year-old male patient. Histopathological examination confirmed the diagnosis of SP, while immunohistochemical analysis revealed p63 positivity and negative staining for BRAF V600E and p16. Molecular analysis detected HPV-11 DNA by PCR-RFLP. To the best of the authors’ knowledge, this is the first reported case of HPV-11 DNA detection in SP. Further studies are needed to clarify the biological significance of HPV detection and to better characterize the molecular pathways involved in the development of this rare lesion.
To summarize the available clinical evidence on biological adjuncts in tooth autotransplantation, including adjunct types, application protocols, procedural variables, reported outcomes, and evidence gaps. This scoping review followed JBI guidance and PRISMA-ScR. PubMed/MEDLINE, Embase, Web of Science, Scopus, and LILACS were searched from inception to 21 June 2026. Clinical human studies reporting tooth autotransplantation with at least one biologic adjunct and clinical or radiographic outcomes were included. Data were charted for study characteristics, population, autotransplanted teeth, adjunct type and application protocol, follow-up, and key findings. Critical appraisal was performed using design-specific tools. Twenty-two sources published between 2005 and 2026 were included, comprising 234 patients and 257 autotransplanted teeth. Most evidence came from case reports and case series, with few comparative clinical studies. Platelet-derived preparations were the most frequently reported adjuncts, including L-PRF, A-PRF, PRP, PRGF, and CGF. Enamel matrix derivative was also reported, mainly as a root-surface application. Most studies described favorable clinical and radiographic outcomes, but protocols, root maturity, recipient-site conditions, stabilization, endodontic strategies, follow-up schedules, and outcome definitions were highly heterogeneous. Comparative and retrospective studies had serious risk of bias, mainly due to confounding. Biological adjuncts in tooth autotransplantation have demonstrated clinical feasibility in selected reports, but current evidence is insufficient to establish their independent benefit or superiority over standard protocols. Root maturity and procedural variables appear to be more consistent determinants of outcomes and should guide interpretation.
Our study aimed to evaluate procalcitonin (PCT) as a prognostic marker in advanced odontogenic infections. In addition, we sought to identify further prognostic markers that could be used to predict the length of hospital stay (LOS). We retrospectively analysed 61 patients who were hospitalised between January and August 2020 for surgical abscess drainage in the Department of Oral and Maxillofacial Surgery at the University Hospital of Bonn. Univariable logistic discrete hazard models were used to assess the association between baseline levels as well as temporal changes in laboratory parameters (PCT, C-reactive protein (CRP), and leukocytes) and LOS. In addition, a tree-based approach for modelling discrete time-to-event data was used to identify risk groups of patients with a prolonged LOS. Median LOS were 5, 7, and 9 days for different PCT concentrations < 0.1 µg/l, 0.1–0.5 µg/l, and > 0.5 µg/l, respectively (p < 0.001). The data-driven tree identified three subgroups with median LOS of 4, 6, and 10 days based on preoperative CRP and PCT levels. Patients with CRP > 153 mg/l had a median LOS of 10 days, while those with CRP ≤ 153 mg/l had median LOS of 6 or 4 days depending on whether PCT was > 0.03 µg/l or ≤ 0.03 µg/l. PCT may serve as a useful prognostic marker for estimating LOS, even in severe odontogenic infections. Exploratory decision tree analysis demonstrated that the combined assessment of PCT and CRP levels could help stratify patients into distinct LOS subgroups, which may facilitate clinical decision-making and more accurate estimation of treatment outcomes.
To evaluate effects of self-activating phthalocyanine mouthrinse on recipient sites of subepithelial connective tissue graft (SCTG), considering clinical outcomes, professional and patient assessments and quantitative somatosensory changes. This randomized controlled, crossover, split-mouth clinical trial included 20 patients treated with SCTG plus coronally advanced flap (CAF). Recipient sites received 0.12
This study aimed to evaluate, compare, and map the specific zones of histomorphological and tissue alterations in human bone following in vivo osteotomy performed by conventional drilling, piezosurgery, and Er: YAG laser ablation, proposing a universal zonal model of bone tissue response. A total of 80 human mandibular bone samples obtained during in vivo third molar extractions requiring bone removal were evaluated. The specimens were divided into three experimental groups based on the active osteotome used: conventional drilling (n = 20), piezosurgery (n = 30), and Er: YAG laser ablation (n = 30). Histological and histomorphometric screenings (Toluidine blue staining, magnifications х 10, х 20, and х 40), and scanning electron microscopy (magnification х 2500) were performed to identify, measure, and compare the zones of structural, mechanical, and collateral thermal alterations adjacent to the cutting edges. Distinct microstructural tissue modification patterns were identified, with significant dependence on the physical cutting mechanism (p < 0.05). Conventional drilling produced an irregular configuration with an attached “smear-like” debris layer (142.0 ± 45.31 μm) and the most extensive collateral thermal necrosis zone (168.05 ± 56.42 μm). Piezosurgery produced a heavily fragmented, irregular cutting line accompanied by a loose peripheral “satellite halo” of micronized fragments (206.73 ± 107.42 μm) but yielded the narrowest thermal damage zone (49.03 ± 39.91 μm). Conversely, Er: YAG ablation produced 100
Cleft lip and palate (CLP) frequently cause maxillary hypoplasia, requiring surgical advancement, and virtual surgical planning (VSP) is increasingly used to improve accuracy. This systematic review and meta-analysis synthesized the evidence on VSP-assisted maxillary advancement in patients with CLP, with surgical accuracy as the primary outcome and skeletal stability, intraoperative efficiency, complications, patient-reported outcomes, and software utility as the secondary outcomes. This review followed the PRISMA 2020 statement and was prospectively registered (PROSPERO CRD420251011475). PubMed, Scopus, Web of Science, Embase, and ScienceDirect were searched. Methodological quality and certainty of evidence were assessed. Conventional osteotomy and distraction osteogenesis were analyzed separately; an exploratory random-effects meta-analysis was performed only for the homogeneous conventional Le Fort I osteotomy subset. Twelve studies were included. VSP achieved clinically acceptable accuracy, with mean linear deviations of 0.05–2.75 mm and most angular deviations below 4°. In the conventional Le Fort I subset, random-effects pooling with Hartung–Knapp adjustment gave mean absolute deviations of 0.65 mm mediolaterally (95
To describe a novel office-based Level II temporomandibular joint (TMJ) arthroscopy technique performed using only two 16-gauge needle punctures, achieving the same level of invasiveness as conventional arthrocentesis while allowing direct visualization and therapeutic intervention. This technical note describes a minimally invasive arthroscopic approach performed under intravenous sedation and local anesthesia using two 16-gauge needle portals. A 0.7-mm diameter fiber-optic endoscope is introduced through one needle for visualization, while a 600-µm optical fiber connected to a 450 nm diode laser (TheraBlue®, DMC, Brazil) is introduced through the second needle for controlled retrodiscal tissue ablation under direct visualization. This technique enables Level II arthroscopic capabilities while maintaining needle-level invasiveness. At 6-month follow-up, the patient demonstrated significant clinical improvement, with bilateral TMJ pain decreasing from a preoperative Visual Analog Scale (VAS) score of 8 to 1, and maximum interincisal mouth opening (MMO) increasing from 33 mm to 42 mm, with no complications observed. The procedure can be performed in an office setting under local anesthesia, reducing the need for hospital-based infrastructure. Office-based Level II TMJ arthroscopy using 16-gauge needle portals appears to represent a feasible, minimally invasive evolution of arthrocentesis, enabling visualization and targeted therapeutic intervention with minimal morbidity in this initial case. Controlled studies with larger cohorts are required before broader clinical implications can be established.
Bruxism (BR) is a repetitive activity of the masticatory muscles influenced by stress-related and neurophysiological mechanisms. Psychological stress activates the hypothalamic–pituitary–adrenal (HPA) axis, leading to cortisol release and modulation of immune responses and tryptophan (Trp) metabolism via the kynurenine (KYN) pathway. The KYN pathway is activated in various systemic and physiological disorders. However, whether KYN pathway activation occurs in BR remains unknown. Investigating KYN pathway activation in BR may help clarify the biochemical basis of BR. This study aimed to investigate changes in cortisol, melatonin, tryptophan (Trp), serotonin (5-hydroxytryptamine, 5-HT), KYN, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ) levels in saliva samples taken from individuals with possible BR, and to examine whether there are differences in these parameters between individuals with possible sleep bruxism (SB) and possible combined bruxism (CB). The study included 84 individuals with possible BR and 84 age-matched healthy controls. BR symptoms were assessed with a five-item questionnaire evaluating sleep- and awake-related grinding and clenching behaviors. Morning saliva samples were collected and analyzed by ELISA to determine concentrations of cortisol, melatonin, Trp, 5-HT, KYN, TNF-α, and IFN-γ. The degradation rate of Trp was evaluated using the KYN/Trp ratio (KTR). Biochemical parameters were compared between groups. Correlation analyses assessed relationships among variables, and regression analyses identified independent predictors of bruxism subtypes. Saliva cortisol, TNF-α, KYN, and KTR levels were higher, and Trp and IFN-γ levels were lower in the possible BR group than in the control group (p < 0.001 for all comparisons). Saliva cortisol, TNF-α, KYN, and KTR levels were higher (p < 0.001 for all comparisons), and melatonin levels were lower in the possible SB group than in the possible CB (p < 0.01). In the possible BR group, cortisol levels were positively correlated with KYN and KTR and negatively correlated with IFN-γ. Low Trp levels were a common independent predictor across both possible BR, while TNF-α was the only independent predictor distinguishing possible SB from possible CB. Our results suggest an interaction among stress-related neuroendocrine responses, immune activation, and Trp metabolism in BR. Patients with possible SB had higher levels of cortisol, KYN, KTR, and TNF-α than those with possible CB, suggesting that SB may be more closely linked to stress and inflammation. Our results may contribute to understanding the interactions among HPA axis activity, inflammation, and Trp metabolism in BR, as well as the biochemical basis of BR type differences. HighlightsKYN pathways may be activated within the BR. Elevated cortisol may be related to the KYN pathway in the BR. Biochemical differences are more severe in the SB. SB may be more closely associated with stress and inflammation. TNF-α may be the only independent predictor distinguishing SB from CB.
Inferior alveolar nerve (IAN) dissection and repositioning is critical for preventing iatrogenic IAN injury during combined mandibular border resection and sagittal split ramus osteotomy (SSRO) in patients with severe hemimandibular hyperplasia (HH). Traditional IAN repositioning includes two-stage and concurrent one-stage procedures. This study introduces a modified one-stage technique and compares the respective advantages and disadvantages of these three surgical protocols. Four patients with HH were enrolled and treated with three different surgical protocols: one two-stage procedure, one conventional one-stage procedure, and two modified one-stage procedures. The modified technique features a vertical osteotomy placed 5 mm anterior to the mental foramen to protect the anterior loop of the IAN. All patients achieved satisfactory facial symmetry and aesthetic improvement postoperatively. Neurosensory assessment at 6-month follow-up confirmed complete recovery of lower lip sensation without persistent numbness. Compared with the two-stage and conventional one-stage approaches, the modified technique effectively preserved the IAN anterior loop, simplified surgical procedures, and minimized bony defects by maintaining buccal cortical bone integrity. The modified one-stage approach is a simplified and effective technique that provides reliable neuroprotection for the anterior loop of the IAN while minimizing bony defects during SSRO in HH patients. Given the limited sample size of this case series, further large-sample and long-term studies are required to fully validate tits efficacy, long-term stability, and complication profile.
Children and young adults with severe pre-existing conditions frequently require dental treatment under general anesthesia (GA) and are commonly scheduled for postoperative inpatient surveillance due to presumed elevated anesthetic or surgical risks. Although this approach prioritizes safety, it may contribute to prolonged or unnecessary hospitalization, increased healthcare costs, and potential psychological burden, particularly in patients with neurodevelopmental or congenital disorders. In light of the reportedly low incidence of severe complications following dental treatment under GA, this study aims to evaluate the necessity of routine inpatient admission in pediatric patients (< 18 years of age) with comorbidities and to assess the frequency and severity of perioperative complications. All pediatric patients with pre-existing conditions who underwent planned inpatient surgical dental treatment under GA at the Department of Oral and Maxillofacial Surgery at Hannover Medical School between 2014 and 2025 were included. The indications for inpatient treatment, anesthesiological parameters such as the American Society of Anesthesiologists (ASA) classification, and severe perioperative complications (corresponding to grade ≥ 2 of the Clavien-Dindo classification) were analyzed. It was assessed whether the ASA classification or the type of pre-existing condition significantly influenced the occurrence of perioperative complications. A total of 199 patients were analyzed. Patients who underwent surgery were mainly categorized as ASA II (n = 80, 40.2
Le Fort I osteotomy is widely performed in orthognathic surgery for maxillary repositioning and for the treatment of dentofacial deformities and obstructive sleep apnea (OSA). Postoperative relapse remains a concern, particularly after large maxillary advancements, highlighting the importance of rigid fixation. This study aimed to determine which fixation technique provides the greatest rigidity. In this in vitro study, the biomechanical rigidity of five commonly used fixation techniques for Le Fort I osteotomies was evaluated using 150 polyurethane specimens with advancements of 5 mm and 10 mm. The techniques included two L-plates (A), four L-plates of different thicknesses (B and C), two precontoured Le Fort I plates (D), and a hybrid configuration with two precontoured Le Fort I plates combined with two L-plates (E). Resistance to vertical displacement was measured at 1, 3, and 5 mm using a biomechanical testing machine. Fixation E consistently showed the highest resistance across both advancement distances and all displacement intervals, significantly outperforming fixations A, C, and D. Fixation B demonstrated resistance comparable to fixation E, whereas fixation C showed inferior performance despite a similar configuration. Fixations A and D showed the lowest resistance, particularly at 10 mm advancement. Overall, fixation E provided the greatest rigidity, while techniques relying on only two plates were biomechanically less effective. Further clinical studies are required to determine the clinical relevance of these findings.
The diagnosis of primary bone tumours of the jaw often presents as a diagnostic dilemma. Overlap in clinical, radiological, and histological features between benign lesions like juvenile trabecular ossifying fibroma (JTOF); osteoblastoma (OB) and malignant tumours like low-grade osteosarcoma (LGOS) makes the diagnosis challenging. While osteosarcoma is a malignant tumour with poor prognosis requiring aggressive treatment, benign lesions have generally favourable outcome. This study aimed to assess the immunohistochemical expression of murine double minute 2 (MDM2) and Cyclin-dependent kinase 4 (CDK4) in low-grade osteosarcoma and benign osseous lesions. Immunohistochemical analysis was performed on tissue samples from diagnosed cases of LGOS, JTOF, and OB. The expression levels of MDM2 and CDK4 were analysed and compared across the three groups. We found significantly higher expression of MDM2 and CDK4 in low-grade osteosarcoma compared to JTOF which showed negative expression in all of the cases. Osteoblastoma showed inconsistent and focal positivity contrary to OS where strong and diffuse expression of both the markers was observed. A strong co-expression of both the markers was also noted in 94
