Objectives : To synthesize the aetiology, management, timing, and sensory outcomes reported after unintended iatrogenic inferior alveolar nerve injury (iIANI). Study Design : A systematic review was conducted in accordance with PRISMA guidelines. PubMed/MEDLINE, Embase, Cochrane Library, Scopus, and Google Scholar were searched for studies of iIANI unintentionally caused by dental or oral and maxillofacial procedures. Outcomes included aetiology, intervention, interval from injury to repair, functional sensory recovery (FSR), and other sensory outcomes. Bias risk was assessed using the Newcastle–Ottawa Scale. Results : Seven reports and 209 IAN injuries with a clearly classifiable unintended iatrogenic aetiology were included. Medical Research Council-defined functional sensory recovery was reported in two predominantly iatrogenic series: 10/16 patients after nerve-sliding repair and 7/9 after surgery for endodontic overfilling. Other studies used neurophysiological improvement, continuous neurosensory measures, symptom resolution, or outcomes that could not be separated by nerve or aetiology. Grafts were used in 11/80 patients. Study-level timing findings generally favoured prompt assessment and referral, although confounding prevented definition of a universal operative threshold. Conclusions : iIANI may cause persistent neurosensory impairment. Microsurgical repair can improve sensation in selected patients, but outcome definitions and reporting were heterogeneous. Early specialist assessment, standardised sensory testing, and aetiology-specific prospective studies are needed.
Objective : To describe clinicopathological features, differential diagnosis, and management of pediatric labial, perioral, and oral molluscum contagiosum (MC) in light of the available literature. Study Design : The present multi-institutional case series included pediatric patients from Venezuela, Brazil, Argentina, and the Dominican Republic. Four databases were searched for pediatric cases involving labial, perioral, and oral sites. Data were analyzed descriptively. Results : Four girls and two boys six to 15 years of age were included. All were asymptomatic. The lesions were solitary or multiple and mainly involved the lips and perioral skin; one patient had intraoral involvement. Differential diagnoses included verruca vulgaris, focal fibrous hyperplasia, and mucocele. Histopathologically, the lesions exhibited a lobulated epithelial proliferation with crater-like invaginations and keratinocytes containing Henderson-Paterson bodies. Management included excisional biopsy, topical cantharidin for cutaneous lesions, and observation or spontaneous regression; five cases had no recurrence. The search yielded 576 records and identified six studies comprising six cases. These included three boys and three girls aged eight months to 17 years. All had labial and/or perioral involvement; two had intraoral lesions. Conclusion : Pediatric labial, perioral, and oral MC is rare. Recognition of its clinicopathological spectrum may prevent misdiagnosis and support individualized conservative management.
Objective To assess the reliability of low-dose(LD) cone-beam computed tomography (CBCT) protocols for radiographic assessment of third molars, including anatomical structures and related pathology, compared with standard-dose(SD) and high-dose(HD) protocols across three CBCT units. Materials and Methods This ex vivo study included 25 teeth from nine anonymized human skulls, each with one to four impacted third molars. Each tooth was scanned using HD, SD, and LD protocols on three CBCT units. Radiographic parameters were assessed by multiple observers, and inter- and intra-observer agreement was statistically analysed. Results Inter-observer agreement varied substantially across diagnostic parameters, CBCT units, and dose protocols, with κ values generally ranging from moderate to almost perfect agreement. Pronounced variability among observer pairs was observed for certain parameters within the same protocol and unit. No consistent reduction in reproducibility was observed when lowering the dose from HD to SD to LD. Intra-observer reproducibility was generally high. Conclusion Reproducibility in the assessment of third molars was primarily influenced by the diagnostic parameter and the observer rather than by CBCT dose level or unit. Lowering dose did not result in a consistent change in reproducibility. These findings indicate that LD protocols may provide sufficient reproducibility for third molar-related assessments.
Background The pedicled buccal fat pad (BFP) flap is used for closure of small to medium-sized oro-facial defects. The epithelialization of the BFP occurs for 2 or 3 weeks without the necessity to cover this with skin grafts. Objective The aim of this study is to evaluate the clinical outcome of pedicled BFP flap reconstruction of oral defects. Study Design This retrospective cohort study between June 2025 and January 2026 included 77 patients having various medium-sized oral defects (up to 4–5 cm in diameter), who underwent reconstruction with the pedicled BFP flap. Results This study included 55 males and 22 females; their ages ranged from 3 to 70 years. Complete epithelialization was observed within 2-3 weeks post-operatively according to the extent of the defect. There were no complications (wound dehiscence, necrosis or infections) or functional disorders during follow-up. Conclusions The pedicled BFP flap is a simple and minimally invasive surgery for reconstruction of various oro-facial defects, with a short recovery time, minimal donor site morbidity, and it permits early initiation of post-operative adjuvant radiotherapy after resection of malignant tumors.
Areca nut (AN), commonly known as betel nut, has been used for centuries in ceremonies and rituals, consumed for unproven therapeutic effects, and abused as a recreational psychostimulant. AN is the fourth-most commonly abused psychoactive substance globally–only behind caffeine, nicotine and alcohol–and consumption is strongly associated with developing adverse oral effects, most notably oral potentially malignant disorders (e.g.oral leukoplakia, oral submucous fibrosis) and oral malignancies. Examples of other areca-related oral adverse reactions include profound dark brownish-blackish extrinsic staining, dentin hypersensitivity, periodontal disease, and betel chewer’s mucosa. AN use is becoming more prevalent in Western countries, such as the US, due to increasing immigration from regions where the habit is endemic—such as the Indian subcontinent and Southeast Asians. However, US dental practitioners are likely unfamiliar with the habit and its significant clinical implications to oral health. Informing these practitioners is essential for identification of users and communicating effectively with them, along with managing the oral complications. This narrative review synthesizes current evidence on AN use with emphasis on US regulations and policy considerations, oral health effects, and findings from US-based studies of AN users. Furthermore, we offer perspective about knowledge gaps (e.g.,increasing public awareness) and the ramifications to US dental practice.
Objectives This study evaluated, for the first time, the radiation exposure of dentists examining thyroid cancer patients following radioactive iodine (RAI) therapy. Study Design External dose-rate measurements were performed at distances of 5–100 cm in 93 differentiated thyroid carcinoma (DTC) patients between Days 1 and 7 after discharge. Patients were classified according to administered RAI activity as Group I (1110–2775 MBq, n=31) and Group II (3700–7400 MBq, n=62). Measurements were obtained in the anterior oblique position with patients seated upright to simulate dental examination conditions. Results In Group I, the cumulative radiation dose potentially received by a dentist was 461.75 µSv on Day 1 after discharge, decreasing to 112 µSv and 92 µSv on Days 2 and 3, respectively. In Group II, cumulative doses on Days 1–4 after discharge were 1148 µSv, 447 µSv, 73 µSv, and 37 µSv, respectively. Conclusions The findings indicate that patients receiving <3700 MBq RAI may safely undergo dental examination approximately 24–26 hours after discharge with appropriate radiation protection precautions, whereas dental treatment in patients receiving ≥3700 MBq RAI should preferably be postponed for at least 48 hours to maintain occupational exposure below the 1 mSv public dose limit.
Background Mandibular symphyseal split osteotomy is an orthognathic procedure used to correct transverse mandibular deficiencies. Limited data exist regarding the stability of transverse mandibular widening achieved with this technique. Objective To evaluate the stability of transverse mandibular widening following symphyseal split osteotomy and report outcomes when combined with genioplasty. Study Design This retrospective cohort study included patients who underwent symphyseal split osteotomy for mandibular transverse discrepancies between September 2021 and January 2023. The predictor variable was planned transverse widening determined by virtual surgical planning. The primary outcome was transverse mandibular stability, defined as the difference between planned dimensions and postoperative cone-beam computed tomography measurements at the intercanine and intermolar levels. Changes in mandibular first molar mesiolingual cusp distance were also evaluated. Results Five of seven patients met inclusion criteria. Mean intercanine and intermolar differences between planned and postoperative measurements were −0.17 ± 1.06 mm (p = 0.74) and 0.56 ± 1.92 mm (p = 0.55), respectively. Mean mesiolingual cusp distance increased from 35.32 ± 2.66 mm to 37.70 ± 2.28 mm, with a mean increase of 2.38 ± 2.03 mm (p = 0.058). Conclusion Mandibular symphyseal split osteotomy provides stable transverse widening with low morbidity. Virtual surgical planning, rigid fixation, and postoperative splinting produced predictable outcomes.
Objectives . This study investigated differences in peri-implant bone level change between straight and tilted implants in the All-on-4 treatment concept and evaluated the influence of anterior-posterior (A-P) spread. Study Design . Thirty-six patients receiving All-on-4 full-arch rehabilitation were included. Peri-implant bone level change was assessed using panoramic radiographs, and A-P spread was measured on plaster models. Independent t-tests compared bone level changes between implant types, while linear regression and Pearson correlation analyses evaluated associations between A-P spread and bone remodeling. Results . A total of 144 implants (72 straight and 72 tilted) were analyzed. Straight implants showed significantly greater peri-implant bone level change than tilted implants (0.065 ± 0.101 vs. 0.019 ± 0.080, p = .003). The mean A-P spread was 14.6 ± 3.1 mm. No significant correlation was observed between A-P spread and peri-implant bone level change for either straight (r = 0.112, p = .350) or tilted implants (r = 0.157, p = .188). Conclusions . Straight implants exhibited greater peri-implant bone level change than tilted implants, whereas A-P spread was not significantly associated with peri-implant bone remodeling, suggesting implant angulation may exert a greater influence on crestal bone changes than A-P spread in this cohort.
Objective Patient positioning errors in dental panoramic radiography are a critical issue that compromises diagnostic quality and necessitates retakes. The purpose of this study is to develop and validate a deep learning-based system for the automatic detection and multi-class classification of positioning errors using mandibular region extraction to enhance diagnostic quality. Furthermore, the study aims to evaluate the performance of hybrid models that combine traditional Convolutional Neural Networks (CNNs) with Vision Transformer (ViT) architectures. Methods In this retrospective study, 1497 panoramic radiographs acquired between 2020 and 2023 were analyzed (691 error-free, 806 erroneous). Errors were classified into six sub-categories: head tilted downward, head tilted upward, biting the notch anteriorly, biting the notch posteriorly, head rotated laterally, and head tilted laterally. YOLOv10 and Mask R-CNN models were compared for mandibular region detection and extraction. For classification, the performance of nine CNN architectures (ResNet18, ConvNeXt, EfficientNetV2-M, VGG19, DenseNet121), three Vision Transformers (DeiT, BEiT, Swin), and a novel Hybrid model combining ConvNeXt and Swin Transformer were evaluated on both full images and isolated mandibular images. Model performances were analyzed using accuracy, precision, sensitivity, F1-score, and AUC-ROC metrics with 5-fold cross-validation. Results : In mandibular region extraction, YOLOv10 demonstrated better performance compared to Mask R-CNN, achieving an mAP@0.5 score of 0.976. In the binary classification (Erroneous/Error-free) task, the Hybrid model trained on mandibular images achieved the highest performance with an accuracy of 73.02%, a precision of 0.7296, and an F1-score of 0.7280. For the 6-class error type classification, the Hybrid model also outperformed all other architectures with an accuracy of 56.91%. In full-image analyses, the Swin Transformer yielded competitive results (Binary: 70.81%, Multi-class: 56.51%). Conclusions : The proposed deep learning system demonstrates feasibility for the automated detection of positioning errors in panoramic radiography. The study proves that mandibular region-focused (ROI) analysis improves classification success compared to full-image analysis and that the hybrid use of CNN and Transformer architectures is more effective than single models in distinguishing complex imaging errors. This system holds promise for standardizing quality control processes in clinical workflows.
OBJECTIVE:Adenomatoid hyperplasia (AH) of minor salivary glands is a benign lesion that clinically mimics salivary gland neoplasms. Histopathologic diagnosis currently relies primarily on qualitative assessment, as objective quantitative criteria and baseline morphometric reference values for normal minor salivary glands have not been formally established. This study aimed to explore objective histomorphometric parameters for the diagnosis of AH and to characterize quantitative reference ranges for normal minor salivary glands. STUDY DESIGN:A retrospective controlled clinico-pathologic study was conducted including 35 AH cases and 35 normal minor salivary gland controls. Digital measurements of long- and short-axis diameters of large and small acini were obtained using ImageJ software, and relative surface area involvement was calculated. RESULTS:The mean long-axis diameter of large acini (LAD-L) was significantly greater in AH than in controls (133.0 ± 21.5 µm vs. 66.6 ± 11.7 µm; p < .001). A cutoff value of 87.6 µm for mean LAD-L achieved complete differentiation between AH and normal glands within the present cohort (AUC = 1.00; 95% CI: 1.00-1.00). Enlarged acini occupied a mean of 71.9% of specimen surface area in AH. Within this single-center biopsy-based cohort, AH accounted for 33.3% of nonulcerated palatal masses, representing one of the more frequent diagnostic entities relative to other lesions. CONCLUSIONS:Within this single-center biopsy-based cohort of nonulcerated palatal masses, AH represented a relatively frequent diagnosis. The proposed morphometric parameters may provide objective diagnostic support while also establishing quantitative reference values for normal minor salivary glands.
Introduction : Burning mouth syndrome is a chronic oral pain condition with limited effective treatments. Cannabidiol has emerged as a potential therapeutic option, but clinical evidence remains limited. This study evaluated the efficacy and safety of full spectrum cannabidiol oil. Methods : A randomized, placebo-controlled clinical trial was conducted in a single-center outpatient clinic for orofacial pain. Thirty-five individuals were screened, and 26 patients were included and randomly assigned to receive cannabidiol oil (n = 13) or placebo (n = 13). Pain intensity and impact were assessed using a visual analogue scale, and oral health–related quality of life was evaluated using the Oral Health Impact Profile-14. Safety outcomes included adverse event monitoring. Results : The sample comprised 96% women, with a mean age of 61.9 years. Baseline measures were comparable. The cannabidiol group showed significant reductions in pain intensity and impact over time, with between-group differences from the third assessment onward (P < .001), while the placebo group remained stable. Quality of life improved significantly in the cannabidiol group (P = .001). No serious adverse events were observed. Conclusions : Full spectrum cannabidiol oil improved pain and quality of life with a favorable safety profile, supporting further investigation.
