Adult immunization protects older and at-risk populations through established and newer vaccine platforms, including adjuvanted subunit and mRNA technologies. This review considers effectiveness, durability, safety, implementation barriers, and possible benefits beyond infection prevention. Protection varies: recombinant zoster vaccine provides sustained benefit, whereas influenza and COVID-19 vaccination require attention to seasonal circulation and waning immunity. Safety surveillance and balanced counseling remain essential when discussing rare adverse events, including Guillain–Barré syndrome and myocarditis. Reactogenicity, incomplete series, and access barriers can limit population benefit. Universal recommendations, shared clinical decision-making, coadministration, and recall systems may improve uptake. Evidence also suggests cardiovascular and post-acute benefits, although emerging associations require cautious interpretation. Integrating vaccination into routine care supports lifelong prevention and healthier aging.
Successful endodontic treatment in pediatric dentistry relies on effective cleaning and disinfection of the root canal system. Irrigating solutions play an important role in eliminating microorganisms, dissolving necrotic tissue, and removing debris during pulpectomy procedures. Over time, root canal irrigants have evolved from conventional solutions such as saline and hydrogen peroxide to advanced agents with improved antimicrobial efficacy and smear layer removal properties. Sodium hypochlorite remains the most commonly used irrigantdue to its strong antimicrobial and tissue-dissolving action, while chlorhexidine is valued for its substantivity. Chelating agents such as EDTA aid in smear layer removal, and surfactants like Triton X-100 improve irrigant penetration by reducing surface tension. Newer irrigants such as MTAD and QMix combine antimicrobial and chelating properties for improved canal disinfection. This review highlights the evolution, properties, and clinical applications of these irrigating solutions and discusses recent advances in endodontic treatment outcomes.
Dental implant therapy has undergone substantial evolution since Brånemark's foundational osseointegration studies, with temporal loading protocols remaining a principal area of clinical investigation. Immediate loading—defined as crown or prosthesis placement within 48 hours of implant surgery—was introduced to reduce treatment duration and patient burden. Yet concerns regarding early biomechanical stress on the implant– bone interface have sustained debate about whether such protocols compromise long-term osseointegration and peri¬implant tissue stability when compared with conventional (delayed) loading approaches. To systematically review and quantitatively synthesize evidence from randomized controlled trials and prospective clinical studies comparing implant survival, marginal bone loss, and secondary peri-implant outcomes between immediate loading and conventional loading protocols. A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library (CENTRAL), Embase, and Google Scholar from database inception to January 2025. Only randomized controlled trials and prospective clinical studies with a minimum follow-up of 12 months were eligible. Two independent reviewers performed study selection, data extraction, and Cochrane RoB 2 risk-of-bias assessment. Primary outcomes were implant survival rate and marginal bone loss. Secondary outcomes included implant stability (ISQ), peri-implant probing depth, bleeding on probing, prosthetic complications, and patient- reported outcomes. Meta-analyses were performed using a random-effects model (DerSimonian–Laird) for heterogeneous outcomes and a fixed-effects model for homogeneous outcomes; heterogeneity was quantified using I2. Eighteen studies (1,622 implants; 811 immediate loading, 811 conventional loading) met the inclusion criteria. Follow-up ranged from 12 to 36 months. Pooled analysis revealed no statistically significant difference in implant survival between immediate and conventional loading groups (RR = 0.98; 95% CI: 0.97–1.00; p = 0.09; I2 = 21%). Marginal bone loss showed a numerically small, clinically modest difference favouring conventional loading (MD = 0.12 mm; 95% CI: -0.02 to 0.26; p = 0.09; I2 = 57%), which did not reach statistical significance. Secondary outcomes including implant stability, peri-implant probing depth, and patient satisfaction were broadly comparable between protocols. Overall risk of bias was low in 10 studies and raised some concerns in 8 studies. Current evidence from high-quality clinical trials indicates that immediate loading of dental implants achieves survival rates and peri-implant bone maintenance equivalent to conventional loading when appropriate patient selection, adequate primary stability, and meticulous occlusal management are observed. These findings support the selective application of immediate loading in contemporary implant practice.
Central giant cell granuloma (CGCG) is a benign but occasionally aggressive osteolytic lesion of the jaws with an uncertain aetiology and variable clinical behaviour. It predominantly affects young individuals and is more commonly seen in the mandible than the maxilla. Clinically, CGCG may present as a painless expansile swelling, often causing cortical expansion, tooth displacement, root resorption, and facial asymmetry in advanced cases. Due to its overlapping clinical and radiographic features with other giant cell lesions and odontogenic pathologies, definitive diagnosis requires careful histopathological evaluation. This case report describes the surgical management central giant cell granuloma of the posterior maxilla. The patient presented with gradually enlarging, painless swelling on the upper left side of the face. Following comprehensive clinical, radiological, and laboratory investigations, the lesion was treated surgically by complete excision with curettage under general anaesthesia. Adequate surgical access facilitated thorough removal of the lesion while preserving adjacent vital structures. Histopathological examination confirmed the diagnosis of CGCG. Postoperative recovery was satisfactory, with good healing and restoration of function with no recurrence and patient is on regular follow-up since 4 months. This report highlights the significance of early diagnosis, appropriate surgical planning, and long-term follow-up in the successful management of central giant cell granuloma of maxilla.
To evaluate the association between periodontal status and systemic inflammatory markers in treated and untreated patients with polycystic ovarian syndrome. This, cross-sectional clinical study included 60 female participants divided into three groups (n=20 each): systemically healthy controls, untreated PCOS patients, and treated PCOS patients. Periodontal parameters assessed were oral hygiene index, probing pocket depth, and bleeding on probing. Systemic parameters included body mass index and hs C- reactive protein. Intergroup comparisons were performed using appropriate statistical tests. Untreated PCOS patients demonstrated significantly higher BMI values (p=0.019), poorer oral hygiene, increased probing pocket depth, generalized bleeding on probing (p<0.001), and markedly elevated hsCRP levels (p<0.001) compared with treated Polycystic ovarian Syndrome patients and healthy controls. Treated PCOS patients exhibited periodontal and inflammatory parameters comparable to healthy individuals. Untreated PCOS is associated with compromised periodontal health and increased systemic inflammation. These findings suggest a potential association between periodontitis and PCOS mediated through inflammatory and metabolic pathways. Effective medical management of PCOS may positively influence periodontal status.
