Context:Artemisinin is a sesquiterpene lactone extracted from Artemisia annua that is best known for its potent antimalarial activity. Recent evidence highlights its additional antimicrobial and antioxidant properties. These features are particularly relevant in endodontics, where safer and more biocompatible alternatives to conventional irrigants are needed. Aims:To evaluate the in vitro antimicrobial and antioxidant effects of artemisinin against Enterococcus faecalis and Candida albicans and characterize its molecular design using Fourier transform infrared (FTIR) spectroscopy. Subjects and Methods:The antimicrobial activity was determined using the ditch plate method and the antioxidant capacity was evaluated using the total antioxidant assay with optical density measured at 695 nm, while FTIR spectroscopy analysis revealed the functional groups present in artemisinin extract. Results:Artemisinin exhibited significant inhibitory activity, against both the test microrganisms. The antioxidant analysis revealed a concentration-dependent increase in activity, with the highest effect at 10 mg/mL (2.08 mm/L). FTIR spectra showed multiple absorption bands corresponding to hydroxyl, phenolic, and aliphatic groups, indicating complex molecular characteristics. Conclusions:Artemisinin demonstrates dual antimicrobial and antioxidant properties, suggesting its potential as a safer, biologically compatible endodontic irrigant. To validate the in vitro findings, further research for defining its efficacy, optimum concentration, and safety parameters are required under in vivo as well as clinical conditions.

Aim: This systematic review and meta-analysis aimed to evaluate the antimicrobial efficacy of propolis-based intracanal medicaments. Methods: An electronic search was conducted in PubMed (MEDLINE), Wiley Online Library, ScienceDirect, and Google Scholar for English-language publications from 2010 to 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Included studies were in vitro models using extracted human permanent teeth to assess the antimicrobial activity of propolis-based intracanal medicaments against Candida albicans, Enterococcus faecalis , or both, compared with other chemical or natural agents. Animal studies, in vivo or ex vivo i nvestigations, randomized controlled trials, clinical trials, non-English articles, and duplicates were excluded. Risk of bias in the final 12 included studies was assessed using the Quality Assessment of In vitro Studies (QUIN) tool. This review was registered with the International Prospective Register of Systematic Reviews (CRD42020206446). Results: Of 356 articles initially identified, 16 duplicates were excluded. After screening titles and abstracts of 340 records, 318 were removed. Full-text evaluation of 22 studies led to the inclusion of 12 studies, of which 3 were eligible for meta-analysis. Pooled analysis demonstrated that propolis exhibited significantly greater antimicrobial efficacy than calcium hydroxide against E. faecalis on day 5 (standardized mean difference = −1.81; 95% confidence Interval = −2.33 to −−1.28; P < 0.00001). Conclusion: Propolis showed superior antimicrobial activity against C. albicans and E. faecalis compared to other natural medicaments and outperformed calcium hydroxide against E. faecalis . Given its biocompatibility and promising in vitro performance, propolis represents a potential alternative intracanal medicament. Further well-designed in vivo and long-term clinical studies are needed to confirm its clinical effectiveness.

INTRODUCTION:Oral cancer patients undergoing surgical resection often develop extensive maxillofacial defects that compromise function, aesthetics, and quality of life. Three-dimensional (3D) printing has enabled the development of customized, patient-specific prostheses, offering improved precision in rehabilitation. However, the extent to which defect type and location influence prosthetic outcomes remains inadequately synthesized in the current literature. OBJECTIVE:To map and synthesize the available evidence on the impact of type of maxillofacial defect on outcomes of 3D-printed prostheses in oral cancer patients. INCLUSION CRITERIA:This review will include studies involving oral cancer patients with surgically acquired maxillofacial defects rehabilitated using a 3D-printed prosthesis. Studies involving intraoral and extraoral defects that report functional, clinical, prosthetic, or aesthetic outcomes of 3D-printed prostheses will be included. METHODS:A comprehensive literature search will be conducted across databases including PubMed, Scopus, Web of Science, Embase, and Cochrane Library using relevant keywords. Two independent reviewers will perform study selection through title/abstract screening followed by full-text review. Data will be extracted using a structured template recording the study characteristics, surgical defect characteristics, prosthetic rehabilitation details, and outcome measures. Findings will be synthesized descriptively and presented in tabular and narrative formats to identify the research gaps. The review will be conducted and reported in accordance with the PRISMA-ScR guidelines. REVIEW REGISTRATION:Open Science Framework https://doi.org/10.17605/OSF.IO/C8STU.

The status of margins in OSCC is a critical prognostic factor that is known to influence local recurrence and overall survival outcomes. Positive or close surgical margins substantially increase the risk of locoregional failure, necessitating revision and adjuvant therapy that may adversely impact patients’ quality of life. Conventional intraoperative techniques of assessment of margins such as visual inspection, palpation, and selective frozen section analysis, have inherent limitations. These include subjectivity, sampling errors, and procedural delays. Narrow Band Imaging (NBI) is an innovative, non-contact, non-invasive optical imaging modality that enhances visualisation of the mucosal and submucosal microvasculature by employing filtered light at specific wavelengths. NBI enables more accurate delineation of tumour margins by accentuating vascular patterns associated with neoplastic transformation. This short correspondence discusses the fundamental principles, intraoperative applications, clinical advantages, and prospects of NBI as a valuable adjunct to conventional methods for margin assessment.

Hospital admission is often a prerequisite for those who endure mandibular fractures, but disagreement arises among patients whose fractures are isolated and favourable. To determine the rate and types of complications between the two cohorts of patients categorized as outpatient and inpatient treatment groups, and also the effect of outpatient management after closed reduction and maxillomandibular fixation. Clinical and demographic data were collected retrospectively about patients who were treated for isolated, favourable, compound mandibular fractures between 1998 and 2022 to explore whether outpatient management is an independent variable influencing post-operative complications. Bivariate and descriptive statistics were computed. Six-hundred and sixty-four (664) patients were evaluated ( n  = 335 in the study group and n  = 329 in the control). There was equitable distribution of subjects between the two groups investigated in relation to their sex, age, aetiology of fractures, sites of fracture and their combinations per subject including number of fractures and duration of injury before treatment. Unifocal fractures occurred in 40.7% of subjects while multifocal fractures were seen in 59.3% ( p  = 0.04). The overall complication rate was 11.7%, more prevalent in multifocal than unifocal fractures ( p  = 0.001). Conversely, the complication rates of outpatient and inpatient cases were 11.4% and 12.1%, respectively with no significant difference ( p  = 0.81). There was no difference between outpatient and inpatient treatment groups. Outpatient management was not a risk factor affecting post-operative isolated favourable mandible fracture complications, if demographic and clinical confounding variables affecting treatment outcomes were controlled.

• Pregnancy and carcinogenesis have remarkably singular similar features. • Uterine and Tumour Microenvironment promote proliferation of cells. • Angiogenesis, immune evasion, invasion and growth are common attributes to both pregnancy and cancer.

One of the most common problems seen in dental practice is oral parafunctional habits. Thumb sucking and tongue thrusting habits are by far the most common ones encountered. These have adverse effects on the dentition and the orofacial structure. Habit breaking appliances can be used to stop these habits and give best results if used at an early stage. Here we present two cases, one each of digit sucking and tongue thrusting treated effectively with habit breaking appliance.

•Metastasis in cancer progression leads to dismal outcomes and poor overall survival.•The chaotic and open structure of tumor blood vessels suggests that tumor intravasation may be passive.•Cancer has a multiplanar configuration.

BackgroundImpacted lower third molar surgeries involve trauma in a highly vascularized zone with loose connective tissue leading to inflammatory sequelae including postoperative pain, swelling, trismus and generalised oral dysfunction during the post-operative phase. In minor oral surgical procedures, an all-inclusive method to protract anaesthesia and reduce the inevitable post-operative sequelae is yet to be explored substantially.AimTo evaluate the efficacy of dexamethasone added to local anaesthetics in extending the depth and duration of anaesthesia and decreasing the postoperative complications after surgical removal of impacted third molars.MethodologyA controlled, randomized, split-mouth, double-blind prospective study involving lower third molar surgery was performed in 35 patients wherein the test group (Group I) received 8 mg dexamethasone added to 2 ml of 2% lignocaine with epinephrine and the control group (Group II) received 2 ml of sterile water added to 2 ml of 2% lignocaine with epinephrine. Onset and duration of anaesthesia were evaluated; followed by evaluation of pain, swelling and trismus for 7 days post-surgery, using independent t-test and ANOVA for repeated measures.ResultsTest group had a faster onset of anaesthesia by 69 s and a lengthier duration of 128.4 min (p < 0.001). Pain scores (Visual Analogue Scale) in the first 24 h were 4.9 and 7.5 in the test and control group respectively (p < 0.001). The average dosing of analgesics until postoperative day 7 in the test and control group were 12.6 and 18.4 respectively (p < 0.001). The swelling was significantly lesser in the test group, in addition, trismus was significantly lesser by 1 cm on postoperative days 1 and 2 and 0.2 cm on day 7.ConclusionThe addition of dexamethasone to lignocaine in the nerve block reduces the time of onset and significantly prolongs the duration of anaesthesia with decreased pain, swelling and trismus. Steroids mixed directly with the local anaesthetic agent can minimise the post-operative sequelae associated with third molar surgery with a single needle prick.

Oral squamous cell carcinoma (OSCC) is the most common type of head and neck cancer, with a high mortality rate. There is growing evidence supporting a link between oral cancer and the microbiome. The microbiome can impact various aspects of cancer, such as pathogenesis, diagnosis, treatment, and prognosis. While there is existing information on bacteria and its connection to oral cancer, the fungi residing in the oral cavity represent a significant component of the microbiome that remains in its early stages of exploration and understanding. Fungi comprise a minuscule part of the human microbiome called the mycobiome. Mycobiome is ubiquitous in the human body but a weakened immune system offers a leeway space for fungi to showcase its virulence. The role of mycobiome as a colonizer, facilitator, or driver of carcinogenesis is still ambiguous. Reactivating the mycobiome that undergoes collateral damage associated with cancer treatment can be watershed event in cancer research. The coordinated, virulent, non-virulent behavior of the fungi once they reach a critical density must be hacked, considering its diagnostic, prognostic and therapeutic implications in cancer. This review highlights the diversity of the mycobiome and its potential role in oral cancer.

It is with interest that we read the comprehensive and relevant meta-analysis and systematic review on the efficacy of low-dose computed tomography (LDCT) screening in female never-smokers in detecting lung cancer compared with male ever-smokers in the Asian population.1Triphuridet N. Zhang S.S. Nagasaka M. et al.Low-Dose Computed Tomography (LDCT) Lung Cancer Screening in Asian Female Never-Smokers Is as Efficacious in Detecting Lung Cancer as in Asian Male Ever-Smokers: A Systematic Review and Meta-Analysis.J Thorac Oncol. 2023; 18: 698-717https://doi.org/10.1016/j.jtho.2023.01.094Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar This study is of great clinical relevance and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We also commend the authors who have comprehensively collected data regarding cancer screening, health check-up using LDCT, ever-smokers, and never-smokers, and relative risk of lung cancer across multiple other studies. Moreover, it is also urged that the Protocol OF A Systematic Review and Meta-Analysis be registered in the International Prospective Register of Systematic Reviews (PROSPERO) to distinguish any replication of the study and act as an ideal for other similar studies. The current evidence unequivocally suggests a significant decrease in mortality in lung cancer with the LDCT lung cancer screening in high-risk populations particularly individuals with smoking exposure and above the age of 40 years.2Bonney A. Malouf R. Marchal C. et al.Impact of low-dose computed tomography (LDCT) screening on lung cancer-related mortality.Cochrane Database Syst Rev. 2022; 8: CD013829PubMed Google Scholar Nevertheless, level I evidence to base recommendations on routine screening in nonsmokers and participant selection and optimal frequency of screening is equivocal considering the potential for significant overdiagnosis of lung cancer. There is still a hearts-and-minds battle to be overcome in LDCT screening in low-risk populations. Immunotherapy may play a pivotal part in the future of lung cancer treatment, but LDCT screening may prove to be a cost-effective and revolutionary approach to improving lung cancer outcomes. Lung cancer screening with LDCT was found to have considerable lung cancer and all-cause mortality risk reduction.3Horst C. Callister M.E.J. Janes S.M. Low-dose computed tomography screening: the (other) lung cancer revolution.Clin Oncol. 2019; 31: 697-701Abstract Full Text Full Text PDF Scopus (2) Google Scholar Nevertheless, routine screening warrants a holistic approach due to incidental findings because LDCT screening captures the entire thoracic cavity. Recommendations for further investigation or management should be evidence based to prevent unnecessary intervention and cross-referrals.4Oudkerk M. Devaraj A. Vliegenthart R. et al.European position statement on lung cancer screening.Lancet Oncol. 2017; 18: e754-e766Abstract Full Text Full Text PDF PubMed Scopus (395) Google Scholar Publication bias is a corollary of the publication process. Small sample studies or negative findings often fail to get published. Abiding the PRISMA, the authors have piloted the publication bias analysis using Egger’s test for continuous variables and Harbord’s test for dichotomous variables but evaded other publication bias indicators in the manuscript or supplementary material, which could derail peer appraisal of the study. Therefore, a suggestion would be to inculcate Classic Fail-Safe N, Orwin Fail-Safe N, Duval and Begg and Mazumdar’s rank correlation test in such studies for comprehensive analysis of publication bias indicators (Table 1 and Fig. 1).5Begg C.B. Mazumdar M. Operating characteristics of a rank correlation test for publication bias.Biometrics. 1994; 50: 1088-1101Crossref PubMed Scopus (12667) Google ScholarTable 1Heterogeneity Testing and Hypothesis Testing and Publication Bias Indicators of Included StudiesNumbersHeterogeneity Testing and Hypothesis TestingSubgroupsHeterogeneityPoint Estimate (Fixed)95% CIPoint Estimate (Random)95% CIFixed Effects ModelRandom Effects StudiesQPI2LowHighLowHighZpStudiesZpStudiesFig. 2AEver smoker157.1480930.9950.9391.0540.9940.761.301−0.1760.8612−0.0430.99612Never smoker265.224095.8530.8940.8330.9590.8470.5871.222−3.1430.00212−0.8860.37512Fig. 2BEver smoker71.3320.51984.5791.2191.091.3631.2130.8851.6633.480.001121.20.2312Fig. 2CMale ever-smoker120.764095.0320.6960.6240.7770.6350.3681.095−6.47507−1.6340.1027Male never-smoker155.495096.1411.6011.5231.6820.5510.271.12618.53107−1.6350.1027Fig. 2APublication-Based IndicatorsGroupsClassic Fail-Safe NOrwin Fail-Safe NBegg and Mazumdar TestEgger’s Regression InterceptDuval and Tweedie (Random Effect)Kendall's Tau Without Continuity CorrectionKendall's Tau With Continuity CorrectionFixed EffectsRandom EffectsZ valuep ValueRatio in ObservedTauZ valuep Value (1-Tailed)TauZ Valuep Value (1-Tailed)Intercept95% Lower Limit95% Upper Limitt-dfp-Value (1-Tailed)Observed Point EstimateAdjusted Point EstimateObserved Point EstimateAdjusted Point EstimateValueEver Smoker−1.047510.294860.994790.151520.685730.246440.136360.617150.26857−0.74891−5.032483.534660.38955100.352520.994790.994790.994080.99408Never Smoker−3.772520.000160.893870.03030.137150.445460.015150.68570.47266−1.43181−8.957726.09410.4239100.34030.893870.893870.847250.84725Fig 2CPublication-Based IndicatorsGroupsClassic Fail-Safe NOrwin Fail-Safe NBegg and Mazumdar TestEgger’s Regression InterceptDuval and Tweedie (Random Effect)Kendall's Tau Without Continuity CorrectionKendall's Tau With Continuity CorrectionFixed EffectsRandom EffectsZ valuep ValueRatio in ObservedTauZ Valuep Value (1-Tailed)TauZ Valuep Value (1-Tailed)Intercept95% Lower Limit95% Upper Limittdfp Value (1-Tailed)Observed Point EstimateAdjusted Point EstimateObserved Point EstimateAdjusted Point EstimateValueEver Smoker3.008510.002631.219120.90910.411440.340380.075760.342860.36585−0.17014−4.061753.721460.09742100.462161.219121.219121.2131.213CI, confidence interval. Open table in a new tab CI, confidence interval. A robust statistical analysis can be interpreted with the addition of tau-square in addition to chi-square and I-square static (measures of statistical heterogeneity). The authors fail to estimate the Z value, a test static for the null hypothesis, and to obtain the p value. Therefore, we recommend presenting the results of all statistical syntheses including heterogeneity and hypothesis testing of the included study (Table 1), conducted according to PRISMA. It is also worth observing that this systematic review and meta-analysis is a literature-based study and not a patient-based meta-analysis. Subsequently, the results may guide clinical decision-making but cannot strongly suggest treatment recommendations. Rama Jayaraj: Conceptualization, Data curation, Formal analysis, Investigation; Methodology, Resources, Project administration, Software, Supervision, Validation, Visualization, Writing—original draft, Writing—review and editing. Sameep Shetty: Resources, Visualization, Writing—original draft, Writing—review and editing. Srinidhi Ilankumaran: Data curation, Resources, Visualization, Writing—original draft, Writing—review and editing. Yash Merchant: Visualization, Writing—original draft, Writing—review and editing. Low-Dose Computed Tomography (LDCT) Lung Cancer Screening in Asian Female Never-Smokers Is as Efficacious in Detecting Lung Cancer as in Asian Male Ever-Smokers: A Systematic Review and Meta-AnalysisJournal of Thoracic OncologyVol. 18Issue 6PreviewLung cancer in never-smokers is the major cancer cause of death globally. We compared the efficacy of low-dose computed tomography (LDCT) lung cancer screening among never-smokers versus ever-smokers using systematic review and meta-analysis. Full-Text PDF Open AccessReply to Jayaraj et al. “Clinical Validity and Conceptual Interpretation of the Meta-Analysis on the Efficacy of LDCT Lung Cancer Screening in Never-Smokers”Journal of Thoracic OncologyVol. 18Issue 10PreviewWe thank the comments of Jayaraj et al. on our manuscript. The following are our responses: Full-Text PDF

BackgroundThe surgical treatment of ameloblastoma of the jaws remains contentious due to the variable recurrence rate amongst its variants, the tumor's local invasive behavior, and the lack of consensus among surgeons concerning the extent of resection in the contiguous healthy tissues.ObjectiveTo determine the recurrence rate of ameloblastoma and its association with the resection margins.Materials and methodsThis is a retrospective cohort study of the medical records of patients who underwent surgical resection of the jaws as the primary modality of treatment for ameloblastoma. Clinical data over the 26 years were analyzed for age, gender, site of the lesion, size, radiographic appearance, histopathological sub-type, and the incidence of recurrence post-treatment. Descriptive and bivariate statistics were computed.ResultsA retrospective audit of 234 cases was included in the study that was typical (solid/multicystic) ameloblastoma. The age of patients ranged from 20 to 66 years with a mean age of 33.4 ± 9.6 years, and a male-to-female ratio of 1.2: 1 (P = 0.52). The follicular and plexiform types accounted for the majority of histopathological variants (89.8%; P = 0.000). Overall, 6.8% of cases relapsed after the initial primary surgery. The rate of recurrence was high with a resection margin of 1.0 or 1.5 cm than 2.0 cm (P = 0.001). No case of recurrence was seen with a resection margin of 2.5 cm margin.ConclusionA low recurrence rate of 6.8% was noted in our series of cases. A wide 2.5 cm resection margin is recommended in the adjacent healthy tissues.

•Accurate pre-operative assessment of depth of Invasion in oral squamous cell carcinoma is challenging.•While it appears that Magnetic Resonance Imaging is the best imaging modality to measure DOI, USG has its own unique applications.•Multiparametric MRI should be employed for pre-operative DOI assessment.•DWI prevents upstaging due to peritumoral oedema.

• Diagnosis and adjuvant management of salivary gland pathology remain challenging due to their diversity and rarity. • Evidence favors surgical management followed by adjuvant radiation in the presence of certain adverse features and histology. • Hormonal and targeted therapy may have a role in the recurrent or metastatic setting only. • Hormonal therapy should be employed judiciously outside the setting of clinical trials .

•Subtle changes in the soil (microenvironment) may contribute to recurrence even after the seed (primary) is addressed.•Genomic alterations in free margins contribute to recurrence.•Cancer has a multiplanar configuration.

Metabolic syndrome (MetS) is a constellation of coexisting cardiovascular risk factors. This study aimed to assess the evidence for the association between the apolipoprotein B/A1 ratio, apolipoprotein B, and apolipoprotein A1, and the MetS in children and adolescents. The English electronic databases including PubMed, Embase, Web of Science, and Scopus were searched up to February 28, 2022. To ascertain the validity of eligible studies, modified JBI scale was used. Standardized mean differences (SMDs) with 95

Chediak-Higashi syndrome (CHS) is an autosomal recessive disorder characterized by leukocytes with giant secretory granules and a myriad of clinical features. However, it is unknown whether oral lesions are part of the syndrome or are refractory to systemic treatment. Herein, we integrated the available data published in the literature on the oral manifestations of individuals with CHS. Searches on PubMed, Web of Science, Embase, Scopus, and LILACS were conducted to identify studies published up to March/2022. The Joanna Briggs Institute tool was used for the critical appraisal of studies. Fourteen articles (21 cases) were detected. The mean age of individuals was 15.9±8.8 years. There was a slight predominance of males (52.4%). The major manifestation was periodontal disease (81%), although ulceration of the oral mucosa (14.3%), gingival/labial abscess (4.8%), and periodontal abscess (4.8%) were also reported. Oral rehabilitation including dental implants (9.5%) was performed after tooth losses due to the poor prognosis of periodontal therapy. CHS is usually diagnosed in an early stage due to its systemic manifestations such as classic oculocutaneous albinism, recurrent infections, and a propensity for bleeding. Oral health providers should be aware of the manifestations of individuals with CHS. Special care, including oral prophylaxis, is indispensable.

Metabolic syndrome (MetS) consists of a cluster of cardiometabolic risk factors and is an important determining factor for cardiovascular diseases (CVDs). We intended to use latent class analysis to classify the study population into several clusters. The baseline information of 6,814 participants of the Multi-Ethnic Study of Atherosclerosis (MESA) aged 45–84 years in 2000–2002 was used. The latent class analysis was conducted to extract different patterns of components. SAS 9.2 and Stata 12 software were used for analysis. The components of MetS tend to accumulate, hence it would be feasible to categorize the population into three classes: [1] Non-Metabolic Syndrome Latent Class (NonMetS-LC), [2] Low Risk Latent Class (LowR-LC), and [3] Metabolic Syndrome Latent Class (MetS-LC). In women, adding high-density lipoprotein (HDL) component to the two-component combinations of NonMetS-LC will transfer the individual to MetS-LC, and it was found in 100