Oral — Health, Diseases, Therapies, and Technologies

Background/Objectives: Mastication is a complex sensorimotor function involving coordination between the brainstem central pattern generator and supraspinal systems, particularly the primary motor cortex (M1). Evidence suggests a link between masticatory activity and corticomotor plasticity, but findings remain fragmented. This scoping review aimed to synthesise the human evidence on the relationships among mastication, tooth loss, dental rehabilitation, ageing, and corticomotor plasticity, with emphasis on M1 mechanisms. Methods: Following PRISMA-ScR guidelines, systematic searches were conducted in MEDLINE/PubMed, Scopus, and Web of Science using terms related to mastication, neuroplasticity, motor cortex, ageing, and rehabilitation. Eligible studies included human experimental, clinical, and observational research employing neuroimaging or neurophysiological methods. Data were extracted and synthesised using a Population–Concept–Context framework across eight conceptual domains. Results: Twenty-two heterogeneous studies (fMRI, TMS, EMG, psychophysical, histological) were included. Mastication consistently activated distributed sensorimotor networks, including M1 and the primary somatosensory cortex (S1). Peripheral sensory input and dental mechanoreception were linked to structural and functional adaptations. Corticomotor excitability was modulated by chewing, oral-motor learning, and rehabilitative interventions. Ageing was associated with altered but preserved cortical responsiveness. Associations between mastication and cognition were reported, though largely cross-sectional. Overall, findings suggested a relationship linking peripheral input, sensorimotor integration, and corticomotor plasticity, but methodological variability limited causal inference. Conclusions: Mastication is linked to modifiable corticomotor activity and supports experience-dependent neuroplasticity. However, the evidence remains largely associative and methodologically heterogeneous. Neural adaptations appear to be preserved with ageing but are influenced by systemic and environmental factors. Longitudinal, multimodal research is needed to clarify the mechanisms, causality, and clinical relevance, particularly in rehabilitation contexts. Full article

Prevention of medication-related osteonecrosis of the jaw (MRONJ) associated with low-dose bone-modifying agents (LD-BMAs) remains a clinically relevant challenge, particularly due to the heterogeneity of recommendations and the growing number of patients exposed to these therapies. Unlike high-dose regimens, LD-BMAs are associated with a lower incidence and longer latency of MRONJ, generating uncertainty regarding the optimal timing and scope of dental interventions. This commentary critically compares four major international position papers and consensus documents (AAOMS 2022, SIPMO–SICMF 2020/2024, Chinese Expert Consensus 2024, and SIOT–SIdP 2023) through four pragmatic questions concerning patient stratification, timing of dental assessment, speed of risk reduction, and the role of prescriber-oriented screening tools. The analysis highlights substantial discrepancies among preventive models, particularly regarding whether pre-treatment dental treatments should be mandatory or whether early post-initiation assessment may be acceptable in selected low-risk patients. Full article

Objectives: This systematic review and meta-analysis aimed to evaluate the role of diode and Nd:YAG lasers as adjuncts to scaling and root planing (SRP) in the non-surgical treatment of moderate-to-severe periodontitis. Methods: The protocol was registered in PROSPERO (CRD420250603025) and conducted following PRISMA guidelines. A comprehensive search in Scopus, PubMed, and Cochrane CENTRAL (up to October 2024) identified randomized controlled trials (RCTs), prospective, and retrospective controlled clinical studies comparing SRP alone versus SRP plus adjunctive laser therapy. The primary outcome was probing pocket depth (PPD); secondary outcomes were bleeding on probing (BoP) and the clinical attachment level (CAL). Risk of bias was assessed using Cochrane RoB 2.0 tool for RCTs and Newcastle–Ottawa Scale for non-RCTs. Meta-analysis was undertaken when at least three studies presenting the same outcome at the same follow-up were found. Results: Nine studies with follow-ups from 3 to 120 months were included, representing a total of 423 participants. Both groups showed PPD reduction at all time points, with pooled analyses revealing no statistically significant differences (mean difference −0.12 to −0.35 mm; p > 0.05), although point estimates often favored laser-treated sites, particularly when baseline PPD ≥ 6 mm. Subgroup analysis showed significantly greater PPD reduction in laser-treated sites compared to SRP alone at 12 months in deep pockets (p = 0.001). These findings should be interpreted with caution, given their exploratory nature, limited sample size, and high heterogeneity. Similar patterns were observed for CAL and BoP, with substantial heterogeneity (I² > 70% at several time points). No adverse events were reported. Conclusions: Within the limitations of the available evidence, adjunctive diode and Nd:YAG laser therapy does not demonstrate consistent statistically significant differences compared to SRP alone in non-surgical periodontal treatment. While a potential adjunctive effect may be observed under specific clinical conditions, particularly in deeper pockets, current evidence is insufficient to support its superiority. Full article

Background/Objectives: Anterior open bite (AOB) is a multifactorial malocclusion often associated with dysfunctional orofacial habits, such as tongue thrusting and lip incompetence. Early functional interventions aim to restore muscular balance; however, evidence supporting orofacial exercise therapy as a preventive measure remains limited. This pilot study evaluated the effectiveness of targeted orofacial physical exercises in reducing anterior open bite and improving tongue and lip function in school-aged children. Methods: A controlled clinical trial was conducted following ethical approval (COD-EC-24-0036). A total of 1531 children were screened, of whom 24 presented with AOB; 14 consented to participate. Participants were allocated to a tongue exercise group, a lip exercise group, or a control group receiving verbal advice only. Orofacial exercises focused on tongue posture, swallowing function, and lip seal. Measurements were obtained at baseline and 6 months using intraoral scans and clinical assessments. Treatment adherence was monitored using monthly exercise charts. Data were analyzed using repeated measures ANOVA (α = 0.05). Results: AOB prevalence among screened children was 1.57%. Descriptive analysis showed that both intervention groups demonstrated numerical reductions in anterior open bite over 6 months, whereas minimal changes were observed in the control group. However, no statistically significant differences were detected between groups (p > 0.05). Children with higher cooperation exhibited greater improvement, suggesting adherence may influence treatment response. Conclusions: Orofacial physical exercises demonstrated a trend toward improving anterior open bite and orofacial function; however, changes were not statistically significant. These exercises may serve as supportive early therapeutic management, but larger, adequately powered trials are needed to clarify their therapeutic potential. Full article

Backround: The aim of this study was to evaluate the effects of probiotic yogurt containing Lactobacillus rhamnosus (LGG) on the microhardness and surface roughness of restorative dental materials commonly used in pediatric dentistry. Methods: Three materials were tested: conventional glass ionomer cement Fuji II, high-viscosity glass ionomer cement Fuji IX, and microhybrid composite resin Te Econom. The samples were prepared according to the manufacturers’ instructions, initially stored in distilled water, and subsequently immersed in probiotic yogurt. Microhardness was measured by the Vickers hardness test, and surface roughness was assessed by 3D profilometers. Results: Statistical analysis was performed using the Wilcoxon signed-rank test and the Kruskal–Wallis test. Exposure to probiotic yogurt resulted in increased microhardness for the resin-modified and high-viscosity glass ionomer cements, whereas the microhardness of the microhybrid composite resin decreased. The surface roughness increased for all the tested materials, with statistically significant differences observed in most groups (p < 0.05). Conclusions: These findings indicate that probiotic yogurt can alter the physical properties of restorative dental materials and highlight the importance of careful selection of preventive agents in pediatric dental practice. Further research is needed to clarify the long-term effects of probiotic preparations on dental restorations. Full article

Hydroxyapatite-based biomaterials are widely investigated for oral-tissue-healing applications; however, the available literature is heterogeneous in terms of material design, experimental models, and reported outcomes. This narrative review synthesizes peer-reviewed studies published between 2014 and 2024 that investigate hydroxyapatite-based biomaterials in the context of oral soft and hard tissue healing. The literature was identified through targeted searches of major scientific databases and selected based on relevance to material characteristics, biological response, and oral regenerative applications. The analysis reveals substantial heterogeneity in material formulation, experimental design, and outcome assessment, limiting direct comparison between studies and translational interpretation. While modified and nano-sized hydroxyapatite systems often demonstrate enhanced biological responses, supporting evidence is predominantly preclinical. Greater standardization of methodologies and outcome measures is required to strengthen clinical relevance. Full article

Objective: This study aimed to assess practicing dentists’ knowledge, attitudes, and self-confidence regarding knowledge about oral manifestations of haematological disorders and interpretation of blood count (BC) tests. Materials and Methods: An online survey was sent to all practicing dentists via email addresses registered with the Dental Chamber. The questionnaire collected sociodemographic data and assessed knowledge of hematological diseases, their oral manifestations, and BC interpretation, as well as dentists’ attitudes toward interdisciplinary collaboration and perceived need for continuing education. In the knowledge section, some questions required a single correct answer, while most allowed multiple selections. For multiple-choice items, any incorrect choice made the response incorrect; responses were partially correct if accurate but incomplete and fully correct only when all correct options were selected. Statistical analysis was performed with p < 0.05. Descriptive statistics, Shapiro–Wilk, Kruskal–Wallis H, Mann–Whitney U, and independent-samples t-tests were used. Results: A total of 308 dentists responded, representing only 7.6% of the national dental workforce. While most recognized the relevance of BC tests and systemic disease indicators in oral health, knowledge gaps were substantial. The mean score on knowledge items was low (2.81 ± 1.52 out of 11), with only 1.3% dentists achieving seven or more correct answers. Interestingly, dentists with higher self-reported confidence in interpreting BC tests had lower knowledge scores, suggesting a potential Dunning-Kruger effect. Knowledge did not differ by specialization or postgraduate education, likely reflecting limited curricular coverage, but was more strongly associated with clinical experience, practice location, and patient load. Most respondents (96.1%) expressed strong interest in further education on the topic. Conclusions: Targeted education and interdisciplinary collaboration are essential to overcome gaps and enhance knowledge and diagnostic accuracy in oral manifestations of blood diseases and BC interpretation. Full article

Background: Temporary dental crowns are an essential component of fixed prosthodontic treatment, protecting prepared teeth and maintaining occlusal function and aesthetics until delivery of the definitive restoration. Their clinical performance is strongly influenced by their internal microstructure, which directly affects mechanical behavior. Therefore, the aim of this study was to compare the internal porosity and fracture resistance of temporary dental crowns fabricated using conventional and 3D-printing techniques. Materials and Methods: This in vitro study compared the porosity and fracture resistance of three materials for provisional restorations: a bis-acrylic resin (Protemp^TM 4), an autopolymerizing resin (Success CD), and a 3D-printed light-curing resin (V-Print c&b temp). Thirty-six standardized single-unit crowns (n = 12 per group) were fabricated. All specimens were analyzed using high-resolution micro-computed tomography to determine total crown volume, pore volume, and relative porosity. Fracture resistance was evaluated under monotonic compressive loading in a universal testing machine. Data were analyzed using appropriate parametric or non-parametric statistical tests (α = 0.05). Results: The 3D-printed material exhibited the lowest mean porosity (0.0029%), whereas Protemp^TM 4 and Success CD showed substantially higher porosity values. However, Protemp^TM 4 demonstrated the highest mean fracture resistance, followed by the 3D-printed resin and Success CD. No direct correlation between porosity and fracture resistance was observed, indicating that material chemistry and internal bonding play a more decisive role than void content alone. Conclusions: These findings suggest that 3D printing improves structural homogeneity, while bis-acrylic materials provide superior load-bearing capacity, and that each fabrication method offers distinct advantages depending on clinical requirements. Full article

Background/Objectives: Photobiomodulation (PBM) is a biologically plausible adjunct for modulating orthodontic tissue response, but its role in conventional clear aligner therapy remains uncertain. This narrative review summarises the mechanistic rationale and clinical evidence on PBM used with clear aligners, focusing on treatment efficiency, predictability, patient-centred outcomes, and biological safety. Methods: Scopus was searched using PBM/low-level laser terms combined with orthodontics and clear aligners. Titles and abstracts were screened for human studies evaluating PBM as an adjunct to conventional staged clear aligner therapy and reporting treatment duration or alignment efficiency, tracking/predictability (for example, additional aligners, refinements, or fit-related outcomes), pain, or biological safety. Eight aligner-based clinical studies formed the core set. Results: The included studies comprised case reports, retrospective cohorts, pilot investigations, and one historical prospective nonrandomized comparison. Most evaluated short daily sessions of home-use near-infrared LED PBM, while some used external laser-based or combined adjunct protocols. Some studies reported shorter treatment duration, faster alignment, or fewer finishing aligners in PBM users, but these findings were difficult to attribute to PBM alone because altered tray-change intervals and close monitoring were common co-interventions. Aligner-specific pain outcomes were inconsistently reported. Limited safety data, based mainly on one retrospective pilot cohort assessing anterior teeth, found no statistically significant difference in root-volume change between PBM users and controls. Conclusions: PBM has been investigated as a potential adjunct in clear aligner orthodontics, but the available evidence remains preliminary, heterogeneous, and largely non-randomised. No high-quality randomized clinical evidence currently supports the clinical effectiveness or routine use of PBM in clear aligner orthodontics. At present, PBM should be regarded as an investigational adjunct rather than an established clinical recommendation, pending larger and better-designed trials with standardised device-specific protocols, objective adherence measures, movement-specific analyses, and longer follow-up for safety and patient benefit. Full article

Background: Antihyperlipidemic medications are widely prescribed for the management of dyslipidemia and prevention of cardiovascular disease and may also influence bone metabolism, formation, and repair. However, their impact on peri-implant bone remodeling and dental implant survival remains insufficiently investigated. Objectives: The aim of this study was to evaluate the influence of antihyperlipidemic therapy on dental implant survival and failure rates over a ten-year period. Methods: A retrospective cohort study included 552 patients receiving 1680 dental implants between 2012 and 2022. Patients were divided into a control group (512 patients; 1581 implants) and a study group receiving antihyperlipidemic monotherapy (40 patients; 99 implants). Clinical, radiographic, and demographic data were collected and analyzed, and implant failure was assessed according to the established clinical criteria of the International Congress of Oral Implantologists. Results: Kaplan–Meier analysis demonstrated significantly better dental implant survival in patients receiving antihyperlipidemic therapy (log-rank p = 0.046). The failure rate was lower in the study group (1.01%) compared with the control group (5.12%). Cox regression analysis, adjusted for age, sex, implant diameter and length, insertion torque, and bone quality, showed that antihyperlipidemic therapy was associated with a markedly reduced risk of implant failure (HR = 0.16). Overall, the use of antihyperlipidemic medications was associated with a significantly lower risk of implant failure (p < 0.05), suggesting a beneficial effect on long-term dental implant survival. Conclusions: The present findings indicate that antihyperlipidemic therapy may be associated with improved dental implant survival and enhanced osseointegration. These results should be interpreted as hypothesis-generating and necessitate confirmation in future prospective randomized controlled studies with expanded and more balanced cohorts. Full article

Background/Aim: This study aims to assess the prevalence of self-reported oral ulcers and their associated factors among patients with type 2 diabetes mellitus (T2DM) in Bangladesh. Materials and Methods: A hospital-based cross-sectional study was conducted among 260 patients with T2DM attending outpatient dental services at three tertiary hospitals in Dhaka. Data were collected using a semi-structured questionnaire covering sociodemographic characteristics, behavioral and dietary factors, medical history, and self-reported oral mucosal conditions. Associations between oral ulcers and potential risk factors were analyzed using Chi-square and Fisher’s exact tests. Results: Most participants were middle-aged (50–59 years), female, of low educational status and married, with a high prevalence of regular tooth-brushing but low use of oral hygiene aids such as mouthwash. Traumatic ulcers (21.5%) and oral lichen planus (19.6%) were the most frequently observed oral mucosal lesions followed by recurrent aphthous ulcers, oral lichenoid reactions, and oral candidiasis. Traumatic ulcers and oral lichenoid reactions showed associations with sharp teeth, dentures or braces, and amalgam restorations, while lichen planus and aphthous ulcers were significantly associated with smoking, systemic conditions such as hypertension, and coexisting oral lesions such as oral candidiasis. Multivariable logistic regression showed that sharp teeth, denture or brace use, amalgam restorations, and tobacco-related habits were associated with oral lesions. Conclusions: Oral ulcers and related mucosal lesions were found to be common among patients with T2DM in Bangladesh, with traumatic ulcers being most frequent and several local and behavioral factors showing significant associations. Full article

Objective: To evaluate the ability of an experimental propolis/chitosan varnish to inhibit the erosive process in primary tooth enamel. Materials and Methods: Forty-two primary incisors were selected and divided into three groups (n = 14): control/no treatment, Duraphat^® varnish, and propolis/chitosan varnish. The varnishes were applied to the experimental area and left in place for 4 h. After varnish removal, the specimens were subjected to erosive challenges with Coca-Cola^®. The quantitative outcome variables were mineral loss assessed by longitudinal microhardness, surface roughness, and wear profile. The data were analyzed using ANOVA and Tukey’s test (p < 0.05). Results: Wear profile and surface roughness analyses showed no significant differences among the groups (p > 0.05). In the microhardness analysis, the control and experimental groups showed significant differences between the control and demineralized areas and between the control and experimental areas (p < 0.05). In the Duraphat group, a significant difference was observed between the control and experimental areas (p < 0.05). Conclusions: The experimental propolis/chitosan varnish was unable to prevent the progression of mineral loss in the enamel of primary teeth subjected to erosive challenge. Duraphat^® fluoride varnish was also unable to protect the enamel. Clinical relevance: Several studies have investigated the use of propolis and chitosan in dentistry, and promising results have been reported when these agents are used individually; however, the propolis/chitosan combination remains poorly explored. To the best of our knowledge, this is the first study to investigate this combination for dental erosion in primary teeth. Full article

Background/Objectives: Vascular complications associated with dermal filler injections are rare but potentially severe, particularly when ocular or neurological structures are involved. Current evidence on pathophysiology, clinical management, and prevention remains heterogeneous. This systematic review aimed to synthesize available clinical evidence on vascular occlusion related to dermal filler injections, focusing on clinical presentation, management strategies, and preventive approaches. Methods: This systematic review was conducted and reported according to PRISMA 2020 guidelines and prospectively registered in PROSPERO (ID: CRD420261323578). PubMed/MEDLINE, Scopus, and the Cochrane Library were searched for studies published between January 2015 and February 2025. Clinical trials, observational studies, case series, and case reports describing vascular complications following facial dermal filler injections were included. Study selection and data extraction were performed independently by two reviewers. Risk of bias was assessed using RoB 2.0 for randomized trials, the Newcastle–Ottawa Scale for observational studies, and Joanna Briggs Institute checklists for case reports and case series. Due to methodological heterogeneity, results were synthesized qualitatively. Results: A total of 1922 records were identified, and 91 studies met the inclusion criteria. Vascular complications were primarily related to intravascular embolization or external vascular compression. Hyaluronic acid fillers accounted for most reported events and were associated with more favorable outcomes owing to enzymatic reversibility with hyaluronidase. Cutaneous ischemia represented the most frequent complication and generally resolved with early high-dose hyaluronidase administration, whereas ocular and neurological events were less common but frequently resulted in permanent deficits. Imaging-guided approaches, particularly ultrasound-assisted techniques, emerged as promising tools for both prevention and targeted management. Conclusions: Vascular occlusion following dermal filler injections represents a time-critical clinical emergency requiring prompt recognition and intervention. The available evidence supports a time-dependent therapeutic model in which early treatment appears to improve cutaneous outcomes, whereas ocular complications remain associated with poor prognosis despite aggressive rescue strategies. Complications related to non-hyaluronic or permanent fillers and autologous fat appear to be associated with more limited therapeutic options and a higher risk of irreversible damage. The certainty of evidence is limited by heterogeneity of study designs and the predominance of descriptive and observational reports. Registration: PROSPERO (ID: CRD420261323578). Full article

Objectives: The primary objective of vital pulp therapy (VPT) is to induce the formation of tertiary dentin bridge through the application of bioactive materials to maintain pulp vitality. This study aimed to evaluate the odontogenic potential of Moringa oleifera ethanolic and aqueous extracts as sustainable herbal pulp capping materials in comparison to mineral trioxide aggregate (MTA) and a bioceramic putty. The evaluation was conducted in vitro on human dental pulp stem cells (DPSCs) and in vivo using a rat model of direct pulp capping. Methods: Moringa leaf extracts were prepared and the cytotoxicity assessed using MTT assay to measure the IC50, and their odontogenic potential was further evaluated in vitro by measuring alkaline phosphatase (ALP) activity and performing Alizarin Red staining for mineralization in comparison to MTA. For the in vivo study, the exposed rat pulps were capped with the extracts, MTA, the bioceramic putty, or a plain collagen sponge (control). Histological analysis was performed to evaluate inflammation and tertiary dentin bridge formation. Results: The ethanolic, aqueous extracts and MTA showed low cytotoxicity, though the ethanolic extract had significantly enhanced ALP expression (p < 0.05) and mineralized nodule formation (p < 0.05) compared to the other groups. In the in vivo study, the plain collagen sponges failed, resulting in necrosis. Conversely, MTA and the ethanolic extract exhibited the best outcomes, inducing the lowest inflammatory response (mainly score 1 and 2) and the successful formation of an irregular dentin bridge by odontoblast-like cells, whereas the aqueous extract and bioceramic putty showed intermediate results, with higher inflammation levels. Conclusions: Ethanolic Moringa oleifera extract is a highly biocompatible material with potent odontogenic induction capabilities, primarily driven by its flavonoid content. It is a promising, novel, and cost-effective material for use in the VPT as an effective alternative to MTA. Full article

Background: Excessive gingival display is frequently associated with upper lip hypermobility and represents a common aesthetic concern. Several therapeutic approaches have been proposed, including botulinum toxin type A injections, lip repositioning surgery (LRS), and combined techniques; however, no clear consensus exists regarding the most effective and stable treatment option. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) guidelines. A comprehensive search of multiple electronic databases was performed, leading to the inclusion of 17 human studies that met predefined PICOS criteria. The review protocol was registered in PROSPERO (CRD420261281920). Results: Most included studies reported favorable outcomes in terms of reduction in gingival display, improvement in smile aesthetics, and patient satisfaction. No major adverse effects were reported, suggesting acceptable safety profiles for all therapeutic modalities. Outcomes varied depending on the type of intervention, surgical technique, botulinum toxin dosage and injection protocol, and the initial severity of upper lip hypermobility. Conclusions: Both botulinum toxin injections and LRS demonstrated effectiveness in reducing excessive gingival display. Botulinum toxin provided a rapid but temporary improvement, whereas modified LRS showed greater stability over time. Combined approaches appeared to offer the most consistent long-term results by limiting postoperative relapse. Further standardized protocols and long-term clinical studies are needed to confirm these findings and support evidence-based clinical decision-making. Full article

Background: Quality-of-life (QoL) assessment has become an essential component of outcome evaluation in oral and maxillofacial surgery (OMFS), particularly in interventions with functional implications for breathing, sleep, and oro-facial performance. Existing instruments often lack specificity for the postoperative OMFS population. This study aimed to develop and psychometrically validate the OMFS-QoL-18 questionnaire, a condition-oriented patient-reported outcome measure designed for postoperative assessment. Methods: A cross-sectional validation study was conducted on 226 adult patients evaluated 6–12 months after orthognathic or function-oriented OMFS procedures. Internal consistency was assessed using Cronbach’s alpha, and reproducibility using the intraclass correlation coefficient (ICC) based on a two-way random-effects model with absolute agreement. The internal structure of the instrument was explored through an exploratory dimensionality analysis using Principal Component Analysis (PCA), including Kaiser–Meyer–Olkin (KMO) testing and Bartlett’s test of sphericity. Descriptive statistics were calculated for item and domain scores. Results: The OMFS-QoL-18 demonstrated good internal consistency (Cronbach’s α = 0.789; standardized α = 0.783) and satisfactory reproducibility (ICC = 0.81; 95% CI: 0.74–0.87). The exploratory dimensionality analysis suggested a multidimensional structure, with five components explaining 67.1% of the total variance. Item clustering was broadly consistent with the predefined conceptual domains, including respiratory comfort, sleep quality, daytime function, oro-maxillofacial function, and global satisfaction. Given the use of PCA as a component-based method, these findings are interpreted as preliminary evidence of dimensional organization rather than confirmation of latent constructs. Conclusions: The OMFS-QoL-18 demonstrated good internal consistency and preliminary evidence of a coherent factor structure. These findings support its use as a promising condition-specific instrument, pending further validation studies. Further multicenter and longitudinal validation studies are warranted to confirm structural stability and responsiveness over time. Full article

Background/Objectives: The uprighting of mesially tipped mandibular second molars following first molar loss is a complex surgical and orthodontic challenge. Conventional methods often result in reciprocal anchorage loss. Mini-implants (MIs) have emerged as essential temporary anchorage devices (TADs) that provide absolute anchorage and enable more predictable tooth movements. Methods: Numerical simulations were performed to evaluate the forces required for mandibular second molar uprighting under two conditions: first, only with the second molar present, and second, with both the second and the third molars present. Although the periodontal ligament exhibits nonlinear and viscoelastic behavior in vivo, a linear elastic approximation was adopted to allow for a reliable evaluation of comparative stress distribution and initial displacement patterns within the scope of this exploratory biomechanical study. Stress distribution in the roots, periodontal ligament, and alveolar bone was assessed for each scenario. Two three-dimensional (3D) models of the left mandibular segment were created from scans of a human mandible and its teeth. The first model included the canine, the first and second premolars, and the second molar. A second model additionally incorporated the third molar. A retromolar MI was placed in both models. Molar uprighting was simulated using a spring connecting the implant to a button bonded on the mesial surface of the second molar. A force of 200 g was applied because in clinical orthodontic practice, forces that exceed approximately 2 N may cause pain or undesirable tooth mobility. Displacements along the X, Y, and Z axes, as well as regions of peak stress, were analyzed. Results: Model 1 showed maximum displacements at the furcation/mid-root, distal root apex, and distal crown, with von Mises stresses of 0.470 to 0.371 MPa. In Model 2, peak displacements occurred at the mesial root and crown, with stresses of 0.185 and 0.149 MPa, respectively. The magnitude of displacements was in the order of 10⁻⁵ mm. Such values represent initial mechanical responses rather than clinically observable tooth movements. However, the differences between models (e.g., the stress reduction) are expected to be clinically meaningful. Conclusions: Since clinical measurements regarding the stress distribution on teeth and surrounding tissues during orthodontic molar uprighting movements are impossible to perform, the finite element method (FEM) can offer insight into these aspects. The presence of the third molar significantly modulates the biomechanics of second molar uprighting via retromolar MIs. When the third molar is present, the second molar exhibits a reduced tendency for deformation during distalization, although this leads to a slower displacement. This FEM provides biomechanical insights but does not support direct clinical decision-making. The present findings should be viewed as theoretical biomechanical tendencies that require confirmation through clinical, experimental, and longitudinal studies before translation into clinical practice. Full article

Background/Objectives: Burning mouth syndrome (BMS) is a chronic idiopathic orofacial pain disorder characterized by persistent intraoral burning in the absence of detectable mucosal alterations. Diagnosis is challenging due to the lack of specific biomarkers and the need to exclude numerous systemic and local conditions that can mimic oral burning. This literature review aims to summarize current and emerging therapeutic strategies for BMS. Methods: A structured and filtered search of PubMed, Scopus, and Web of Science identified studies evaluating pharmacological, phytotherapeutic, and non-pharmacological interventions. Results: Various antidepressants, anticonvulsants, benzodiazepines, H2 receptor antagonists, and low-dose naltrexone have demonstrated varying degrees of symptom reduction, while alpha lipoic acid (ALA) and phytomedicines such as capsaicin, Hypericum perforatum, Catuama, lycopene, crocin, and melatonin show mixed clinical benefits. Non-pharmacological approaches, including photobiomodulation (PBM), oral cryotherapy, neuromodulation techniques, and cognitive behavioral therapy, also provide meaningful symptom improvement in many patients. Conclusions: Across all modalities, therapeutic responses remain heterogeneous and generally incomplete, underscoring the absence of a universally effective treatment. Current evidence supports an individualized and multidisciplinary approach that integrates pharmacological, psychological, and adjunctive therapies to address the multifactorial nature of BMS. Full article

Objectives: To retrospectively evaluate the survival rate and complications of immediately loaded implant-supported restorations in atrophic mandibles of patients subjected to inferior alveolar nerve relocation for the placement of dental implants. Methods: Consecutively treated patients having a follow-up of four years after loading of implants immediately placed after inferior alveolar nerve repositioning were included. Outcome measures were implant and prothesis survival rates and any type of complications related to the surgery, in particular related to post-operative neurosensory disturbance. Results: Data from 14 consecutive patients rehabilitated with 51 implants were analyzed. All provisional prosthetic restorations could be immediately placed after implant placement, none failed, and no patient dropped out over the four years after definitive loading. Only one implant failed. One day postoperatively, all patients experienced dysesthesia or paresthesia. At two weeks, nine patients had a total neurological recovery and one had partial recovery, while the remaining four patients did not recover. One mandible fractured three weeks after implant placement. At one-year post-loading, one patient was still affected by neurosensory dysfunction and three partially recovered (one of these had it preoperatively). After three years, two patients still presented partial recovery. After four years, no further changes were recorded, and no patients reported total neurosensory dysfunction. The patient with the fractured mandible recovered completely with no neurosensory disturbances. Conclusions: Implant placement in atrophic mandibles following inferior alveolar nerve transposition or lateralization may represent a viable alternative to vertical ridge augmentation, with the added advantage of allowing immediate fixed provisional prothesis. Although severe complications and neurosensory disturbances are not uncommon, all patients experience gradual recovery within one to three years. Full article