Search Results (1,946)

Background: Esophageal schwannomas are extremely rare, benign mesenchymal tumors originating from the nerve sheath tissues of autonomic nerves, accounting for less than 2% of all esophageal tumors. This systematic review aims to provide a detailed analysis of esophageal schwannomas (ESs), focusing on tumor characteristics, diagnostic methods, and treatment options. Methods: A systematic search of English literature databases, including ScienceDirect, Springer, PubMed, and Google Scholar, was conducted up to 2023. The keywords used were ‘esophageal schwannoma,’ ‘gastrointestinal schwannoma,’ ‘esophageal neurinoma,’ and ‘esophageal neurilemoma.’ Studies were reviewed for patient demographics, clinical presentation, diagnostic methods, tumor characteristics, and management options. Results: A total of 370 articles met the inclusion criteria, with 80 articles (89 cases) included in the final analysis. The mean age of patients was 51.8 years, with a female predominance (73%). Most cases were reported from East Asia (60.7%). Most (71%) patients presented with dysphagia, and 12% were asymptomatic. Preoperative diagnosis often involved CT scans (75.28%), upper endoscopy (73.03%), and EUS (49.4%). Tumors averaged 77.86 mm in size as per CT, MRI and PET-CT, with the upper esophagus being the most common location (55.55%). Surgical resection was the primary treatment, with enucleation being the most frequent procedure (58.9%). The prognosis was generally excellent, with no reported recurrences during follow-up periods. Conclusions: Esophageal schwannomas are extremely rare. Surgical resection remains the treatment of choice, with a high success rate and excellent prognosis. Further studies are needed to standardize diagnostic and treatment protocols for these rare tumors. Full article

This article presents a novel compact high-Q bandpass filter (BPF) utilizing a 3-D stacked stripline configuration. T-shaped stepped impedance resonators (SIRs) are employed to achieve miniaturization. By folding the filter geometry from an inline arrangement into a U-shape along the broadside direction, both broadside and edge coupling structures are realized, enabling various cross-coupling schemes for flexible placement of transmission zeros (TZs). A comprehensive analysis of both electric and magnetic coupling structures is conducted to support the overall filter design. To validate the concept, a tenth-order general Chebyshev BPF prototype centered at 3.485 GHz with a 1 dB bandwidth of 380 MHz is designed, fabricated, and measured. The filter is constructed by vertically soldering two patterned sheet metal layers together with three stacked cavities. Despite having an electrical size of only 0.58 × 0.23 × 0.19 λ_g³, the filter exhibits a high unloaded Q-factor (Q_u) of 1200, along with up to six TZs and a spurious-free frequency range extending to 12 GHz. Measured results show an insertion loss of 0.58 dB at the center frequency and a return loss of better than 20 dB within the passband, demonstrating favorable agreement with simulations. Featuring solid electrical performance, the proposed filter is ideally suited for 5G and 5G-Advanced (5G-A) communication base stations. Full article

Despite abundant scholarship on religious architecture and urban history, a systematic city-wide analysis that treats the parish system as a territorially relevant infrastructure for planning remains uncommon. This article examines Barcelona’s network of 132 Catholic parish churches as a cartographic layer for interpreting distributed centralities and their relationships with public space. The study is grounded in an exhaustive inventory based on on-site visits and archival consultation, and on a standardised redrawing protocol (Sitte and Nolli conventions) developed from municipal cartography and architectural plans. Synthesis maps and fabric-specific drawings document spatial patterns that vary across phases of urban growth, as well as recurrent typologies of relationships between churches, squares, and urban axes. Across the corpus, at least 25 churches are associated with squares and can be grouped into four recurrent arrangements (12 with a single frontal square; 4 with concatenated lateral squares; 3 surrounded by open space; and 6 with squares severed by through-traffic infrastructure). District plates further reveal contrasting typological distributions between Ciutat Vella (n = 16), Eixample (n = 19), Gràcia (n = 11), and Nou Barris (n = 14). The findings show that Barcelona’s Catholic parish cartography constitutes a key interpretative layer for understanding the city’s complexity, including its social and urban transformations, neighbourhood-level mechanisms of resilience, and the interaction between religious networks, urban form, and civic culture. The resulting cartographic protocol is reproducible and transferable to studies of urbanisation and regional development, offering an operational framework for planning debates on the governance of public space, heritage conservation, and urban sustainability. Full article

Background/Objectives: Transcatheter aortic valve implantation (TAVI) has become an established treatment for patients with severe aortic stenosis. The accurate post-procedural assessment of transvalvular gradients is essential for evaluating procedural success and long-term prognosis. However, significant discrepancies have been reported between gradients measured invasively and those derived by Doppler echocardiography. This systematic review aims to summarize the current evidence comparing invasive and echocardiographic gradient measurements after TAVI. Methods: A comprehensive literature search was conducted of the PubMed database from inception to 8 November 2025 using the keywords: “TAVI/TAVR,” “invasive versus echocardiographic gradient,” and related terms. Studies were included if they compared invasive and Doppler-derived aortic valve gradients following TAVI. Out of 44 identified articles, 12 studies met the inclusion criteria and were analyzed. Results: Across all the included studies, the echocardiography-derived mean gradients were consistently 4–7 mmHg higher than those obtained invasively, reflecting physiologic rather than procedural discordance. The difference was more pronounced in balloon-expandable and small-diameter valves and in patients with high-flow states. Invasive gradients were independently associated with mortality and major adverse cardiovascular events (MACEs) in multiple studies. An invasive mean gradient ≤ 10 mmHg immediately post-TAVI was repeatedly identified as the threshold for optimal procedural success and improved long-term outcomes. Conclusions: Doppler echocardiography systematically overestimates transvalvular gradients after TAVI. While both modalities remain valuable, an invasive hemodynamic assessment provides the most reliable evaluation of immediate procedural success and long-term prognosis. Echocardiographic gradients should be interpreted relative to the baseline invasive measurement to avoid overdiagnosis of prosthetic dysfunction and ensure appropriate clinical management. Full article

The sustainable management of waste is a significant problem facing humanity, especially in regions with low recycling rates and a lack of infrastructure. For example, Romania has a recycling rate of only 12%, a long way from meeting the European Union’s target of 42%. This article proposes a framework for sustainable waste management, called CETHTB-Chain, by combining the circular economy, Triple Helix Twins collaboration, and blockchain technology. To test the viability of this framework, a Monte Carlo simulation with 10,000 iterations and system dynamics modelling with a 10-year simulation period was conducted. The Monte Carlo simulation revealed that CETHTB-Chain can improve recycling rates by a mean of 45.6% (95% CI, 38.6–52.6%), material recovery rates by 62.7% (95% CI, 54.4–70.0%), cost savings by 18.53 euros per ton, and CO₂ reduction by 629 kg per ton of waste. System dynamics modelling revealed that CETHTB-Chain is feasible for implementation, following S-curve growth, with recycling rates of 38.6% in 7–10 years. Sensitivity analysis revealed that blockchain technology adoption (ρ = 0.612) and citizen participation (ρ = 0.379) were key drivers of CETHTB-Chain performance. By combining Monte Carlo simulation and system dynamics modelling, this article has shown CETHTB-Chain to be a statistically significant and temporally feasible blueprint for transitioning from a linear economy to a circular economy in waste management. By engaging academia, industry, and government in a collaborative relationship facilitated by blockchain technology, CETHTB-Chain has provided valuable evidence for strategic planning in waste management in the European Union. Full article

Background: Musculoskeletal pain affects an estimated 1.7 billion people worldwide and ranks among the leading causes of global disability. This review evaluates the effectiveness and safety of osteopathy in treating musculoskeletal pain across multiple body regions and conditions. Methods: A systematic literature review following PRISMA guidelines was conducted across five databases (Embase, Medline via Ovid, The Cochrane Library, PEDro, and INAHTA), yielding 964 citations. Eligible studies were RCTs published in English or German up to May 2022; conference abstracts were excluded. A hybrid design was employed: a systematic review of RCTs for neck, shoulder, knee, foot, osteoporosis, and fibromyalgia was combined with a pre-specified umbrella review component for chronic non-specific low back pain (registered in PROSPERO) to avoid duplication of an existing high-confidence evidence synthesis. From 35 critically appraised articles, the best available evidence (n = 15) was selected per body region based on a risk of bias (RoB) assessment (Cochrane Collaboration tool, version 1); the existing review was appraised with AMSTAR 2. An updated search (2022–July 2025) was performed without a RoB assessment. Data were synthesised qualitatively and reported narratively. Results: Fifteen RCTs and one systematic review were included, covering eight body regions and conditions (2408 participants). Pain improved immediately post-treatment in most regions; statistically significant between-group differences were less consistent at mid- and long-term follow-ups. Key findings: neck pain (n = four RCTs)—improvement in three of four studies immediately post-treatment; shoulder pain (n = two RCTs)—improvements across all follow-up points in one study; low back pain (n = one systematic review, 10 RCTs, 1160 participants)—pain reduced immediately and at mid-term follow-up; knee pain (n = two RCTs)—significant reduction in one study; foot pain (n = two RCTs)—improvement in both studies post-treatment and at mid-term follow-up; osteoporosis (n = one RCT)—no improvement immediately post-treatment; fibromyalgia (n = two RCTs)—significant between-group differences in one study post-treatment and at mid-term follow-up. Functional outcomes were heterogeneous across regions. Adverse events were minor and transient; no serious side effects were reported across any included study. The updated search (2022–July 2025) identified 12 additional RCTs across five regions, with findings broadly consistent with the primary analysis, though results for the neck region were marginally less favourable. Discussion: Based on current evidence, osteopathy can improve neck and low back pain for up to three months and may reduce shoulder and foot pain; evidence for other body regions remains inconclusive. RoB was unclear to high across studies, largely due to the inherent inability to blind patients and practitioners in manual therapy trials. Substantial heterogeneity in interventions, outcome measures, and study designs limits comparability. Overall certainty of evidence was low to moderate, warranting cautious interpretation. The consistent absence of serious adverse events across all included studies supports osteopathy as a safe therapeutic option. High-quality research with standardised interventions, rigorous designs, long-term follow-ups, and a focus on technique, dosage, and safety is needed to inform clinical practice and healthcare policy. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sector. Full article

Background: Giant cell myocarditis (GCM) is a rare condition with an incompletely understood immune pathogenesis, characterized by inflammatory damage to the myocardium and the presence of multinucleated giant cells on histopathological examination. The frequently fulminant and severe course requires rapid intervention for a correct diagnosis and the initiation of immunosuppressive therapy, which is often life-saving. Materials and methods: This article contains information from observational studies and case reports, systematically collected from prestigious publications such as JACC, NEJN, ESC, JCC, Heliyon, and Cureus found in the PubMed and ClinicalTrials.gov databases. Thus, 25 patients diagnosed with giant cell myocarditis between March 2019 and May 2025 were analyzed, with a focus not only on the initial clinical evolution, mortality incidence, and the need for heart transplantation but also on the incidence of major complications such as cardiogenic shock and malignant rhythm and conduction disorders refractory to drug treatment. These parameters were studied according to certain intrinsic factors that cannot be influenced, such as age at onset, gender, and associated pathology of the patient, as well as extrinsic factors that can be influenced, such as the time of diagnosis and the start of immunosuppressive therapy. The results obtained were compared with those in the literature from previous years, considering the limitations of the current study. Results: The selected patients were 13 women (52%) and 12 men (48%), mostly from the US and Japan, aged between 22 and 76 years, with an average age of 44.92 years. An associated autoimmune pathology was found in 40% of patients in this group, and previous cardiovascular pathology in 28%. Only 8% had a history of GCM. The clinical onset of new-onset heart failure, refractory to usual therapy, with progressive dyspnea as the cardinal symptom was found in 12 patients, representing 48% of cases; palpitations as an expression of rhythm or conduction disorders were found in five patients, representing 20%; precordial discomfort to precordial pain accompanied or not by ST-T segment changes was present in four patients, representing 16%; and general signs and symptoms or those of other organs were present in three (12%) cases. The diagnosis was made by histological examination of the biopsy fragment obtained by endomyocardial biopsy or from the myocardial fragment obtained during the implantation of mechanical cardiovascular support devices and, less frequently, on the explanted heart and at autopsy. In terms of progression, of the 25 patients, four (16%) died, four (16%) required heart transplantation, and 16 (64%) had a severe progression with cardiogenic shock, which required mechanical circulatory support in 11 (44%) cases. The outcome was mainly influenced by the early diagnosis and administration of immunosuppressive medication, but also by the age of the patients and associated chronic diseases. Conclusions: Giant cell myocarditis is a serious condition that, in the absence of rapid diagnosis and appropriate immunosuppressive therapy, has a fulminant, often fatal course. Clinical suspicion of giant cell myocarditis remains important in the initial diagnosis. Raising this suspicion, together with modern and improved paraclinical investigations compared to previous years, has led to faster diagnosis and administration of immunosuppressive therapy in this pathology. Histological examination remains the gold standard for final diagnosis, but it should be noted that it may be non-diagnostic. In the face of a strong suspicion of giant cell myocarditis, the best approach is to start immunosuppressive therapy and monitor the patient’s progress. Immunosuppressive treatment remains decisive in influencing the evolution of this condition, both through prompt administration and through the adaptation of therapeutic regimens to the evolution of patients. A more detailed understanding of the immune-mediated pathogenesis of GCM and the identification of clinical risk factors for unfavorable short- and long-term outcomes may enable earlier risk stratification and the development of more targeted, individualized therapeutic strategies. Full article

Given ongoing uncertainty about the benefits and harms of prostate-specific antigen (PSA) screening, this systematic review updates the evidence to inform guideline recommendations for adults aged ≥ 18 years in primary care. We searched multiple bibliographic databases from inception to 30 May 2022, with an update on 24 July 2024, for randomized controlled trials (RCTs) and comparative observational studies evaluating PSA-based screening with or without adjunctive technologies such as magnetic resonance imaging (MRI). Studies were selected in duplicate, with data extraction and quality assessment verified by a second reviewer; risk of bias and evidence certainty were assessed using study design-specific tools and GRADE. Four RCTs and one cohort study (17 articles) were included: ERSPC, PLCO and CAP compared PSA screening with no screening, while STHLM3-MRI evaluated a risk-based test combined with MRI targeted biopsy. Meta-analysis showed 0.96 fewer prostate cancer deaths per 1000 individuals invited to screen, corresponding to a 12% relative reduction over 9.5–22 years (RR 0.88, 95% CI 0.81–0.95). One trial estimated 2.3% to 10.3% overdiagnosis over 10–14 years. Overall certainty of evidence was low or very low. PSA screening may offer a small mortality benefit, but uncertainty and variable harms limit confidence, underscoring the need for high-quality evidence, particularly for MRI and risk-based screening strategies. Full article

Background/Objectives: In the area of pharmacology and clinical research, it is necessary to use versatile technologies able to quantify last-line antibiotic molecules with high specificity and sensitivity. This article describes the development of two types of immunosensors based on amperometric and surface plasmon resonance (SPR) measurements and their applicability in the measurement/assessment of therapeutic drug monitoring (TDM) of four last-line antibiotics such as vancomycin, colistin, daptomycin and meropenem in human plasma. In this study, ligand immobilization by preconcentration assays, sensor surface regeneration, determination of sensitivity and correlation of plasma sample quantification results by HPLC were considered. Results: In the case of the electrochemical biosensor the IC50 values obtained were 3.49 μg/L for vancomycin (VAN), 5.44 μg/L for colistin (COL), 0.82 μg/L for meropenem (MER) and 5.10 μg/L for daptomycin (DAP). For the SPRi biosensor the LODs achieved were 19 ng/mL for VAN, 9 μg/L for COL, 12 μg/L for MER and 12.3 μg/L for DAP. Finally, both electrochemical biosensor and the SPRi optical biosensor showed that for the four antibiotics the standard deviations were less than 10% with respect to the HPLC results, with ranges for VAN between ~5–6 µg/mL, for COL ~0.2–0.7 µg/mL, for MER ~4.5–5.5 µg/mL and for DAP ~0.09–0.65 µg/mL. Conclusions: These kinds of biosensors provide a precise and sensitive strategy, together with real-time determination, to quantify last-line antibiotics, with working ranges like those shown by robust techniques such as HPLC and great potential for the clinic. Full article

There is a high rate of morbidity and considerable functional dependence in older adults, requiring care from informal caregivers. Person-centered care is a personalized approach that meets the person’s needs, taking their context into account. Objectives: Our aim was to assess the available evidence on Person-Centered Health Intervention Programs (PCHCIPs) in a home setting among older adults with multimorbidity and their informal caregivers, namely regarding their main characteristics and respective health outcomes. Methods: A systematic literature review was conducted in accordance with the PRISMA guidelines. Bibliographic searches were performed in five databases (CINAHL, MEDLINE, MedicLatina, Scopus, and Psychology and Behavioral Sciences Collection) in November 2024, including studies published between January 2014 and November 2024. Inclusion criteria: Randomized Controlled Trials of person-centered health intervention programs delivered to older adults and their caregivers in home care settings, and scientific articles published betweeen 2014 and 2024. The review protocol was registered in PROSPERO (registration number: CRD42022303687. Results: Twelve articles were included (n = 12). The PCHCIPs provides psychoeducational training and empowerment with physical, psychological, and social interventions that result in health outcomes for the dependent older adults (decreased health-related events and increased social involvement), for the caregiver (improved QoL, reduced burden), and for both participants (increased life satisfaction and reduced costs in health). Conclusions: PCHCIPs covering different areas of intervention (physical, psychosocial and economic) demonstrate positive health outcomes for older adults and their caregivers. It is important to explore more programs that encompass both participants. Full article

Background: Dietary calcium and dairy products are hypothesized protective factors against metabolic syndrome (MetS), yet epidemiological evidence remains inconsistent. This systematic review and meta-analysis evaluated the association between total dietary calcium intake or dairy consumption and MetS prevalence in adults. Methods: Following PRISMA 2020 guidelines, PubMed, Cochrane Library, ClinicalTrials.gov, and SCOPUS were searched through to October 2025 for eligible cross-sectional studies assessing dietary calcium or dairy intake and MetS (NCEP ATP III, IDF, or JIS criteria). Longitudinal studies, non-English articles, and pediatric populations were excluded. Quality was assessed via an adapted Newcastle–Ottawa Scale. Random-effects meta-analyses pooled fully adjusted odds ratios (ORs) and 95% confidence intervals (CIs) comparing the highest versus lowest intake categories. Results: Twenty-four studies were included (12 for dietary calcium intake, 12 for dairy products). Higher dietary calcium intake was significantly associated with lower MetS odds (pooled OR: 0.85; 95% CI: 0.80–0.91), despite substantial heterogeneity (I² = 70.1%). Higher dairy consumption was also inversely associated with MetS (pooled OR: 0.78; 95% CI: 0.72–0.85; I² = 64.6%). While small-study effects were observed for dairy, trim-and-fill analysis confirmed the robustness of the findings. Higher calcium intake further correlated with favorable profiles in individual MetS components, including blood pressure, HDL cholesterol, waist circumference, triglycerides, and fasting glucose. Conclusions: Higher total dietary calcium intake and dairy product consumption are associated with a lower prevalence of MetS in adults. However, the cross-sectional nature of the included studies precludes any inference of causality between calcium intake and MetS. Therefore, although these findings suggest a protective role of calcium-rich diets, well-designed prospective and interventional studies are warranted to clarify whether this relationship is causal. Full article

Globally, breast cancer is one of the most prevalent tumors in women and remains a major concern due to its high mortality rate. Although treatment options for this disease have evolved over the years, there are still many cases of recurrence and metastasis. In this context, considering the importance of evaluating less aggressive and more efficient therapeutic alternatives to aid in the treatment of breast cancer, the present study critically discusses the cytotoxic effects of diterpenoids isolated from Croton species (Euphorbiaceae). The articles were retrieved from different databases, from the first report published in 2005 to October 2025. A total of 115 diterpenoids were isolated from 15 Croton species and investigated against different breast cancer cell lines (MDA-MB-231, MCF-7, and MDA-MB-468). These compounds mainly belong to the kaurane group (40%), followed by clerodane (14%), tigliane (12%), and abietane (10%). Of this total, only 25 compounds showed promising results (IC₅₀ = < 10 µM). The mechanisms of action of the compounds crokokaugenoid A, kongensin A, kongensin D, ent-16β,17α-dihydroxykaurane, and lauicyclone A have been reported. These compounds likely act by inducing apoptosis, autophagy, cell cycle arrest, inhibition of cell migration and invasion, and DNA fragmentation in breast cancer cell lines. To date, no randomized clinical trials have been conducted using Croton diterpenoids for the treatment of breast cancer. Therefore, further studies on the modulation of the immune response by these natural products are essential to better understand their immunotherapeutic activity in the tumor microenvironment during breast cancer progression. Full article

Purpose: A scoping review of the published risk stratification scores for febrile neutropenia (FN) was performed to provide a basis for further research and optimization of risk stratification models that can support evidence-based clinical decision-making with a combined individual patient and health resource perspective. Methods: The scoping review utilized the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR). Studies reporting risk stratification models for FN and published in the PubMed and/or Scopus databases between 2000 and 2024 were retrieved and reviewed. Study eligibility criteria were adult cancer patients and articles utilizing FN risk stratification methods. Two researchers reviewed all relevant studies separately to determine if they were eligible for inclusion and extracted the necessary data. Results: A total of 210 papers was screened by title and abstract. A further 158 were screened by retrieval and eligibility, and 14 studies were found eligible after reviewing full papers. Studies have different cohort sizes (min 31, max 4434), age and gender distributions, cancer types (1 hematological, 3 gynecological, 10 mixtures of hematological and solid cancers), definitions of FN and complication, study type (2 retrospective, 12 prospective). The resulting papers mostly focused on validating CISNE and MASCC scores. Additionally, they investigated possible improvements by evaluating revised versions of the MASCC score. Conclusions: The scoping review revealed inconsistencies in key definitions when using risk stratification scores. It is concluded that the field could benefit from more consensus in definitions and research approaches to secure the generalizability and utility of the research. Full article

This article evaluates how artificial intelligence (AI) and educational technology (EdTech) support inclusive learning in Russia and Kazakhstan, two Eurasian countries that share post-Soviet educational legacies but differ in their levels of digital infrastructure and teacher preparedness. Using an asymmetric mixed-methods design, the study draws on a primary survey of N = 2570 educators and staff in four Russian cities (Moscow, Saint Petersburg, Yekaterinburg, Novosibirsk; October–December 2024; response rate 59.8%) and secondary policy/indicator analysis for Kazakhstan. Russia exhibits higher broadband access, AI/EdTech platform adoption, and teacher digital skill levels compared with Kazakhstan. Structural equation modeling (SEM; SmartPLS 4.1) tested four latent constructs—learning environment (LE), general digital competencies (HCg), specialized AI skills (HCs), and inclusion (I)—with satisfactory validity (AVE > 0.5; HTMT ≤ 0.85). A three-stage Measurement Invariance of Composite Models (MICOM) procedure confirmed configural, compositional, and full mean/variance invariance across Russian city subgroups, enabling pooled path analysis. Kazakhstan indicators from secondary sources are discussed as a descriptive benchmark. Semi-structured interviews with 24 stakeholders (12 Russia, 12 Kazakhstan; March 2025; analyzed with NVivo 14) revealed four themes: policy coherence, teacher readiness, infrastructure access, and ethical AI governance. Key SEM paths were LE → HCg (β = 0.278), HCg → HCs (β = 0.652), and HCs → I (β = 0.188), all p < 0.001. A formal mediation analysis confirmed a significant indirect effect across the full LE → HCg → HCs → I chain. The findings indicate that infrastructure is necessary but insufficient: the key to inclusion lies in sustained development of both basic and specialized digital skills, supported by coherent policies and continuous professional development. China and India are discussed as secondary international benchmarks drawn from published reports, not as sites of primary data collection. Full article

Background/Objectives: This systematic review and meta-analysis evaluated the clinical effectiveness of regenerative surgical treatments compared with open flap debridement (OFD) in the management of peri-implantitis and, secondarily, assessed whether more advanced regenerative approaches, including guided bone regeneration (GBR), platelet-rich fibrin (PRF), and hyaluronic acid (HA), provide additional clinical benefit compared with bone grafting alone. Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted in accordance with PRISMA guidelines and the PICO model, covering the period from 1993 to 2024. From 2119 identified articles, 63 full-text papers were reviewed, and 12 studies met all inclusion criteria. These studies compared regenerative treatments with OFD and bone grafting using clinical outcomes of probing pocket depth (PPD), radiographic bone level (RBL), bleeding on probing (BOP), suppuration (SUP), mucosal recession (REC), and clinical attachment level (CAL). Meta-analysis was performed using a random-effects model. Results: Regenerative treatments demonstrated superior outcomes in radiographic bone level gain compared with OFD (p < 0.001), while no statistically significant differences were observed for PPD (p = 0.77), BOP (p = 0.13), SUP (p = 0.42), REC (p = 0.14), or CAL (p = 0.96). Comparisons between bone grafting and other regenerative materials also showed no statistically significant differences. Conclusions: Regenerative procedures improved radiographic bone outcomes but did not consistently outperform OFD in soft tissue parameters, and no advanced regenerative modality demonstrated clear clinical superiority over bone grafting alone. Further high-quality randomized controlled trials with standardized methodologies are needed to establish clinical guidelines for peri-implantitis surgery. Full article