Search Results (124)

Objectives: The objective of this study was to evaluate changes in anatomical point position, cranio-cervical posture, and respiratory dimensions following conventional bimaxillary total prosthetic rehabilitation. Methods: A prospective, longitudinal, observational, analytical study was conducted on 12 patients, aged 55 to 75 years, at the Department of Dental Prosthetics at the University of Medicine and Pharmacy in Cluj-Napoca. All patients had complete bimaxillary edentulism and received removable dentures as treatment. Clinical and cephalometric analyses were performed before and after prosthetic treatment to compare changes. The cephalometric analysis was based on the guidelines of Tweed and Rocabado for evaluation. Quantitative data were described using the mean and standard deviation for normal distribution and represented by bar graphs with error bars. A paired samples t-test was used to determine differences between groups, with a significance threshold of 0.05 for the bilateral p-value. Results: When analyzing changes in cranial base inclination, the corresponding angles exhibited an increase, indicating cephalic extension. A statistically significant difference in the anteroposterior diameter of the oropharyngeal lumen with and without bimaxillary complete dentures was identified (p < 0.05). For hyperdivergent patients, modifications in the position of anatomical features on cephalometry slightly reduced the VDO and had a slight compensatory effect on skeletal typology. In contrast, for hypodivergent patients, modifications to the position of anatomical landmarks also had a compensatory effect on skeletal typology, increasing the VDO. Conclusion: Changes in the position of anatomical features on cephalometry generally have a compensatory effect on skeletal typology after complete denture placement. Complete prosthetic treatment with removable dentures can significantly influence respiratory function by reducing the oropharyngeal lumen and body posture by cephalic extension and attenuation of the lordotic curvature of the cervical spine. Full article

Introduction: Traumatic brain injury (TBI) is a leading cause of morbidity worldwide, with the Glasgow Coma Scale (GCS) serving as a tool to measure injury severity. This study aimed to investigate the relationship between GCS admission scores and various socio-demographic, clinical, injury-related, and hospital-related variables in patients with TBI across two tertiary care centers in Eastern Europe, a region that remains underrepresented in the literature. Methods: A retrospective observational study was conducted using data from 119 TBI patients admitted between March 2020 and June 2023 at Cluj County Emergency Hospital (Romania) and Saint Vincent Hospital (Poland). GCS scores were analyzed as both categorical and continuous variables. Statistical analyses included Wilcoxon and Kruskal–Wallis tests for group comparisons and Spearman correlations for continuous variables. Results: Most patients included suffered a mild TBI (GCS score between 13 and 15). There were significant associations between GCS scores and post-traumatic amnesia (p < 0.05), discharge status (p < 0.01), discharge destination (p < 0.01), and education level (p < 0.01). GCS scores at admission were linked to survival, absence of post-traumatic amnesia, higher education levels, and home discharge. No significant differences observed across sex, residence, employment status, injury type, cause, or mechanism of injury. A weak but significant negative correlation was observed between GCS and length of hospital stay (rho = −0.229, p > 0.05), while age showed a non-significant correlation. Conclusions: The GCS score at admission is significantly associated with various clinical and socio-demographic outcomes in TBI patients, supporting the utility of the GCS score as a prognostic tool. The predominance of mild cases and the absence of radiological data, such as cerebral contusions or epidural or subdural hematomas, limit the generalizability of the findings. Further studies with larger samples and comprehensive imaging data are necessary to validate these findings. Full article

Groundwater contamination by nitrates (NO₃⁻) and nitrites (NO₂⁻) is an urgent problem in rural areas of Eastern Europe, with profound public health and sustainability implications. This paper presents an integrated assessment of groundwater vulnerability and water quality in rural wells in the Ceanu Mare commune, Cluj County, Romania—a representative area of the Northern Transylvania Basin, characterized by diverse geological structures, intensive agricultural activities, and incomplete public water infrastructure. This study combines detailed hydrochemical analyses, household-level studies, and geological context to identify and quantify key factors influencing nitrate and microbial contamination in rural wells, providing a comprehensive perspective on water quality challenges in the central part of Romania. This study adopts a multidisciplinary approach, integrating detailed geotechnical investigations conducted through four strategically located boreholes. These are complemented by extensive hydrogeological and lithological characterization, as well as rigorous chemical and microbiological analyses of nearby wells. The results reveal persistently elevated concentrations of NO₃⁻ and NO₂⁻, commonly associated with inadequate livestock waste management and the proximity of manure storage areas. Microbiological contamination was also frequent. In this study, the NO₃⁻ levels in well water ranged from 39.7 to 48 mg/L, reaching up to 96% of the EU/WHO threshold (50 mg/L), while the NO₂⁻ concentrations varied from 0.50 to 0.69 mg/L, exceeding the legal limit (0.5 mg/L) in 87% of the sampled wells. Ammonium (NH₄⁺) was detected (0.25–0.34 mg/L) in all the wells, below the maximum allowed limit (0.5 mg/L) but indicative of ongoing organic pollution. All the well water samples were non-compliant for microbiological parameters, with E. coli detected in 100% of cases (5–13 CFU/100 mL). The regional clay–marl substrate offers only limited natural protection against pollutant infiltration, primarily due to lithological heterogeneity and discontinuities observed within the clay–marl layers in the study area. This research delivers a replicable model for rural groundwater assessment and addresses a critical gap in regional and European water safety studies. It also provides actionable recommendations for sustainable groundwater management, infrastructure development, and community risk reduction in line with EU water directives. Full article

Background: Epidemiological research has shown that regular walnut (from Juglans regia L.) consumption is associated with a reduced risk of cardiovascular disease (CVD), potentially attributable to their antioxidant and anti-inflammatory properties. The vascular cellular adhesion molecule-1 (VCAM-1), a protein upregulated in CVD, has been previously examined in relation to walnut consumption. However, the clinical findings regarding the effects of walnuts on endothelial function among middle-aged individuals susceptible to metabolic syndrome (MetS) remain inconclusive. Objective: This study examined the effects of daily walnut consumption over a four-week period on cardiometabolic parameters (lipid and glycemic profiles, as well as soluble VCAM-1 levels) and anthropometric measurements in middle-aged individuals with at least one altered MetS parameter and no medication. Methods: In a randomized controlled cross-over trial, 22 eligible Caucasian participants (48.81 ± 4.3 years) were selected and randomly assigned to receive either 45 g of walnuts per day or no walnuts within a controlled diet. There were two 28-day intervention periods, with a one-month washout period in between. Clinical and biochemical evaluations were conducted at the beginning and end of each intervention period. Results: A total of 20 participants completed the intervention and were analyzed, with walnuts being well tolerated. A significant decrease in waist circumference (p = 0.049) and a slight change in fasting blood glucose (p = 0.089) were noted following walnut intake. Conclusions: Short-term (4 weeks) dietary supplementation with walnuts resulted in a statistically significant reduction in waist circumference while not impacting the overall health status of participants. Longer-term studies are necessary to investigate the benefits of daily walnut consumption and its impact on the onset and development of MetS in this age group. Full article

Chitosan–hydroxyapatite (CS-HAp) biocomposites, combining the biocompatibility and bioactivity of chitosan with the osteoconductive properties of hydroxyapatite, are emerging as promising candidates for tissue engineering applications. These materials consistently exhibit excellent cytocompatibility, with cell viability rates greater than 95% in MTT and Neutral Red Uptake assays, and minimal cytotoxicity, as demonstrated by low levels of cell death in DAPI and Trypan blue staining. More importantly, CS-HAp biocomposites modulate the immune environment by enhancing the expression of anti-inflammatory cytokines (IL-10 and IL-4) and the pro-inflammatory cytokine TGF-β, while avoiding significant increases in TNF-α, IL-6, or NF-κB expression in fibroblast cells exposed to HAC and HACF scaffolds. In an in vivo dermatitis model, these biocomposites reduced mast cell counts and plasma histamine levels and significantly decreased pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), JAK1/3, VEGF, and AnxA1 levels. Structurally, HACF scaffolds demonstrated larger average pore sizes (95 µm) compared to HAC scaffolds (74 µm), with porosities of 77.37 ± 2.4% and 65.26 ± 3.1%, respectively. These materials exhibited high swelling ability, equilibrium water content, and controlled degradation over a week in culture media. In addition to their immunomodulatory effects, CS-HAp composites promote essential cellular activities, such as attachment, proliferation, and differentiation, thereby supporting tissue integration and healing. Despite these promising findings, significant gaps remain in understanding the underlying mechanisms of immune modulation by CS-HAp biocomposites, and formulation-dependent variability raises concerns about reproducibility and clinical application. Therefore, a comprehensive review is essential to consolidate existing data, identify key knowledge gaps, and standardize the design of CS/HAp composites for broader clinical use, particularly in immunomodulatory and regenerative medicine contexts. Full article

Skin aging is a complex process influenced by several factors, including UV exposure, environmental stressors, and lifestyle choices. The demand for effective, natural skincare products has driven research into plant-based oils rich in bioactive compounds. Rosehip oil has garnered attention for its high content of carotenoids, phenolics, and antioxidants, which are known for their anti-aging, photoprotective, and skin-rejuvenating properties. Despite the growing interest in rosehip oil, limited studies have investigated its efficacy on human skin using advanced imaging technologies. This study aims to fill this gap by evaluating the efficacy of cold-pressed Rosa canina seed oil on facial skin characteristics, specifically wrinkles, ultraviolet (UV) spot reduction, and erythema mitigation, using imaging technologies (the VISIA analysis system). Seed oil pressed from R. canina collected from the Băișoara area of Cluj County has been selected for this study due to its high carotenoid, phenolic, and antioxidant contents. The oil has also been analyzed for the content of individual carotenoids (i.e., lutein, lycopene, β Carotene, and zeaxanthin) using HPLC-DAD (High-Performance Liquid Chromatography—Diode Array Detector), along with lutein and zeaxanthin esters and diesters. After the preliminary screening of multiple Rosa species for carotenoid, phenolic, and antioxidant contents, the R. canina sample with the highest therapeutic potential was selected. A cohort of 27 volunteers (aged 30–65) underwent a five-week treatment protocol, wherein three drops of the selected rosehip oil were topically applied to the face daily. The VISIA imaging was conducted before and after the treatment to evaluate changes in skin parameters, including the wrinkle depth, UV-induced spots, porphyrins, and texture. Regarding the bioactivities, rosehip oil showed a significant total carotenoids content (28.398 μg/mL), with the highest levels in the case of the β-carotene (4.49 μg/mL), lutein (4.33 μg/mL), and zexanthin (10.88 μg/mL) contents. Results indicated a significant reduction in mean wrinkle scores across several age groups, with notable improvements in individuals with deeper baseline wrinkles. UV spots also showed visible declines, suggesting ideal photoprotective and anti-pigmentary effects attributable to the oil’s high vitamin A and carotenoid content. Porphyrin levels, often correlated with bacterial activity, decreased in most subjects, hinting at an additional antimicrobial or microbiome-modulatory property. However, skin responses varied, possibly due to individual differences in skin sensitivity, environmental factors, or compliance with sun protection. Overall, the topical application of R. canina oil appeared to improve the facial skin quality, reduce the appearance of age-related markers, and support skin health. These findings reinforce the potential use of rosehip oil in anti-aging skincare formulations. Further long-term, large-scale studies are warranted to refine dosing regimens, investigate mechanisms of action, and explore synergistic effects with other bioactive compounds. Full article

Glomerular diseases are a major cause of chronic kidney disease worldwide, yet epidemiological data from Eastern Europe, and Romania in particular, remain scarce. This study aimed to characterize the spectrum of biopsy-proven glomerulopathies in Romania through a multicenter national registry over a 10-year period. We retrospectively analyzed 4047 native kidney biopsies performed between 2014 and 2023 across four national nephrology reference centers. Patient demographics, clinical presentation, and histopathological diagnoses were collected and categorized into primary and secondary glomerular diseases, glomerulosclerosis, tubulointerstitial nephropathies, hereditary nephropathies, and vascular nephropathies. The mean patient age was 48 years, 54.8% were male, and 51.4% presented with nephrotic-range proteinuria. The most common primary glomerulopathies were membranous nephropathy (16.7%), immunoglobulin A nephropathy (15.6%), focal segmental glomerulosclerosis (8.8%), and membranoproliferative glomerulonephritis (10%). Among secondary glomerular diseases, lupus nephritis (9.3%), diabetic nephropathy (8.5%), and vasculitis (7.7%) were most frequent. Marked inter-center variability was observed, with a notably high prevalence of membranous nephropathy in Iași (31.1%). Over the study period, the incidence of focal segmental glomerulosclerosis increased while immunoglobulin A nephropathy declined. This study provides the first nationwide epidemiological assessment of biopsy-proven glomerular disease in Romania, revealing both similarities and distinctive differences compared to patterns reported in other European countries. Full article

Background/Objectives: Mesenchymal tumors of the gastrointestinal tract are rare and can pose significant diagnostic challenges, particularly when located in atypical sites such as the sigmoid colon. Gastrointestinal stromal tumors (GISTs) are often the primary consideration based on imaging findings; however, other spindle cell neoplasms, such as schwannomas, must also be considered. We present a case of a sigmoid colon schwannoma initially suspected to be a GIST and provide a literature review on the diagnostic and therapeutic challenges associated with these tumors. Methods: A literature review based on articles from 2015 to 2024 was conducted to identify cases of mesenchymal tumors of the colon misdiagnosed as GISTs. The review focused on the role of imaging, endoscopic biopsy, and immunohistochemistry in differentiating these neoplasms. Additionally, treatment approaches, including surgical resection versus targeted therapy, were assessed. Results: The literature review revealed that GISTs and schwannomas share overlapping imaging characteristics, including submucosal location, hyperintensity on T2-weighted MRI, and contrast enhancement. However, immunohistochemical markers remain the gold standard for differentiation. Studies also highlighted the increasing role of minimally invasive diagnostic techniques, such as fine-needle aspiration and molecular profiling, in achieving a definitive preoperative diagnosis. Unlike GISTs, which often require adjuvant therapy with tyrosine kinase inhibitors, schwannomas are typically treated with surgical excision alone, with a low risk of recurrence. Conclusions: Current evidence supports a multimodal diagnostic approach combining imaging, biopsy, and immunohistochemistry to accurately classify mesenchymal tumors of the colon. While imaging can suggest a probable diagnosis, histopathological confirmation is essential before initiating targeted therapy. Full article

With the advancement of interventional coronary procedures, drug-coated balloons have become an increasingly common alternative to drug-eluting stents in the treatment of various lesions. This paradigm shift stems from several advantages that DCBs entail, including a reduction in stent length burden, the possibility of late vessel positive remodeling, and the preservation of bifurcation anatomy. Conversely, several studies compared the efficacy of DCB treatment to stents or POBA in various scenarios. In this review, we will discuss the areas in which a DCB can be of paramount importance. We will begin by examining the role of DCBs in in-stent restenosis, for which the current practice guidelines do not clearly state the role of this technology, as opposed to the previous ones, in which it was mentioned as a first-line armamentarium. We will then discuss the indications and advantages of using DCBs in de novo lesions, concerning both small and large vessels, with growing emphasis on diffuse lesions. Lastly, we will address the current data on the use of DCBs in special scenarios such as the treatment of chronic total occlusion and left main and bifurcation lesions, without forgetting the primordial role of drug-eluting stents in all these lesions. Full article

Background/Objectives: Cushing’s syndrome (CS), including Cushing’s disease (CD)—the most common type—has a substantial negative impact on morbidity, mortality, and patients’ quality of life. Medical management of CS is essential for controlling hypercortisolism as part of preoperative preparation for definitive surgical treatment and for managing residual or relapsed hypercortisolism post-surgery. Osilodrostat, a dual inhibitor of glucocorticoid and mineralocorticoid biosynthetic pathways, has been approved for the medical treatment of CS since early 2020. However, real-world data on its adverse effects remain limited. We mined the FAERS database and analyzed the reports associated with osilodrostat up to 1 October 2024. Methods: Descriptive and disproportionality methods based on Relative Odds Ratio (ROR), Chi-square (χ²), and Proportional Reporting Ratio (PRR), were used to discern potential safety signals and assess the significance of osilodrostat-associated adverse events. Results: This study identified 782 reports in which osilodrostat was the primary suspected drug, containing 593 preferred terms (PTs) and 2481 occurrences. The most frequently registered events belonged to the following SOCs: “General disorders and administration site conditions” (n = 457, 18.4%), “Injury, poisoning and procedural complications” (n = 311, 12.5%), “Gastrointestinal disorders” (n = 278, 11.2%), “Investigations” (n = 260, 10.5%), and “Nervous system disorders” (n = 184, 7.4%). Among PTs, off-label use was the most commonly reported, aligning with the fact that the vast majority of cases originated from the U.S. (84%), where osilodrostat is officially approved only for the treatment of CD. Disproportionality analysis confirmed previously known and new potential adverse drug reactions associated with osilodrostat treatment, including reports of cardiac flutter (n: 4; PRR: 19.42; χ²: 49.57), ventricular extrasystoles (n: 4; PRR: 11.85; χ²: 29.62), muscular weakness (n: 8; PRR: 2.25; χ²: 4.38), rib fracture (n: 4; PRR: 6.66; χ²: 13.99), spinal fracture (n: 3; PRR: 4.66; χ²: 5.35), sepsis (n: 9; PRR: 2.63; χ²: 7.56), fungal infections (n: 4; PRR: 3.67; χ²: 5.33), and COVID-19 (n: 32; PRR: 5.07; χ²: 101.16). Conclusions: This study highlights new risks and offers valuable insights into osilodrostat use; however, further research and validation are necessary, particularly for adverse reactions not yet explicitly documented in the summary of product characteristics. Full article

Background: Chronic liver disease (CLD) is a major global health concern, contributing significantly to morbidity and mortality. Cirrhosis and liver cancer are the leading causes of liver-related deaths, with various etiological factors, such as metabolic disorders and alcohol-related and viral hepatitis, driving its global prevalence. Non-invasive biomarkers and scoring systems have emerged as key tools for assessing liver disease severity and differentiating CLD from cirrhosis. This study evaluates biomarkers and non-invasive scores and their utility in distinguishing CLD from cirrhosis. Methods: This retrospective observational study included 250 adult patients hospitalized between January 2021 and December 2023 at Cluj County Emergency Clinical Hospital, Romania. Patients were diagnosed with either cirrhosis or CLD of viral, autoimmune, or primary biliary cholangitis (PBC) etiology. Non-invasive biomarkers, scores, and various hemogram-derived ratios were evaluated. Statistical analysis involved descriptive statistics, comparative tests, and receiver operating characteristic (ROC) curve analysis. Results: Among the 250 patients, 137 had liver cirrhosis (54.8%) and 113 had CLD without cirrhosis (45.2%). Significant differences were observed in laboratory parameters, with cirrhosis patients showing lower hemoglobin, platelet count, and albumin levels alongside higher liver enzymes and INR values. Non-invasive scores such as APRI, FIB-4, and NFS demonstrated higher values in the cirrhosis group, indicating more advanced liver damage. Hemogram-derived ratios, particularly the neutrophil-to-lymphocyte ratio (NLR), were higher in cirrhosis patients. ROC analysis revealed that the Lok index had the highest discriminatory power (AUC 0.89), followed by the King score (AUC 0.864) and the Fibrosis index (AUC 0.856), which effectively distinguished cirrhosis from CLD. Conclusions: This study underscores the utility of non-invasive biomarkers and scoring systems in differentiating CLD from cirrhosis. The Lok index, King score, and Fibrosis index demonstrated excellent diagnostic accuracy, while hemogram-derived ratios, such as NLR, offer insights into systemic inflammation associated with liver disease progression. These findings support the integration of non-invasive markers into clinical practice for improved risk stratification and management of liver diseases. Full article

Background/Objectives: Primary hyperparathyroidism (PHPT) is a prevalent endocrine disorder, with ectopic mediastinal parathyroid adenomas accounting for up to 30% of cases, posing significant diagnostic and surgical challenges. While traditional management relies on invasive procedures, minimally invasive techniques such as video-assisted thoracoscopic surgery (VATS) have emerged as viable alternatives. This study addresses a gap in the current literature by presenting our experience with VATS for mediastinal ectopic parathyroid adenomas, particularly in underreported retrotracheal/paraesophageal locations. By integrating a retrospective case series with a systematic literature review, we highlight evolving surgical strategies and their implications for patient outcomes in anatomically complex cases. Methods: A retrospective analysis was conducted over a three-year period on patients diagnosed with mediastinal ectopic parathyroid adenomas. Data on demographic characteristics, preoperative imaging, surgical techniques, intraoperative findings, and postoperative outcomes were collected. This study primarily compared the outcomes of VATS with those of traditional thoracotomy, with a focus on surgical success, complication rates, and length of hospital stay. Results: Six patients underwent surgical resection for mediastinal ectopic parathyroid adenomas (two intrahymic and four retrotracheal/paraesophgeal). VATS was the preferred approach in all cases, with one patient requiring conversion to thoracotomy due to challenging vascular anatomy. Surgical success, defined as the normalization of postoperative serum calcium levels, was achieved in all cases. The median operative time was 80 min, and the mean hospital stay was 6.25 days. One patient developed transient postoperative hypocalcemia, necessitating supplementation. No major surgical complications were observed. Conclusions: This study supports VATS as a safe and effective approach for mediastinal ectopic parathyroid adenoma resection, offering reduced morbidity and shorter recovery times compared to traditional open surgery. The findings align with emerging evidence advocating for minimally invasive techniques in complex mediastinal surgeries. Full article

This study is concerned with the research and development of nanofibrous hybrid materials functioning as membranes composed of polyvinylidene fluoride (PVDF) polymer and enriched with metal–organic frameworks (MOFs) as dopants for the adsorption and detection of gases, dyes, and heavy metals in wastewater. Several types of nanofiber composites are fabricated by electrostatic spinning. The prepared samples and their chemical, optical, and material properties are analyzed. Subsequently, the preliminary investigation of dye removal is conducted. Accordingly, the design and investigation of these nanofibrous structures may contribute to addressing critical environmental and technological challenges. Full article

Background/Objectives: Otosclerosis causes progressive hearing loss through abnormal bone remodeling within the otic capsule and predominantly affects young individuals. Surgical intervention can markedly enhance a patient’s quality of life and socio-economic status. Anesthetic management may involve either general anesthesia or monitored anesthesia care, with the latter enabling real-time assessment of hearing improvement while providing optimal surgical conditions and patient satisfaction. This study examines the efficacy and safety of continuous dexmedetomidine infusion and target-controlled remifentanil infusion for conscious sedation combined with local anesthesia in otosclerosis surgery. Methods: Seventy-four adult patients undergoing otosclerosis surgery were randomly assigned to either the dexmedetomidine group or the remifentanil group. Primary outcomes included patient satisfaction at 24 h post-surgery and surgeon satisfaction with operative conditions. Secondary outcomes comprised hemodynamic effects, the necessity for adjuncts to the proposed sedation protocols, and intra- and postoperative complications. Results: There was no statistically significant difference between the dexmedetomidine and remifentanil groups regarding patient satisfaction (p = 0.943) and surgeon satisfaction (p = 0.069). A strong correlation was observed between surgeons’ assessments and patients’ satisfaction Composite Scores (η² = 0.185, p = 0.003). Dexmedetomidine was more effective in significantly reducing arterial pressure and heart rate without undesirable clinical effects. Conclusions: No significant difference was found between the groups concerning patient and surgeon satisfaction. Dexmedetomidine infusion led to considerable reductions in arterial pressure and heart rate compared to remifentanil. Full article

Background/Objectives: Peri-implantitis is a prevalent inflammatory condition affecting dental implants, leading to increased treatment costs, patient dissatisfaction, and potential implant failure. Novel biomarker-based approaches may contribute to early detection, thereby decreasing the burden of the disease. The aim of this review was to assess in vivo studies using metabolomics to identify the metabolic profiles and potential biomarkers of peri-implantitis. Methods: The protocol for this study was registered with PROSPERO (CRD42025634865). Five databases and grey literature sources (PubMed, Scopus, Web of Science, ProQuest, and Google Scholar) were searched using keywords related to metabolomics and peri-implantitis. Studies were selected by independent, inter-calibrated researchers. Data were extracted using predefined, custom forms. The risk of bias was assessed using the ROBINS-I tool. Results: An electronic literature search retrieved 543 articles, of which five were selected. All studies were published within the last five years of the search. All but one study used untargeted metabolomics, and all studies identified metabolites associated with peri-implantitis or distinct metabolomic profiles of peri-implantitis. SCFAs and lysine metabolites were recurring in the results, confirming the findings of previous metabolomic studies on periodontal disease. Conclusions: Metabolomics has not been widely used to study peri-implantitis. Evidence from existing studies confirms the findings of metabolomics studies on periodontitis. Several metabolites related to PI are associated with immune response, tissue degradation, and cellular energy pathways. Integrating -omics technologies into peri-implantitis diagnosis may facilitate biomarker discovery and improve early detection strategies. Full article