Search Results (253)

Gastric cancer (GC) is the fifth most common cancer worldwide, with the highest incidence in East Asia. Although H. pylori is a well-known risk factor, carcinogenesis can occur independently of H. pylori infection, and approximately 43% of adults carry H. pylori as part of their native microbiota. This study aimed to identify potential oral and gastric microbial markers across different histological stages of GC in both H. pylori-positive and -negative patients. Buccal swabs and gastric mucosa samples were collected from patients with intestinal metaplasia, low-grade dysplasia, high-grade dysplasia, early GC, or advanced GC. Total DNA was extracted, and 16S rRNA gene amplicon sequencing was performed. Microbiome diversity generally remained stable across histological stages, with no directional shifts in community structure. Differential abundance analysis revealed higher relative abundances of Anaerostipes, Phocaeicola, and Collinsella in the gastric antrum of cancerous samples. Anaerostipes and Phocaeicola are typically enriched in the intestinal microbiota but are rarely observed in the stomach, suggesting their potential ecological and pathological relevance in gastric carcinogenesis. In H. pylori-negative patients, however, a different stage-associated abundance pattern was observed, in which Faecalibacterium, a genus predominantly associated with the intestinal environment, was less abundant in advanced gastric cancer samples than in earlier histological stages within the gastric body. These findings suggest that microbial changes during gastric cancer progression may follow different trajectories depending on H. pylori infection status. In oral samples, Haemophilus and Prevotella were more abundant in intestinal metaplasia than in low-grade dysplasia, and network analysis indicated links between Neisseria and Filifactor at oral and gastric sites. However, as the study population was limited to a single country and ethnicity, the applicability of these microbial markers should be carefully considered. Full article

Background: Chronic periodontitis (CP) is a prevalent inflammatory disease worldwide, characterized by the destruction of periodontal tissue due to an immune response triggered by periodontopathogenic bacteria and the prolonged release of reactive oxygen species (ROS). Excess ROS leads to tissue damage through mechanisms such as lipid peroxidation and DNA damage. The aim of this study was to evaluate oxidative and genotoxic damage by quantifying 8-hydroxy-2-deoxiguanosine (8-OHdG), malondialdehyde (MDA), and nuclear abnormalities (NAs) in individuals with CP. Methods: The participants were divided into a CP group (n = 30) and a control group without CP (n = 30). Saliva was collected to quantify 8-OHdG (via ELISA) and MDA (via spectrophotometry). Buccal mucosa samples were collected to assess NAs. Periodontal parameters, probing depth (PD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP), were recorded. Results: The levels of 8-OHdG and MDA were significantly higher in the CP group. NAs were also significantly increased. Positive correlations were observed between 8-OHdG, MDA levels and NAs with clinical parameters. Conclusions: The elevated levels of 8-OHdG, MDA and NAs reflect oxidative and genotoxic damage correlated with CP severity. These biomarkers could complement diagnosis, monitor progression, and assess treatment efficacy. Their elevation may also indicate increased systemic disease risk. Full article

Background: Ameloblastomas account for roughly 1% of all jaw tumours and cysts, typically manifesting as slow-growing, painless swellings that expand both buccal and lingual cortical plates and may infiltrate adjacent soft tissue, often leading to a delayed diagnosis. These benign tumours, characterized by local invasiveness, originate from epithelial tissues and may develop from dental lamina cell rests, the enamel apparatus, the epithelial lining of odontogenic cysts, or basal epithelial cells of the oral mucosa. Methods: This paper aims to describe the comprehensive and interdisciplinary management of an extensive ameloblastoma in a 16-year-old patient, emphasizing the diagnostic challenges, surgical resection, reconstructive procedures, and subsequent oral rehabilitation. Results: At the eleven-year follow-up, clinical and radiographic examinations showed no signs of tumour recurrence. The patient presented no symptoms, indicating neither pain nor functional impairment. The prosthetic rehabilitation utilizing implant-supported fixed restorations was successfully completed, resulting in satisfactory masticatory function and aesthetics. This case adds to the existing evidence on the management of extensive ameloblastomas by demonstrating successful long-term outcomes following interdisciplinary surgical reconstruction and rehabilitation. Conclusions: The presented case highlights the complexity of restoring the lost tissues and functions, as well as the long-term clinical, functional, and aesthetic outcomes over an eleven-years follow-up period. Full article

Objectives: This study aimed to evaluate the malignant transformation (MT) risk profile in patients with oral proliferative leukoplakia (OPL) referred to the Oral Medicine and Oral Surgery units of Umberto I Hospital, Sapienza University of Rome. Methods: The departmental database and medical records of OPL patients were reviewed from January 2014 to June 2024. Demographic, clinical, and histopathological features and treatment strategies were collected in a de-identified dataset. Results: A total of 51 OPL patients (33 females and 18 males; mean age 62.86 ± 13.55 years) were included. MT occurred in 17.6% (n = 9) after a mean follow-up of 4.78 ± 2.59 years. A higher percentage of the presence of a previous history of solid or hematological tumor was observed in patients with MT, with an OR of 2.940 (95% CI 0.064–1.350), without statistical significance. The homogeneous clinical form was more common in patients without MT (78.57%), and the speckled clinical form was more common in patients with MT (44.44%). The percentage of patients with lesions located on the floor of the mouth, ventral surface of the tongue, and dorsal surface of the tongue was higher in patients with MT. The tongue was the most common site of MT, followed by the gingiva, buccal mucosa, and palate. At the histological level, a verrucous, nodular, or bulky architecture was more commonly observed in patients with MT, and the presence of band-like lymphocytic infiltrate was observed in all patients with MT. Higher dysplasia grades were significantly associated with MT (p = 0.009). No significant association was found between the treatment modality and MT risk, although laser ablation was associated with a trend toward lower risk. Conclusions: This study further suggests that the clinical morphology, lesion site, and histological grading may be important predicting factors for MT in OPL. The presence of a non-homogeneous lesion form, a higher grade of dysplasia, and a history of previous solid or hematological tumor led to a more aggressive disease course. Individualized risk assessment and long-term surveillance may be advisable. Full article

Therapeutic peptides have gained significant attention due to their high specificity, potency, and safety profiles in treating various diseases. However, their clinical application via the oral route remains challenging. Peptides are inherently unstable in the gastrointestinal environment, where they are rapidly degraded by proteolytic enzymes and acidic pH, leading to poor bioavailability. Additionally, their large molecular size and hydrophilicity restrict passive diffusion across the epithelial barriers of the gastrointestinal tract. These limitations have traditionally necessitated parenteral administration, which reduces patient compliance and convenience. The oral cavity, comprising the buccal and sublingual mucosa, offers a promising alternative for peptide delivery. Its rich vascularization allows for rapid systemic absorption while bypassing hepatic first-pass metabolism. Furthermore, the mucosal surface provides a relatively permeable and accessible site for drug administration. However, the oral cavities also present significant barriers: the mucosal epithelium limits permeability, the presence of saliva causes rapid clearance, and enzymes in saliva contribute to peptide degradation. Therefore, innovative strategies are essential to enhance peptide stability, retention, and permeation in this environment. Nanoparticle-based delivery systems, including lipid-based carriers such as liposomes and niosomes, as well as polymeric nanoparticles like chitosan and PLGA, offer promising solutions. These nanocarriers protect peptides from enzymatic degradation, enhance mucoadhesion to prolong residence time, and facilitate controlled release. Their size and surface properties can be engineered to improve mucosal penetration, including through receptor-mediated endocytosis or by transiently opening tight junctions. Among these, niosomes have shown high encapsulation efficiency and sustained release potential, making them particularly suitable for oral peptide delivery. Despite advances, challenges remain in translating these technologies clinically, including ensuring biocompatibility, scalable manufacturing, and patient acceptance. Nevertheless, the oral cavity’s accessibility, combined with nanotechnological innovations, offers a compelling platform for personalized, non-invasive peptide therapies that could significantly improve treatment outcomes and patient quality of life. Full article

Background: Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread musculoskeletal pain, fatigue, unrefreshed sleep, and cognitive disturbances. Despite extensive research, its pathophysiology remains incompletely understood, and there are no validated biomarkers for diagnosis. Videocapillaroscopy is a non-invasive imaging technique that enables detailed visualization of microvascular structures and may provide insights into microcirculatory alterations associated with FM. Methods: Thirty patients with FM and 30 healthy controls underwent oral videocapillaroscopy at four sites: right and left buccal mucosa and upper and lower labial mucosa. Quantitative parameters, including capillary caliber, density, and length, were extracted using a validated neural-network-based software, while qualitative parameters, including visibility, orientation, and the presence of microhemorrhages, were assessed by the operator. Results: Capillary length was significantly reduced in fibromyalgia patients (297.49 ± 26.82 µm) compared to healthy controls (324.43 ± 37.59 µm; p = 0.002), and capillary orientation differed significantly between groups (p < 0.05). Capillary caliber, density, and visibility did not show statistically significant differences. Conclusions: These findings indicate subtle microvascular alterations in the oral mucosa of patients with fibromyalgia. Although the observed changes are not sufficient for diagnostic purposes or early detection, they provide preliminary evidence that videocapillaroscopy can detect microvascular features associated with FM in the oral mucosa. Further studies with larger cohorts and longitudinal designs are warranted to clarify the clinical relevance of these observations and to explore their potential association with symptom severity or disease progression. Full article

Background and Objectives: Adequate peri-implant soft tissue dimensions are essential for health, hygiene, and esthetics. When ridge volume is sufficient, phenotype modification may avoid bone grafting. This case report describes a pedicled roll flap performed concurrently with single-stage implant placement after spontaneous socket healing, without bone substitute, and assesses soft-tissue stability with serial intraoral scans. Clinical case: A single-tooth edentulous site underwent prosthetically driven, fully guided implant placement. A modified roll flap with vertical and palatal incisions was prepared; the de-epithelialized crestal connective tissue was elevated and rolled into a buccal envelope to augment thickness. No graft material was used. A provisional crown conditioned the emergence profile. Follow-up included photographs, radiographs, and intraoral scan superimpositions at 2 weeks, 3–4 months, 8 months, and 14 months after implant treatment. Healing was uneventful. Buccal soft-tissue thickness increased, keratinized mucosa was preserved, and midfacial levels remained stable. Emergence profile and papillae integrated harmoniously. Crestal bone levels were stable radiographically. Digital scans corroborated soft-tissue thickness maintenance. No donor-site morbidity occurred. Conclusions: In healed sockets with adequate bone, a modified pedicled roll flap at implant placement can thicken the peri-implant phenotype and achieve stable esthetic integration without bone substitutes. Full article

Background/Objectives: The oral cavity has been discussed as a possible reservoir for pathogens involved in pediatric appendicitis. In a previous study, microbial similarities between oral and appendix samples were observed, but clinical dental findings showed no significant associations. The present study aimed to (1) perform a more detailed analysis of dental variables—such as eruption status, caries indices, oral hygiene behavior, and the Periodontal Screening Index (PSI)—to identify potential overlooked associations with appendicitis, and (2) compare two oral sampling sites (buccal mucosa and dental sulcus) in terms of their correlation with appendix microbiota. Methods: This secondary analysis used previously collected clinical and microbiological data from 36 children who had undergone appendectomy or elective surgery. Quantitative PCR (qPCR) was used to assess bacterial mRNA levels in appendix, buccal mucosa, and sulcus samples. Dental variables were derived from standardized clinical examinations performed at the time of surgery. Results: No significant group differences were observed in caries indices, PSI, or oral hygiene behavior. However, patients with appendicitis had a significantly higher number of erupting teeth compared to controls (3.82 vs. 1.68; p = 0.021). Bacterial mRNA levels did not differ notably between oral sites, and neither showed stronger correspondence with appendix samples; notably, sulcus swabs were not obtained from erupting teeth, limiting the ability to test a site-specific eruption mechanism. Conclusions: Tooth eruption may be associated with appendicitis, although this remains speculative and requires confirmation in larger studies. Full article

Background and Objectives: Adequate buccal bone thickness is critical for long-term peri-implant health and stability. When residual alveolar bone volume is insufficient, guided bone regeneration (GBR) is a widely adopted technique. While non-resorbable membranes provide structural support, they carry a higher risk of complications and require secondary surgery. Resorbable collagen membranes, offer promising biological properties and easier clinical handling, yet clinical data remain limited. This prospective cohort study aimed to evaluate the clinical and radiographic outcomes of horizontal GBR using a native, non–cross-linked resorbable porcine pericardium membrane fixed with titanium pins, in conjunction with simultaneous implant placement. Materials and Methods: Eighteen patients (26 implants) with horizontal alveolar defects (<6 mm) underwent implant placement and GBR with deproteinized bovine bone mineral and a porcine pericardium collagen membrane. Horizontal bone gain and buccal bone thickness were measured at baseline and 6 months post-operatively. Post-operative complications, patient-reported outcomes (PROMs), and peri-implant tissue health were assessed up to 1 year post-loading. Results: Mean bone gain was 2.95 ± 0.95 mm, and all sites achieved a buccal bone thickness ≥ 1.5 mm. No membrane-related complications occurred. PROMs revealed low morbidity. At 1-year follow-up, marginal bone loss averaged 0.54 ± 0.7 mm, mean probing depth was 2.79 ± 0.78 mm, 92% of sites exhibited keratinized mucosa ≥ 2 mm. Conclusions: Native resorbable porcine pericardium membranes, when combined with DBBM and mechanical stabilization, seem to be effective for horizontal bone regeneration. Full article

Background: Reconstruction of nasal, septal, and nasosinusal defects is challenging when the native mucosa is absent or damaged. Oral mucosal grafts have been proposed as a reconstructive option due to their favorable biological properties, but their use in rhinology remains poorly defined. Objective: To evaluate the clinical efficacy and technical characteristics of oral mucosal grafting for nasal, septal, nasosinusal, and skull base reconstruction. Data Sources: PubMed, Embase, Web of Science, and Cochrane Library were searched for studies published between January 2005 and May 2025. Study Eligibility Criteria: We included original human studies (case reports or series) reporting the use of free or pedicled oral mucosal grafts in nasal, septal, nasosinusal, or skull base reconstruction. Non-original studies, animal or preclinical studies, and articles not in English or Spanish were excluded. Methods of Review: One reviewer screened titles, abstracts, and full texts using Rayyan. Methodological quality was assessed using JBI tools for case reports and case series. A narrative synthesis was conducted due to clinical heterogeneity and absence of comparison groups. The resulting assessments were reviewed by the co-authors to confirm accuracy and resolve any potential discrepancies. Results: Of 467 records identified, 10 studies were included. All were case reports or series involving buccal, palatal, or labial mucosa. Most reported good graft integration, low complication rates, and favorable functional outcomes. No randomized studies or comparative analyses were found. Limitations: Included studies had small sample sizes, lacked control groups, and showed heterogeneous methods and follow-up. The certainty of evidence could not be formally assessed. Conclusions: Oral mucosal grafting is a promising reconstructive option in selected nasosinusal and skull base defects. However, stronger comparative studies are needed to determine its clinical superiority. Registration: This review was not registered in any public database. Full article

Mixtures containing polyvinyl alcohol (PVA) and methylcellulose (MC) were obtained and used to synthesize hydrogels in various ratios of components. The swelling kinetics of the resulting hydrogels were studied, revealing that the equilibrium swelling degree in artificial saliva is nearly twice as high as in water. It was found that increasing the volumetric content of PVA in the mixture leads to a higher swelling degree. The kinetics of active pharmaceutical ingredient (API) sorption and release from the hydrogels were also investigated. It was demonstrated that hydrogels with a higher PVA content exhibit greater sorption capacity; however, the release of the API from such samples occurs at a slower rate. For the first time, the mucoadhesive properties of PVA-MC-based hydrogels were studied. It was established that the PVA-MC hydrogel with a ratio of 6:4 vol.% remained on the surface of the porcine cheek mucosa for two days, the 5.5:4.5 vol.% sample detached after 24 h, and the 5:5 vol.% sample adhered for approximately 10 h. These findings confirm the mucoadhesive potential of the hydrogels and their suitability for buccal drug delivery forms. The synthesized PVA-MC hydrogels are promising for applications in medicine and pharmacology. Full article

Background/Objectives: Buccal mucosa graft (BMG) is increasingly utilized in reconstructive urological surgeries due to its versatility, robust integration, histological characteristics and low morbidity at the donor site. Initially employed in urethral surgery, BMG use has expanded to complex ureteral and penile reconstructive procedures. This narrative review examines BMG applications in various urological surgeries, comparing its outcomes to other graft types, with a focus on surgical techniques and patient outcomes. Methods: A narrative review was conducted using PubMed and Scopus to identify relevant studies published over the last three decades on the use of BMG in urological reconstructive surgery. Articles in English addressing BMG harvesting, applications and functional outcomes were analyzed. Results: BMG has demonstrated high success rates in every field of its application, especially in urethral reconstruction with an 83–91% efficacy rate in intermediate follow-up. Studies have also reported positive outcomes in complex ureteral and penile curvature surgeries, with patient satisfaction rates reaching up to 85%. Conclusions: BMG is an adaptable tissue graft for urological reconstructive surgeries, offering favorable outcomes with minimal morbidity. Although the current results are encouraging, larger prospective studies with standardized protocols are necessary to fully validate its long-term efficacy and optimize treatment approaches for complex urological reconstructions. Full article

Background: Local anesthesia is essential for most dental procedures, but its parenteral administration is often painful. Topical anesthetics are commonly used to minimize local anesthesia pain; however, commercial formulations fail to fully prevent the discomfort of local anesthetic injection. Methods: We developed and characterized a novel lidocaine and epinephrine co-loaded liquid crystalline precursor system (LCPS) for topical anesthesia. The formulation was structurally characterized using polarized light microscopy (PLM) and small-angle X-ray scattering (SAXS). Rheological behavior was assessed through continuous and oscillatory rheological analyses. Texture profile analysis, in vitro mucoadhesive force evaluation, in vitro drug release and permeation studies, and an in vivo toxicity assay using the chicken chorioallantoic membrane (CAM) model were also conducted. Results: PLM and SAXS confirmed the transition of the LCPS from a microemulsion to a lamellar liquid crystalline structure upon contact with artificial saliva. This transition enhanced formulation consistency by over 100 times and tripled mucoadhesion strength. The LCPS also provided controlled drug release, reducing permeation flow by 93% compared to the commercial formulation. Importantly, the CAM assay indicated that the LCPS exhibited similar toxicity to the commercial product. Conclusions: The developed LCPS demonstrated promising physicochemical and biological properties for topical anesthesia, including enhanced mucoadhesion, controlled drug delivery, and acceptable biocompatibility. These findings support its potential for in vivo application and future clinical use to reduce pain during dental anesthesia procedures. Full article

Background: Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of lower respiratory tract infections in children under two years of age. NF-κB is a key transcription factor in antiviral and inflammatory responses. This study investigates the expression of NF-κB mRNA in both blood and buccal swab samples of pediatric patients hospitalized for RSV bronchiolitis, comparing levels at admission and discharge. Methods: Paired peripheral blood and buccal swab samples were collected from pediatric patients (n = 85) at hospital admission and discharge. Quantitative real-time PCR was used to assess NF-κB mRNA levels. Results: NF-κB mRNA levels significantly decreased in blood between admission and discharge (p < 0.05), while no significant change was observed in buccal swabs. Conclusions: These results suggest a compartment-specific regulation of NF-κB, with systemic inflammatory resolution at discharge and persistent or distinct mucosal immune activity. Understanding these dynamics may improve our approach to monitoring and treating RSV bronchiolitis. Full article

Background/Objectives: Oral cavity wound recovery presents unique challenges due to constant moisture exposure and functional mechanical stresses. Nanoscale extracellular vesicles (exosomes) with regenerative properties offer promising therapeutic potential for tissue regeneration, contributing to improved health outcomes. This study evaluated human exosomal preparations in promoting oral mucosal regeneration. Methods: We established standardized full-thickness wounds in the buccal mucosa of SD rats and divided subjects into experimental (receiving 50 billion human exosomes) and control (receiving carrier solution only) groups. Comprehensive wound assessment occurred at predetermined intervals (days 0, 3, 7, and 10) through photographic documentation, histological examination, and quantitative measurement. Results: Exosomal-treated tissues demonstrated statistically significant acceleration in closure rates (p < 0.05), achieving 87.3% reduction by day 10 versus 64.1% in the controls. Microscopic analysis revealed superior epithelial development, reduced inflammatory infiltration, and enhanced collagen architectural organization in exosomal-treated specimens. Semi-quantitative evaluation confirmed consistently superior healing metrics in the experimental group across all assessment timepoints. Conclusions: These findings demonstrate that human exosome preparations significantly enhance oral mucosal regeneration in SD rats, suggesting potential clinical applications for accelerating recovery following oral surgical procedures. Full article