Search Results (98)

Background: Auricular defects resulting from congenital anomalies, trauma, or oncologic resection pose significant functional and psychosocial challenges. When autologous reconstruction is not feasible or not desired, implant-retained auricular prostheses represent a reliable alternative with high patient satisfaction. This study aimed to systematically evaluate the clinical performance of craniofacial implants used for auricular prosthetic rehabilitation, focusing on implant survival, prosthetic outcomes, workflow typologies, and complications. A secondary objective was to illustrate the long-term validity of a minimally invasive navigation technique through a clinical case with 6-year follow-up. Methods: A systematic review was conducted according to PRISMA guidelines. Clinical studies published between 2005 and 2025 reporting outcomes of implant-retained auricular prostheses were searched in PubMed and Scopus databases. Data were extracted on implant type, survival rates, prosthetic performance, workflow, and complications. Risk of bias was assessed using appropriate tools based on each study design. Results: A total of thirty-two studies were included, comprising fifteen case reports, fifteen case series, one cohort study, and one prospective observational study. Implant survival was consistently high across all workflow categories, with failures predominantly associated with irradiated or anatomically compromised bone. Prosthetic outcomes were favorable, showing excellent esthetics, stable retention, and high patient satisfaction irrespective of manufacturing method, although digital and navigation-assisted workflows improved reproducibility, symmetry, and planning precision. Complication rates were low and generally limited to mild peri-abutment inflammation manageable with conservative care. The clinical case confirmed these findings, showing stable osseointegration, healthy soft tissues, and uncompromised prosthetic function at 6-year follow-up. Conclusions: Implant-retained auricular prostheses show predictable long-term success, independent of whether traditional, hybrid, or fully digital workflows are employed. Digital technologies enhance surgical accuracy, minimize morbidity, and streamline prosthetic fabrication, although high-quality comparative studies remain limited. Full article

Background: Hyperbaric oxygen therapy (HBOT) is considered a potential adjunctive modality to enhance tissue regeneration in oral and maxillofacial surgery. By increasing tissue oxygen availability, HBOT may support bone and soft-tissue repair under hypoxic and chronically inflamed conditions. Aim: This narrative review evaluates current experimental and clinical evidence regarding HBOT in high-risk dental indications, including osteoradionecrosis (ORN), medication-related osteonecrosis of the jaw (MRONJ), chronic osteomyelitis, poorly healing postoperative wounds, and procedures in patients with systemic comorbidities. Methods: A structured search of PubMed, Web of Science, and the Cochrane Library identified 123 relevant English-language publications (from 1 January 2000–September 2025) addressing HBOT mechanisms and clinical applications in oral and maxillofacial surgery, including clinical trials, observational studies, preclinical models, and systematic reviews. Results: Available evidence suggests that HBOT may improve healing outcomes and reduce complication rates in early-stage ORN and MRONJ when used as an adjunct to surgery and systemic therapy. However, findings in implantology—particularly in irradiated or diabetic patients—and in periodontal therapy remain limited, heterogeneous, and methodologically inconsistent. Conclusions: HBOT may be considered in selected clinical scenarios, particularly where healing is impaired by hypoxia or systemic disease. Nevertheless, current evidence remains insufficient to support routine use. Standardized, high-quality studies with clearly defined endpoints and uniform therapeutic protocols are needed to determine its clinical effectiveness and optimal indications. Full article

Spinal sarcomas are rare, aggressive tumors requiring wide resection that creates large, challenging defects. Conventional reconstruction using allografts or metallic implants is prone to failure in compromised settings like irradiated or infected tissue. This narrative review synthesizes the literature on biologic reconstruction strategies, focusing on vascularized bone grafts (VBGs) and the ‘spinoplastic’ reconstruction approach, to provide a clinical framework for their application. We performed a narrative literature review using PubMed and Scopus to synthesize clinical studies describing biologic spinal reconstruction in compromised host beds. The main findings show that pedicled VBGs (e.g., rib, iliac crest) and free VBGs (e.g., fibula) function as living structural components. ‘Spinoplastic’ reconstruction leverages these grafts to promote biologic fusion, with clinical series reporting high union rates, even in irradiated or revision settings, offering a durable alternative to avascular constructs. Biologic reconstruction using VBGs is a critical strategy for achieving durable spinal stability in these challenging scenarios, and future directions point toward hybrid strategies combining 3D-printed implants with the biologic power of VBGs. Full article

Background and Objectives: Periodontitis leads to progressive destruction of periodontal tissues and, despite advances in regenerative approaches, clinical outcomes remain inconsistent. Lasers have been proposed as adjuncts in regenerative periodontology because of their antimicrobial, hemostatic, and photobiomodulatory properties. However, available evidence remains heterogeneous. This scoping review aims to systematically map clinical and experimental evidence on the role of lasers in periodontal tissue regeneration. Materials and Methods: The review was conducted in accordance with the PRISMA-ScR guidelines. PubMed, Scopus, and Web of Science were searched up to September 2025 without time restrictions. Eligible studies included in vitro, ex vivo, in vivo and clinical research assessing the application of lasers for periodontal healing. Reviews, conference abstracts and studies unrelated to regeneration were excluded. Results: The electronic search retrieved 314 records, of which 193 unique articles were screened after duplicates removal and 17 full texts were assessed. A total of 15 studies met the eligibility criteria and were included in the review. Included studies comprised 5 in vitro investigations, 2 ex vivo studies, 1 in vivo animal study, 4 case reports and 3 RCTs, published between 2015 and 2025. In vitro and ex vivo evidence demonstrated that laser irradiation enhanced cell proliferation, differentiation, growth factor release, and root surface conditioning. The in vivo study confirmed increased angiogenesis and bone formation after Er:YAG PBM. Clinical studies, including RCTs and case reports, reported improvements in PD reduction, clinical attachment gain, and radiographic bone fill, particularly when lasers were applied as adjuncts to regenerative techniques or biomaterials. Conclusions: Available evidence suggests that lasers can positively modulate biological processes and enhance the outcomes of regenerative periodontal procedures. However, the limited number of high-quality clinical trials, variability in laser types and parameters, and heterogeneity in protocols limit the strength of current conclusions. Further standardized RCTs with long-term follow-up are needed to clarify the clinical relevance of lasers in periodontal regenerative outcomes. Full article

Radiotherapy is a fundamental component in the management of head and neck malignancies, but its non-selective effects on surrounding normal tissues can result in significant oral complications. The oral cavity and oropharynx contain several radiosensitive structures, including mucosa, salivary glands, and alveolar bone, which are susceptible to both acute and late toxicities resulting in mucositis, xerostomia, and osteoradionecrosis. Although dentomaxillofacial diagnostic imaging, such as intraoral radiography, panoramic imaging and cone-beam computed tomography (CBCT), delivers radiation doses several orders of magnitude lower than therapeutic exposures, its biological impact on previously irradiated tissues remains underexplored. Even low-dose X-rays may act as secondary stressors, reactivating oxidative and inflammatory pathways in tissues with compromised repair capacity. In this review, we examine the radiobiological and dosimetric implications of using diagnostic ionizing imaging in patients undergoing or recently having completed head and neck radiotherapy. We summarize current evidence on potential additive effects of low-dose imaging, emphasizing the importance of justification, timing, and protocol optimization. Finally, we discuss radioprotective strategies (e.g., dose modulation, field limitation, and integration of modern low-dose imaging technologies) designed to reduce unnecessary exposure, thus enhancing tissue preservation and ensuring diagnostic safety in this vulnerable patient population Full article

Among the methods for increasing the specificity of tumor radiotherapy, FLASH radiotherapy (FLASH-RT) stands out, having recently entered clinical trials. A distinctive feature of this treatment method is the delivery of a therapeutic dose in a fraction of a second with a typical mean dose rate greater than 40 Gy/s. In addition to improved patient comfort and a shorter hospital stay, this therapy potentially carries a lower risk of radiation-related side effects due to reduced damage to normal tissues. Numerous preclinical and in vivo laboratory trials of FLASH-RT have demonstrated that, in addition to reducing the severity of radiation-related complications, FLASH radiotherapy has antitumor efficacy similar to conventional radiotherapy. Partly reduced radiotoxicity after such a dose rate delivery obtained, in a broader radiobiological sense, an eponymous term FLASH effect. Although the first clinical trials aimed to evaluate the safety and efficiency of FLASH-RT against bone metastases (FAST-01/02), melanoma skin metastases (IMPulse, Flash-Skin I), Squamous Cell Carcinoma, or Basal Cell Carcinoma (LANCE) have already started or even finished and showed promising results (FAST-01), the radiobiological basis of the FLASH effect is far from a complete explanation. The fundamental factors explaining the nature of the FLASH effect are mainly considered to be the following: (1) changes in the balance of water radiolysis products and a decrease in the generation of stable reactive oxygen species (ROS), (2) differential oxygen depletion, depending on the initial oxygen concentration in tissues, and (3) physiological and metabolic, gene expression and probably epigenetic shifts in response to irradiation in normal and tumor cells. The main purpose of this review is the systematization of the radiobiological manifestations of the FLASH effect together with a consideration of the elementary processes laying in the basis of the FLASH effect in order to actualize rationale and future application developments of FLASH-RT. Full article

Galactic cosmic ray (GCR) radiation is a major barrier to human space exploration beyond Earth’s magnetic field protection. Mesenchymal stem cells (MSCs) are found in all organs and play a critical role in repair and regeneration of tissue. We engineered bone marrow-derived MSCs and evaluated their response to ionizing radiation exposure. Epidermal growth factor receptor (EGFR) expression by certain types of cancers has been shown to induce radioresistance. In this study, we tested the feasibility of transfecting MSCs to overexpress EGFR (eMSC-EGFR) and their capacity to tolerate and recover from X-ray exposure. Quantitative real-time PCR (qRT-PCR) and immunoblotting results confirmed the efficient transfection of EGFR into MSCs and EGFR protein production. eMSC-EGFR maintained characteristics of human MSCs as outlined by the International Society for Cell & Gene Therapy. Then, engineered MSCs were exposed to various dose rates of X-ray (1–20 Gy) to assess the potential radioprotective role of EGFR overexpression in MSCs. Post-irradiation analysis included evaluation of morphology, cell proliferation, viability, tumorigenic potential, and DNA damage. eMSC-EGFR showed signs of radioresistance compared to naïve MSCs when assessing relative proliferation one week following exposure to 1–8 Gy X-rays, and significantly lower DNA damage content 24 h after exposure to 4 Gy. We establish for the first time the efficient generation of EGFR overexpressing MSCs as a model for enhancing the human body to tolerate and recover from moderate dose radiation injury in long-term manned space travel. Full article

Introduction: The work presented here is part of our study series aimed at investigating the countermeasure effectiveness of apigenin (AP) against both early and late effects of heavy silicon (²⁸Si) on the same cohort of exposed male C57BL/6 mice. We previously reported the countermeasure of AP against ²⁸Si-induced early effects of ²⁸Si ions. This section focuses on the protective effects of AP on late effects, specifically on the induction of acute lymphoma/lymphoblastic leukemia. Method: Mice received a diet containing 20 mg/kg body weight of AP for five days before and after total-body irradiation with either 0 or 0.5 Gy of 260 MeV ²⁸Si ions. They were divided into four groups based on AP intake and irradiation status. At one-week after irradiation, six mice from each group were euthanized to assess AP’s effectiveness against early inflammation (in the bone marrow and gut tissues) and gut dysbiosis. The remaining mice were monitored until approximately 770 days of age. Incidence rates were analyzed using Chi-Square tests, while survival data were evaluated with Kaplan–Meier plots and log-rank tests, setting significance at p ≤ 0.05. Results: At 770 days, survival rates were 37% for ²⁸Si-exposed mice and 63% for those consuming AP, despite irradiation. There was a 2.57-fold increase in acute lymphoma/lymphoblastic leukemia incidence among ²⁸Si-exposed mice not receiving AP compared to controls and AP-fed mice. Together with our previous report on the countermeasure activity of AP against early effects, these findings suggest that the gut–bone marrow axis plays an important role in ²⁸Si-induced acute lymphoma/lymphoblastic leukemia. Conclusion: Our findings demonstrate that AP is an effective means of tackling the challenges posed by space radiation, and it has the potential to revolutionize protection in this critical area. Full article

Photobiomodulation (PBM) consists of applying low-level laser light to biological tissues, leading to modulation of cellular functions. PBM has recently gained much attention in the field of regenerative dentistry thanks to its powerful effect on tissue repair and regeneration. Dental pulp mesenchymal stem/stromal cells (DP-MSCs) represent the ideal targets in regenerative dentistry due to their ability to stimulate the regeneration of mineralized and soft tissues and the paracrine factors that they produce. Although there have been several studies evaluating the influence of PBM on DP-MSCs’ regenerative capacity, the results are conflicting, and there are few studies on the influence of PBM on the paracrine factors released by DP-MSCs. Therefore, the aim of this study was to investigate the effect of PBM, using different energy doses of laser irradiation, on the osteogenic capacity of DP-MSCs, focusing on changes in gene expression, mineralizing ability, and release of pro-osteogenic factors. DP-MSCs were irradiated in vitro and differentiated into an osteogenic phenotype. A cell viability assay, alizarin red staining, and TEM analysis were carried out to evaluate the effect of PBM on cell activity, morphology, and mineralization ability. The expression of the main osteogenesis-related markers Runx2, Col1A1, ALP, and BMP was measured to evaluate the influence of PBM on the ability of DP-MSCs to differentiate toward an osteogenic phenotype. The release of IL-6 and IL-8, which are mainly involved in bone remodeling processes, was investigated in the cell medium following PBM irradiation. The results showed a high level of cell viability, suggesting a lack of phototoxicity under the tested conditions. Furthermore, PBM had a significant effect on mineral deposition, IL-6 and IL-8 release, and expression of osteogenic markers. TEM analysis showed intracellular modifications linked mainly to mitochondria, the endoplasmic reticulum, and autophagic vesicles after PBM treatment. These findings demonstrated that the impact of PBM on the osteogenic potential of DP-MSCs is energy dose-dependent, supporting its potential as an effective strategy in regenerative dentistry, particularly for enhancing bone remodeling. Full article

In this study, a shape-changeable 3D scaffold with photothermal effects was developed to address the clinical challenges of complex bone defects. The multifunctional construct was fabricated via in situ polymerization combined with a gas foaming technique, creating hierarchical porous architectures that mimic the native bone extracellular matrix. By incorporating polydopamine (PDA)-modified amorphous calcium phosphate (CA) into poly(propylene glycol) (PPG)- and poly(ԑ-caprolactone) (PCL)-based polyurethane (PU). The obtained scaffolds achieved osteoinductive potential for bone tissue engineering. The surface PDA modification of CA enabled efficient photothermal shape conversion under near-infrared (NIR) irradiation, facilitating non-invasive remote control of localized hyperthermia. The optimized scaffolds exhibited interconnected porosity (approximately 70%) with osteoconductive pore channels (200–500 μm), resulting in good osteoinduction in cell culture, and precise shape-memory recovery at physiological temperatures (~40 °C) under NIR for minimally invasive delivery. The synergistic effect of osteogenesis promotion and photothermal transition demonstrated this programmable scaffold as a promising solution for integrated minimally invasive bone repair and defect reconstruction. Full article

Piezocatalytic therapy (PCT) is a promising strategy for combating implant-associated infections due to its high tissue penetration depth and non-invasive nature. However, its catalytic efficiency remains limited by inefficient electron–hole separation. In this work, an ultrasound-responsive heterojunction (BiOI/Ti₃C₂) was fabricated through in situ growth of bismuth iodide oxide on titanium carbide nanosheets. Subsequently, we integrated BiOI/Ti₃C₂ into poly(e-caprolactone) (PCL) scaffolds using selective laser sintering. The synergistic effect between BiOI and Ti₃C₂ significantly facilitated the redistribution of piezo-induced charges under ultrasound irradiation, effectively suppressing electron–hole recombination. Furthermore, abundant oxygen vacancies in BiOI/Ti₃C₂ provide more active sites for piezocatalytic reactions. Therefore, it enables ultrahigh reactive oxygen species (ROS) yields under ultrasound irradiation, achieving eradication rates of 98.87% for Escherichia coli (E. coli) and 98.51% for Staphylococcus aureus (S. aureus) within 10 minutes while maintaining cytocompatibility for potential tissue integration. This study provides a novel strategy for the utilization of ultrasound-responsive heterojunctions in efficient PCT therapy and bone regeneration. Full article

Food irradiation is gaining popularity worldwide due to its potential to extend shelf life, improve hygienic quality, and meet trade requirements. The electron paramagnetic resonance (EPR) method is a reliable and sensitive technique for detecting untreated and irradiated foods. This study investigated the effectiveness of EPR in identifying irradiated meat and seafood containing bones. Beef, lamb, chicken, and various fish were irradiated with electron beams at different doses and analysed using an EPR spectrometer. During irradiation, the food samples were surrounded by small ice bags to prevent autodegradation of cells and nuclei. After the irradiation process, the samples were stored at −20 °C. For EPR signal recording, the flesh, connective tissues, and bone marrow were removed from the bone samples, which were then oven-dried at 50 °C. The EPR spectra were recorded using an X-band EPR analyzer. Unirradiated and irradiated samples were identified based on the nature of the EPR signals as well as the g-values of symmetric and asymmetric signals. The study found that the EPR method is effective in distinguishing between unirradiated and irradiated bone-containing foods across nearly all applied radiation doses. The peak-to-peak amplitude of the EPR signals increased with increasing radiation doses. It was observed that unirradiated bone samples showed low-intensity symmetrical signals, while irradiated samples showed typical asymmetric signals. Overall, the study demonstrated that the EPR method is a reliable and sensitive technique for identifying irradiated foods containing bones and can be used for the control, regulation, and proper surveillance of food irradiation. Full article

Humanized mice generated by hematopoietic stem cell (HSC) transplantation are limited by the immune system developed being allogeneic to the tumor. We have innovated a platform to reconstitute an autologous human immune system (HIS) in immunodeficient NOG-EXL mice from mobilized peripheral blood (MPB)-CD34 cells, along with PDX generated from the same patient’s tumor tissue. Patients consented under an IRB-approved protocol for tumor biopsy and HSC apheresis at Emory University. HSC collection included mobilization with G-CSF and plerixafor, immunomagnetic bead isolation with CliniMACS, and cryopreservation of CD34⁺ cells. PDX were established from biopsies or surgical specimens by passaging into immunodeficient mice. Irradiated NOG-EXL mice were engrafted with HSCs by intravenous transplantation of CD34⁺ HSC. Engraftment of human T cells, B cells, and myeloid cells in peripheral blood was assessed by serial flow cytometry of blood samples, with final assessment of immune components in spleen and bone marrow at 30 weeks. Twenty-eight PDX models were generated from 43 patients with HNSCC; 1 patient underwent apheresis. HSC engraftment in blood was observed in 100% of NOG-EXL mice at 8 weeks post-transplant, with 5–20% hCD45⁺ cells present in the periphery. B-cell development was predominant at early time points and declined over time. Human T-cell and subset development of CD4⁺ and CD8⁺ T cells were observed in blood from 15 weeks post-transplant. Strong development of the myeloid lineage (CD33⁺) was observed starting at 8 weeks and persisted throughout the study. These data demonstrate that mobilization and apheresis of HNSCC patients is technically and clinically feasible and may allow the establishment of autologous HIS-PDX mice. Full article

A 56-year-old female with a history of Luminal A breast cancer, previously treated with surgery, radiotherapy, and systemic therapy, underwent palliative re-irradiation in November 2024 for painful bone metastases. Three weeks later, following the initiation of Fulvestrant, she developed a grade 3 erythematous reaction localized to the re-irradiated area. The reaction persisted with minimal improvement over two months, despite symptomatic management. No infectious or allergic etiologies were identified, and dosimetric analysis confirmed that the delivered radiation dose to the skin was insufficient to directly induce such a reaction. Notably, the erythema was most pronounced along a pre-existing surgical scar, suggesting a localized inflammatory response. Given the temporal relationship with Fulvestrant administration, we hypothesize a drug-induced recall-like phenomenon, though no previous reports have specifically linked Fulvestrant to such an event. This case underscores the need for awareness of unexpected cutaneous reactions following re-irradiation and highlights the potential role of systemic therapies in modulating local tissue responses. Full article

Objective: Reconstructing the anterior mandible in patients with irradiated and contracted soft tissues remains challenging despite advances in computer-assisted design and three-dimensional printing. Unpredictable soft-tissue changes reduce the effectiveness of these technologies. This paper explores an alternative using a single-adjustable-osteotomy fibula flap technique. Methods: A retrospective study was performed on patients with anterior segmental mandibular defects due to recurrent tumors, secondary reconstruction, or osteoradionecrosis and previously received radiotherapy who represented the highest risk of soft tissue complexity while limiting the utility of computer technology. All patients underwent mandible reconstruction using the adjustable, single-osteotomy fibula method, which eliminated the need for computer-assisted design. We evaluated the effectiveness and outcome. Results: From 2016 to 2023, 11 patients were included in this study. The median patient age was 58 (ranging 49–65) years. Included patients had either recurrent tumors (n = 6), secondary reconstruction needs (n = 3), or mandibular osteoradionecrosis (n = 2). No complete flap failures occurred. Five of six patients with recurrent cancer required two skin island fibular flaps for intraoral and external defect repair. One patient experienced partial skin paddle loss requiring an additional free flap, and another had plate exposure requiring removal after bone union was achieved. Conclusions: The adjustable single-osteotomy fibula flap technique offers a reliable alternative for anterior mandibular reconstruction in complex cases. This approach demonstrates advantages in surgical simplicity and flexibility while maintaining acceptable outcomes. However, careful patient selection and consideration of defect extent remain crucial for success. Full article