Search Results (1,211)

Background/Objectives: Enteric drug forms are developed to delay drug release to avoid drug degradation in the acidic environment of the stomach or to prevent irritation of the stomach mucosa. The bioavailability of posaconazole (POS) after oral administration depends on stomach pH and food intake. Delayed-release tablets and unmodified oral suspension are the POS formulations currently available on the market. The oral suspension formulation is characterized by highly variable bioavailability, which may significantly affect therapy effectiveness. Methods: In this study, multi-unit drug forms with delayed and sustained POS release were designed. Polymeric microparticles consisting of sodium alginate (ALG), methacrylic acid–ethyl acrylate copolymer (EUD), or both, were prepared using the spray-drying technique. The formulations that met the pharmacopoeia enteric release standards in the in vitro dissolution test were subjected to further in vitro evaluation via swelling and mucoadhesion assays, an antifungal activity test, attenuated total reflectance–Fourier transform infrared spectroscopy (ATR-FTIR), and thermal analysis. Results: It was shown that EUD formulations at concentrations of 5% and 6% provided enteric release, whereas ALG at 1.5% concentration exhibited a sustained, although not delayed, POS release profile. The optimal blended formulations (EAP15–EAP18), comprising 4% EUD with 1.5–2.0% ALG and either 1% or 4% POS, met the pharmacopoeia criteria for enteric dosage forms. Furthermore, these blends demonstrated the most favorable sustained-release profiles in the buffer phase, ranging from 2 to 3 h. The microparticles exhibited beneficial swelling and mucoadhesive properties, which are essential for prolonging contact with the intestinal mucosa; combined with antifungal properties. Conclusions: Obtained carrier may provide a promising preliminary basis for developing a multi-unit, sustained-release enteric dosage form for POS and future in vivo investigations. Full article

Currently, GLP-1RAs are peptide drugs, typically administered by injection due to insufficient absorption, and only one GLP-1RA, semaglutide, is available as an orally administered drug. To overcome the absorption challenges of oral peptides, this drug product contains the absorption enhancer SNAC. As the tablet is eroded in the stomach, SNAC neutralizes the acidic gastric environment, thereby protecting the semaglutide from enzymatic degradation. Then, SNAC fluidizes the stomach lipidic membrane to increase semaglutide transcellular permeability across the gastric epithelium. It is necessary to realize that the use of such a unique drug product, that relies solely on the stomach for absorption, is expected to be affected by the extreme gastric anatomy/physiology changes post-MBS. Hence, we analyzed the key mechanisms that may affect the bioavailability of oral semaglutide post-MBS. Several mechanisms appear to potentially reduce oral semaglutide absorption post-MBS, including decreased inner gastric surface area, decreased gastric contractility, and faster gastric emptying. Hence, the effectiveness of the complex formulation, that relies solely on the stomach for the SNAC activity and semaglutide absorption, may be severely hampered post-MBS; clinicians should be aware of the potential malabsorption of oral GLP-1RA post-MBS, and preferably consider subcutaneous therapy until specific pharmacokinetic/clinical data are available. Full article

Long-term aesthetic success in dentistry largely depends on the color stability of restorative materials. This study investigated the color changes (ΔE₀₀) of resin nanoceramic and lithium disilicate ceramic restorative materials used in computer-aided design and computer-aided manufacturing (CAD/CAM) systems following beverage immersion and after repolishing. One hundred specimens were prepared from lithium disilicate (Initial LiSi Block) and resin nanoceramic (Cerasmart), and polished. The specimens were divided into ten groups according to material and beverage type (n = 10) and immersed in distilled water, cola, tea, coffee, and turnip juice at 37 °C for 3 months. Color values were recorded at baseline, 1 week, 1 month, and 3 months, and after repolishing. ∆E₀₀ values were calculated using the CIEDE2000 color difference formula. Data were analyzed using three-way repeated measures ANOVA and post hoc Tukey and Bonferroni tests (α = 0.05). Material type, beverage type, and immersion time significantly affected color stability (p < 0.05). The highest ∆E₀₀ observed in the resin nanoceramic–tea group at 3 months (ΔE₀₀ = 11.39 ± 1.76). Lithium disilicate demonstrated better color stability. After repolishing, all ΔE₀₀ values were below the clinically acceptable limit (ΔE₀₀ ≤ 1.8). Repolishing may help maintain the long-term aesthetic success of dental restorations in the oral environment. Full article

Biomimetics in dental restorative materials has gradually shifted from simply copying the appearance of natural teeth to better understanding how those tissues actually behave. Instead of focusing only on aesthetics, there is now more attention on how enamel and dentin function in real conditions, how they respond to stress, interact with their surroundings, and change over time. Because of this, newer materials are no longer just passive fillers; they are being designed to reflect aspects of natural tooth structure, composition, and behavior within the oral environment. This review brings together key ideas in this area, recent developments, and the challenges that remain. One issue that often comes up is how terms like bioinspired, biomimetic, and bioactive are used. They are sometimes treated as if they mean the same thing, but in practice, they point to different goals or levels of complexity in material design. For instance, some studies focus on creating more organized composite structures or mimicking natural mineralization processes, while others focus on antibacterial surfaces or peptide-based approaches that may support remineralization. There is also growing interest in materials that respond to environmental changes, such as shifts in pH or the early stages of wear. Even with promising laboratory results, these materials are not yet widely used in everyday clinical practice. Several issues continue to slow their adoption, including unclear terminology, limited availability of testing models that reflect real oral conditions, and a lack of long-term clinical data. Part of the challenge lies in the lack of consistent terminology, which can make it harder to compare findings across studies. Manufacturing challenges also remain, particularly when scaling up more complex systems. Moving forward, progress will depend on closer collaboration across disciplines, including materials science, oral biology, microbiology, and digital manufacturing. Such efforts will be important for developing restorative materials that behave more like natural tissues and perform reliably over time inside the mouth. Full article

Liraglutide (Lira), a glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated substantial efficacy in improving glycemic control and reducing body weight. However, subcutaneous injection is poorly adherent for patients. To improve treatment compliance, we developed a poly(lactic-co-glycolic acid) (PLGA)-based nanovesicle (PLGA-Lira-NV) system for the oral delivery of Lira using a double-emulsion solvent evaporation technique. The optimized formulation yielded a narrow size distribution and high encapsulation efficiency (>95%). In vitro release studies showed that PLGA-Lira-NVs remained relatively stable under acidic conditions (pH 1.2 to 6.8) and exhibited sustained drug release in a neutral environment (pH 7.4), enabling protection of the fragile peptide in the stomach and controlled release after crossing the intestine. Following oral administration to obese mice (10 mg/kg), PLGA-Lira-NVs achieved prolonged glycemic control for up to 72 h. Notably, body weight decreased to 83% of baseline after 12 days, outperforming the subcutaneous injection (free Lira) group (88%). The consistent trend toward weight reduction confirms the sustained-release properties of PLGA nanocarrier for Lira, highlighting its potential to reduce dosing frequency and improve patient compliance. Collectively, these findings underscore the promising potential of PLGA nanovesicles as an oral delivery platform for peptide therapeutics. Full article

Glass ionomer cements (GICs) are considered functionally biomimetic as they participate in ion-exchange processes that partially resemble the behavior of natural enamel and dentin, chemically bond to dental hard tissues, and release fluoride. While GICs are designed to interact with aqueous oral environments, their exposure to dietary beverages may affect their esthetic stability and water-related behavior within the oral environment. For biomimetic restorative materials to perform successfully in the oral environment, they must maintain not only bioactive properties but also esthetic stability and resistance to water-related degradation during exposure to dietary beverages. This study evaluated beverage-induced color changes, water sorption, and water solubility of six GICs following their immersion in coffee, tea, berry juice, cola, and distilled water (n = 5 per material per solution). Color measurements were recorded at baseline and after 2, 4, 6, and 8 weeks using a spectrophotometer, and color change (ΔE) values were calculated using the CIE L*a*b* system. Specimen mass was measured at baseline, after 8 weeks of immersion and then after 4 weeks of desiccation. Data were analyzed using repeated-measures Analysis of Variance (ANOVA) and Fisher’s least significant difference post hoc tests (α = 0.05). The results showed time, material, and solution significantly affected ΔE (p < 0.001). Tea produced the greatest discoloration overall, followed by coffee. ChemFil exhibited the greatest staining susceptibility, while Fuji II showed the lowest staining susceptibility. Water sorption and solubility were material- and solution-dependent. Clinically relevant discoloration of GICs was found when immersed in common beverages over time, with tea showing the strongest staining effect. These findings indicate that although GICs exhibit biomimetic characteristics through their interaction with tooth structures and aqueous environments, their long-term esthetic stability and resistance to environmental challenges should also be considered when selecting restorative materials for clinically visible areas. Full article

This study investigates cross-dialectal influence in native Brazilian Portuguese (BP) immigrants in Portugal regarding the pragmatic distribution of pronominal subjects within a novel framework of second dialect acquisition and first dialect attrition, the Bidialectal Dynamics Model (BDM). Twenty-eight immigrants completed a spontaneous oral production task in both BP and European Portuguese (EP). Two control groups (24 BP speakers in Brazil and 24 EP speakers in Portugal) did the same in their respective native varieties only. All groups favored overt subjects for topic shift. For topic maintenance, BP speakers in Brazil preferred overt subjects despite omitting more pronouns in this context than in topic shift, while EP speakers strongly favored null subjects. At the group level, immigrants produced fewer null subjects than EP controls and more than BP controls, suggesting bidirectional cross-dialectal influence. At the individual level, profiles varied: most participants displayed bidirectional cross-dialectal influence, some maintained their native preferences, others used their second dialect across the board, and only a few displayed target-like behavior. Following the BDM, it is argued that this cross-dialectal influence stems from the co-activation of dialects’ overlapping grammars, particularly in the lexicon, and the different profiles observed reflect bidialectals’ diverse and dynamic environments. Full article

Background and Clinical Significance: Vascular lesions of the face, particularly arteriovenous malformations (AVM) and mixed hemangiomas (MH), pose significant diagnostic and therapeutic challenges because of their complex anatomy, unpredictable behavior, and high risk of bleeding. Surgical planning should be individualized and often requires a staged approach with meticulous interdisciplinary coordination to ensure patient safety. The presence of a concomitant odontogenic infection further complicates management, as local inflammation may exacerbate vascular instability and increase the risk of life-threatening complications. Local inflammation and infection might cause some life-threatening conditions, especially when an abscess occurs in the area of any vascular lesion. Ensuring that the oral cavity is free from potential odontogenic infections is a particularly important issue in many complex cases, especially in patients treated for oral, head, and neck cancer or in those with other coexisting morbidities affecting the oral and facial regions. Case Presentation: A 72-year-old man was referred for management of a severe odontogenic infection associated with an extensive facial vascular lesion. The patient’s medical history was significant for arterial hypertension and chronic liver dysfunction (CLD) of unclear etiology. Complete blood testing, including coagulation assessment and liver ultrasonography, was performed, with no contraindication to surgery identified. The scope of odontogenic-related infections was scheduled for simultaneous removal during initial surgery. Preparation for surgery included the local application of sclerotherapy agents. Conclusions: Quite often, a routine panoramic radiograph can help in assessing the status of bone and dentition to undertake all necessary treatment. Severe odontogenic disease, including multiple retained roots, periapical infections, and odontogenic cystic lesions in the context of poor oral hygiene, may lead to the occurrence of possible inflammation. In case of any vascular lesion, a careful diagnostic and therapeutic strategy is needed. This case report highlights that maintaining an infection-free oral environment is a critical component of care in patients with complex facial MH and should be regarded as an essential element of overall treatment planning. Full article

Background/Objectives: Oral diseases remain among the most prevalent noncommunicable conditions worldwide, with biofilm-driven dysbiosis playing a central role in dental caries, gingivitis, periodontitis, and oral candidiasis. Curcumin has attracted considerable interest because of its anti-inflammatory, antioxidant, antimicrobial, and regenerative properties. However, its clinical use remains limited by poor water solubility, chemical instability, rapid metabolism, and low bioavailability. This review aimed to provide a comprehensive analysis of curcumin-based nanoformulations for oral health applications, with emphasis on their mechanistic actions, antibiofilm activity, and translational relevance. Methods: This review examined representative nanocarrier systems developed for curcumin delivery in oral health. These included polymeric nanoparticles, nanomicelles and nanoemulsions, solid lipid nanoparticles and nanostructured lipid carriers, nanogels, hydrogels, mucoadhesive films, and metallic or hybrid nanosystems. The analysis focused on molecular mechanisms of action, antimicrobial and antibiofilm effects against major oral pathogens, and key translational challenges. Results/Findings: Across the reviewed studies, nanoformulations consistently improved curcumin solubility, stability, tissue penetration, mucosal retention, and controlled release. Mechanistically, they enhanced anti-inflammatory activity through inhibition of nuclear factor kappa B (NF-κB), strengthened antioxidant defenses via the nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) axis, supported tissue repair and osteogenic responses, disrupted oral biofilms, and modulated local immune responses. Antimicrobial activity was reported against Streptococcus mutans, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Candida albicans, with reduced exopolysaccharide production, impaired adhesion, and improved biofilm penetration. Conclusions: Curcumin-based nanoformulations represent promising adjunctive platforms for oral healthcare. However, their clinical translation still requires improved stability in the oral-environment standardized manufacturing and characterization, rigorous safety evaluation, and well-designed controlled clinical studies. Full article

In the oral environment, silicone (polysiloxane) supports healing by creating low-permeability interfaces that limit microleakage, whereas silicon/silica systems support healing via hydroxyapatite nucleation. We synthesized human evidence on intraoral healing associated with silicone and silicon/silica-based materials and assessed translational differences between preclinical models and clinical settings. A systematic review (1990-September 2025) identified 14 clinical studies of bioactive glass (BAG) that met the inclusion criteria. Periodontal outcomes included probing depth (PD), clinical attachment level (CAL), and radiographic fill; endodontic outcomes included the periapical index (PAI). Human BAG studies showed periodontal benefits versus controls in intrabony defects, with reduced PD, improved CAL, and greater radiographic fill. For endodontic healing, a multicenter randomized clinical trial reported improved PAI at 12 months in both the zinc-oxide-eugenol and silicone-sealer groups without a significant between-group difference. The literature supports a functional split: silicone primarily provides sealing and permissive healing, whereas silicon/silica-based materials support signaling, interfacial bonding, and regenerative healing. Clinically, BAG appears most relevant for contained periodontal intrabony defects, whereas silicone sealers should be viewed primarily as stable sealing adjuncts to well-executed root canal therapy. Full article

Resin-matrix ceramics are among the increasingly preferred dental biomaterials in restorative dentistry. However, these materials are continuously exposed to staining from beverages in the oral environment, and continue to present limitations in terms of long-term aesthetic performance. This study was designed to evaluate the effects of different surface finishing procedures and immersion in commonly consumed beverages on the color change (ΔE₀₀) of four different resin-matrix ceramics (Cerasmart, Lava Ultimate, Shofu Block HC, and Vita Enamic). A total of 256 specimens were randomly assigned to mechanical polishing or glazing, then immersed in coffee, red wine, cola, or distilled water for 14 days. Data were analyzed using three-way repeated-measures analysis of variance (ANOVA), with Tukey and Bonferroni post hoc tests (α = 0.05). Surface finishing procedure, material type, beverage type and immersion time significantly affected ΔE₀₀ values (p < 0.05). The highest ΔE₀₀ values were observed at 14 days in the red wine-immersed glaze groups of Shofu Block HC (ΔE₀₀ = 7.44 ± 0.45) and Lava Ultimate (ΔE₀₀ = 7.24 ± 0.83). These findings suggest that surface finishing procedures and material selection play a critical role in preserving the aesthetic performance of resin-matrix ceramic restorations, and mechanical polishing may be considered a clinically favorable approach for computer-aided design and computer-aided manufacturing (CAD/CAM) restorations. Full article

The present study demonstrates that the corrosion behavior of dental cobalt–chromium (Co–Cr) alloys is strongly influenced by the interaction between microstructure, manufacturing technique, and oral chemical environment. A comparative investigation was conducted on Co–Cr specimens fabricated using four technological routes: conventional casting, CAD/CAM machining, Selective Laser Melting (SLM), and Direct Metal Laser Sintering (DMLS). The study included microstructural characterization, evaluation of generalized corrosion behavior using the rotating electrode technique, assessment of localized crevice corrosion, and quantitative analysis of the release of twenty metallic cations. Extraction tests were performed for 168 h in two media simulating aggressive oral environments: 0.07 N HCl (acidic medium) and a fluoride-containing electrolyte (0.1% NaF + 0.1% KF). Electrochemical measurements were recorded in the current density range of 10⁻¹⁰ to 10⁻⁷ A/cm², while released cation concentrations were quantified at the µg/L level. All alloys exhibited very low corrosion current densities (icorr in the 10⁻⁸ to 10⁻⁹ A·cm⁻² range), confirming overall good corrosion resistance. Among all manufacturing routes, CAD/CAM specimens demonstrated the highest electrochemical performance, with a wide passivity domain extending up to approximately 740 mV/SCE. A statistical interaction analysis between extraction media and manufacturing techniques was performed using the non-parametric Mann–Whitney (MW) U test. Among the analyzed elements, only chromium showed a statistically significant difference between media (p < 0.05), with an approximately 25-fold-higher release in acidic conditions compared with the fluoride medium, confirming the predominant role of proton-induced destabilization of the protective Cr₂O₃ passive film. In contrast, fluoride-containing media induced selective release of elements such as Cu (3× higher), W (2.5× higher), and Mo (1.4× higher), associated with complexation phenomena. The manufacturing route significantly influences corrosion behavior. Although additive manufacturing technologies (SLM/DMLS) enable highly accurate and customized prosthetic designs, rapid solidification and microstructural heterogeneities may increase susceptibility to localized corrosion compared with more homogeneous CAD/CAM materials. Clinically, these findings suggest that future restorative strategies should incorporate corrosion-aware material selection within digital workflows. As digital dentistry evolves, predictive models integrating patient-specific oral conditions may assist clinicians in selecting the most appropriate material system for long-term performance. In conclusion, the long-term success of dental Co–Cr prosthetic devices depends not only on mechanical strength and precision of fit, but also on sustained electrochemical stability in the complex oral environment. Full article

Background: Direct oral anticoagulants (DOACs) have transformed antithrombotic therapy but carry significant bleeding risks requiring prompt reversal. Recent regulatory changes have altered the reversal landscape, notably with the withdrawal of andexanet alfa from the U.S. market. Anticoagulation stewardship programs (ASPs) are essential for navigating this evolving environment and optimizing safe use of anticoagulants. Methods: This narrative review synthesizes evidence from landmark clinical trials (RE-VERSE AD, ANNEXA-4, ANNEXA-I), contemporary guidelines, emerging literature on reversal agents, and critical regulatory updates including the 2025 U.S Food and Drug Administration (FDA) withdrawal of andexanet alfa. Results: Idarucizumab remains the only FDA-approved specific antidote for dabigatran. Following the withdrawal of andexanet alfa, prothrombin complex concentrates (PCCs), both 4-factor and activated are now the primary reversal options for Factor Xa inhibitors, with recent evidence demonstrating comparable hemostatic efficacy. Ciraparantag, a universal reversal agent, is currently in Phase III development. Effective ASPs must now adapt protocols to the post-andexanet era while ensuring timely access to alternative reversal strategies. Conclusions: The reversal landscape has undergone a fundamental transformation with the loss of andexanet alfa. Success in DOAC-associated bleeding management now depends on optimizing PCC-based strategies, integrating systematic stewardship approaches, and preparing for emerging universal antidotes. Institutions must urgently update algorithms, ensure PCC availability, and monitor outcomes in this new therapeutic environment. Full article

This review aims to assess the clinical performance and application results of oral wearable devices in in vivo trials. Following a systematic search of PubMed, Cochrane, Embase, and Scopus databases up to 15 October 2025, and strict screening in accordance with PRISMA 2020 guidelines, 13 in vivo human trials were finally included for analysis. These were analyzed across four clinical functions: diagnosis, treatment, monitoring, and prevention. These devices have evolved from bulky prototypes into miniaturized, wireless systems with diverse diagnostic and therapeutic functions. Their applications now extend beyond common conditions like caries and bruxism to postoperative recovery and pediatric dental anxiety intervention. The findings show that some devices already offer practical value for clinical screening and auxiliary diagnosis. They demonstrate significant potential in early disease detection and medical cost control. However, development still faces many challenges. Technical issues include limited battery life, insufficient mechanical durability, and wireless transmission constraints within the oral environment. Furthermore, clinical evidence levels remain low, indications are narrow, and dedicated ethical and regulatory frameworks are lacking. Inconsistent regulatory standards, production costs, and clinician adoption hurdles slow its commercial development. In the future, the integration of AI, breakthroughs in energy harvesting, and the creation of digital health platforms will be key to overcoming technical bottlenecks. Full article

Intergenerational memories, migration histories, and the lasting influence of colonial linguistic systems profoundly shape heritage language maintenance in Afro-descendant communities of Central America. This study examines how genealogy functions as a pedagogical tool for sustaining English-based Creole languages among Afro-descendant populations in Costa Rica, Panama, and Belize, three nations linked by Afro-Caribbean migration yet shaped by distinct colonial and educational systems. Drawing on scholarship documenting oral histories, family narratives, and community-based linguistic practices, the study advances a genealogy-as-pedagogy framework to explain how families transmit language, identity, and belonging across generations through ancestral memory, positioning family-based knowledge transmission as curriculum. In Costa Rica and Panama, where Spanish colonial and post-independence language ideologies marginalize English-based Creole varieties, genealogical practices operate as primary mechanisms of linguistic continuity in the absence of sustained institutional support. In Belize, by contrast, British colonial legacies and the national recognition of Belizean Kriol create a distinct sociolinguistic environment in which state institutions, the media, and educational policy reinforce genealogical memory. Through comparative analysis, the study argues for integrating genealogical knowledge into multilingual education, community revitalization initiatives, and heritage language policy to strengthen Afro-descendant linguistic continuity in Costa Rica, Panama, and Belize. Full article