Search Results (101)

Background/Objectives: Anterior dental trauma in adolescents presents complex restorative challenges due to ongoing craniofacial development and high aesthetic expectations. This study evaluated the long-term clinical performance of feldspathic ceramic veneers and lithium disilicate crowns used in the anterior region following dental trauma in adolescents. Methods: A total of 209 restorations were placed in 85 adolescents (50 females, 35 males), aged 11.1–17.9 years (mean age: 15.1 years). Of these, 144 were lithium disilicate crowns, and 65 were feldspathic ceramic veneers. All restorations were fabricated using minimally invasive protocols and followed up for periods ranging from 3 to 60 months. Outcomes were assessed based on standardized clinical criteria for success and failure. Results: Lithium disilicate crowns exhibited superior long-term performance, with the majority of failures occurring in feldspathic veneers (p < 0.001), primarily due to chipping or structural fracture. Age and gender had no statistically significant influence on failure rates. Conclusions: Both feldspathic and lithium disilicate ceramic restorations represent viable treatment options for anterior dental trauma in adolescents. However, lithium disilicate demonstrates greater mechanical reliability, particularly in teeth with significant hard tissue loss. These results support the use of durable ceramic materials in adolescent restorative protocols involving dental trauma. Full article

Background and Objectives: The extraction of mandibular third molars poses challenges due to their proximity to the mandibular canal and risk of inferior alveolar nerve (IAN) injury. Accurate preoperative evaluation is essential to minimize complications. This study assessed the three-dimensional positional relationship between the mandibular canal and lower third molars using cone-beam computed tomography (CBCT), aiming to identify anatomical positions associated with increased surgical risk. Materials and Methods: This retrospective study analyzed 253 CBCT scans of fully developed lower third molars. The mandibular canal position was classified as apical (Class I), buccal (Class II), lingual (Class III), or interradicular (Class IV). Contact was categorized as no contact, contact with a complete or defective white line, or canal penetration. In no-contact cases, the apex–canal distance was measured. Statistical analysis included descriptive and contingency analyses using the Chi-Square Likelihood Ratio test. Results: Class I was most common (70.8%) and presented the lowest risk, while Classes III and IV showed significantly higher frequencies of canal contact or penetration. Class II exhibited shorter distances even in no-contact cases, suggesting residual risk. Statistically significant associations were found between canal position and both contact type (p < 0.001) and apex–canal distance (p = 0.046). Conclusions: CBCT offers valuable insight into the anatomical relationship between third molars and the mandibular canal. High-risk positions—particularly lingual and interradicular—require careful assessment. Even in the absence of contact, close proximity may pose a risk and should inform surgical planning. Full article

Background: Dynamic computer-aided navigation systems are a real-time motion tracking technology widely applied in oral implantology and endodontics to enhance precision and reduce complications. However, their reliability, accuracy, and usability in dentoalveolar surgery and maxillary bone augmentation remain underinvestigated. Methods: A systematic review following PRISMA guidelines was conducted and registered on PROSPERO (CRD42024610153). PubMed, Scopus, Web of Science, and Cochrane Library databases were searched until October 2024 to retrieve English eligible studies, without restrictions on the publication year, on dynamic computer-assisted navigation systems in dentoalveolar and bone augmentation surgeries. Exclusion criteria were surgery performed without dynamic computer-assisted navigation systems; dental implant placement; endodontic surgery; and maxillo-facial surgery. The outcomes were reliability, accuracy, post-operative course, surgical duration, complications, patient- and clinician-reported usability, acceptability, and satisfaction. Included studies were qualitatively synthetized and judged using dedicated tools for the different study designs. Results: Twenty-nine studies with 214 patients were included, showing high reliability in dentoalveolar and bone augmentation surgeries comparable to or superior to freehand surgeries, higher accuracy in dentoalveolar surgery compared to maxillary bone augmentation, and reduced complication rates across all surgeries. While overall surgical duration slightly increased due to technology installation, operative time was reduced in third molar extractions. Patient-reported outcomes were poorly investigated. Clinician-reported outcomes were mixed, but difficulties in the differentiation of soft tissue from hard tissue were recorded, especially in sinus floor elevation. Conclusions: Dynamic computer-assisted navigation systems enhance accuracy and safety in dentoalveolar and bone augmentation surgery. Further studies are needed to assess the underinvestigated patient-reported outcomes and standardize protocols. Full article

Objective: Lower third impacted molar extraction, despite being a routinary procedure for oral and maxillo-facial surgeons, may often result in a significantly negative impact in patient’s post-operatory quality of life. Among others, treatments based on oxygen-enriched oils have been shown to provide valuable therapeutic benefits in promoting wound healing, and therefore improving the immediate post-operatory symptomatology. The aim of this triple-blinded randomized controlled study is to supplement the existing evidence in the scientific literature by assessing the effectiveness of NovoX^®-Drop (Moss S.p.A., Lesa, Novara), a specific type of oxygen enriched oil-based device in reducing pain and inflammatory stimulus of post-surgical wounds following the extraction of lower third impacted molars. Materials and methods: Seventy-one patients undergoing surgical extraction of a single lower third impacted molar were randomly assigned to receive either NovoX^®-Drop (Group A) or a glycerin-based gel (Group B). Additionally, both patient groups followed the same standard therapy with amoxicillin-clavulanic acid and ibuprofen. Data were collected preoperative (T0) and after three (T3) and seven (T7) days postoperative in order to assess the following outcomes: mean visual analogue scale (VAS) score during the seven days protocol treatment, total duration of nonsteroidal anti-inflammatory drug (NSAID) usage, trismus (maximum mouth opening) and facial oedema. Results: Group A (treatment group) reported significatively lower pain levels at T7 compared to group B (average VAS value during the week: Group A: 3.57 ± 0.39 cm; Group B: 4.47 ± 0.40 cm; p-value = 0.0014) despite a significatively shorter period of NSAID usage (average NSAID usage duration: Group A: 2.43 ± 0.38 days; Group B: 3.38 ± 0.44 days; p-value = 0.00001). Therefore, trismus seems to be better controlled in group A, although the difference between the groups did not reach the threshold for statistical significance. Conclusions: The results of this study suggest that application of NovoX^®-Drop is capable of significantly reducing the post-operatory pain as well as NSAID usage, representing a promising and effective option for third impacted molar extraction surgery management. Full article

Background: The aim of this study was to evaluate the effect of Photobiomodulation Therapy (PBMT) on the eruption rate of impacted maxillary canines after surgery, using a split-mouth design. Methods: A 16-year-old patient was referred to the Department of Oral and Maxillo-Facial Sciences of “Sapienza” University of Rome. Clinical examination revealed the persistence of maxillary primary canines and the absence of a palpable canine bump. CBCT scans confirmed that both upper permanent canines were impacted in the palatal osteomucosal region and showed a mesial inclination. Conventional surgery with cold blade was performed for both impacted canines, and PBMT was applied on element 2.3 for three sessions after surgery. Since this is a case report, no statistical analysis was performed. Results: The eruption movement of the two impacted canines was evaluated 16 weeks after surgery. The extent of the spontaneous eruption movement of element 1.3 was 0.21 mm, while element 2.3, which underwent three sessions of PBMT following surgery, moved 3.16 mm. Conclusions: The element that underwent PBMT appears to respond positively in terms of spontaneous eruption following disinclusion surgery compared to the contralateral element that was not stimulated with the laser. These findings suggest that photobiomodulation therapy could be effective in accelerating the eruption of palatally impacted canines following surgery, avoiding the need to use orthodontic traction. Future randomized controlled clinical trials are needed to demonstrate these preliminary results. Full article

The entry of artificial intelligence, in particular deep learning models, into the study of medical–clinical processes is revolutionizing the way of conceiving and seeing the future of medicine, offering new and promising perspectives in patient management. These models are proving to be excellent tools for the clinician through their great potential and capacity for processing clinical data, in particular radiological images. The processing and analysis of imaging data, such as CT scans or histological images, by these algorithms offers aid to clinicians for image segmentation and classification and to surgeons in the surgical planning of a delicate and complex operation. This study aims to analyze what the most frequently used models in the segmentation and classification of medical images are, to evaluate what the applications of these algorithms in maxillo-facial surgery are, and to explore what the future perspectives of the use of artificial intelligence in the processing of radiological data are, particularly in oncological fields. Future prospects are promising. Further development of deep learning algorithms capable of analyzing image sequences, integrating multimodal data, i.e., combining information from different sources, and developing human–machine interfaces to facilitate the integration of these tools with clinical reality are expected. In conclusion, these models have proven to be versatile and potentially effective tools on different types of data, from photographs of intraoral lesions to histopathological slides via MRI scans. Full article

Background/Objectives: Dental implant success is influenced by a range of systemic and local factors. Emerging evidence suggests that metabolic markers such as lipid profiles and vitamin D levels may play a role in osseointegration and implant survival. The aim of this study was to evaluate the influence of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, and vitamin D levels on the short-term survival rate of dental implants. Materials and Methods: A prospective observational study was conducted on patients receiving dental implants. Preoperative serum levels of LDL, HDL, triglycerides, and vitamin D were recorded. A total of 556 conical, platform-switching implants were placed in 166 patients, smokers and no smokers with mean age 48 years ± 4.7. Implant survival was evaluated from 14 to 21 days after placement, at 6- and at a 12-month follow-up. Spearman’s rank correlation was performed to assess potential correlations between the abovementioned systemic factors and implant loss. Results: Out of 556 implants, 13 (2.34%) were lost from 14 to 21 days after placement, a further two (0.35%) were lost after 6 months after surgery and a further eight (1.44%) were lost 12 months after placement. No significant correlation was found between HDL levels, cholesterol levels, triglyceride levels and implant loss. Spearman’s correlation analysis revealed a strong negative correlation between vitamin D levels and implant loss with no statistical significance. Conclusions: Within the limitations of this study, no statistically significant associations were found between lipid profile markers or vitamin D levels and early dental implant loss. Further large-scale and long-term studies are warranted to validate these findings and better understand the interplay between systemic biochemical markers and implant survival rate. Full article

All-ceramic restorations are the foundation of modern restorative aesthetic dentistry. The industry for dental materials now provides a large selection of biomaterials with a range of constantly improving qualities. Although this is undoubtedly advantageous, the vast array of materials may confuse even experienced dentists. Even if recently the demand of digital dentistry in daily dental practice has significantly increased, due to a lack of understanding concerning cementation techniques, which are different for each type of ceramic used, dentists are continuing to be hesitant to utilise these various CAD/CAM materials. This study analysed 58 articles from 2008 to 2025, focusing on narrative, comprehensive, and systematic reviews and in vitro studies on dental dentistry materials. English articles were included, but non-English articles and case reports were excluded. The analysis included articles from all journal categories, ensuring adherence to inclusion and exclusion criteria. The aim of the research is to assess material classifications and properties that guide practices concerning the adhesive cementation of all-ceramic restorations. In order to provide a clear overview of the composition, characteristics, clinical considerations, and current trends of contemporary dental materials, as well as some recommendations for future research in this area that would be relevant to dentists and the scientific community, the authors of the paper were guided by this structure when writing the article content. The key is to ensure the aesthetics, resistance, and long-term clinical success of the treatment plan by providing dental professionals with clear, accurate information and instructions about resin-luting materials and indirect restoration materials. Full article

Background and Objectives: Laryngeal cancer poses a significant clinical challenge, with late-stage diagnosis contributing to high morbidity and mortality. Circulating microRNAs (miRNAs) represent promising, minimally invasive biomarkers for earlier detection and improved therapeutic monitoring. This pilot study focused exclusively on miRNAs found to be upregulated in laryngeal carcinoma patients, aiming to elucidate their diagnostic and prognostic relevance. Methods: A total of 50 participants meeting standardized inclusion criteria were recruited from the ENT Clinic in Timișoara. Of these, 30 patients provided paired blood samples before and after treatment (surgical or non-surgical). Samples were pooled into three preoperative groups (P1, P2, P3) and three corresponding postoperative groups (C1, C2, C3). miRNAs were extracted from plasma and exosomes, and relative expression was measured by qPCR (Qiagen platform). Statistical analyses included Mann–Whitney U tests, receiver operating characteristic (ROC) curves, and logistic regression. Results: Seven miRNAs consistently exhibited significant upregulation preoperatively. Notably, hsa-miR-424-5p displayed a mean fold change of 4.59 (p = 0.0091) relative to postoperative samples, while hsa-miR-186-5p increased by 2.19-fold (p = 0.0030). hsa-miR-15b-5p also showed a substantial preoperative upregulation of 1.77-fold (p = 0.0057). In ROC analyses, hsa-miR-424-5p yielded an area under the curve (AUC) of 0.82 (95% CI 0.70–0.94), with 78% sensitivity and 80% specificity in distinguishing preoperative from postoperative status. Logistic regression indicated that elevated levels of hsa-miR-424-5p (OR = 1.56, 95% CI 1.10–2.20) and hsa-miR-186-5p (OR = 1.32, 95% CI 1.02–1.68) significantly predicted the preoperative disease state. Conclusions: These data underscore the potential of upregulated circulating miRNAs to serve as biomarkers for active laryngeal cancer and to monitor treatment response. Although preliminary, the findings encourage further research with larger cohorts and additional endpoints. With thorough validation, upregulated miRNAs could be integrated into clinical workflows, enhancing diagnostic precision, risk stratification, and postoperative surveillance in laryngeal cancer. Full article

Mesenchymal stem cells (MSCs) have emerged as a relevant strategy in regenerative medicine due to their multipotent differentiation capacity, immunomodulatory properties, and therapeutic applications in various medical fields. This review explores the therapeutic use of MSCs, focusing on their role in treating autoimmune disorders and neoplastic diseases and in tissue regeneration. We discuss the mechanisms underlying MSC-mediated tissue repair, including their paracrine activity, migration to injury sites, and interaction with the immune system. Advances in cellular therapies such as genome engineering and MSC-derived exosome treatments further enhance their applicability. Key methodologies analyzed include genomic studies, next-generation sequencing (NGS), and bioinformatics approaches to optimize MSC-based interventions. Additionally, we reviewed preclinical and clinical evidence demonstrating the therapeutic potential of MSCs in conditions such as graft-versus-host disease, osteoarthritis, liver cirrhosis, and neurodegenerative disorders. While promising, challenges remain regarding standardization, long-term safety, and potential tumorigenic risks associated with MSC therapy. Future research should focus on refining MSC-based treatments to enhance efficacy and minimize risks. This review underscores the need for large-scale clinical trials to validate MSC-based interventions and fully harness their therapeutic potential. Full article

Background/Objectives: Although factors acting both prenatally and postnatally are taken into consideration, the etiopathogenesis of developmental defects of enamel (DDE) is not fully understood. Among the medications used for a variety of ailments, amoxicillin and cefaclor are indicated as having a part in the development of DDE. The objective of the present study was to reproduce DDE in the laboratory in rats by administering amoxicillin, ibuprofen, and cefaclor. These lesions were subsequently diagnosed using polarized light microscopy (PLM). Methods: This study was conducted on Wistar rats, which were given prenatally drugs possibly involved in the production of DDE. After macroscopic examination and identification of enamel defects, bright-field microscopy (BFM) and PLM examination were performed. Results: The group that received cefaclor was the most affected, according to the data gathered from this study. This group was followed by the groups that received amoxicillin in a double dose, ibuprofen, amoxicillin in a standard dose, and the control group. Conclusions: In the control group, DDE was identified in a reduced number, resulting in the fact that there are other factors involved, besides the drugs administered, in the development of DDE. Following this research, it was concluded that DDE in the form of demineralization was more frequently recorded in the cefaclor and ibuprofen groups, while DDE in the form of hypoplasia was more frequently recorded in the double-dose and standard-dose amoxicillin groups. Full article

Background and Objectives: Odontogenic infections (OIs) can lead to severe complications if not promptly diagnosed and treated. The Quick Sequential Organ Failure Assessment (qSOFA), derived Neutrophil-to-Lymphocyte Ratio (dNLR); Modified Early Warning Score (MEWS); and Predisposition, Infection, Response, and Organ Dysfunction (PIRO) scores are clinical tools used to predict the severity and outcomes in various infections. This study aims to evaluate the efficacy of these scores in predicting the severity of OIs in adult patients. Methods: A retrospective cohort study was conducted on 120 patients hospitalized for OIs, divided into two groups based on infection severity, using the Symptom Severity (SS) scale. The qSOFA, dNLR, MEWS, and PIRO scores were calculated upon admission. Statistical analyses were performed to assess the predictive value of these scores for severe OIs. Results: Patients with severe OIs (Group B) had significantly higher qSOFA, dNLR, MEWS, and PIRO scores compared to those with lower severity (Group A). The median qSOFA score was 2.00 in Group B versus 0.85 in Group A. No significant difference was observed between young patients and adults in terms of severity. ROC curve analysis showed that the PIRO score had the highest predictive value for severe OI (AUC = 0.912), followed by MEWS (AUC = 0.878), qSOFA (AUC = 0.845), and dNLR (AUC = 0.812). Multivariate logistic regression indicated that the PIRO score was an independent predictor of severe OI (OR = 8.45, 95% CI: 4.12–12.78). Conclusions: The qSOFA, dNLR, MEWS, and PIRO scores are valuable tools for predicting the severity of OIs. Among them, the PIRO score demonstrated the highest predictive accuracy and may be incorporated into clinical practice for early identification of high-risk patients. Full article

Background and Objective: The aim of this systematic review was to assess clinical trials on the efficiency of sinus lift techniques with and without bone grafting in the atrophic posterior maxilla. Materials and Methods: This article was written under the PRISMA and the Cochrane Handbook for Systematic Reviews of Interventions guidelines. PubMed, Scopus, and Web of Science databases were electronically searched until December 2023. The risk of bias was assessed according to Cochrane Risk of Bias tool guidelines. Statistical analysis was performed for implant survival rate (ISR), marginal bone loss (MBL), and endo-sinus bone gain (ESBG). Results: At the end of the electronic search, 5 clinical trials were considered eligible. Statistical analysis was achieved for osteotome sinus floor elevation. The ISR at 3 years had a risk ratio (RR) of 0.98 [0.90, 1.07] (CI 95%), p = 0.7, and at 5 years, RR 1.02 [0.93, 1.11] (CI 95%), p = 0.68. The MBL, at 3 years, indicated a weighted mean difference (WMD) of 0.01 [−0.15, 0.16] (CI 95%), p = 0.93, and at 5 years, WMD of −0.08 [−0.53, 0.37] (CI 95%), p = 0.73. ESBG at 3 years had a WMD of −0.44 [−1.05, 0.17] (CI 95%), p = 0.16, and at 5 years, WMD of −0.61 [−1.63, 0.41] (CI 95%), p = 0.24. Conclusions: The available evidence underlines that the osteotome sinus floor elevation technique without bone graft may be used. Full article

Background/Objectives: Oral cancer ranks among the top ten cancers globally, with a five-year survival rate below 50%. This study aimed to evaluate the effectiveness of autofluorescence-guided surgery compared to standard surgical methods in identifying tumor-free margins and ensuring complete excision. Methods: A prospective cohort of 80 patients was randomized into two groups: the control group underwent excision with a 10 mm margin based on clinical judgment, while the experimental group used autofluorescence guidance with a 5 mm margin beyond fluorescence visualization loss. Autofluorescence imaging was performed using the OralID device, which employs a 405 nm excitation laser to detect abnormal tissue. Ethical approval was obtained from the “Spitalul Clinic Municipal de Urgență Timișoara” Ethics Committee (approval number 08/26.02.2021), and the trial was registered at the University of Medicine and Pharmacy Timisoara (trial no. 59/25.11.2021). A double analysis was conducted: a primary analysis of the full cohort and a subgroup analysis focusing on squamous cell carcinoma (control: n = 19; experimental: n = 24). Histopathological analysis was the gold standard for margin evaluation, with margins coded as tumor-free margins (0), close (1), or infiltrated (2). Results: Statistically significant differences were observed in tumor-free margins between the control (73.17%) and experimental (97%) groups (p = 0.003). Subgroup analysis for SCC showed no significant difference (control: 84.21%; experimental: 95.83%; p = 0.306). Tumor location also differed significantly (p = 0.011), while other baseline variables, such as tumor type and patient characteristics, showed no significant differences. Conclusions: Autofluorescence-guided surgery improves the detection of tumor-free margins and may serve as an effective adjunct in oral cancer management. Larger studies are recommended to confirm these findings. Full article

Background/Objectives: The most common form of supernumerary teeth is represented by the mesiodens. Very often, they are impacted, usually palatially, but can be found buccally or between the roots of the permanent central incisors. Their position can be normal, inclined, or inverted. In the possible case where the impacted mesiodens crown is oriented upwards towards the nasal cavity, they are called inverted mesiodens. The inverted mesiodens are mainly asymptomatic, and the main diagnostic methods are radiological, especially CBCT. Methods: This paper presents the intraoral approach through the nasal floor as a very reliable method for the surgical removal of inverted mesiodens. We report a protocol, including the diagnosis process, criteria for choosing this surgical approach, and description of the surgical procedure. Preoperative CBCT is mandatory for diagnosis and choice of the surgical approach. This is chosen based on measurements on the cross-sectional view of the CBCT investigation and is in compliance with our criteria related to the appropriate surgical approach. Results: Using this approach, the mesiodens were extracted without intraoperative or postoperative complications or accidents, and operating times were relatively short. Conclusions: The intraoral approach through the nasal floor for surgical removal of inverted mesiodens satisfies all the conditions to be a predictable, safe, and time-efficient technique. It has its limitations, mainly regarding the surgical skills of the operating team. The cone–beam computed tomography (CBCT) has a fundamental role in the diagnosis and treatment of included mesiodens. Full article