Search Results (495)

Artificial Intelligence (AI) is a computer science that focuses on developing systems and machines capable of performing tasks that typically require human cognitive abilities. It has widespread applications in medical diagnostics. Its use has led to rapid advancements in diagnostic methodology, enabling the analysis of large datasets. The major applications of AI in medical diagnostics include personalized treatment based on patient genetics, preventive measures, and medical image analysis. AI is employed to analyse genomic data and biomarkers, aiding in the precise tailoring of therapies to individual patient needs. It could also be employed in modern dentistry in the near future, helping to achieve higher efficiency and accuracy in diagnosis and treatment planning. AI may be utilized in screening for oral mucosa lesions and to discriminate between oral potentially malignant disorders and cancers from benign lesions. The potential advantages of AI include high speed and accuracy in the diagnostic process, as well as relatively low costs. The aim of this review was to present the potential applications of AI methods in the diagnosis of selected mucocutaneous diseases. A literature review focuses on oral lichen planus, recurrent aphthous stomatitis, and oral and laryngeal leukoplakia. Full article

Background: Adult patients with a thin buccal cortical plate and fragile periodontal phenotype are at high risk of dehiscence, fenestration and recession during transverse orthodontic expansion. Conventional mechanics often create a cervical compression-dominant environment that exceeds the adaptive capacity of the periodontal ligament (PDL)–bone complex. Objectives: This study proposes an integrative mechanobiological model in which a skeletal-anchorage-assisted loading protocol (Bone Protection System, BPS) transforms expansion into a tension-dominant regime that favours buccal phenotype preservation. Methods: Patient-specific finite element models were used to compare conventional expansion with a BPS-modified force system. Regional PDL stress patterns and crown/apex displacement vectors were analysed to distinguish tipping-dominant from translation-dominated mechanics. A pilot CBCT proof-of-concept (n = 1 thin-phenotype adult) with voxel-based registration quantified changes in maxillary and mandibular alveolar ridge width and buccal cortical plate thickness before and after BPS-assisted expansion. The mechanical findings were integrated with current evidence on compression- versus tension-driven inflammatory and osteogenic pathways in the PDL and cortical bone. Results: FEM demonstrated that conventional expansion concentrates high cervical compressive stress along the buccal PDL and cortical surface, accompanied by bending-like crown–root divergence. In contrast, the BPS protocol redirected forces to create a buccal tensile-favourable region and a more parallel crown–apex displacement pattern, indicative of translation-dominated movement. In the proof-of-concept (n = 1) CBCT case, BPS-assisted expansion was associated with preservation or increase of buccal ridge dimensions without radiographic signs of cortical breakdown. Conclusions: A tension-dominant orthodontic loading environment generated by a skeletal-anchorage-assisted force system may support buccal cortical preservation and vestibular phenotype reinforcement in thin-phenotype patients. The proposed mechanobiological model links these imaging and FEM findings to known molecular pathways of inflammation, angiogenesis and osteogenesis. It suggests a functional biomaterial-based strategy for widening the biological envelope of safe tooth movement. Full article

Background: Patients with a thin gingival phenotype and a narrow buccal alveolar plate are highly susceptible to periodontal complications during orthodontic expansion. Traditional biomechanics often fail to maintain root control in thin alveolar housing. This report presents two clinical cases illustrating soft- and hard-tissue responses to a novel biomechanical approach, the Bone Protection System (BPS), designed to reduce buccal cortical overload during expansion. Case Presentation: Two adult patients with a thin gingival phenotype assessed by a standardized periodontal probe transparency test and narrow alveolar ridges underwent orthodontic expansion. Patient 1 was treated with the full BPS protocol in both arches. Patient 2 received BPS only in the maxilla, while the mandible was treated conventionally, creating an intra-individual control model under identical systemic conditions. Soft-tissue phenotype and cortical plate response were evaluated clinically and radiographically when applicable. Results: In Patient 1 clinically, the vestibular phenotype showed clear thickening and stabilization. In Patient 2, the maxillary arch treated with BPS exhibited progressive thickening of the vestibular phenotype, whereas the mandible treated conventionally presented thinning and increased translucency—features consistent with buccal compression in thin alveolar bone. No soft- or hard-tissue augmentation procedures were performed in either case. Conclusions: The Bone Protection System may contribute to improved periodontal safety during orthodontic expansion in thin-biotype patients by reducing buccal cortical loading and supporting adaptive soft-tissue and bone responses. Preliminary observations suggests that BPS has potential value for possibly expanding the biological limits of safe tooth movement. Further studies on larger cohorts are warranted. Full article

Background: Mechanical loading is a fundamental regulator of bone remodelling; however, the mechanotransduction mechanisms governing alveolar bone adaptation under tensile-dominant orthodontic loading remain insufficiently defined. In particular, the molecular pathways associated with tension-driven cortical modelling in the periodontal ligament (PDL)–bone complex have not been systematically interpreted in the context of advanced biomechanical simulations. Methods: A nonlinear finite element model of the alveolar bone–PDL–tooth complex was developed using patient-specific CBCT data. Three loading configurations were analysed: (i) conventional orthodontic loading, (ii) loading combined with corticotomy alone, and (iii) a translation-dominant configuration generated by the Bone Protection System (BPS). Pressure distribution, displacement vectors, and stress polarity within the PDL and cortical plate were quantified across different bone density conditions. The mechanical outputs were subsequently interpreted in relation to established mechanotransductive molecular pathways involved in osteogenesis and angiogenesis. Results: Conventional loading generated compression-dominant stress fields within the marginal PDL, frequently exceeding physiological thresholds and producing moment-driven root displacement. Corticotomy alone reduced local stiffness but did not substantially alter stress polarity. The BPS configuration redirected loads toward a tensile-favourable mechanical environment characterised by reduced peak compressive pressures and parallel (translation-dominant) displacement vectors. The predicted tensile stress distribution is compatible with activation profiles of key mechanosensitive pathways, including integrin–FAK signalling, Wnt/β-catenin–mediated osteogenic differentiation and HIF-1α/VEGF-driven angiogenic coupling, suggesting a microenvironment that may be more conducive to cortical apposition than to resorption. Conclusions: This study presents a computational–molecular framework linking finite element–derived tensile stress patterns with osteogenic and angiogenic signalling pathways relevant to alveolar bone remodelling. The findings suggestthat controlled redirection of orthodontic loading toward tensile domains may shift the mechanical environment of the PDL–bone complex toward conditions associated with osteogenic than resorptive responses providing a mechanistic basis for tension-induced cortical modelling. This mechanobiological paradigm advances the understanding of load-guided alveolar bone adaptation at both the tissue and molecular levels. Full article

Background: Postoperative bone healing can be impaired by systemic factors and surgical trauma, leading to delayed recovery. Photobiomodulation therapy (PBMT) has been proposed as a non-invasive method to enhance osteogenesis, but variability in protocols and outcomes limits its clinical use. Aim: To systematically review and synthesize evidence from randomized controlled trials (RCTs) evaluating PBMT’s effectiveness in promoting postoperative osteogenesis. Methods: A systematic search of PubMed, Embase, Scopus, and Cochrane Library was conducted following the PRISMA 2020 guidelines. Only RCTs comparing PBMT with sham treatment or standard care were included. Data on laser parameters, surgical indications, and outcomes such as bone regeneration, healing time, and implant stability were extracted. The risk of bias of the included randomized studies was evaluated using the Cochrane Risk of Bias 2 (RoB version 2) tool. Results: Twelve RCTs were included. PBMT consistently improved early soft tissue healing and reduced postoperative inflammation and edema. Some studies showed accelerated bone maturation, especially in grafted sockets and distraction osteogenesis, while others reported no significant long-term effects on implant stability or chronic lesion healing. Heterogeneity in laser parameters limited comparability. Conclusions: PBMT is a safe adjunct that reliably enhances early postoperative healing and may promote bone remodeling in selected cases. Standardized protocols and larger, high-quality RCTs are needed to confirm long-term benefits and optimize treatment parameters. 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

Gingival recession, particularly in patients exhibiting a thin periodontal phenotype, is a prevalent and challenging complication associated with orthodontic treatment, among other factors. Recent advances in biostimulation therapies aim to support soft tissue augmentation by increasing gingival thickness (GT) and keratinized tissue width (KTW) while minimizing the need for invasive surgical procedures. This narrative review explores the available clinical evidence regarding several biostimulation techniques, including injectable platelet-rich fibrin (i-PRF), microneedling (MN), concentrated growth factors (CGF), atelocollagen, hyaluronic acid (HA), and low-level laser therapy (LLLT), with a particular focus on their potential adjunctive role in orthodontic patients with a thin periodontal phenotype. While i-PRF and microneedling—used alone or in combination—have shown promising short-term soft tissue thickening and reduced patient morbidity when compared with conventional grafting procedures, the available evidence is largely derived from small, randomized trials, pilot studies, and non-orthodontic cohorts, limiting the strength of comparative conclusions. Minimally invasive biostimulation techniques may represent potential adjunctive strategies for soft tissue management in selected clinical scenarios. Nevertheless, current evidence remains limited and heterogeneous, and robust, long-term, orthodontic-specific clinical trials are required before these approaches can be considered reliable alternatives to established surgical protocols or validated preventive strategies against gingival recession. Full article

Background: Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease. Certain clinical forms of the disease may cause significant discomfort and negatively impact patients’ quality of life. The first-line treatment is topical corticosteroids. The purpose of this narrative review is to evaluate the influence of corticosteroid injections in the treatment of OLP. Methods: A search of the literature was conducted in October 2025 using the following databases: PubMed, Web of Science, Scopus, and Cochrane. Results: Fifteen studies were evaluated. Injections with triamcinolone acetonide at a concentration of 10–40 mg/mL at weekly intervals demonstrated efficacy in reducing pain and healing OLP lesions in these studies. They showed minor adverse effects. Conclusions: Noting the limitations of this narrative review, intralesional corticosteroid injections are an effective and safe method of treating OLP. They should be considered in patients with symptomatic OLP. Full article

Transmissible gastroenteritis (TGE), caused by the TGE virus (TGEV), is a highly contagious enteric disease characterized by vomiting, dehydration, and watery diarrhea. It mainly endangers piglets within two weeks of age, with a 100% mortality rate, inflicting severe economic losses on the global swine industry. Since enteric tropism of the virus and mucosa serves as the first line of defense against viral invasion, an oral vaccine inducing sufficient secretory immunoglobulin A (SIgA) antibodies in animals should be developed. Being a generally recognized as safe (GRAS) microorganism, Bacillus subtilis can form endospores under extreme environmental conditions, which confer resistance to the hostile gastric environment and have been widely employed as delivery vehicles for oral vaccines owing to their immunoadjuvant activity and non-specific antidiarrheal effects. In this study, the AD antigenic epitope of the TGEV S protein was selected as the immunogen. The mature peptide of the B subunit of the heat-labile enterotoxin from enterotoxigenic Escherichia coli served as a mucosal adjuvant, and B. subtilis WB800N was used as the delivery host to construct the recombinant strain pHT43-LTB-AD/WB800N. After confirming the successful expression of the target protein, oral immunization was performed using mice as a model. The results demonstrated that this recombinant strain induced robust mucosal, humoral, and cellular immunity, along with considerable levels of neutralizing antibodies. These findings indicate that recombinant B. subtilis could serve as an oral vaccine candidate to combat TGEV infections. Full article

Background: This study evaluates the increase in gingival thickness following the administration of injectable atelocollagen. Materials and Methods: A retrospective analysis was conducted using the medical records of 60 patients with a thin gingival phenotype at baseline, treated between 2017 and 2025. All patients received a standardised protocol for soft tissue thickness modification using atelocollagen injections. Based on the continuation of maintenance therapy, patients were divided into Group A (n = 30), consisting of patients who received booster doses at six-month intervals following completion of the full treatment protocol, and Group B (n = 30), consisting of patients who did not continue maintenance therapy. The observation period for all patients was five years. Gingival thickness was assessed by periodontal probe transparency using a standard WHO probe (WHO 621) and the Hu-Friedy Colorvue Biotype Probe. Longitudinal changes were analysed using linear mixed-effects models (LMMs) for continuous outcomes and generalised linear mixed-effects models (GLMMs) with a binomial distribution and logit link for binary outcomes, accounting for repeated measurements at the patient level. Results: Significant effects of Group and Time, as well as their interaction, were observed for the proportion of sites with a thick gingiva (Group effect: F (1,93.14) = 57.94, p < 0.001; Group × Time interaction: p < 0.001). GLMM analysis confirmed a significant Group × Time interaction (χ² = 23.11, p < 0.001), indicating sustained gingival thickness improvement in Group A and a gradual decrease in effectiveness in Group B. Conclusions: Injectable atelocollagen represents a reliable, effective, and user-friendly method for long-term modification of gingival thickness, particularly when supported by maintenance therapy. Full article

Urethral stricture is a disease of fibrotic narrowing that compromises the urethral mucosa and spongiosum. Oral mucosal graft urethroplasty delivers excellent outcomes in complex cases, yet its procedural demands restrict availability beyond specialized centers. Endoscopic transplantation of oral mucosa has been proposed; while feasibility is shown, clinical efficacy remains suboptimal. We asked whether extracellular vesicles from stem cells of human exfoliated deciduous teeth (SHED-EVs) promote oral mucosa fibroblast (OMF) growth under urethra-mimetic paracrine conditions and whether culture growth phase tunes EV function. SHED-EVs were collected during logarithmic (SHED-EV-L) or stationary (SHED-EV-S) phases under xeno-free conditions, isolated by a standardized workflow, and characterized by nanoparticle tracking analysis. miRNA cargo was profiled with a human miRNA microarray platform and normalized for comparative analyses. OMF proliferation was quantified in a horizontal indirect co-culture with urethral epithelial cells using incubator-based time-lapse imaging. SHED-EV-L produced a sustained pro-proliferative effect across 24–96 h, whereas SHED-EV-S showed a weaker early effect with a late catch-up; both exceeded vehicle at 96 h. Fibrosis-related miRNA heat maps showed culture growth phase-dependent patterns: SHED-EV-L displayed relatively higher signals for miR-31-3p, miR-146b-3p, several let-7 members, and selected miR-181 isoforms, whereas SHED-EV-S showed a marked relative increase of miR-486-3p; miR-21, miR-99/100, and miR-205 were broadly comparable between phases. These findings indicate that culture growth phase is a practical design lever that orients SHED-EV cargo and function, supporting phase-matched formulations for adjunctive transurethral applications and motivating in vivo validation and manufacturing-oriented quality controls. Full article

Head and neck cancer (HNC) affects nearly 1 million people every year. The main risk factors include tobacco, alcohol, or human papilloma virus (HPV) viral infections, which contribute to HNC development through various, mostly unknown, mechanisms. One of these postulated mechanisms is cellular senescence. This biological aging-associated process is responsible not only for the arrest of cellular growth and division but also mediates the modulation of cell metabolism and secretory phenotype. Consequently, it may play a crucial role in carcinogenesis, which makes it an interesting topic in the context of cancer development, prognosis, prevention, and therapy. This review focuses on the current state of knowledge regarding all aspects of the association between cellular senescence and head and neck cancer. Full article

Background and Objectives: Pemphigus vulgaris (PV) is a rare autoimmune blistering disease caused by IgG au-toantibodies against desmoglein 1 and/or desmoglein 3, leading to flaccid blisters on the skin and mucous membranes. The course of PV during pregnancy represents a special clinical challenge due to immunological changes accompanying physiological immunosuppression and the need to protect the developing fetus. Materials and Methods: To analyze the current state of knowledge, a literature review was performed covering the years 2015–2025. Publications describing PV diagnosed during pregnancy or in neonates were screened, and nine case reports discussing ten patients meeting the inclusion criteria were selected for detailed analysis. In this study, we also present our own clinical case of PV in pregnancy to complement the literature review and provide practical insight into disease management. Results: In most cases, the disease was diagnosed in the first trimester of pregnancy, and the most common symptoms were flaccid blisters and erosions of the oral mucosa. The diagnosis was confirmed by direct immunofluorescence (DIF) and ELISA testing. The first-line treatment remained systemic glucocorticosteroids (GCS), mainly prednisolone, which is considered the safest. In resistant cases, intravenous immunoglobulins (IVIg) were used, which were considered effective and safe, though their use may limit the transplacental transfer of autoantibodies to the fetus. In newborns, the symptoms rarely occurred, were mild, and resolved spontaneously. Drugs with proven teratogenic effects, such as methotrexate, cyclophosphamide, and mycophenolate mofetil, are contraindicated during pregnancy. In the case of rituximab therapy, it is recommended to postpone pregnancy for at least 12 months after the completion of treatment to minimize the potential risk of immunosuppression in the newborn. Conclusions: The treatment of PV during pregnancy requires close interdisciplinary cooperation. Therapy should be carefully individualized, taking into account both therapeutic efficacy and fetal safety. Perhaps then, pregnancy-related pemphigus diseases, given their peculiarities, should be classified as a distinct variety within the desmosomal type of autoimmune blistering diseases. Full article

Background/Objectives: Candida biofilms exhibit high resistance to antifungal treatment, motivating investigation of adjunctive physical disinfection methods. To quantitatively assess the effect of Er:YAG laser fluence on growth inhibition and viability of single-species Candida biofilms in vitro using a 7 mm full-beam handpiece. Methods: Biofilms of Candida albicans ATCC 10231, C. glabrata ATCC 90030, C. parapsilosis ATCC 22019, and C. krusei ATCC 6258 were grown on Sabouraud agar. In phase 1, growth inhibition zones (GIZs) were evaluated after non-contact Er:YAG irradiation (2 Hz, 300 µs, 10 mm distance, no air or water spray) at fluences from 0.3 to 3.4 J/cm², with incubation for 24 to 96 h. In phase 2, 96 h mature biofilms were irradiated for 120 s at 0.8, 1.0, 1.5, or 2.0 J/cm², and viability was quantified by colony-forming unit (CFU) imprinting. All experimental conditions were tested in quadruplicate. Results: GIZ diameters increased significantly with fluence for all species (p < 0.05) and remained stable up to 96 h. At the highest fluence, mean GIZs reached approximately 8.0 mm for C. albicans, 7.7 mm for C. parapsilosis, 7.0 mm for C. krusei, and 5.2 mm for C. glaxfbrata. In mature biofilms, CFU counts decreased significantly with increasing fluence (p < 0.05). For C. albicans, CFUs were reduced from 164.0 ± 25.1 at 0.8 J/cm² to 16.5 ± 5.2 at 2.0 J/cm², while C. glabrata decreased from 103.5 ± 5.4 to 20.8 ± 1.7. C. parapsilosis and C. krusei showed maximal reductions at 1.0–1.5 J/cm², followed by partial CFU rebound at 2.0 J/cm². Conclusions: Er:YAG irradiation delivered over a large, uniformly illuminated area induces stable, fluence-dependent inhibition and significant reduction of Candida biofilm viability in vitro. Optimal fluence ranges are species specific, underscoring the need for parameter optimization and further evaluation in more complex biofilm models before clinical extrapolation. 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