Li informem dels canals usuals corresponents per al dipòsit, articles de revista: es dipositen a través de GREC (https://www.uv.es/sbiblio/Roderic/com_dipositar_articles_GREC.pdf). Altres documents com llibres o capítols de llibre (https://www.uv.es/sbiblio/Roderic/guia_investigaci%c3%b3_2024.pdf), s’han de dipositar directament en el repositori institucional RODERIC.

Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2026. Vol. 31, no. 02

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https://hdl.handle.net/10550/127829

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Longevity factors for short and extra-short implants: an eight-year retrospective observational clinical study
(2026) Tavares Leite, Sérgio José; Harduin, Marcelo; Rizzato, Marcelo; Gonçalves, Alexandre Oliveira; Fernandes, Juliana Campos Hasse; Fernandes, Gustavo Vicentis Oliveira
This study aimed to evaluate implants placed in the mandible and maxilla and analyze the correlation between local and systemic factors that affect the clinical and prosthetic performance of short and extra-short implants.Implants were analyzed based on 18 factors: Location (anterior or posterior; maxilla or mandible); presence or not of previous grafting; bone quality; prosthesis was/was not installed immediately; type of prosthetic connection (external hexagon or Morse Taper); thread type (trapezoidal, triangular, or hybrid); surface's characteristic; implant length; implant width; prosthesis installation follow-up; type of prosthesis retention (cemented or screw-retained); single prosthesis or splinted to another implant; antagonist occlusion type; presence or absence of intermediary prosthetic component; prosthetic abutment height; distance between intermediaries component; presence or absence of implant bicortilization; and implant insertion torque. Clinical intraoral analysis included dimensions of the occlusal part and the inclination of the cusps (15 degrees versus >15 degrees). Possible systemic influences were also evaluated. Patient satisfaction was assessed through a questionnaire. The statistical analysis considered results significant if p2mm, Morse taper connections, bicorticalization, insertion torque 35N, anterior placement, maxillary location, and prior bone grafting (p<0.05 for all). These findings suggest that such variables may positively influence os-seointegration and support the long-term success of short implants.The use of short- and extra-short implants is a feasible treatment option for mid- and long-term rehabilitation of the full and partial maxillary and mandibular arches.
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Deep learning-based approach for differential diagnosis of odontogenic cysts from histopathological images
(2026) Torul, Damla; Bayrakdar, Ibrahim-Sevki; Bozkurt, Mustafa Hakan; Erdem, Havva; Akcay-Celik, Muruvvet; Ersan-Erdem, Busra; Salman, Fadime Gul
This study aims to provide Deep Learning (DL) based artificial intelligence (AI) methods using histopathology images to diagnose different types of odontogenic cysts (OCs) differentially.Within the scope of the proposed study, hematoxylin and eosin (H&E) stained images of 3 different cyst groups were used. The dataset consists of histopathology images of 87 Dentigerous cysts (DC), 198 radicular cyst (RC), and 63 odontogenic keratocyst (OKC). Each image was zoomed with 3 different zoom levels and resized to 224x224 as preprocessing. In addition to the classical CNN method, Inception V3, VGG16, VGG19, and Xception architectures were used. The data set was split into training, validation, and test groups to avoid retesting.The average accuracy, precision, sensitivity (recall), and F1-Score values obtained for CNN were 0.77, 0.80, 0.77, 0.75, and for VGG16 were 0.89, 0.90, 0.89, 0.89. For VGG19, these values were determined as 0.89, 0.90, 0.89, and 0.88, for Xception, these values were determined as 0.62, 0.52, 0.62,and 0.52 and for Inception, these values were determined as 0.62, 0.62, 0.62 and 0.56.It was observed that VGG16 and VGG19 models showed superior performance on the data set in question, while Xception and Inception V3 models converged slower, meaning the training process progressed slower. Results showed that deep neural networks can be efficiently used in detecting OCs. AI-based OC detection may be a decision support tool that reduces interprofessional variability, expedites the diagnostic process, and lessens clinician workload.
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Multimodal physiotherapeutic management of postoperative complications in orthognathic surgery: a literature review and institutional protocol proposal
(2026) Fernández de la Reguera, Alejandro; Muñoz, Alicia; Sotelo, Ornella; Toledo, Ximena
Orthognathic surgery (OS) corrects skeletal and dental discrepancies in the maxillofacial region, improving occlusion, masticatory function, respiration, and facial aesthetics. However, the immediate and intermediate postoperative periods are frequently associated with acute pain, facial edema, neurosensory disturbances (e.g., paresthesia of the inferior alveolar and/or infraorbital nerves), and restricted mandibular mobility (trismus), which may prolong recovery and impair quality of life. Physiotherapeutic rehabilitation has emerged as a key component of postoperative care, yet standardized guidance remains limited.The objective is to present a standardized, evidence-based physiotherapeutic protocol for managing common postoperative complications after OS, aiming to optimize functional recovery and reduce morbidity.A narrative review of the literature on postoperative physiotherapeutic rehabilitation in OS was conducted, focusing on interventions for pain, edema, neurosensory disturbances, trismus, and bone healing. The protocol was developed within the Postgraduate Program in Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, University of Chile, integrating current evidence and clinical experience.The protocol proposes multimodal strategies-including photobiomodulation, manual therapy, and therapeutic exercises-to address the most frequent postoperative complications. Evidence supports early, structured, and systematic intervention to improve analgesia, accelerate edema resolution, enhance neurosensory recovery, increase mandibular mobility, and promote bone healing.Early, structured physiotherapeutic management is fundamental to postoperative care in OS. The proposed protocol offers a replicable, evidence-based framework to facilitate optimal recovery and functional reintegration.
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Laser treatment of oral vascular anomalies. A retrospective observational study
(2026) Monteiro, Luis; Fazendeiro, Carla; Ferreira, Sara; Delgado, Maria Leonor; Pacheco, José Júlio; Salazar, Filomena
Oral vascular anomalies, though benign, may impact comfort and aesthetics, particularly in visible or functional areas. Laser therapies have gained prominence due to their precision, minimal invasiveness, and favourable outcomes. This study aimed to analyse the laser treatment modalities for oral vascular anomalies and their respective outcomes in a population of the north of Portugal.This retrospective study analysed 111 vascular anomalies in 95 patients treated between January 2011 and May 2025 in the University Clinics of IUCS-CESPU. Data on demographics, type and location of vascular anomalies, treatment (Nd:YAG, CO2 or diode laser), and outcomes were collected.Venous lakes were the most frequent diagnosis (n=77;69.4%) and lip was the most common location (n=81;73%). Induced photocoagulation (IPC) (n=79;71.2%), essentially with Nd:YAG, was the predominant technique. Recurrence was observed in 4 cases (3.6%), healing occurred mostly 21 days (n=88; 79.3%), scar tissue was present in 10 cases (9%), pain was reported in 29 patients (26.1%) (mean of 0.85±0.14), and satisfaction was high (n=103; 92.8%). No major complications were observed. Logistic regression analysis showed that larger vascular anomalies were associated with delayed healing (p=0.009) and scar formation correlated with presence of pain (one day after intervention) (p=0.03) and recurrence (p=0.039).Laser-based management in particular, IPC, is a safe, effective, and well tolerated option for the treatment of small oral vascular anomalies. Prospective studies are encouraged to optimize protocols and standardize the technique.
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Advantages of implantology-related preventive infra-occluded primary teeth extraction in cases of underlying agenesis: a retrospective study of 290 patients
(2026) Leporcq, Adrien; Nicot, Romain; Raoul, Gwenael; Komakli, Yamen; Lauwers, Ludovic
This study aimed to evaluate the impact of preventive infra-occluded primary teeth extraction in patients with dental agenesis on the success of pre-implantation and implantation treatment, and the preservation of alveolar ridge height.This retrospective analysis included 290 patients with dental agenesis treated at Lille University Hospital between December 2019 and January 2024, including 92 patients with infra-occluded primary teeth. Clinical and radiographic data were collected, and the implant outcomes were compared between those who underwent preventive versus delayed extractions.Preventive extraction was associated with 100% preservation of alveolar ridge height and eliminated the need for vertical bone grafting. In contrast, 28% of patients with delayed extractions experienced vertical bone loss and implant infraposition despite complex grafting procedures. The second primary molars were the most frequently infra-occluded (66.5%), mostly at a moderate degree. The median ages at diagnosis, extraction, and implantation were 14, 17, and 18 years, respectively.Compared to delayed extraction, preventive extraction of infra-occluded teeth in agenesis cases facilitates better implant positioning and reduces the need for complex pre-implant surgeries. Timely intervention is key, particularly in the maxilla, to avoid vertical bone loss and implant complications.
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Descriptive transcriptomic profiling differentiates oral leukoplakia from proliferative verrucous leukoplakia and reveals distinct molecular signatures
(2026) Pérez Sayáns, Mario; Silva, Fábio França Vieira e.; Fernández Rozadilla, Ceres; Carracedo Álvarez, Ángel; Carlés González, Silvia; Lorenzo Pouso, Alejandro Ismael; Pérez Jardón, Alba; Gándara Vila, Pilar; García García, Abel; Suárez Peñaranda, José Manuel; Blanco Carrión, Andrés; Chamorro Petronacci, Cintia Micaela
Oral leukoplakia and proliferative verrucous leukoplakia represent oral potentially malignant disorders. Oral leukoplakia typically presents as solitary lesions, while proliferative verrucous leukoplakia manifests as multifocal lesions with higher malignant potential. This study aimed to investigate the genetic heterogeneity between these disorders through differential gene expression, genetic variants, and microRNA profiling to identify potential biomarkers for diagnosis and prognosis.Biopsies and peripheral blood samples were obtained from 20 patients. Subsequently, RNA extraction, RNA-Seq libraries preparation, and bioinformatic analyses were conducted to ascertain differential gene expression, genetic variants, and microRNA expression.In mRNA analysis, overexpressed genes in proliferative verrucous leukoplakia are primarily associated with inflammation and immune regulation, while underexpressed genes relate to skin barrier maintenance. Pathway analysis reveals underexpressed genes related to impaired keratinization in proliferative verrucous leukoplakia and with keratin envelope formation in oral leukoplakia, while overexpressed genes are linked to synaptic processes and protein-protein interactions. Somatic mutation drivers in proliferative verrucous leukoplakia include variants in NRXN3, SRGAP2B, INIP, MYO18A, and ATF7IP genes. Regarding variant analysis, two variants in the Syndecan 3 (SDC3) gene identified in proliferative verrucous leukoplakia have demonstrated enormous value and indicate an important biomarker for a differential diagnosis and to predict prognosis. Proliferative verrucous leukoplakia shows in miRNA analysis MIR1246 and MIR767 overexpression, with MIR135B being the most underexpressed.Our findings emphasize the intricate transcriptomic profiles in oral leukoplakia and proliferative verrucous leukoplakia development, laying the groundwork for future studies to enhance clinical management and patient outcomes in oral oncology. Syndecan 3 gene polymorphisms may represent a key point in proliferative verrucous leukoplakia differential diagnosis and prognostic prediction.
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Is chronological age predictable on panoramic images using the Demirjian method on third molars? Insights from a Turkish population-based study
(2026) Tas, Ayse; Agbulut, Nelli; Oztoprak, Yasemin; Aydin, Kader
Third molars are crucial in forensic age estimation during adolescence due to their late and variable development. The modified Demirjian method employs a nine-stage classification (0-H) for assessing dental maturity. However, population-specific validation is essential for forensic accuracy. This study aims to evaluate the relationship between chronological age and M3 development stages in a Turkish population using panoramic radiographs, and to investigate the influence of gender and anatomical location, including impaction classifications (Pell-Gregory and Winter).A total of 1656 individuals (mean age: 13.9±3.78 years) underwent digital panoramic radiography. Developmental stages of 2770 mandibular and 2553 maxillary M3s were assessed using the modified Demirjian method. Statistical analyses included Spearman correlation, Kruskal-Wallis tests and generalized linear models.Third molar development strongly correlated with chronological age. Most teeth were in stages B-E, with mandibular M3s most frequent in stages C and E, and maxillary in C and D. Age differed significantly across all stages (p<0.001). Generalized linear models confirmed age as a significant predictor (R²=0.330 mandible; R²=0.337 maxilla). Gender and impaction classifications had no main effects, but significant interactions were found (Pell-Gregory×Gender: p<0.001; Winter×Pell-Gregory: p=0.016).The modified Demirjian method reliably estimates age in Turkish adolescents, with high age-stage correlation. While gender and anatomical location alone do not alter developmental progression, their interaction with impaction patterns reveals complex growth dynamics. These findings support context-sensitive forensic protocols.
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An italian multicenter triple-blind randomized controlled trial on photobiomodulation after third molar extraction (BIOSTOTT). A study of Italian society for laser in dentistry (SILO)
(2026) Giovannacci, Ilaria; Romeo, Umberto; Spadari, Francesco; Biasotto, Matteo; Pentenero, Monica; Pedrazzi, Giuseppe; Venuti, Aurora Andrea; Meleti, Marco; Tenore, Gianluca; Pergolini, Daniele; Porrini, Massimo; Bosotti, Moreno; Ottaviani, Giulia; Rupel, Katia; Val, Matteo; Vescovi, Paolo
Surgical extraction of third molars is a common oral and maxillo-facial surgery procedure frequently associated with postoperative complications, such as pain, swelling, and trismus. Photobiomodulation (PBM), also known as Low-Level Laser Therapy (LLLT), involves the use of low-intensity laser to promote tissue healing, reduce inflammation, and relieve pain.This study evaluated the effectiveness of PBM following surgical extraction of mandibular third molars.This was a prospective, multicenter, randomized, triple-blind clinical trial conducted across five Italian centers. Seventy-nine patients were randomly assigned to a test group (PBM) or control group (no PBM). PBM was delivered immediately after surgery and on the following two days, using a multiband diode laser (445, 660 and 970nm).Primary outcomes were postoperative pain, facial swelling, and trismus. Secondary outcomes included health-related quality of life and analgesic consumption.Covariates included patient age, gender, the extracted tooth and the impaction classification according to Pell & Gregory and Winter. The time of the surgical procedure, measured in seconds from incision to final suture, was also documented.Descriptive statistics were calculated for all variables. Normality was assessed using the Shapiro-Wilk test, and homogeneity of variances was evaluated using Levene's test. Between-group comparisons for continuous outcomes were performed using Student's t-test or the Mann-Whitney U test, depending on data distribution. Categorical vari-ables were analyzed with chi-square or Fisher's exact test. A p-value< 0.05 was considered statistically significant.No statistically significant differences were found between groups for any of the measured outcomes. However, trends favored the PBM group, particularly regarding reduced pain and improved quality of life.The study was powered to detect a large effect size (Cohen's d=0.8); therefore, the lack of statistical significance suggests that any true effect, if present, is likely smaller than this threshold. Further studies with larger sample sizes and standardized protocols are needed to explore smaller yet clinically relevant effects.
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The mouth as a window: a multi-center retrospective study of oral extraintestinal manifestations of IBD and their management
(2026) Aristizabal-Torres, Miguel A.; Janovska, Marketa; Loeb, Lauren P.; Ma, Yaohua; Rogers-III, Roy S.; Farraye, Francis A.; Bruce, Alison J.; Chedid, Victor; Hashash, Jana G.; Bodiford, Katherine J.
Up to 50% of patients with inflammatory bowel disease (IBD) have associated oral extraintestinal manifestations (OEIMs). We aim to describe the prevalence of OEIMs in IBD and propose a therapeutic algorithm.Electronic health records of adult patients with IBD who presented with at least one oral symptom between January 2017 and November 2021 at a tri-state tertiary academic medical center were retrospectively reviewed. Data included demographics, IBD history, oral diagnoses, OEIM treatments, clinical outcomes, and comorbidities.A total of 116 patients were included; 67 (57.8%) had Crohn's disease (CD) and 49 (42.2%) had ulcerative colitis (UC). Aphthous ulcers were the most common OEIM (80.2%). Frequently used treatments included compounded or mixed mouthwashes (51.7%), topical corticosteroids (33.6%), systemic corticosteroids (20.7%), and topical anesthetics (19.8%). In CD, colchicine was significantly associated with OEIM improvement (p=0.009). In UC, systemic corticosteroids (p=0.03), colchicine (p=0.048), and topical tacrolimus (p=0.048) were significantly associated with improvement.OEIMs are common in IBD and can influence treatment decisions. Colchicine and topical agents demonstrated benefit in selected cases. These findings support multidisciplinary care and inform a therapeutic algorithm for OEIM management in IBD.
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Cone-beam CT evaluation of impacted mandibular third molars and their possible association with mandibular incisor crowding
(2026) Akkitap, Melda Pelin
The relationship between impacted mandibular third molars and mandibular incisor crowding remains controversial. This study aimed to evaluate whether the impaction pattern of mandibular third molars is associated with lower incisor crowding using cone-beam computed tomography (CBCT).A retrospective sample of 140 patients was analyzed, including 70 with unilateral and 70 with bilateral mandibular third molar impactions. Little's Irregularity Index (LII) was measured on CBCT images to quantify incisor crowding. Arch length, depth, intercanine width, and intermolar width were also recorded. Non-parametric tests were used to compare groups, and intra-observer repeatability was assessed.The mean LII was 9.04.8, with 85% of patients showing some degree of crowding. Bilateral impaction cases presented significantly higher LII scores than unilateral cases (p=0.047). However, no significant differences were found in arch dimensions between groups, and LII was not associated with gender or age. Categorical analysis of crowding prevalence did not differ significantly between unilateral and bilateral groups.Bilateral mandibular third molar impaction showed a weak association with greater mandibular incisor irregularity. Crowding is a multifactorial condition, and CBCT may provide additional insight into its assessment in patients with impacted third molars.
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Oncologic safety of autologous fat grafting in head and neck cancer patients: a scoping review
(2026) Andura-Correas, Martín; Chacón-Ferrer, Guillermo; González Martín-Moro, Javier; Morán Soto, M. J.; Cebrián Carretero, José Luis
Autologous fat grafting (AFG) has become increasingly used in reconstructive surgery due to its accessibility, safety, and regenerative potential. In head and neck cancer (HNC) patients, however, concerns remain regarding its oncologic safety, particularly due to the presence of adipose-derived stem cells (ASCs), which may theoretically influence tumor recurrence. This scoping review aims to synthesize current evidence regarding the safety of AFG in this unique patient population.The review was conducted following the PRISMA-ScR guidelines. PubMed and Scopus databases were searched up to December 2024 using the terms "autologous fat grafting," "lipofilling," "head and neck cancer," and "oncologic safety." Eligible studies included clinical or experimental works reporting on AFG in HNC patients with oncologic outcome assessment. Exclusion criteria included purely aesthetic procedures and studies without relevance to oncologic safety. Data were extracted on study design, patient population, fat grafting technique, follow-up, and reported oncologic outcomes.Five key studies fulfilled the inclusion criteria. Across these works, no evidence of increased recurrence or metastasis following AFG was reported. Favorable functional and aesthetic outcomes were consistently observed, although methodological variability and short follow-up durations limited the robustness of conclusions.Current evidence suggests that AFG is oncologically safe and beneficial for reconstructive purposes in head and neck cancer patients, improving contour and tissue quality. Nevertheless, the lack of large, prospective, and long-term studies precludes definitive recommendations. Standardized protocols and extended oncologic follow-up are essential to confirm safety and guide future clinical practice.
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Use of topical Vitamin E in oral mucositis in patients undergoing oncology treatment. Scoping review
(2026) Sanmartín-Barragáns, Valeria; Vázquez-Rico, Mencia; Camolesi, Gisela; Prado-Pena, Irene B.; García Carnicero, Tamara; Pérez Sayáns, Mario; Blanco Carrión, Andrés; Gándara Vila, Pilar
Oral mucositis (OM) refers to lesions characterized by erythema and ulceration of the oral mucosa, commonly observed in cancer patients undergoing chemotherapy (CT) and/or radiotherapy (RT). Currently, there is no specific therapy supported by robust scientific evidence for the treatment of OM-related lesions. However, the literature suggests that antioxidants such as vitamin E may help prevent oxidative cellular damage and limit tissue injury caused by free radicals, potentially reducing the severity of OM during cancer treatment. This review aims to analyze the existing literature on the use of topical vitamin E and its effects on oral mucositis lesions induced by cancer therapy.This scoping review was conducted in accordance with the PRISMA-ScR guidelines. A comprehensive search was performed in Web of Science (WOS), PubMed, and Scopus databases using the keywords: "vitamin E", "oral mucositis", "chemotherapy", and "radiotherapy". Studies published between 1990 and 2025 were considered for inclusion.A total of 167 articles were identified. After screening and eligibility assessment, 7 clinical trials were included in the review 4 involving pediatric populations and 3 involving adults. Six of the studies reported favorable outcomes in the vitamin E group compared to placebo, including improved healing, reduced symptom severity, and shorter duration of oral mucositis.Based on the studies included in this review, topical vitamin E appears to offer beneficial effects in mitigating the severity and duration of oral mucositis lesions in patients undergoing cancer treatment. However, no standardized protocol currently exists regarding dosage, mode of application (therapeutic vs. preventive), or duration of treatment. Further clinical trials are warranted to establish clear guidelines for the use of topical vitamin E in this context.
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Impact of surgical margins on recurrence and survival rate in patients with oral squamous cell carcinoma: a systematic review and meta-analysis
(2026) Rubert, Andrea; Bagán Debón, Leticia; Proaño, Alex; Sarrión Pérez, María Gracia; Bagán Sebastián, José Vicente
Oral squamous cell carcinoma (OSCC) accounts for approximately 90% of malignant neoplasms of the oral cavity. At early stages, the treatment of choice is surgical resection with clear margins, commonly defined as 5mm of tumor-free tissue. However, the optimal surgical margin in relation to recurrence and survival remains controversial. The objective of this study was to evaluate the impact of surgical margin status on local recurrence and overall survival in patients with OSCC through a meta-analysis.An electronic search was conducted in Medline-PubMed, Web of Science, and Scopus up to January 2025. Two investigators independently selected the studies according to the inclusion criteria. The study included prospective and retrospective studies assessing patients with oral squamous cell carcinoma who underwent surgical treatment and reported data regarding surgical margin status, recurrence rates, and survival outcomes. The Newcastle-Ottawa Scale was used for non-randomized observational studies. Odds ratios were estimated with 95% confidence intervals, and forest plots were generated using random-effects or fixed-effects meta-analyses depending on heterogeneity. Sensitivity analyses and publication bias analyses were performed using funnel plots and Egger's test. All statistical analyses were conducted using Comprehensive Meta-Analysis software, version 3.0.Positive margins (<5mm) were significantly associated with a higher rate of local recurrence (OR=2.72; 95% CI: 2.04-3.62; p<0.001), while negative margins (5mm) were linked to a 1.58 -fold increase in the probability of 5-year survival (RR=0.63; 95% CI: 0.55-0.74; p<0.001).Surgical margin status is a prognostic factor for locoregional control and overall survival in OSCC. A cutoff value of 5mm is proposed as the optimal surgical margin.
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A simplified sagittal split osteotomy of the mandibular ramus: a single-cut approach for orthognathic surgery
(2026) Costa, Samuel Macedo; Bahia, Marcelo Santos; Kadooka, Marcella Yumi; Bertelli Trivellato, Priscila Faleiros; Sverzut, Cássio Edvard; Trivellato, Alexandre Elias
This study aims to evaluate the feasibility, and reliability of a novel simplified sagittal osteotomy (SSO) technique for mandibular repositioning in orthognathic surgery. The research question focuses on whether this approach can reduce technical complexity and complication rates, especially in a residency training environment.A prospective observational study was conducted involving 118 patients (62 females, 56 males) diagnosed with Angle Class II or III malocclusions and indicated for orthognathic surgery. All patients underwent a novel mandibular osteotomy as part of a Double-jaw surgery. Exclusion criteria included patients under 18 years of age, third molar presence, mandibular pathologies, and incomplete follow-up. The primary outcomes included feasibility, complication rates, and the need for conversion to the conventional BSSO. Statistical analysis was performed using the Chi-square test.A total of 236 osteotomies were performed. The technique was considered feasible in 98.7% of cases, with no conversions to traditional BSSO. No bad splits occurred. IAN injury was observed in 0.8% of cases, and long-term paresthesia (>1 year) occurred in 1.2%. No cases of hemorrhage or dental injury were reported. No significant associations were found between complications and patient gender or deformity type (p>0.05).The SSO technique demonstrated high feasibility and a low complication profile, supporting its use as a reliable alternative to BSSO.
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Immediate implant using an inverted body-shift design versus a conventional conical implant: a randomized clinical trial with 1 year follow-up
(2026) Galve-Huertas, Andrea; García-González, Susana; Decadt, Louis; Ortiz Puigpelat, Octavi; Hernández Alfaro, Federico; Aboul-Hons Centenero, Samir
Immediate implant placement is a technique-sensitive procedure, requiring precise positioning on the palatal aspect to ensure ideal prosthetic emergence and contour. Achieving primary stability is essential for the placement of an immediate provisional crown. The Inverted Co-Axis implant is uniquely designed for this purpose, featuring a 12-degree angled neck and a widened middle third, allowing central positioning within the alveolar socket while maintaining primary stability. Given its uncommon use, this study aimed to compare the performance of the Inverted Co-Axis implant with that of a conventional conical implant.A randomized controlled trial was conducted with 30 patients, equally divided into two groups (n=15). Immediate implants were placed in the anterior maxilla, each restored with an immediate provisional crown and accompanied by connective tissue grafting during surgery. Outcomes included implant survival, success rates, primary stability (insertion torque, ISQ), bone remodeling, and aesthetic results. Statistical analysis comprised descriptive measures (mean, SD, median, quartiles) and appropriate inferential tests: Mann-Whitney U, Wilcoxon signed-rank, Student's t-test, Chi-square, Kruskal-Wallis, Spearman's correlation, and Brunner-Langer. Significance was set at =0.05.All implants survived (100% survival rate). Success rates were 93.3% in the control group and 73.3% in the test group, with no statistically significant difference. Insertion torque averaged 35 Ncm (control) and 42 Ncm (test), with ISQ values between 56-62 in both groups. Minimal horizontal bone loss was observed at 1mm, 3mm and 5mm. Vertical bone loss was greater on the buccal aspect in the test group, while palatal loss was higher in the control group. Aesthetic evaluation via the Pink Esthetic Score yielded comparable results.Both implant designs proved effective and reliable for immediate post-extraction implantation, with favorable outcomes in stability, bone preservation, and aesthetics.
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Clinicopathological spectrum of non-sinonasal intestinal-type adenocarcinomas of the head and neck: systematic review of case reports, case series, and cross-sectional studies
(2026) Vieira, Gustavo de-S; A Gonçalves, Moisés W.; Tincani, Priscila C.; Tincani, Alfio J.; Chone, Carlos T.; Antolini-Tavares, Arthur; Altemani, Albina; Mariano, Fernanda Viviane
Intestinal-type adenocarcinomas (ITACs) most often arise in the sinonasal tract, typically associated with occupational exposures, but they rarely occur in other head and neck sites. When present in extra-sinonasal regions, their clinicopathological and molecular characteristics remain poorly understood. This systematic review aimed to clarify the clinicopathological, immunohistochemical, and molecular features of non-sinonasal intestinal-type adenocarcinomas (ITACs) of the head and neck.This review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD42022309841). Two reviewers independently screened, extracted data, and assessed risk of bias using the Joanna Briggs Institute tools. Sources included PubMed/MEDLINE, Scopus, Embase, Web of Science, Google Scholar, and OpenGrey. A comprehensive search identified 1,376 records. After applying eligibility criteria, 26 studies comprising 37 cases were included. Data on clinical, histological, immunophenotypic, molecular, and prognostic features were analyzed.Most patients were male (73%), with a mean age of 57.9 years. The oral cavity, particularly the mobile tongue (51.4%), was the most commonly affected site. Histologically, colonic (59.5%) and mucinous (56.8%) architectures were the most frequent microscopic patterns presented. Immunohistochemistry frequently showed positivity for CK7, CK20, and CDX2, while SATB2, MUC1, and MUC5AC had variable expression. Mismatch repair proteins were intact in all cases. Molecular findings included mutations in MLL3, TP53, EGFR, and AKT1, and upregulation of PAX1, MUC5B, and EMT-related genes, suggesting a distinct profile from sinonasal ITACs. Surgical resection, often with adjuvant therapy, was the main treatment. Tumors were aggressive, with metastases being present in 35.1% and disease-specific mortality in 24.3%.Non-sinonasal ITACs are rare, aggressive malignancies requiring accurate diagnosis and further molecular investigation to improve management and outcomes.
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Directed pterygomaxillary disjunction versus direct downfracture in Le Fort I osteotomy: application of a fracture quality framework using bilateral ten-point cone-beam computed tomography in a retrospective cohort of 205 patients
(2026) Aragón Niño, Íñigo; del Castillo Pardo de Vera, José Luis; Cebrián Carretero, José Luis; López Martínez, Clara; Tapia Salinas, Blanca; Zheng, Chongyang; Navarro Cuéllar, C.
Control of the pterygomaxillary junction (PMJ) fracture is critical in Le Fort I osteotomy. We tested whether a directed PMJ disjunction (osteotome-assisted intermediate release) improves fracture quality, symmetry, and alignment versus direct downfracture.Single-center retrospective comparative cohort (January 2019-April 2025). Two hundred five consecutive patients underwent Le Fort I: directed disjunction (n=127) or direct downfracture (n=78). Postoperative cone-beam computed tomography at day 90-110 was scored with a bilateral ten-point map. Primary outcomes were per-side quality (poor/good/excellent) and a patient-level overall quality status (poor/fair/good/very good/excellent). Inclusive and strict "clean-cut," symmetry, and alignment were predefined. Group comparisons used chi-square or Fisher's exact tests (two-sided =0.05).Directed disjunction shifted side-level quality toward inferior, contained patterns: "excellent" 59.1% vs 6.4% (right) and 48.0% vs 12.8% (left); "poor" 22.0% vs 91.0% and 29.9% vs 85.9% (all p<0.001). Patient-level status improved (poor 38.6% vs 98.7%; excellent 37.8% vs 1.3%; p<0.001). Perfect symmetry rose to 49.6% vs 1.3% and correct alignment to 61.4% vs 1.3% (p<0.001). Maxillary tuberosity involvement decreased from 60.3%/56.4% (right/left) without disjunction to 2.4%/5.5% with disjunction. Inclusive and strict clean-cut were higher with directed disjunction (69.3% vs 37.2% and 53.5% vs 9.6%; p<0.001).Within a standardized early postoperative window, directed PMJ disjunction was associated with superior fracture quality, greater bilateral coordination, and fewer undesired trajectories than downfracture. Adoption of a targeted release and standardized reporting is supported. Interpretation is limited by the retrospective single-center design and focus on fracture behavior without complication or long-term outcome analysis.
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Proposed modified Brandwein-Gensler histological risk assessment score as prognosticator in oral squamous cell carcinoma
(2026) Sharma, Deepti; Gupta, Shruti; Koshy, George; Kwatra, Kanwardeep Singh; Sharma, Vishal Kumar; Kaur, Atampreet
Histopathological parameters significantly impact the prognosis and treatment strategies of oral squamous cell carcinoma (OSCC). Various risk assessment scores and grading systems have been proposed in the past, primarily based on subjective assessment of microscopic features. To modify Brandwein-Gensler risk score by including the worst pattern of invasion-5, perineural invasion and percentage stromal tumor infiltrating lymphocytes(TILs) and evaluate the relationship of the modified score with clinicopathological variables.This retrospective observational study was conducted on 58 OSCC patients. The density of stromal TILs was determined on routine microscopic sections using image analysis software, thereby quantifying lymphocytic host response as percentage stromal lymphocytes. Furthermore, the modified Brandwein-Gensler risk score was derived from the assessment of the worst pattern of invasion-5, perineural invasion and percentage stromal tumor infiltrating lymphocytes. Chi-square test and Univariate analysis were used to find the association of categorical and continuous variables. The Kaplan-Meier and log-rank tests were used to estimate the survival rates.A significant positive association of modified Brandwein-Gensler score was observed with pathological node (p=0.005), tumor grading (p=0.025), depth of invasion(p=0.016) and overall survival (p=0.03), signifying that high score tumors showed poor differentiation, invasive features and lower survival time.A modified, simplified and objective version of Brandwein Gensler histological risk assessment score is derived, revealing a significant association with tumor differentiation, depth of invasion and lymph node involvement.
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Comparison of five anesthetic delivery systems for palatal infiltration: a randomized clinical trial
(2026) Küçükkurt, Sercan; Saadat, Ashkan
Pain and anxiety during palatal infiltration remain barriers to patient cooperation. The anesthetic delivery system may influence subjective outcomes and physiological stress responses, yet robust comparative data are lacking.In this randomized, parallel-arm superiority trial, 200 healthy adults (18 years) were equally allocated into five groups (n=40) by block randomization with concealed allocation. Tested systems were conventional dental syringe (CDS), manual pressure syringe (MCJ), spring-activated pressure syringe (PCJ), needle-free jet injector (NFI), and computer-controlled local anesthetic delivery system (CCLAD). Each participant received 0.4 mL of 4% articaine with epinephrine (1:100,000) via standardized palatal infiltration by a single calibrated operator. The study was single-blind: outcome assessors and statisticians were blinded to allocation. The primary outcome was post-injection pain (VAS, 0-10cm). Secondary outcomes were dental fear (VAS pre/post), pulse rate, and oxygen saturation, recorded at baseline, during, and after injection.Mean VAS pain did not differ significantly across groups (overall p=0.380); adjusted analyses (ANCOVA including injection duration as covariate) confirmed no clinically relevant mean differences [95% CI within ±0.5 cm; Hedges' g <0.20]. MCJ showed slightly higher discomfort. All systems significantly reduced fear (p<0.05), with PCJ showing the largest reduction (VAS-2.7). Pulse rate varied across groups (p<0.001), peaking in CCLAD and remaining most stable in MCJ; oxygen saturation was unchanged. No adverse events were observed.All systems were clinically safe and effective but differed in psychophysiological impact. Devices that reduce fear and stabilize vital responses, particularly those targeting PCJ and CCLAD, may help improve patient cooperation and the overall treatment experience.
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Autogenous dentin grafts in implant dentistry: a scoping review of clinical applications and processing protocols
(2026) Braga, Yuri Freires; Maferano, Eduardo Frederico Eduardo; Lopes, Timóteo Sousa; Neto, Miguel Ribeiro-do-Nascimento; Velez Macas, Luis Eduardo; Costa, Fabio Wildson Gurgel
This scoping review aimed to systematically map and synthesize the current evidence regarding the use of autogenous dentin grafts (ADG) in bone augmentation procedures.The review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A comprehensive search was performed in MEDLINE (PubMed), EMBASE, CINAHL, Cochrane Library, Livivo, LILACS, Web of Science, Scopus, and ProQuest Dissertations & Theses Global Google Scholar (gray literature) using the descriptors "Bone Regeneration," "Dentin," and "Dental Implants" combined with the Boolean operator and 7,690 studies identified through Google Scholar.The initial search, conducted on December 23, 2024, retrieved 2,391 records, of which 16 met the eligibility criteria and were included in the final review. The findings indicate that autogenous dentin demonstrates efficacy in bone regeneration and alveolar ridge preservation, frequently exceeding the performance of allografts and xenografts. ADG was associated with increased bone density, enhanced implant stability, and improved soft tissue outcomes, particularly when combined with growth factors. Moreover, it was found to be a cost-effective alternative, producing outcomes comparable to other biomaterials regarding new bone formation and bone quality. Its osteoinductive properties further support long-term bone regeneration.Nonetheless, a lack of standardization in dentin processing protocols was noted across studies. ADG represents an effective and accessible option for implant-supported rehabilitation, and future research should focus on standardizing its clinical application.