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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2025. Vol. 30, no. 03
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- Dimensional changes in buccal cortical bone and lesion volume in teeth with persistent chronic periapical disease subjected to periapical surgery: a cone beam computed tomography study at one year of follow-up(Medicina Oral S.L., 2025) Boronat-López, A.; Bernabeu-Mira, JC.; Peñarrocha-Diago, M.; Peñarrocha Oltra, DavidThis study aimed to evaluate changes in buccal cortical bone and lesion volume in teeth with persistent periapical disease one year after periapical surgery using cone-beam computed tomography (CBCT). A prospective study was conducted involving patients with persistent periapical disease undergoing periapical surgery, with one year of follow-up. Data collected included patient age, gender, teeth involved, and the number of roots/lesions. CBCT measurements were taken preoperatively and one year post-surgery, including the distance from the cementoenamel junction to the buccal bone crest (CEJ-BBC), marginal bone loss, buccal cortical height, presence of fenestration, apical depth, cortical bone width at 1, 3, and 5 mm from the buccal bone crest, and lesion volume in mm³. Success was assessed using the “Modified Penn 3D criteria.” The study included 92 patients with 111 roots exhibiting persistent chronic periapical lesions. Statistically significant changes were observed in all buccal cortical bone parameters one year after surgery. The CEJ-BBC distance increased, indicating a marginal bone loss of 0.23 mm. Notably, the height from the buccal cortical bone crest to the lesion, apical depth, buccal bone thickness, the number of fenestrations, and lesion volume decreased (91.1%). Buccal cortical bone thickness was a predictor of volume reduction, showing a significant relationship at T1 between greater thickness and smaller volume variation. Patient age and gender did not significantly influence these changes. Fenestrations and larger lesion volumes correlated with reduced healing probabilities. The overall success rate was 88%, with tooth position and root involvement impacting healing outcomes. One year post-surgery, buccal cortical bone showed no clinically relevant changes, while lesion volume decreased by 91.1%, more significantly in anterior teeth. Greater buccal cortical bone width was associated with smaller volume reduction. A larger lesion volume and presence of fenestrations adversely affected healing rates.
- Assessing nerve injuries in oral surgery: a survey-based study on prevention and management(Medicina Oral S.L., 2025) Agbulut, NelliUnderstanding and mitigating iatrogenic nerve injuries, specifically IAN and LN, is crucial in the field of oral and maxillofacial surgery. These injuries may lead to profound sensory deficits, pain syndromes, and impaired quality of life for patients. This study aims to assess the prevention and management practices for inferior alveolar nerve and lingual nerve injuries among dental professionals. By gathering data through a survey, the study seeks to evaluate current experiences, awareness, and protocols, ultimately contributing to improved guidelines for nerve injury management. This cross-sectional study utilized an online survey distributed via Turkish Dental Association to registered dentists and specialists. The predictor variables were the procedure types associated with nerve injuries. The main outcome variables were preventive measures and patient management strategies. Demographic profiling including age, years in profession, specialty, and type of current workplace were determined as covariates. 1477 respondents provided complete answers, with questions addressing demographics, nerve injury incidents, preventive measures, and management strategies. The most reported IAN and LN injuries were linked to dental implant surgery (n=1067), mandibular third molar surgery (n=958), and local anesthesia applications (n=459). Interestingly, more than 30% of participants reported no experience with nerve injuries. For preventive measures in tooth extraction, 281 respondents performed coronectomies, and in implant surgery over 80% of the participants evaluated tomographic images in high-risk cases. Most common management strategies for paresthesia included vitamin B12 (n=1093) and NSAIDs (n=1051). The use of gabapentin, and non-medical treatments like biofeedback and alternative therapies were rarely employed. The survey revealed a diverse range of practices regarding nerve injury prevention and management, emphasizing the need for evidence-based approaches and consensus guidelines. Understanding current practices for managing IAN and LN injuries can inform future guidelines, reduce complications, and improve patient outcomes in oral and maxillofacial surgery.
- Endoscopic litectomy: optimizing the management of sialolithiasis(Medicina Oral S.L., 2025) Almeida-Parra, F.; Ranz-Colio, Á.; Bueno-de-Vicente, Á.; Cárdenas-Serres, C.; de Leyva-Moreno, P.; Acero-Sanz, J.Sialolithiasis of the salivary glandular complex appears with high frequency in the major salivary glands. The most affected salivary gland is the submandibular gland, followed by the parotid and sublingual glands. The treatment of this disease by endoscopic litectomy has reduced the need of adenectomy. We reviewed retrospectively a series of 77 patients who had salivary gland stones between January 2020 and January 2024. Inclusion criteria for endoscopic treatment was lithiasis smaller than 8 mm. Follow-up was performed at a week, one month and three months after the surgery by clinical examination with a mean follow-up of 17 months and CT in selected cases. Treatment was successful in 69 cases, while in 8 patients the treatment failed, with a successful extraction of the stone in 89.61% of patients. A total of 74 stones were removed from 69 patients. The mean stone size was 6.68 mm (range 3 to 8 mm), located mainly in hilum (n=61, 75.60%), median duct (n=14, 17.07%) and retrocaruncular (n=6, 7.31%). Adenectomy, due to failure of the procedure, was performed in 10 patients, 7 in patients due to lack of recovery of the sialolith and in 3 patients due to postoperative stenosis after removal of the sialolith. Complications involved 6 patients with the presence of stenosis after the lithectomy procedure, in 3 patients it was resolved with endoscopic dilation and in the other 3 an adenectomy was necessary. Minimally invasive intraoral surgery has high success rate, contributes to reduce the need for glandular radical surgery with a low rate of severe complications.
- Emotional states in patients with cancer or with suspected oral potentially malignant disorders: a cross-sectional study in an oral medicine setting(Medicina Oral S.L., 2025) Bazzano, M.; Mauceri, R.; Marcon, G.; Coppini, M.; Montemaggiore, D.; Campisi, G.This cross-sectional study aims to investigate the emotional states (i.e., anxiety, depression, and stress) of 4 distinct groups of patients attending an Oral Medicine setting. four distinct subgroups of patients have been enrolled: 25 patients with OSCC (OSCC group); 25 patients with other solid tumor (ONCO group), 25 cancer patients with MRONJ (MRONJ group), 25 patients with oral potentially malignant disorder (OPMD group). Standardized assessment tools (i.e. Beck Depression Inventory (BDI) and Depression Anxiety Stress Scales-21 (DASS-21) questionnaires) were utilized to evaluate the patients’ emotional states. Among the 100 patients enrolled, 59% of whom were female, and most patients were aged between 70 and 80 years. The mean total BDI score was 16.57, and the mean total DASS-21 score was 15.32. The mean scores of the OSCC group showed moderate depression, all the other groups were classified as mild depression. The OPMD group showed a significantly higher level of anxiety. Patients in the oral medicine setting may face various diseases and may develop emotional states that affect their treatment adherence. For effective management of these emotional states, the presence of a multidisciplinary team, including a psychologist, and the adoption of individualized approaches, seem to be necessary.
- Epithelial salivary gland neoplasms in pediatric patients: a comprehensive review(Medicina Oral S.L., 2025) Pérez-de-Oliveira, ME.; Sousa-Neto, SS.; Vargas, PA.Salivary gland tumors (SGTs) are a rare group of neoplasms in pediatric patients, characterized by diverse histological subtypes and distinct biological behaviors. This manuscript aims to provide a comprehensive overview of the demographic, clinical, and histopathological characteristics of SGTs in this population, with the goal of enhancing understanding of their presentation and implications for treatment. An updated descriptive literature review was performed to identify studies reporting the clinicopathological features of epithelial SGTs in pediatric patients. SGTs in pediatric patients are slightly more prevalent in females and typically arise during the second decade of life. The parotid gland is the most commonly affected site for both benign and malignant tumors, which usually present as an asymptomatic mass. Pleomorphic adenoma and mucoepidermoid carcinoma are the most frequently observed entities. Surgical intervention remains the primary treatment modality, and the overall prognosis is generally favorable. This review highlights that SGTs in pediatric patients present distinct clinical features and prognostic outcomes compared to adults. Although they are rare in this age group, clinicians should remain vigilant to these neoplasms when assessing nodular masses in both major and minor salivary glands.
- Effects of ozone therapy on postoperative pain, swelling, and trismus caused by surgical extraction of unerupted lower third molars: a double-blinded split-mouth randomized controlled trial(Medicina Oral S.L., 2025) Almeida RB.; Campos FU.; Ramacciato JC.; Peruzzo DC.; Fernandes GV.; Joly JC.; Sperandio M.Third molar extraction surgery is a common procedure, but it results in pain, swelling, and trismus. Ozone therapy (Oz) has emerged as a viable option for pain control and as an option to limit bacterial growth, improving the wound healing. Then, this randomized controlled trial aimed to evaluate the effectiveness of adjunctive use of ozone therapy (OzT) in managing pain, swelling, and trismus after lower third molar removal. A split-mouth design was selected, enrolling 60 patients. There were 2 groups (Sham and OzT). The same surgeon performed all procedures. The pain was evaluated using the VAS scale and the number of paracetamol Tablets taken. The quality of life was assessed using the OHIP-14 questionnaire. The data were statistically evaluated. 120 surgical procedures were performed on 60 participants (34 males [56%] and 26 females [44%]). Regarding the number of paracetamol Tablets taken, the test group had a significantly lower consumption (p<0.002). In addition, the test group presented a significantly lower pain score on days 1, 3, and 5 postoperatively, with no difference between groups on the 7th day (p<0.0145). Both sides presented postoperative edema, which regressed from day 5 (no significant difference). A similar case scenario was observed for mouth opening. OzT impacted the patient’s quality of life (OHIP-14, p<0.05), favoring ozone therapy. The results demonstrated that OzT is an effective adjunctive strategy for reducing postoperative pain following the extraction of lower third molar teeth.
- Bibliometric analysis in Scopus of scientific production on the relationship between periodontitis and gastrointestinal cancer (2014 - 2023)(Medicina Oral S.L., 2025) Asmat-Abanto, AS.; Portocarrero-Reyes, A.; Espejo-Carrera, RE.; Minchón-Medina, CA.; Timaná-Palacios, DJ.Recent studies have suggested that some opportunistic periodontal pathobionts have oncogenic properties. However, few bibliometric studies investigate the relationship between periodontitis and gastrointestinal cancer. This bibliometric study aimed to analyze these epidemiological studies conducted between 2014 and 2023 to guide future research. In March 2024, the Scopus database was explored. The articles selected were subjected to a bibliometric analysis of study designs, trends in annual scientific production, and networks of collaboration among countries. Furthermore, the most outstanding countries, academic institutions, authors and journals with the most significant number of publications and the top most cited articles were analyzed. For this purpose, Microsoft Excel, SPSS and VOSviewer 1.6.20 were used. A total of 123 documents were included for analysis. China contributed the most significant number of publications (33 articles) and the United States had the most significant number of citations (2709). Weimin Ye (h-index:81) and Dominique Michaud (h-index:73) were the most prolific authors (5 articles); Dominique Michaud also had the most citations (470). International Journal of Cancer was the journal with the highest number of articles published (6), in addition to being the publication that had the most citations of these articles (409). Tufts University in the United States had the highest number of citations. Between 2014 and 2023, 123 articles on the relationship between periodontitis and gastrointestinal cancer were published. The largest scientific production was found in China, and the most cited articles were those from the United States. Likewise, the research design most commonly used was the cross-sectional type.
- Association between prediabetes and periodontitis: a meta-analysis of observational studies with multivariate analysis(Medicina Oral S.L., 2025) Zhou, Y.; Sun, F.; Zhu, Q.Growing evidence suggests that prediabetes may increase the risk of periodontitis, though the extent of this association remains unclear. To provide a clearer understanding, this meta-analysis focused on observational studies that utilized multivariate analyses to adjust for key confounding factors. A comprehensive search of PubMed, Embase, and Web of Science was conducted to identify observational studies assessing the relationship between prediabetes and periodontitis. Only studies that utilized multivariate analyses were included to minimize confounding bias. The quality of the studies was evaluated with the Newcastle-Ottawa Scale (NOS). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model, with heterogeneity assessed by the I² statistic. Ten observational studies with 38,727 participants were included. Overall, individuals with prediabetes had a significantly higher risk of periodontitis compared to normoglycemic individuals (OR: 1.27, 95% CI: 1.09 to 1.48, p < 0.001) with moderate heterogeneity (I² = 53%). Subgroup analyses revealed a stronger association in studies where the proportion of men was < 45% compared to those ≥ 45% (OR: 1.75 vs. 1.15, p for subgroup difference = 0.01). Studies with lower quality (NOS score = 7) showed a stronger association compared to higher-quality studies (NOS score = 8 or 9, p for subgroup difference = 0.003).Conclusion: This meta-analysis found that prediabetes may be independently associated with an increased risk of periodontitis. Further research is needed to explore the mechanisms underlying this association and potential sex-specific effects.
- Severity, extent, distribution and predisposing factors of gingival recession in Turkish patients: a cross-sectional study(Medicina Oral S.L., 2025) Çelik, H.; Güngörmek, HS.The aim of this cross-sectional study was to assess the extent, severity, distribution and potential predisposing factors of gingival recession (GR), utilizing a questionnaire and clinical periodontal measurements obtained from Turkish patients. A total of 534 subjects were examined. Participants meeting the inclusion criteria evaluated by dental hygiene habits, educational level, smoking habit and past orthodontic treatment. Plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing (BOP), clinical attachment level (CAL), gingival thickness (GT), high frenum attachment, and mobility were recorded on the tooth with GR. Probe transparency (PT), crown width/crown length ratio (CW/CL), papilla height (PH) and height of gingival scallop were measured on the index tooth (#11FDI). The GR severity was categorized by using Miller’s classification. Of the 534 individuals examined in this study, 376 (70.4%) had gingival recession, while 262 patients (49%) were meeting the inclusion criteria and 2,721 teeth (37%) were affected. The majority of the teeth (44.8%) showed Miller class I. The highest GR frequency was detected in incisors (39.5%), particularly in mandible. The correlation between GR and PI (p=0.025), PD (p=0.034), PH (p=0.007), CW/CL (p=0.009), CAL (p0,05), tooth brushing frequency (p>0,05) and gingival recession. Gingival recession is a multifactorial condition significantly influenced by clinical and anatomical parameters such as PI, PH, CW/CL, PT while toothbrushing habits, including duration and frequency, appear to have a minimal impact.
- The interaction between third molars and surrounding periapical tissues in mandibular stress distribution during high-impact trauma: a finite element study(Medicina Oral S.L., 2025) Nogueira, CB.; Costa, FW.; Carvalho, FS.; Bezerra, TP.; Neto, IC.; Júnior, FI.; Soares, EC.The presence of mandibular third molars has been associated with the risk of mandibular fractures, highlighting the need for comprehensive studies considering the interaction with other mandibular structures. This study investigates how mandibular third molars and neighboring tissues can influence the structural fragility of the mandible using finite element analysis. A finite element analysis study following the guidelines proposed by RIFEM 1.0 was performed using three previously created mandible models: Model A, without right and left third molars; Model B, without one third molar; Model C, with bilateral presence of third molars. A 2452N force was applied to the right mandibular body in a virtual environment, allowing for a structural analysis of each mandible. Models without third molars and with only one third molar showed similar energy dissipation patterns, contrasting with the model with both third molars. The presence of third molars influenced the magnitude and distribution of stress, highlighting fragility points in specific areas such as the lingual surface, the condyles bilaterally (models without and with one contralateral third molar to trauma), and the distal cervical region of the second molar (third molar absent), as well as significantly showed the path of energy towards the contralateral side of the trauma with a concentration of energy at the contact points of virtually all teeth present immediately after impact. The presence of mandibular third molars influenced the distribution and magnitude of stress within the mandible during a simulated high-impact trauma. Models with third molars exhibit distinct stress patterns, with fragility points appearing in critical areas such as the lingual surface, condyles, and second molar regions. These findings suggest that the presence of third molars increases the structural fragility of the mandible, potentially elevating the risk of mandibular fractures, especially in the context of traumatic impacts.
- State of knowledge of the relationship between celiac disease and oral pathology: a scoping review(Medicina Oral S.L., 2025) Martín-Masot, R.; Ramos-García, P.; Torcuato-Rubio, E.; Pérez-Gaspar, MI.; Navas-López, VM.; González-Moles, MÁ.; Nestares, T.Celiac disease (CD) is a systemic disorder characterized by an enteropathy of highly variable clinical expression, in which the relationship with oral pathology has not yet been fully elucidated. We aimed to update the current knowledge on oral manifestations in CD, to identify evidence gaps and to point out future research lines. PRISMA-ScR guidelines were followed. MEDLINE/PubMed, Embase, Web of Science and Scopus were searched for primary-level observational studies to analyze the prevalence of oral pathology in CD patients, without language or publication date restrictions. We included 107 studies, encompassing a total of 26148 celiac patients and 36063 controls. Our results point to several oral pathologies with higher prevalence in CD patients than in healthy controls, most notably recurrent aphthous stomatitis (RAS)(n=69 studies/12606 celiac patients), developmental enamel defects (n=61 studies/5037 patients), dental caries (n=33 studies/2730 patients), delayed eruption (n=12 studies/1062 patients), atrophic glossitis (n=10 studies/1062 patients), angular cheilitis (n=7 studies/10606 patients), gingivo-periodontal diseases (n=7 studies/1122 patients), and Sjögren's syndrome (n=5 studies/953 patients). CD is frequently associated with oral pathologies, including RAS, dental caries, gingivitis, decreased salivary flow, dental enamel defects and some relevant autoimmune processes, such as oral lichen planus and probably Sjögren's syndrome.
- Oral side effects of fluoxetine in patients with depressive disorder: a systematic review(Medicina Oral S.L., 2025) Pérez, MG.; Jiménez Soriano, Yolanda; Bagán Debón, Leticia ; Bagán Sebastián, José VicenteSelective serotonin reuptake inhibitors (SSRIs) are the preferred drugs for treating depression, a condition that has become increasingly prevalent in recent years. Fluoxetine is one of the most widely used SSRIs; however, like other antidepressants, it can cause various systemic and oral adverse effects. This systematic review aimed to analyze the frequency of oral adverse effects associated with fluoxetine compared to other antidepressants. A systematic review was conducted following PRISMA guidelines. A comprehensive literature search was performed in MEDLINE via PubMed, Scopus, The Cochrane Library, and Web of Science, with no date restrictions, including randomized clinical trials and observational studies. The risk of bias was assessed using the Revised Cochrane Risk-of-Bias Tool for randomized trials. A total of 333 articles were identified. After removing duplicates and applying inclusion criteria, 31 randomized clinical trials were selected for analysis. Fluoxetine was primarily compared with tricyclic antidepressants, SSRIs, serotonin-norepinephrine reuptake inhibitors, and other antidepressants. The most frequently reported oral side effect was dry mouth, with prevalence rates ranging from 2.71% to 52.17%, though it was generally lower than with other antidepressants. Dysgeusia was less frequently reported, with only two studies documenting taste alterations. Oral side effects were primarily assessed through subjective patient reports, and no studies incorporated objective salivary flow measurements. Other adverse effects, such as nausea and vomiting, were commonly mentioned, but their potential oral consequences were not evaluated. Fluoxetine is associated with oral side effects, with dry mouth being the most frequently reported. However, data on dysgeusia remain limited, highlighting the need for further research to determine its prevalence. Given the potential impact of dry mouth on oral health and quality of life, future studies should incorporate objective salivary measurements and further investigate the clinical implications of these adverse effects.
- Oral Medicine in Latin America and the Caribbean: a comprehensive survey of recognition, training, and practice(Medicina Oral S.L., 2025) Saldivia-Siracusa, C.; González-Pérez, LV.; Rivera, C.; Guevara, DP.; Aviles, D.; Piemonte, ED.; Garcia, EC.; Contreras-Vidaurre, E.; Anaya-Saavedra, G.; Pérez, GG.; Gómez, GG.; Rios, I.; Espinal, LP.; Londoño, NA.; Rejas, RA.; Epifanio, NA.; Mora, NA.; Celhay, NA.; Lopes, NA.; Santos-Silva NA.This study aimed to investigate the scope of training and practice in Oral Medicine in Latin American and Caribbean countries. It explored legal, professional, and academic scope of regional OM practice, as well as current challenges perceived by experts in the field. We employed an observational, cross-sectional approach, utilizing a self-administered questionnaire delivered through the REDCap web platform. Oral Medicine is officially recognized as a dental specialty in 66.7% of Latin American and Caribbean countries, and 66.7% countries recognize it as a standalone field, separate from Oral Pathology. Additionally, 23.8% of the surveyed countries have national postgraduate Oral Medicine programs. Nearly half (47.6%) of the countries lack specific regulations, and there is significant variation in understanding clinical competencies. Private practice emerged as the dominant field of work for Oral Medicine practitioners. Notably, 90.5% of respondents identified the lack of recognition by multidisciplinary teams as a significant barrier to the practice. This study provides information on the current landscape of Oral Medicine practice in Latin American and Caribbean countries. It highlights disparities in recognition, regulation, and performance of the specialty. These findings call for international initiatives aimed at enhancing training pathways, scope of practice and the impact of Oral Medicine in the region.
- Association between rheumatoid arthritis and periodontitis: a study based on a two-sample mendelian randomisation analysis(Medicina Oral S.L., 2025) Cai, Q.; Li, C.; Quan, Z.; Yang, X.; Chen, T.; Han, X.; Xu, X.The association between Rheumatoid arthritis (RA) and Periodontitis (PD) has been increasingly recognised, yet traditional epidemiological studies face challenges in establishing associations. Therefore, this study aims to genetically assess the association between RA and PD through Mendelian randomisation (MR) analysis, using genetic variations as instrumental variables. Data on RA and PD were downloaded from the EBI website. The RA data contained 8,255 cases and 409,001 controls, with a total of 24,175,266 SNPs; the chronic PD data contained 950 cases and 409,001 controls, with a total of 11,842,647 SNPs; the acute PD data contained 128 cases and 456,220 controls, with a total of 11,842,647 SNPs. Additionally, the potential association between RA and PD was investigated. The intercept between Mendelian randomisation (MR)-Egger regression, MR-PRESSO test results and funnel plots was used to analyse the horizontal pleiotropy of SNPs along with the effect of individual SNPs on inverse-variance weighting (IVW) analysis results, assessed using the leave-one-out method. In total, 26 SNPs highly associated with RA were screened; MR-Egger regression (OR=1.242, 95% CI (1.032-1.494), P=0.031), WM (OR=1.190, 95% CI (1.015-1.395), P=0.032), IVW (OR=1.191, 95% CI (1.053-1.348), P=0.006) and weighted mode (OR=1.212, 95% CI (1.043-1.409), P=0.019) suggested that RA was a likelihood factor for chronic PD, whereas RA was not associated with the incidence of acute PD, and the Cochran’s Q test indicated no statistical heterogeneity between SNPs highly associated with RA. Moreover, analyses using the intercept between the MR-Egger regression, MR-PRESSO test results and funnel plot revealed no horizontal pleiotropy in SNPs highly associated with RA. Rheumatoid arthritis was genetically identified as a likelihood factor for PD and the onset of chronic PD, but no association was observed between RA and acute PD.
- Efficacy of platelet-rich-fibrin for the treatment of alveolar osteitis: a systematic review and meta-analysis(Medicina Oral S.L., 2025) Ávila-Oliver, C.; Veloso, V.; Laissle, G.; Rojas, AM.; Verdugo-Paiva, F.; Ramos-Rojas, J.This systematic review aims to provide an updated summary of the available evidence on the role of platelet-rich fibrin (PRF) in the treatment of alveolar osteitis. Searches were conducted in several electronic databases, including PubMed, EBSCO, Cochrane Central Register of Controlled Trials (CENTRAL) LILACS and ClinicalTrials.gov. No date or language restrictions were applied. Two reviewers independently evaluated eligible studies according to predefined criteria and extracted data using a standardized form. Meta-analyses were performed to estimate results and the certainty of evidence, using the GRADE approach, was assessed. The search strategy yielded 1.706 references. Finally, 4 randomized trials were included and assessed quantitatively. Overall, the risk of bias was low for 75% of the domains reviewed across studies. The studies included a total of 179 patients, where the intervention group received PRF, and the control group received several treatment alternatives, including iodoform gauze, zinc oxide eugenol, and saline solution. Results showed that the use of PRF may decrease pain severity measured on day 3 (MD -1.66, CI 95%, -4.11 to 0.78) and on day 7 (MD -1.57, CI 95%, -4.00 to 0.88), and improves alveolar socket healing (SMD 2.25; 95% CI 1.70 to 2.80; p<0.00001; I2=12%). The results of this study demonstrate that PRF improves alveolar healing, reduces analgesic use in patients, and likely increases overall clinical efficacy, making it a valuable alternative in the treatment of alveolar osteitis. Despite these findings, this review also showed a great degree of uncertainty on the impact of PRF on pain severity associated with alveolar osteitis. Although these results are promising, further randomized clinical trials with standardized methodologies must be performed to validate these findings.
- A comparison of piezoelectric surgery and conventional techniques in the enucleation of cysts and tumors in the jaws: a systematic review and meta-analysis(Medicina Oral S.L., 2025) Suárez-Pérez, L.; Peralta-Mamani, M.; Velázquez-Cayón, RT.Despite the comprehensive classifications provided by the WHO, the most common lesions include radicular cysts, dentigerous cysts, odontogenic keratocysts, ameloblastomas, and odontomas. The piezoelectric technique has shown effectiveness in removing intraosseous pathologies by relying on ultrasonic microvibrations, which help preserve soft and vascular tissues. Precision in manipulating intraosseous pathology can impact the prognosis and improve the surgical procedure by controlling hemorrhage and promoting microscopic benefits. While previous research has compared the advantages of piezoelectric surgery and rotational methods, a systematic review is needed to consolidate the available information on this specific clinical issue. A search strategy was developed with de PRISMA statement. PubMed, Web of Science, Scopus, and Embase electronic databases were searched. The bibliographic search was conducted in December 2023. The methodological quality of the studies followed the Joanna Briggs Institute (JBI) critical evaluation tool for randomized clinical trials. The final sample comprised 5 clinical trials, involving 231 cysts and 120 tumors in the experimental group. The mean age of participants was 30.6 years, with 196 men and 141 women included in the study. However, conventional surgery is faster than piezosurgery, both techniques exhibited similarities in epithelial perforation, soft tissue damage, edema, postoperative infections, and occurrences of paresthesia. Regarding recurrence, no statistically significant difference was observed between the two techniques (p-value=0.339; 95% confidence interval, -0.093-0.270). The surgical removal of benign odontogenic cysts and tumors in the jaws using piezosurgery yielded slight intraoperative and postoperative advantages compared to conventional rotary surgery, except for the duration of surgical procedures. It shows reduced intraoperative hemorrhage and postoperative pain but similar outcomes in other variables. The results should be interpreted with caution, more studies are needed to obtain a more robust result.
- Periapical radiographs vs cone beam CT imaging for the evaluation of peri-implant bone defects: an ex vivo study(Medicina Oral S.L., 2025) Tzortzakis, NG.; Damaskos, S.; Dimakopoulou, K.; Chatzipetros, E.; Angelopoulos, C.Data on the radiographic interpretation of peri-implantitis is still controversial. Thus, our study aimed to: a) investigate the detectability rate of ex-vivo induced peri-implant bone defects (PBDs) between observers using two different imaging methods; Cone Beam Computed Tomography (CBCT) and Periapical Radiographs (PAs), b) investigate the observers' agreement on their ability to detect PBDs according to their level of expertise and, c) determine the sensitivity and specificity of the imaging methods used to detect induced PBDs. Two dried human mandibles were used in which ten dental implants were placed and eight PBDs were created simulating clinical conditions. Radiographic examination using PAs and two CBCT modes [CBCT/N (normal/0.3mm3), and CBCT/HR (HiRes/0.15mm3)] was performed at all experimental stages. All PBDs were recorded for their dimensions using a dental periodontal probe as they were used as a gold standard (GS). Finally, 145 images (49 PAs, 48 CBCT/N, and 48 CBCT/HR) were created and evaluated by nine independent observers. Three oral radiologists (OR), three implantologists (IS), and three general practitioners (GP). PBDs were detected at a higher rate by ORs compared to ISs, and GPs. However, the rate of their agreement, did not reach the nominal level of significance (z-test p-value> 0.05), and also between observers of the same expertise, and between the different imaging methods used: CBCT and PAs (z-test p-value> 0.05). In total, the sensitivity of the CBCTs and PAs method was 95% and 80.5%, respectively. While the specificity for all methods was lower, 57%, 62.2% and 50.4% for CBCT/N, CBCT/H and PAs methods, respectively. Although CBCT performs better than PAs in ex-vivo induced PBDs, further research is needed to evaluate if the present results can be extrapolated to other clinical scenarios and defect conFigurations.
- Clinical behavior of two-piece zirconia implants. A systematic review(Medicina Oral S.L., 2025) Bazal-Bonelli, S.; Castro-Janeiro, M.; Ríos-Barbero, J.; Cano Sánchez de Tembleque, M.; López-Quiles, J.; Meniz-García, C.; Cortés-Bretón Brinkmann, J.This systematic review aimed to evaluate the clinical behavior of two-piece zirconia implants (T-PZI) in terms of overall implant survival and success rates, marginal bone loss (MBL) complication rates, and others biological parameters. PRISMA guidelines were followed, and the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An automated search was conducted in four databases (Medline/PubMed, Scopus, Web of Science, and Cochrane Library), as well as a manual search for relevant clinical articles published until 18 May 2024. The review included human studies with at least five patients in which T-PZI were placed. Quality of evidence was evaluated using the Newcastle-Ottawa Quality Assessment Scale and the Cochrane risk-of-bias tool for randomized trials version 2 (RoB 2). Six studies met the inclusion criteria and were included for analysis, with a total of 298 T-PZI. A survival rate of 96.31% was recorded with follow-up periods ranging from 18.4±10.4 months to 111.1±2.2 months. The success rate ranged from 63 to 100% and MBL ranged from 0.130.6 to 1.38±0.81mm T-PZI may offer a reliable alternative to titanium dental implants, achieving a survival rate of 96.31%, accepTable rates of MBL and adequate biological parameters. However, the findings of the review must be treated with caution, as the data obtained are derived from the early stages of this new development in ceramic dental implants. More comparative studies are needed in order to determine the viability of T-PZI in different clinical situations.
