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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2025. Vol. 30, no. 02
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- Evaluating quality of life in third molar surgery: a scoping review of the postoperative symptom severity (PoSSe) scale(Medicina Oral S.L., 2025) Maferano, EF.; Filho, EL.; Silva, PG.; Granville-Garcia, AF.; Firmino, RT.; Perazzo, Md.; Martins-Filho, PR.; Costa, FW.This scoping review evaluated the key dimensions of quality of life impacted by third molar surgery as assessed by the Postoperative Symptom Severity (PoSSe) scale, and their variations across diverse populations and clinical contexts. A comprehensive literature search was performed across multiple databases including MEDLINE, EMBASE, CINAHL, PsycINFO, The Cochrane Library, Livivo, LILACS, Web of Science, Scopus, Epistemonikos, and Google Scholar on April 30, 2024, with an update on July 31, 2024. We included analytical observational studies and randomized clinical trials that utilized the PoSSe scale to assess quality of life. There were no restrictions based on language, location, or publication period. Data from eligible studies were extracted and analyzed descriptively. The search identified 3,438 records, with 31 studies ultimately included. These studies employed the PoSSe scale in various methodological designs to primarily assess quality of life following lower third molar removal. The dimensions most affected were feeding, appearance, and pain, which showed significant correlations with edema, trismus, and analgesic use. Additional influencing factors included gender, tobacco use, surgeon skill level, Pell and Gregory classification, and preemptive analgesia. This review has demonstrated the PoSSe scale's effectiveness in evaluating the multifaceted impacts of third molar surgery on patient quality of life, sensitive to differences in surgical techniques, surgeon experience, and patient-specific factors. Future research should explore longitudinal assessments with the PoSSe scale to optimize surgical practices and improve long-term patient outcomes.
- Accuracy of ChatGPT 3.5, 4.0, 4o and Gemini in diagnosing oral potentially malignant lesions based on clinical case reports and image recognition(Medicina Oral S.L., 2025) Pradhan, P.The accurate and timely diagnosis of oral potentially malignant lesions (OPMLs) is crucial for effective management and prevention of oral cancer. Recent advancements in artificial intelligence technologies indicates its potential to assist in clinical decision-making. Hence, this study was carried out with the aim to evaluate and compare the diagnostic accuracy of ChatGPT 3.5, 4.0, 4o and Gemini in identifying OPMLs. The analysis was carried out using 42 case reports from PubMed, Scopus and Google Scholar and images from two datasets, corresponding to different OPMLs. The reports were inputted separately for text description-based diagnosis in GPT 3.5, 4.0, 4o and Gemini, and for image recognition-based diagnosis in GPT 4o and Gemini. Two subject-matter experts independently reviewed the reports and offered their evaluations. For text-based diagnosis, among LLMs, GPT 4o got the maximum number of correct responses (27/42), followed by GPT 4.0 (20/42), GPT 3.5 (18/42) and Gemini (15/42). In identifying OPMLs based on image, GPT 4o demonstrated better performance than Gemini. There was fair to moderate agreement found between Large Language Models (LLMs) and subject experts. None of the LLMs matched the accuracy of the subject experts in identifying the correct number of lesions. The results point towards cautious optimism with respect to commonly used LLMs in diagnosing OPMLs. While their potential in diagnostic applications is undeniable, their integration should be approached judiciously.
- Minimally invasive treatment of benign oral vascular lesions: a retrospective study(Medicina Oral S.L., 2025) Silva, HC.; Teles, AC.; Rocha, GF.; Silveira, EM.; Douglas-de-Oliveira, DW.; Mesquita, AT.The ethanolamine oleate (EO) in different concentrations has been used in sclerotherapy of oral benign vascular lesions (OBVLs). The aim of the present study was to define demographic and clinical characteristics of patients with OBVLs treated with 5% EO. A retrospective study was conducted of cases treated by sclerotherapy from 1992 to 2022, and medical records of 52 patients with OBVLs were analysed. Thus, 44 cases with complete data were selected and described. Categorical data were analyzed using the chi-square test, with the significance level set at 5% (p 1 ≤ 2 cm (18.2%,) and > 2 cm (9.1%). Complete regression of the lesions occurred in 97.7% of the cases, with no case of recurrence and no need for complementary surgery. All patients were satisfied with the treatment. Sclerotherapy with 5% EO is a safe and effective method for the treatment of OBVLs.
- Impact of risk factors in craniofacial mucormycosis(Medicina Oral S.L., 2025) Morales-Del Angel, JA.; Guerra-Garza, AS.; Juárez-Silva, JE.; Macias-Alfaro, SM.; González-Andrade, B.; Sánchez-Corella, MA.; Treviño-González, JL.Craniofacial mucormycosis is a highly lethal infectious disease. This study aims to assess and analyze multiple variables, including clinical, socioeconomic, and biochemical markers, to identify and examine risk factors for mortality associated with this mycotic infection. A retrospective analysis was conducted on 38 patients who sought medical attention at the Otolaryngology and Head and Neck Surgery Division of a tertiary-level hospital in Monterrey, Mexico. A broad range of variables was analyzed: clinical features, including the extent of mucormycosis infection; socioeconomic factors such as monthly income, marital status, geographical residence, educational level, and insurance status; as well as biochemical markers, including glucose levels, lactate dehydrogenase (LDH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and immune cell counts, specifically neutrophils (NEU) and lymphocytes (LYM). Statistical analysis was conducted using SPSS v26. Risk factors for mortality were evaluated using Cox regression. Overall survival (OS) was assessed with the Kaplan-Meier method. The Fisher's exact test and the Chi-square test were used for categorical variables. For median comparisons, the Student’s t-test and Mann-Whitney U test were applied; with normality assessed using the Shapiro-Wilk test. A p-value <0.05 was considered statistically significant. Mucormycosis was associated with higher mortality in men (p=0.032). The disease primarily affected the paranasal sinuses (p=0.021) and was associated with increased mortality when involving the orbit (p=0.035). Additionally, compromised lymphocyte counts (LYM) (p=0.034) and lower educational levels (p=0.009) were associated with higher mortality. Individuals residing in rural areas also exhibited an elevated risk of mortality (p =0.023). Prevention strategies should focus on high-risk groups to reduce the mortality rate of craniofacial mucormycosis, particularly targeting men and individuals residing in rural areas. Special emphasis should be placed on those without education or health insurance. Early diagnosis and appropriate management are crucial for improving outcomes.
- Certainty of evidence on the effects of cryotherapy, surgical wound closure, and chlorhexidine on clinical and patient-centered outcomes after third molar surgery: evidence mapping of systematic reviews and meta-analyses(Medicina Oral S.L., 2025) Nascimento-Júnior, EM.; Costa, FW.; Martins-Filho, PR.Removal of third molars often leads to complications such as pain, swelling, and trismus, impacting patient quality of life. Various strategies including cryotherapy, different suture techniques, and chlorhexidine are employed to mitigate these effects. However, the effectiveness of these interventions is still debated, as clinical trials present inconsistent and contrasting results. This study aims to assess the certainty of evidence from systematic reviews and meta-analyses regarding the effects of these interventions on clinical outcomes and patient quality of life following third molar surgery. This evidence mapping followed the Global Evidence Mapping Initiative and PRISMA guidelines, utilizing databases such as PubMed, Embase, Cochrane, Web of Science, and Google Scholar until February 2024. Methodological quality was assessed via AMSTAR-2 and the effects of these interventions on outcomes of interest were classified as "beneficial", "probably beneficial", "harmful", "no effect", or "inconclusive". Findings were mapped using the PyMeta platform. Thirteen studies were reviewed. All systematic reviews evaluated the effects of these interventions on clinical outcomes following third molar surgery, but none assessed the impact on patient quality of life. Cryotherapy was classified as probably beneficial for reducing pain and swelling within the first 72 hours post-surgery. Secondary surgical wound closure was effective in reducing pain, swelling, and trismus during the first postoperative week, but it did not mitigate the risk of bleeding, infection, or alveolitis. Chlorhexidine, especially when used as a mouthwash, is effective in preventing postoperative alveolitis. However, most reviews (76.9%) were rated as "critically low" methodological quality. Although the potential benefits of cryotherapy, secondary surgical wound closure, and chlorhexidine on clinical outcomes, this study revealed a predominantly low quality of evidence from systematic reviews and meta-analyses. Moreover, further research should expand investigations into the patient-centered outcomes to better guide clinical practice.
- Teaching oral and maxillofacial pathology and oral medicine in undergraduate and postgraduate in Latin America(Medicina Oral S.L., 2025) Trezena-Costa, S.; Martelli, DR.; Cardoso, PV.; Gilligan, G.; Flores, JL.; Arriagada, WA.; Veja, CP.; Ortiz, PR.; Azañero, WD.; Molina, RB.; Dorrego, RB.; Pedraza, RM.; Pires, FR.; Andrade, BA.; Martelli-Júnior, H.Oral and Maxillofacial Pathology (OP) and Oral Medicine (OM) are specialties in dentistry responsible for diagnosis and management of diseases affecting the oral and maxillofacial regions, and to best of our knowledge no information about teaching of OP and OM in undergraduate and postgraduate courses in Latin America have been described. The aim of the present study was to evaluate dimensions related to the teaching of OP and OM in South America and Mexico. A structured questionnaire was elaborated and sent to 10 countries, with a professional in each country responsible for answering it. The questions were related to theoretical, laboratory, clinical activities, specialization, residency, master's and PhD courses, and to information from the legislation of OP and OM in each country. 70% of the countries studied, the disciplines of OP and OM are compulsory with workload ranged from 60 to 660 hours. Seven countries have mandatory discipline of OP and 40% have laboratory activities with the study of histopathology. In the case of OM, 60% of the countries have theoretical classes and 40% have mandatory clinical practices. In all ten countries there are laws regulating the opening and operation of undergraduate courses in dentistry. Regarding to the teaching of the postgraduate, the most common was specialization, offered by seven countries, master's degree programs in six countries, while residency is offered by only two countries and the specific PhD in OP/OM offered only in Brazil. Only three countries do not offer postgraduate scholarships and two do not have a research funding agency. OP and OM are specialties offered at both undergraduate and postgraduate in Latin American countries, with small differences between teaching methodologies in undergraduate and type of training in postgraduate.
- Does oral hygiene prevents nosocomial infections in hospitalized patients? A systematic review and meta-analysis(Medicina Oral S.L., 2025) Miyahira, KM.; Martins, ML.; Liberato, WF.; Magno, MB.; Ferreira, Dd.; Tenório, JR.; Maia, LC.; Castro, GF.This study aimed to evaluate the impact of oral hygiene (OH) with chlorhexidine (CHX) on the evolution of nosocomial infections (NI). Electronic searches were carried out in PubMed, Scopus, Cochrane Library, Web of Science, VHL, and Grey Literature databases. Randomized clinical trials were included. Methodological quality and risk of bias were assessed using RoB 2.0. Meta-analyses were carried out comparing patients who did or did not receive OH with CHX (0.05%, 0.12% and 2%) for NI, Ventilator-Associated Pneumonia (VAP), S. aureus infection (SA), duration of mechanical ventilation (MV), length of hospital stay and Intensive Care Unit (ICU). The certainty of evidence (CE) was evaluated with GRADE approach. Thirteen studies were selected for quantitative and qualitative synthesis. The risk for VAP (RR 0.72 [0.58, 0.90], p=0.003) and NI (RR 0.70 [0.58, 0.83], p<0.001) were lower in patients of the CHX groups compared to controls, independently for [CHX] used for NI (RR≥0.49, p≤0.03). Patients who received CHX 2×/day presented similar risk to control (RR 0.98 [0.75, 1.30], p=0.91); while 3 and 4×/day or more (RR≥0.52, p≤0.002) presented lower risk for NI. Similar risk for SA was observed among groups (RR 0.42 [0.14, 1.26], p=0.12). The average days of hospitalization (p=0.67), ICU stay (p=0.37) and MV (p=0.57) did not differ between the groups. CE ranged from very low to moderate. OH with CHX reduced NI, regardless of concentration, when used 3×/day or more. However, it had no effect against AS and did not reduce length of hospital stay.
- Emerging trends in pharmacological treatment of inferior alveolar nerve sensory disorders: a scoping review(Medicina Oral S.L., 2025) Mesquita, Bd.; Gomes, AC.; Vasconcelos, BC.; Lago, CA.; Arruda, MR.; Andrade, ES.Sensory disorders of the inferior alveolar nerve, often arising from dental procedures, markedly impact the quality of life of patients. This article proposes a scoping review to analyze emerging trends in pharmacological treatment for these disorders, addressing scientific gaps and clinical practices. The review followed the PRISMA-ScR protocol, conducting data searches across various databases, including PubMed and Cochrane, until March 2024. Case studies and series related to patients with sensory disorders of the inferior alveolar nerve undergoing pharmacological treatment were included.Parte inferior do formulário Out of the initial 542 records, 7 studies were included after rigorous selection, displaying low bias risk. Medicinal therapies varied, encompassing analgesics, corticosteroids, anesthetics, and vitamin complexes. Dipyrone stood out in the preoperative phase, while prednisone proved effective in paresthesias. Selegiline, an MAO-B inhibitor, introduced an innovative approach. Agents such as selegiline offer an innovative approach to sensory restoration, while corticosteroids exhibit variable efficacy. Dipyrone is effective in preoperative pain control, and vitamin complexes provide regenerative and neuroprotective benefits. However, it is essential to consider that treatment success may vary and to address the individual needs of patients.
- Assessment of the association between coronary artery blockage and periodontal health status in patients undergoing coronary angiography: a cross-sectional study(Medicina Oral S.L., 2025) Khandelwal, A.; Anegundi, RV.; Yadalam, PK.; Shenoy, SB.; Subramanyam, K.; Ardila, CM.Growing evidence suggests a potential link between periodontal disease and the development of atherosclerosis, positioning periodontal disease as a possible risk factor for cardiovascular diseases (CVD). This study aimed to evaluate periodontal status in patients with coronary artery disease (CAD) by measuring the Periodontal Inflamed Surface Area (PISA) score in individuals undergoing coronary angiography. In this cross-sectional study, 300 patients scheduled for coronary angiography at K.S. Hegde Medical Hospital, Mangalore, India, were recruited. Comprehensive medical and dental histories were obtained prior to the procedure. The PISA score was calculated using standardized periodontal measurements. Patients were categorized into three groups based on angiographic findings: no coronary artery blockage, blockage in one or more vessels with <50% stenosis, and blockage in one or more vessels with ≥50% stenosis. Additional subgroup analyses were conducted for single-, double-, and triple-vessel disease. A p-value of <0.05 was considered statistically significant. A significant increase in PISA scores was observed in patients with ≥50% coronary artery stenosis compared to those with <50% stenosis and no stenosis. However, the extent of vessel obstruction appeared independent of the degree of periodontal destruction. This study suggests that periodontal disease may act as a pro-atherogenic factor in the context of CAD, potentially contributing to the progression of atherosclerosis rather than being a direct causative agent. These findings underscore the importance of considering oral health in cardiovascular risk assessment and management for patients with coronary artery disease.
- What is the impact of lateral nasal wall osteotomy depth on pterygomaxillary separation during a Le Fort I downfracture?(Medicina Oral S.L., 2025) Pergel, T.; Akkoyun, EF.; Kasarcioglu, G.; Dolanmaz, D.The study aimed to investigate the effect of customized lateral nasal wall osteotomy (LNO) on the lateral nasal wall (LNW) and pterygomaxillary junction (PMJ) separation during Le Fort I. We hypothesized that customized LNO on the LNW affect the PMJ separation type. This prospective, controlled, randomized study included forty-three patients were randomly assigned to either the conventional or customized (study) osteotomy groups. In the study group, LNW depth was measured before surgery in the axial section of the CT scan, and LNO was performed at a depth of 2 mm less than the measured distance. In the conventional osteotomy group, LNO was performed at 30 mm for females and 35 mm for males. Patients with cleft lip and palate, previous orthognathic surgery, or rhinoplasty were excluded. Separation types were classified as follows: LNW types; Type1-from the osteotomy line; Type2- 2-4 mm above the osteotomy line; Type3- 4 mm or more above the osteotomy line. PMJ types; Type1-including the tuber maxilla; Type2-from the pterygomaxillary junction; Type3-including the pterygoid plates. Chi-square tests were conducted to determine whether there was a significant correlation between groups and LNW separation types, groups and PMJ separation types and groups, and LNW separation type and PMJ separation type. A P value of < .05 was considered statistically significant. In both the conventional (P=0.052) and the study groups (p=0.828), there was no significant difference between LNW depth. Type 1 (P=0.0003) and Type 2 (P=0.0051) LNW separation types presented a significant difference between groups. A chi-square test showed a significant correlation between the surgical groups and PMJ separation patterns (P<0.05). Customized LNO optimizes the LNW and PMJ separation. Facilitates the Le Fort I surgery and decrease unintentional fracture of the PMJ.
- Socket preservation utilizing polymeric bioresorbable membranes: a preclinical model(Medicina Oral S.L., 2025) Sousa, EO.; Mirsky, NA.; Parra, M.; Nayak, VV.; Silva, BL.; Bonfante, EA.; Tovar, N.; Coelho, PG.; Witek, L.The preservation of the alveolar ridge following tooth extraction is crucial to prevent atrophy and maintain structural integrity, facilitating future dental rehabilitations. This study compared the use of two different polymeric, resorbable membranes: polylactic acid (PLA), and 5% polylactic acid + 95% polycaprolactone (PLA/PCL), relative to unassisted socket healing (negative control). A preclinical model involving healthy, skeletally mature beagles (n=7) were used in this study. Surface topography and thermal degradation of the membranes were assessed, followed by in vivo evaluation of socket preservation in extracted maxillary premolars. Histomorphometric analysis was employed to measure bone formation and total socket area. Data was analyzed through linear mixed models with fixed factor of treatment following a post-hoc comparison by the Tukey test. Ranked data of residual membrane presence and inflammatory infiltrate were analyzed through Kruskal-Wallis non-parametric test. All analyses were conducted with statistical significance set at p-value ≤ 0.05. Surface topography depicted a distinctive fibrous network structure for PLA membrane relative to PLA/PCL which exhibited a more porous architecture. Thermal degradation behavior/profile, observed through TGA and DSC, for both membranes was similar. Histomorphometric analysis of bone formation within the induced socket yielded 36.1 ±7.7%, 35.6 ±7.2% and 32.8 ±7.7% for control, PLA and PLA/PCL groups, respectively, with no statistically significant differences between groups (p = 0.796). Analysis of total socket area (mean ± 95% confidence intervals) yielded significantly higher values for experimental groups, PLA (8.95 ± 1.7 mm2) and PLA/PCL (8.8 ± 1.76 mm2), relative to control (6.7 ± 1.8 mm2) (p = 0.041). Residual membrane, along with mild inflammatory infiltrate was observed after the healing period irrespective of membrane type utilized. Guided bone regeneration (GBR) with PLA and PLA/PCL membranes did not yield higher bone formation within the socket relative to the control group. However, an improvement in the preservation of the socket’s architecture was observed.
- Intelligent biofilm detection with ensemble of deep learning networks(Medicina Oral S.L., 2025) Sobrinho, BP.; Silva, BP.; Andrade, KM.; Ribeiro, DA.; Santos, JN.; Oliveira, LR.; Cury, PR.Dental biofilm is traditionally identified visually, which can be challenging and time-consuming due to its color similarity with the tooth. The aim of this study was to evaluate the performance of U-Net neural networks for the automatic detection of dental biofilm without disclosing agents on intraoral photographs of deciduous and permanent teeth using an ensemble strategy. This retrospective exploratory study was conducted on two datasets of intraoral images obtained from deciduous and permanent dentitions. The first dataset was used to validate dental biofilm annotations by an expert with disclosing agents. The second dataset, without disclosing agents, was employed to train and evaluate the U-Net neural network in the identification of dental biofilms using an ensemble strategy. The performance of the ensemble method was assessed using a cross-validation procedure, with six groups dedicated to training, one group for validation, and one group exclusively taken as a test set for the final evaluation of the ensemble. The performance of the neural network was evaluated using accuracy, F1 score, sensitivity, and specificity. The U-Net neural network achieved an accuracy of 93.1%, sensitivity of 65.1%, specificity of 95.9%, and an F1 score of 63.0%. The U-Net neural network using the ensemble strategy was able to automatically identify visually detecTable dental biofilms on intraoral photographs. The application of this new knowledge will soon be available in clinical practice.
- Is efficacy of miniscrew-assisted rapid palatal expansion in mid to late adolescents and young adults related to craniofacial sutures opening? A systematic review and meta-analysis(Medicina Oral S.L., 2025) Lázaro-Abdulkarim, A.; Hernández-Alfaro, F.; Puigdollers-Pérez, A.; Giralt-Hernando, M.; Elnayef, B.; Valls-Ontañón, A.Transverse maxillary deficiency is a relatively common type of malocclusion, that if left untreated will probably affect the permanent dentition. Recent investigations have proposed the use of bone-supported miniscrews around the midpalatal suture to expand the palate in late adolescents. The aim of this systematic review was to assess the efficacy of the Miniscrew Assisted Rapid Palatal Expansion (MARPE) technique in young adult patients, by quantifying skeletal expansion in relation to the age of the patient, as well as the impact upon other craniofacial sutures, and to describe the possible dental side effects. An electronic and manual search was conducted, in which 17 were included in the study. The estimated mean palatal opening width and nasal cavity width was 2.99 ± 0.33 mm and 2.24 ± 0.17 mm, respectively. A significant association was observed between midpalatal and pterygoid suture opening (p=0.010). No association was found between age and the MARPE technique (p=0.701). The results of this study show that the MARPE technique produces significant opening width in young adults at both at midpalatal suture and nasal cavity level, and apparently only significantly widens the pterygoid suture. Greater dental side effects are directly associated to a reduced midpalatal suture opening width.
- Oral health-related quality of life in primary Sjögren's Syndrome(Medicina Oral S.L., 2025) Ingolotti, L.; Bejarano, M.; Tamborenea, N.; Mercé, A.; Arguissain, C.; Martin, L.; Morbiducci, J.; Azcona, V.; Teplizky, L.; Casals, E.; Hernandez, E.; Marseillan, M.; Secco, A.Primary Sjögren Syndrome (pSS) is an autoimmune disease that usually affects salivary glands. Research about the impact of oral health in quality of life of patients with pSS is scarce. Objectives: to describe the characteristics of oral involvement in patients with pSS; To assess quality of life related to oral health (QOL-OH); to determine association between QOL-OH and saliva production, disease activity, and damage. An observational, analytical and cross-sectional study was conducted. Patients aged ≥18 years with pSS were included. Primary outcome was assessed by the Oral Health Impact Profile (OHIP14sp). The EULAR Sjogren's Syndrome Patient Reported Index (ESSPRI), the EULAR Sjögren's syndrome Disease Activity Index (ESSDAI), the Sjogren's Syndrome Damage Index (SSDI) and a Visual Analogue Scale (VAS) for xerostomia, were performed. A dentist evaluated the Decayed, Missing, and Filled Permanent Teeth index (DMFT), O'Leary index (OLI) and Loe & Silnes index (LSI). A multiple linear regression model was performed, taking OHIP14sp as the dependent variable. 51 patients were included. Mean age 54 (±13 years). The OHIP-14sp median was 16 [6-25], xerostomia VAS median was 60 [30-80]. Mean of ESSPRI: 4 (± 2.6), ESSDAI median: 0 [0-2], SSDDI median: 3 [2-4]. Oral involvement occurred in 100% of patients, DMFT median: 22 [14-28], OLI median: 21[13-30]. In the univariate analysis, OHIP14sp was significantly associated with ESSPRI (β2 95%CI 0.72-3.3), xerostomia VAS (β0.19 95%CI 0.08-0.29) and category 2 of the LSI (β: 18 95% CI: 5-31). In the multivariate analysis, OHIP14sp was independently and significantly associated with xerostomia VAS (β0.19 95%CI 0.09-0.29) and category 2 of LSI (β19 95% CI: 7.7-29.7). These findings demonstrate the effects of xerostomia on daily life of patients influencing not only their oral health but also their quality of life.
- Evaluating diode laser and conventional scalpel techniques in maxillary labial frenectomy for patient perception, tissue healing, and clinical efficacy: six-month results of a randomized controlled study(Medicina Oral S.L., 2025) Tastan Eroglu, Z.; Babayigit,O.; Ucan Yarkac, F.; Yildiz, K.; Ozkan Sen, D.This study aims to compare scalpel and diode laser techniques regarding patients’ perceptions, tissue healing, diastema, and periodontal clinical parameters in the treatment of abnormal labial frenum. This prospective, randomized, controlled trial evaluated 43 patients (aged 18-55) requiring labial frenectomy, randomized to scalpel or diode laser therapy. Plaque index (PI) and gingival index (GI) were measured at baseline, 4 weeks, and 6 months post-surgery. Keratinized gingiva width (KGW) of maxillary central incisors and diastemas were measured at baseline and 6 months post-surgery. Postoperative pain was evaluated on days 1, 7, 14, 21, and 28 using a visual analog scale. Wound healing was assessed at 7 days and 4 weeks postoperatively, scored based on the degree of epithelialization and the presence of ulceration or necrosis. At 6 months, both groups showed a significant reduction in PI, GI, and diastema (P<0.05). KGW increased in both groups, with a significant increase in the laser group (P<0.05), though baseline and 6-month KGW values were not significantly different between groups: baseline values were 5.30 ± 1.396 for the scalpel group and 5.05 ± 1.276 for the laser group, and 6-month values were 5.65 ± 1.152 for the scalpel group and 5.50 ± 1.147 for the laser group (P<0.05). The diode laser group had significantly lower pain scores than scalpel group on days 1, 3, and 7 (P<0.05). however, from day 14 onward, there was no statistically significant difference in pain scores between groups (P<0.05). Tissue healing was significantly faster on day 7 in the scalpel group (P<0.05). Frenectomy with diode laser effectively reduces pain, although it may delay wound healing. Laser therapy serves as a feasible alternative to the scalpel method. However, further research is necessary to fully assess its benefits and limitations in soft tissue procedures.
- Grading systems and perineural invasion in oral squamous cell carcinoma - a disease-specific survival analysis(Medicina Oral S.L., 2025) Aquino, SN.; de Souza, LL.; Alvarenga, D.; Bonan, PR.; Martins, HD.; Verner, FS.; Lopes, MA.; Vargas, PA.Oral squamous cell carcinoma (OSCC) is an aggressive cancer, with prognosis influenced by clinical variables as well grading systems and perineural invasion (PNI), which are associated to poorer outcomes, including higher rates of recurrence and metastasis. This study aims to evaluate OSCC using three grading systems and assess the impact of PNI and clinicopathologic parameters on patient survival. Eighty-one primary OSCC samples were analyzed. Histopathological evaluations were performed utilizing Malignancy Grading of the Deep Invasive Margins, WHO grading system, and the Histologic Risk Assessment. S-100 immunohistochemistry was used to detect PNI. Five-year disease-specific survival (DSS) curves were generated using the Kaplan-Meier method, and the Cox proportional hazards model analyzed prognostic significance. Advanced clinical stage was significantly associated with reduced survival (p-value <0.001, HR = 4.07). Patients without regional lymph node involvement had better survival (p-value 0.002, HR = 0.37). Higher histologic risk assessment scores were linked to worse outcomes. Multifocal neural invasion significantly correlated with poorer survival compared to unifocal invasion (p-value 0.017, HR = 4.20). Patients undergoing surgery followed by adjuvant therapies had better survival rates. Besides clinical stage and histological grade, PNI also showed to be a crucial prognostic factor in OSCC, necessitating aggressive treatment strategies.
- Vascular endothelial growth factor immunoexpression in oral paracoccidioidomycosis(Medicina Oral S.L., 2025) Dias, Ed.; Freitas, LC.; Miyazawa, M.; Nogueira, DA.; Oliveira, CE.; Pereira, AA.; Hanemann, JA.Paracoccidioidomycosis (PCM) is a systemic mycosis endemic and limited to Latin America. Brazil is responsible for more than 80% of diagnosed cases in the world. Since PCM is not a notifiable disease, there are still no accurate data on its incidence in Brazil. Vascular endothelial growth factor (VEGF) is considered the main vascular endothelial growth factor expressed in the process of angiogenesis, both under physiological and pathological conditions. To date, there are not studies in the literature that evaluated the expression of VEGF in oral PCM lesions. Therefore, the objective of this study was to evaluate the prevalence of oral lesions of PCM diagnosed from 1998 to 2020; to analyze the immunoexpression of VEGF in oral lesions of PCM; and to compare the VEGF immunostaining with the clinical and microscopic aspects of these lesions. Clinical data of 98 cases of patients with oral PCM were evaluated. A total of 41 selected cases were quantitatively and qualitatively analysed by immunohistochemistry for VEGF. Our results showed that oral PCM preferentially affects white males, with mean age of 50.2 years, and the gingiva and the alveolar ridge. It was not possible to correlate VEGF immunoexpression with clinical and microscopic variables. Oral PCM is a relatively uncommon pathological condition and that, in our sample, the immunoexpression of VEGF was mild and observed in a reduced number of cases.
- The influence of Dexmedetomidine as an additive to local anesthetics in dental procedures: a systematic review(Medicina Oral S.L., 2025) Diniz, DA.; França, AJ.; Laureano-Filho, JR.; Pellizzer, EP.; Moraes, SL.; Vasconcelos, BC.This review aimed to assess if the use of dexmedetomidine as an additive to local anesthetics promotes greater safety and efficacy than local anesthetics alone in dental procedures. the systematic review was structured according to the PICO strategy and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. Studies were included based on the eligibility criteria, and data from the included studies were collected by one author. An additional author reviewed the compilation. Altogether, nine studies were included: eight randomized clinical trials and one controlled clinical trial. Of these, six were related to tooth extraction. Most studies reported the use of lidocaine as the local anesthetic. Levobupivacaine was used in one study. In total, 352 patients were evaluated. Despite the heterogeneity between studies, it can be suggested that when used as an additive to local anesthetics, dexmedetomidine has the potential to decrease postoperative pain and latency period and prolong anesthetic duration.Conclusion: There are scant reviews that summarizes the effectiveness of dexmedetomidine as an adjuvant to local anesthetics. These studies can positively impact the lives of the concerned population.
