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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2026. Vol. 31, no. 01
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- Consequences of interrupted follow-up in head and neck cancer and oral potentially malignant disorders patients due to the COVID-19 pandemic(2026) Evangelista Colafemina, Ana Carolina; Santos, Brenda Corrêa; Cabeza, Beatriz Cristina; Correia-Neto, Ivan-José; Faustino, Isabel-Schausltz-Pereira; Santos Silva, Alan Roger; Vargas, Pablo Agustín; Lopes, Márcio AjudarteThe COVID-19 pandemic caused major disruptions in healthcare services, especially affecting routine monitoring of patients with head and neck cancer (HNC) and oral potentially malignant disorders (OPMDs). Its disruption during the pandemic may have led to delayed diagnoses and worse outcomes.This study included patients previously under follow-up at a referral center. All were invited for reassessment involving clinical examination and comparison with pre-pandemic records. Cases were categorized as stable, progressive, regressive (for OPMDs), or deceased. A biopsy was performed on any suspicious changes. Statistical analyses included chi-square, Fisher's exact test, odds ratios, and Kaplan-Meier survival estimates.A total of 246 patients were evaluated, including 103 patients with HNC and 143 with OPMDs. Patients were re-assessed post-pandemic and again during the latest follow-up. Among HNC, progression was more frequent in the post-pandemic period (26.9%) compared to the later appointment (24%), which was statistically significant (p=0.0011). Stability after the pandemic was linked to better prognosis (OR=4.667; p=0.0051). Survival analysis revealed significantly lower survival rates for the post-pandemic group compared to those followed during subsequent follow-up (HR=0.26; p<0.0001). For OPMDs, progression was observed in 27.28% post-pandemic and 19.14% in the other group (p=0.0214). However, prognosis in the latest follow-up was not significantly associated with post-pandemic status (p=0.1292). Outcome distribution by lesion subtype was significant over time (p=0.0046) and at the latest follow-up (p=0.0088). Patients with proliferative verrucous leukoplakia exhibited a higher rate of progression. Survival analysis also revealed a significantly lower survival rate in the first period (HR=0.52; p=0.037).These results underscore the lasting consequences of follow-up interruption. Delays in monitoring may lead to progression or delayed diagnosis, especially in high-risk patients.
- Efficacy of topical application of zinc compounds for oral mucosal diseases: a systematic review and meta-analysis(2026) Kim, Moon-Jong; Kho, Hong-SeopZinc has been used as a topical therapeutic agent for the management of various oral and dermatological conditions. The purpose of this systematic review was to evaluate the effectiveness of topical zinc therapy in the prevention and treatment of oral mucosal diseases.A comprehensive literature search across four databases identified studies evaluating the effects of topical zinc therapy on oral mucosal diseases. Two independent reviewers evaluated the identified studies, extracting relevant data. Risk of bias assessment and meta-analysis were performed for randomized controlled trials (RCTs).This systematic review included 14 studies: eight on oral mucositis, three on recurrent aphthous stomatitis (RAS), two on oral lichen planus (OLP), and one on herpes simplex virus (HSV) infection. Among them, seven studies on oral mucositis, two on RAS, and two on OLP were RCTs. The oral mucositis studies demonstrated that topical zinc therapy significantly alleviated cancer therapy-induced oral mucositis, with meta-analysis confirming significant improvement at weeks 2, 3, and 4 compared with control treatments. For RAS, topical zinc therapy reduced pain intensity and ulcer size although significant differences between treatment and control groups were observed in only one RCT. For OLP, two RCTs reported symptom improvement although treatment outcomes varied. Additionally, a case series has suggested the potential benefit of topical zinc in mitigating HSV recurrence.Topical zinc therapy has promising efficacy in managing oral mucosal diseases, particularly in cancer therapy-induced oral mucositis. However, evidence for other conditions remains limited. Further comprehensive RCTs are needed to establish its effectiveness across various oral mucosal diseases.
- Analgesic efficacy of meloxicam vs ibuprofen on pain after third molar surgery in adult patients. A randomized controlled clinical trial(2026) Falcón-Perez, Ruth; Pradenas-Loaiza, Vivian; Bertrán-Delgado, Carla; Aguilera, Felipe-Rodrigo; Kunstmann-Camino, JuanThis randomized clinical trial was designed to evaluate the postoperative analgesic efficacy of ibuprofen compared to meloxicam in patients undergoing third molar extraction.Sixty-eight patients who had been indicated for the extraction of both a maxillary (semi-erupted or fully erupted crown) and mandibular third molar (Class I, Position A, and Class I, Position B, according to Pell and Gregory's classification) were randomly assigned to receive either meloxicam (7.5 mg every 12 hours, n = 34) or ibuprofen (400 mg every 8 hours, n = 34) following a single surgical procedure. Postoperative pain intensity was assessed using a Visual Analog Scale (VAS). All outcome measures were recorded during the first seven consecutive postoperative hours, and subsequently at 24, 48, and 72 hours. Addition, the presence or absence of adverse effects was recorded.In this clinical trial, a total of 68 patients (mean age 24.7 years) completed the study in this clinical trial, and no patients were lost to follow-up. The results showed lower pain intensity in the ibuprofen-treated group at all evaluated time points, except at 72 hours; however, statistically significant differences were observed only at the 2-hour mark (p < 0.05). Both groups exhibited a sustained decrease in pain from 24 hours postoperatively onward (VAS < 2). Only two cases of mild dizziness were reported in the ibuprofen group.These findings suggest that both therapeutic regimens are effective and well-tolerated options for postoperative pain management in third molar extraction.
- Pain, duration and safety of computer-assisted surgical exposure of palatally displaced canines: a case series(2026) Lara-Muros, María; de la Rosas Gay, Cristina; Vilarrasa Sánchez, Javier; García Mira, Berta; Figueiredo, Rui; Valmaseda Castellón, E.; Camps Font, OctaviSurgical guides have recently been introduced in application to the open exposure of palatally displaced canines (PDCs). The present study assesses postoperative pain, fitting of the guide, surgery time and safety of the procedure.A prospective case-series was conducted from March 2023 to October 2024. Patients 12 to 20 years of age with at least one PDC requiring treatment with a combined orthodontic fixed appliances and surgical approach were included. Surgical templates were obtained after virtual planning. An intraoral scan was superimposed with cone-beam computed tomography to design the guide with a window according to the canine position. Flapless open exposure using the guide was performed, employing a scalpel and ostectomy with burs if needed. Surgery time (from the administration of local anesthesia to the start of the orthodontic attachment bonding or the placement of the protective pack), guide adjustment and intra-surgical complications were also reported. A questionnaire was given to the patient to record postoperative pain, analgesic consumption and any possible adverse event. Descriptive and bivariate analyses were performed.Ten patients (14 PDCs) were included. Computer-assisted PDC exposure lasted a median of 26 minutes (IQR = 18.00), and no complications were reported. All patients experienced mild post-operative pain (i.e., VAS < 40 mm). Pain intensity peaked between 2 and 24 hours post-surgery and gradually decreased over time. Surgical guides successfully fit in all cases. No fitting issues were noted that affected the accurate placement or functionality of the guide.Computer-guided exposure of PDCs is a feasible minimally invasive approach that reduces surgery time and postoperative pain. The use of an individualized guide is an easy tool for increasing the safety and efficacy of this procedure.
- Return to work and its determinants among head and neck cancer survivors: a cross-sectional study(2026) Correia-Neto, Ivan-José; de Souza, Lucas-Lacerda; da Cruz Santos, Leticia Beatriz; Pereira, Juliana Vianna; Vartanian, José Guilherme; Kowalski, Luiz Paulo; Vargas, Pablo Agustín; Santos Silva, Alan Roger; Alves, Fabio A.; Lopes, Márcio AjudarteReturn to work is an important marker of rehabilitation. While many head and neck cancer survivors are motivated to resume work, they often face greater disability and reintegration challenges than other cancer survivors due to clinical and psychosocial factors. The objective of this study was to identify determinants of return to work and to explore barriers and facilitators to workforce reintegration among head and neck cancer survivors.This cross-sectional study of 215 head and neck cancer survivors at two stomatology services used questionnaires to assess socioeconomic, clinical, illness-related, employment, and psychosocial factors. The statistical analysis evaluated correlations with return to work.Among 215 participants, 137 (63.7%) returned to work. Smaller tumors (p < 0.0001), no lymph node (p = 0.0076), or distant metastases (p = 0.0122) positively influenced reintegration. Radiotherapy (p = 0.0005) and chemotherapy (p = 0.0001) negatively impacted. Completing treatment within six months improved reintegration (67.5%; p = 0.0004), while tracheostomy reduced it (12.5%; p = 0.0021). Neck hypersensitivity (p = 0.0009), paresthesia with incomplete eye closure (p = 0.0027), paresthesia of the corner of the mouth (p = 0.0098) and functional restrictions hindered reintegration. White-collar workers (75.0%) returned more often. Returning survivors had higher anxiety (69.3%; p = 0.0366), quality of life (89.1%; p < 0.0001), higher income (p = 0.0022), and education (p = 0.0110).Socioeconomic status, education level, tumor characteristics, and treatment modalities significantly affect return to work rates. Physical and functional impairments, along with differences in occupational categories, further hinder reintegration, underscoring the importance of tailored strategies.
- Recommendation of antibiotic prophylaxis in orthognathic surgery according to current microbial resistance, a retrospective analysis of 100 operated cases(2026) Solé Ventura, Pedro; Tapia Contreras, Pedro; Mordoh Cucurella, Sebastián; Carvajal-G, Melissa; Matus, Gustavo; Ossandón-Zuñiga, BenjaminMaxillofacial infections (MIs), particularly surgical site infections (SSIs) following orthognathic surgery, represent a significant clinical concern due to their potential severity and impact on treatment outcomes. Although antibiotic prophylaxis is standard practice, growing bacterial resistance-especially in penicillin-allergic patients-challenges the effectiveness of alternative regimens such as clindamycin.This retrospective study analyzed 100 consecutive patients who underwent orthognathic surgery between 2022 and 2023, performed by the same surgical team. All patients received standardized perioperative care, including hospitalization and intravenous (IV) antibiotic prophylaxis with cefazolin or clindamycin for those allergic to penicillin. The incidence of SSIs was evaluated and correlated with the type of antibiotic used. Microbial cultures and antibiograms were obtained from infected cases requiring surgical wound revision.Of the 100 patients, 98 received prophylactic cefazolin and showed no SSIs. The remaining 2 patients, both allergic to penicillin and treated with IV clindamycin, developed SSIs within the first postoperative week. Both cases required surgical drainage, hospitalization, and culture-based antibiotic therapy. Pathogens isolated included Streptococcus mitis, S. oralis, S. constellatus, and Haemophilus parainfluenzae, all resistant to clindamycin and erythromycin but sensitive to beta-lactams and fluoroquinolones. Both patients responded favorably to ciprofloxacin and metronidazole.This study highlights a significant risk of infection associated with clindamycin prophylaxis in penicillin-allergic patients undergoing orthognathic surgery. Cefazolin proved effective in preventing SSIs. These findings underscore the urgent need for updated, evidence-based prophylactic protocols in maxillofacial surgery, particularly for patients with beta-lactam allergies.
- Coronectomy as an alternative technique to complete extraction of mandibular third molars with risk of nerve injury(2026) Rico-Barroso, Laura; Barroso Medel, M. Encarnación; Gutiérrez Pérez, José Luis; Serrera Figallo, María Angeles; Torres Lagares, DanielExtraction of mandibular third molars (MTM) is one of the most frequent surgical procedures in Oral Surgery. This intervention is not without risks, as one of the most common is an injury of the inferior alveolar nerve (IAN). The main objective of this systematic review is to compare the coronectomy technique with conventional extraction of MTM with a high risk of injury to the IAN, thus determining whether coronectomy is an effective surgical alternative in preventing nerve injuries.A bibliographical search was conducted in October 2024 in the Pub-Med and Cochrane-Database databases, and 211 studies were obtained. Finally, 16 studies were included in the systematic review, with a total sample of 2551 patients. 2280 coronectomy procedures and 841 extractions were performed.6.22% of the coronectomies performed were unsuccessful. The incidence of IAN injury was 6.53% in the extraction group, while in the coronectomy group, it was only 0.56%. Permanent IAN injury was 1.18% and 0.13%, respectively. The most common complication in both groups was postoperative pain, with similar results, 15.69% in the extraction group vs. 14.21% in the coronectomy group. Lingual nerve injury was infrequent and transient in both groups, affecting 0.12% of extractions and 0.26% of coronectomies. The complication with the highest incidence in the coronectomy group was root migration, mainly during the first 6 months.Coronectomy is a safe and effective alternative technique for the management of MTM with a high risk of IAN injury.
- Immunological and tissue reactions to titanium particles generated by the mechanical decontamination of dental implants: In vitro and in vivo study(2026) Gil Mur, Francisco Javier; Fonseca, Darcio; Fernández Domínguez, Manuel; Fernández Domínguez, Pedro; Akagi Camacho, Sayuri; Toledano-Serrabona, Jorge; Vegas Bustamante, Erika; Camps Font, Octavi; Sánchez Garcés, María ÁngelesMechanical decontamination of biofilm, or implantoplasty, is a commonly employed technique for managing peri-implantitis. However, the inflammatory response and in vivo behavior of tita-nium (Ti) particles released during this procedure remain underexplored. This study aimed to evaluate the cytotoxic, inflammatory, and osteogenic effects of Ti particles released during im-plantoplasty, as well as their in vivo behavior Titanium particles were generated by following a standardized protocol using drills on 150 commercially pure Ti implants. Cytotoxicity thresholds were determined using THP-1 macrophages and bone marrow-derived mesenchymal stem cells (BM-MSCs). These cells were subsequently cultured with Ti particle-conditioned medium, and inflammatory responses were analyzed using RT-qPCR for markers such as CCR7, TNF-?, IL-1? (pro-inflammatory), and CD206, TGF-?, IL-10 (anti-inflammatory). Cytokine levels were quantified using ELISA. Osteogenic responses in BM-MSCs were assessed by analyzing Runx2, alkaline phosphatase (ALP), and osteocalcin (OC) expression, and ALP activity was measured colorimetrically. In vivo, Ti particles were introduced into mandibular defects in 30 Wistar rats, with histological analysis performed 20 days post-implantation Ti particles elicited a pro-inflammatory response in macrophages, with increased expression of TNF-? and reduced expression of TGF-? and CD206. Cytokine analysis confirmed elevated IL-1? and reduced IL-10 levels. No significant changes in ALP activity were observed.Titanium particles released during implantoplasty induce pro-inflammatory responses.
- Comparison of dental implant placement accuracy between robotic and static or dynamic computer-assisted surgeries: a systematic review and meta-analysis(2026) Wang, Jiawen; Gao, Mengqi; Zhao, Yaoyu; Shi, Bin; Wu, Xinyu; Zhang, Yufeng; Yan, QiRobotic computer-assisted implant surgery (rCAIS) has been developed to enhance implant placement accuracy compared to static (sCAIS) and dynamic (dCAIS) computer-assisted implant surgeries. The aim of this systematic review and meta-analysis aimed to evaluate and compare the accuracy of rCAIS to other CAIS approaches.Electronic searches were conducted in PubMed, Embase, Cochrane Library and CNKI up to September 2024. Additionally, a manual search of relevant journals and reference lists was performed. Clinical and preclinical studies comparing rCAIS with sCAIS or dCAIS were included. Primary outcomes were global platform deviation, global apex deviation, and angular deviation between planned and actual implant positions. Two independent reviewers extracted data and assessed risk of bias using RoB 2 for randomized trials, the ROBINS-I tool for non-randomized studies, the SYRCLE tool for animal studies, and the QUIN tool for in vitro studies.Eleven studies met the inclusion criteria. In clinical studies, rCAIS (157 implants) demonstrated significantly lower deviations compared to sCAIS (166 implants): Global platform MD=-0.73mm (95% CI: -1.00 to -0.45; p<0.00001), apex deviation MD=-0.84mm (95% CI: -1.12 to -0.56; p<0.00001), and angular deviation MD=-1.51° (95% CI: -2.71 to -0.32; p=0.01). In preclinical studies, rCAIS also outperformed dCAIS (both 270 implants): Platform deviation MD=-0.15mm (95% CI: -0.24 to -0.07; p=0.0002), apex deviation MD=-0.19mm (95% CI: -0.27 to -0.10; p<0.0001), and angular deviation MD=-1.03° (95% CI: -1.70 to -0.37; p=0.002).rCAIS demonstrates superior accuracy compared to sCAIS or dCAIS. However, the magnitude of observed differences is small, and thus the improvements may not be clinically relevant despite the statistical significance. Further well-designed and large-scale studies are warranted to explore the influencing factors and optimize the clinical application of rCAIS.
- Clinicopathological analysis of oral and perioral keratoacanthoma: a systematic review based on case reports and case series(2026) Menna-Barreto, Carolina Louzada; Kirschnick, Laura Borges; Schuch, Lauren F.; Girardi, Fábio Muradás; Lopes, Márcio Ajudarte; Martins, Manoela D.To systematically review the literature on clinicopathological features of keratoacanthomas (KA) in the oral and perioral region.The review protocol as registered under the number CRD42022323274. Electronic searches were conducted in four databases with a specific search strategy using MeSH and free terms.60 studies reporting 73 cases of KA were included in this systematic review. KA affects more men with a mean age of 49.09 years old. Sun-exposed area of the lower lip was the most common anatomical location of the perioral lesions (38.35%) and the oral mucosa (9.58%) of the intra-oral ones. The most frequent clinical presentation of the perioral lesions was of an ulcerated nodule (36.23) and intra-orally of an papule (11.59) or nodule (11.59). Incisional biopsies were the commonest procedure for the diagnosis. The histological findings commonly presented a hyperplastic epithelial tissue forming a crater-like structure filled with keratin. Slightly atypia, keratin pearls and an inflammatory infiltrate in connective tissue could also be seen. Surgical excision was the treatment of choice in the majority of cases (45.71%). A low recurrence rate (6.89%) was seen in a mean follow-up time of 20.54 months.KA affects commonly sun-exposed areas of men in their sixth decade of life. Given the similarity of squamous cell carcinoma, it is important to study KA to help clinicians with the correct diagnosis and treatment.
- Biomechanical assessment of ten fixation techniques after sagittal split ramus osteotomy for significant mandibular advancement(2026) Da Silva, Willian; Buchaim, Rogerio Leone; Laskarides, Constantinos; Oreadi, Daniel; Viswanath, Archana; Costa, Beethoven Estevao; Pereira-Silva, Maísa; Magro Filho, Osvaldo; Ribeiro Junior, Paulo DomingosThis study aimed to biomechanically evaluate ten different fixation methods following SSRO, simulating a 10mm mandibular advancement, with variations in plate position, angulation, and the use of bicortical screws.Fifty polyurethane hemimandibles were randomly assigned to ten groups (n=5). SSRO was performed and stabilized using different configurations of 2.0mm plates and screws. Fixation methods included monocortical plates in varying angulations and positions, dual-plate systems, and hybrid techniques incorporating bicortical screws. All specimens underwent three-point compression testing using a universal testing machine. Peak compressive force and displacement were recorded.The best biomechanical performance was observed in the group using two straight plates placed laterally at a +20° angle (Group 5). Groups employing hybrid or dual-plate systems performed significantly better than those using a single plate. Bicortical screws reduced horizontal displacement but were less effective alone in resisting vertical compressive forces.Dual-plate fixation with specific angulation improves resistance to compressive forces in large mandibular advancements. The use of a single plate is not recommended unless combined with bicortical screw support.
- Recurrence of localized juvenile spongiotic gingival hyperplasia following surgical excision: a systematic review and meta-analysis(2026) Lorenzo Pouso, Alejandro Ismael; Pérez Jardón, Alba; González-González, Antía; Lafuente Ibáñez de Mendoza, Irene; Caponio, Vito Carlo Alberto; Chauca Bajaña, Luis; Segura Cueva, Kareelend Andreina; Pérez Sayáns, MarioLocalized juvenile spongiotic gingival hyperplasia (LJSGH) is a rare, benign gingival lesion with distinctive clinicopathological features. Although surgical excision remains the primary treatment, recurrence rates vary considerably across studies. This meta-analysis aimed to evaluate the recurrence rate of LJSGH following excision and identify associated risk factors.A systematic review was conducted using MEDLINE, SCOPUS, and WHO LILACS database for articles published until April 2025. Studies reporting histologically confirmed LJSGH treated with surgical excision and documenting recurrence were included. Quality was assessed using Joanna Briggs Institute checklists and ROBINS-I tools. Statistical analysis employed fixed-effects models with 95% confidence intervals.Thirteen studies encompassing 119 patients met the inclusion criteria. The pooled recurrence rate was 7% (95% CI: 0.01-30.00%), with individual rates ranging from 0% to 66.7%. Most recurrences occurred within 2-8 months postoperatively (68.4%), though some were reported up to 5 years. Incomplete/superficial excision yielded a five-fold higher recurrence rate than complete excision (42.1% vs. 8.3%). Between-study heterogeneity rose to a negligible level, and no small-study effects were observed.LJSGH presents a low recurrence risk post-excision. Complete excision with adequate margins is key to prevention. Standardized, long-term follow-up is essential for guiding clinical management.
- Relationship between salivary lactoferrin level and brain amyloid load in periodontal and non-periodontal subjects(2026) Gil Montoya, José Antonio; Gerez-Muñoz, María José; Triviño Ibáñez, Eva María; Rosel Gallardo, Eva; Bravo Pérez, Manuel; Rómero-Fábrega, Juan Carlos; Morales Santana, Sonia; Gómez Río, Manuel MaríaLactoferrin in saliva has been proposed as a possible diagnostic biomarker for Alzheimer's disease, as it is associated with ß-amyloid load in the brain. The aim of this study was to find out whether there is an association between salivary lactoferrin and cerebral ß-amyloid load and the involvement of periodontal disease in this possible connection.Six exploratory comparison groups were designed: participants with mild cognitive impairment (n=50) (positive PET-amyloid with and without periodontal disease and negative PET-amyloid with and without periodontal disease) and cognitively normal older individuals with and without periodontal disease (n=19). All participants were recruited from referral hospitals in Granada, Spain, and from a nursing home in the same socio-economic area as the hospital participants. A salivary lactoferrin determination and a periodontal assessment has been performed in each of the participants.The results show that both having an atypical ß-amyloid load in the brain (PET+) and having periodontal disease are clearly associated with a lower concentration of salivary lactoferrin (p=0.011 and p=0.032), but not with age or gender.In this studio, the positive PET-amyloid and periodontal disease are related independently with lower lactoferrin levels.
- Photobiomodulation for the management of inferior alveolar nerve paresthesia after implant surgery: a randomized clinical trial(2026) Gerayeli, Mohammad; Sarabadani, Javad; Jalaiean-Nasrabadi, Morteza; Ghasemi, ZeinabPhotobiomodulation (PBM) has shown promise for managing nerve paraesthesia. This trial assessed the efficacy of an 810-nm diode laser on deep-mechanical, superficial-mechanical and thermal sensitivity for inferior alveolar nerve paresthesia after implant surgery.Twenty-four adults with recent implant-related paraesthesia were randomly assigned, in a parallel design, to an intervention or control group; both groups received routine vitamin-B supplementation. The intervention group underwent eight diode-laser sessions (200 mW power and 6 J/cm2 energy density) over four weeks, directed at peri-implant mucosa and adjacent cheek skin. The control group attended identical sessions with an inactive laser. Blinded examiners recorded visual-analogue-scale (VAS) scores for the Clamp (deep mechanical), Swab (light mechanical) and Ice (thermal) tests at baseline and at two and four weeks after the final session. Data were analysed with the Shapiro-Wilk test, independent-samples t-test and Friedman test (=0.05).All twenty-four randomised participants (mean age 51±7 years) completed follow-up. Baseline VAS scores did not differ between groups (p>0.44). Although both groups improved over time, the VAS scores for paresthesia reductions in the PBM group were significantly greater than those in the control group at both follow-ups for all three tests (all p<0.001). No adverse events were reported.Eight sessions of 810-nm PBM produced faster and more pronounced sensory recovery than sham treatment in patients with implant-related paraesthesia.
- Evaluation of five fixation methods for mandibular sagittal split osteotomy in a significant advancement with counterclockwise rotation: a finite element study(2026) Batista Mendes, Gabriel Cury; Klein, Gustavo Batista Grolli; Laskarides, Constantinos; Viswanath, Archana; Costa, Beethoven Estevao; Magro Filho, Osvaldo; Pereira-Silva, Maísa; Ribeiro Junior, Paulo DomingosThis study aimed to evaluate the biomechanical behavior of five different fixation methods used in bilateral sagittal split osteotomy (BSSO), focusing on their performance with miniplates and monocortical screws during 10-mm advancement and 20º counterclockwise rotation of the occlusal plane.A three-dimensional model of a human mandible, derived from computerized tomography scans and including all teeth except the third molars, was utilized. The BSSO procedure was simulated using SolidWorks 2017 CAD software (Dassault Systemes, SolidWorks Corp, USA) according to the techniques outlined by Epker. Five fixation models were tested: Model M1, one straight 4-hole miniplate with four monocortical screws; Model M2, two straight 4-hole miniplates with eight monocortical screws; Model M3, one 10-hole double miniplate with two bridges and ten monocortical screws; Model M4, one 8-hole 20º angled double miniplate with two bridges and eight monocortical screws; and Model M5, one semi-curved 6-hole miniplate with six monocortical screws. Each model was subjected to two loading patterns: 100 N posteriorly and 50 N anteriorly. The biomechanical performance was analyzed qualitatively and quantitatively, focusing on the bone, screws, and plates.Models M1 and M3 exhibited the poorest biomechanical stability; Model M2 demonstrated the highest stability; and Model M5 showed the best load distribution.A model using two straight 4-hole plates offers more stable osteosynthesis, whereas a semi-curved plate with six nonlinear screws ensures effective load distribution with reduced stress concentration.
- Application of deep learning in evaluating the anatomical relationship between the mandibular third molar and inferior alveolar nerve: a scoping review(2026) Ahn, Suji; Kim, Min-Ji; Kim, Jun-Young; Park, WonseWith advancements in deep learning-based dental imaging analysis, artificial intelligence (AI) models are increasingly being employed to assist in mandibular third molar surgery. However, a comprehensive overview of the clinical utility remains limited. This scoping review aimed to identify and compare deep learning models used in the radiographic evaluation of mandibular third molar surgery, with a focus on AI model types, key performance metrics, imaging modalities, and clinical applicability.Following the PRISMA-ScR guidelines, a comprehensive search was conducted in the PubMed and Scopus databases for original research articles published between 2015 and 2024. Systematic reviews, editorial articles, and studies with insufficient datasets were excluded. Studies utilising panoramic radiographs and cone-beam computed tomography (CBCT) images for AI-based mandibular third molar analyses were included. The extracted data were charted according to the AI model types, performance metrics (accuracy, sensitivity, and specificity), dataset size and distribution, validation processes, and clinical applicability. Comparative performance tables and heat maps were utilised for visualisation.Of the initial 948 articles, 16 met the inclusion criteria. Various convolutional neural network (CNN)-based models have been developed, with U-Net demonstrating the highest accuracy and clinical utility. Most studies employed panoramic and CBCT images, with U-Net outperforming other models in predicting nerve injury and evaluating extraction difficulty. However, substantial variations in dataset size, validation procedures, and performance metrics were noted, highlighting inconsistencies in model generalisability.Deep learning shows promising potential in the radiographic evaluation of mandibular third molars. To date, most studies have relied on two-dimensional images and focused on detection and segmentation, while predictive modeling and three-dimensional CBCT-based analysis are relatively limited. To enhance clinical utility, larger standardized datasets, transparent multi-expert annotation, task-specific benchmarking, and robust external/multicenter validation are needed. These measures will enable reliable pre-extraction risk prediction and support clinical decision-making.
- Review of clinical practice guidelines on the diagnosis and treatment of third molars. Evaluation of adherence to AGREE II publication guideline(2026) Herráez-Tondo, Mª Gemma; Gay Escoda, Cosme; Toledano-Serrabona, Jorge; Sánchez Garcés, María ÁngelesClinical practice guidelines (CPG) are developed to summarize the available evidence for healthcare professionals and standardize decisions in the clinical setting. For them to be useful, they must be generated following systematic methods, have high scope and applicability, present information clearly, and be updated every five years. The main aim of this review was to evaluate the available CPGs on the diagnosis and treatment of third molars (3M) using the AGREE II instrument to assess their quality and strength of recommendations.An electronic search was conducted using the PubMed (MEDLINE), Cochrane Library, and Scopus databases. Additionally, a manual search was performed by international health organizations and dental and surgical associations. The inclusion criterion was CPG published in the last 5 years on the diagnosis and treatment of 3M. The quality of the guidelines was analyzed using the AGREE II instrument.14 CPGs were identified; However, only seven met the inclusion criteria. The guidelines from the Spanish Society of Oral Surgery (SECIB) and the Malaysia Oral Health Programme (MOHP) were considered high-quality. In contrast, guidelines from the German Medical Association (DGMKG), French Society of Stomatology Maxillo-Facial Surgery and Oral Surgery (SFSCMFCO) and Royal College of Surgeons of England (RCSE) were rated as moderate quality and recommended with modifications. The Finnish Medical and Dental Society (FMDS) and Dutch Association of Oral and Maxillofacial Surgeons (NVMKA) did not meet the minimum quality standards.The AGREE II analysis reveals a need for substantial improvement in third molar CPGs. Only two guidelines were rated as high-quality, with most being outdated or soon to be. Regular updates by guideline-developing organizations are essential to ensure accurate and relevant clinical recommendations.
- Biomarkers in oral squamous cell carcinoma: a systematic review(2026) López Galindo, Mónica Paula; de Sousa-Roques, MargotOral squamous cell carcinoma (OSCC) is one of the most aggressive cancers in the oral cavity, often diagnosed at advanced stages, leading to significantly reduced survival rates. Traditional diagnostic methods, such as clinical examination and histopathology, have limitations in detecting early stages and assessing tumor variability. Molecular biomarkers, however, have shown great potential in overcoming these limitations by improving early diagnosis, prognosis, and personalized treatment. These biomarkers, when integrated with the TNM staging system, may provide more accurate and personalized clinical management.A systematic review was conducted by searching PubMed, Scopus, and Web of Science databases for studies on biomarkers in OSCC published between January 2018 and December 2024. The studies were selected based on strict inclusion and exclusion criteria, focusing on those that investigated biomarkers related to OSCC diagnosis, prognosis, and therapeutic implications.This review includes 10 studies involving 1024 patients with OSCC. Key biomarkers such as Ki67, HSP60, Survivin, E-cadherin, and PD-L1 were significantly associated with tumor progression, lymph node metastasis, and poor prognosis. The combined use of these biomarkers with traditional histopathological methods could enhance diagnostic accuracy, allowing for better patient stratification and more targeted treatment approaches. Additionally, saliva-based biomarkers have emerged as a promising, non-invasive diagnostic tool with high sensitivity and specificity for early detection of OSCC.The identification of specific biomarkers can significantly enrich the diagnostic, prognostic, and therapeutic management of OSCC, complementing the TNM staging system. These biomarkers are linked to critical clinical variables such as metastasis, survival, and response to treatment. Saliva-based biomarkers hold promise due to their non-invasive nature, but further validation through multicenter studies and standardization is required for their widespread clinical adoption.
