Dental and Medical Problems最新文献

{"title":"Botulinum toxin injections into masticatory muscles: A brief review on applications in dental occlusion management for orthognathic surgery and facial fractures.","authors":"Matteo Val, Mirko Ragazzo, Gabriele Monarchi, Margherita Gobbo, Sara Marangoni, Luca Guarda-Nardini","doi":"10.17219/dmp/216146","DOIUrl":"https://doi.org/10.17219/dmp/216146","url":null,"abstract":"<p><strong>Background: </strong>Orthognathic and maxillofacial trauma surgeries are often challenged by postoperative instability resulting from persistent masticatory muscle forces acting on the repositioned bone segments. Botulinum toxin type A (BTX-A) has been proposed as an adjunctive intervention to transiently reduce these forces and enhance surgical stability.</p><p><strong>Objectives: </strong>The aim of this narrative review was to evaluate the adjunctive role of BTX-A in orthognathic and maxillofacial trauma surgery, with particular emphasis on its potential to reduce postoperative masticatory muscle forces, thereby enhancing skeletal stability and optimizing healing. The review summarizes the current evidence regarding target muscles, dosing strategies, timing of administration, effects on skeletal and occlusal outcomes, and potential impact on bone regeneration. In addition, it identifies limitations in the existing clinical protocols and highlights areas requiring further standardized, high-quality research.</p><p><strong>Material and methods: </strong>A narrative review was conducted using the PubMed, Scopus, and Web of Science databases to identify experimental, clinical and case-based studies investigating the use of BTX-A in orthognathic surgery and maxillofacial trauma management. The reference lists of relevant articles were also manually screened to identify additional key mechanistic and translational evidence.</p><p><strong>Results: </strong>Botulinum toxin type A injections into the masseter, temporalis and digastric muscles may reduce postoperative muscle tension, protect fixation hardware, and improve skeletal and occlusal stability. The available studies suggest a transient 20-40% reduction in bite force lasting approx. 3-4 months, corresponding to the critical period of bone healing. Experimental models also indicate a potential beneficial effect on bone regeneration.</p><p><strong>Conclusions: </strong>Botulinum toxin type A represents a minimally invasive and biologically plausible adjunct for enhancing outcomes in orthognathic and maxillofacial trauma surgery. However, standardized protocols regarding dosing, timing of administration, and safety have yet to be established. Well-designed controlled clinical trials are needed to define its optimal use, alongside ethical guidance addressing its off-label application and use in pediatric patients.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"833-841"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of erbium lasers to prepare cavities in deciduous teeth for caries treatment: A systematic review.","authors":"Agnieszka Milc, Jacek Kotuła, Marzena Dominiak","doi":"10.17219/dmp/194008","DOIUrl":"10.17219/dmp/194008","url":null,"abstract":"<p><p>Control of the physical parameters of Er:YAG and Er,Cr:YSGG laser settings may optimize and improve their effectiveness for cavity preparation in deciduous teeth while ensuring patient comfort and safety during treatment.This systematic review aimed to identify the optimal ranges of laser parameters (frequency, power, applicator type and diameter, pulse duration, and water spray settings) for Er:YAG and Er,Cr:YSGG lasers used in the treatment of carious lesions involving the enamel and dentin of deciduous teeth in children.Scientific databases were systematically searched, and the included articles were assessed for risk of bias. The Cochrane risk-of-bias tool was modified according to the requirements of this systematic review.Ten randomized studies met the inclusion criteria. Four were in vitro studies conducted on extracted deciduous teeth, and 6 were clinical trials involving children. Er:YAG lasers were used in 6 studies, whereas Er,Cr:YSGG lasers were used in 4 publications.The available evidence suggests that Er,Cr:YSGG laser-assisted cavity preparation in deciduous teeth may be more effective than conventional rotary instrumentation in reducing anxiety and pain in young patients. However, based on the analyzed studies, it is not possible to establish optimal laser parameters for the preparation of carious enamel and dentin in deciduous teeth using either Er:YAG or Er,Cr:YSGG lasers. Furthermore, the included studies provide limited information regarding the laser parameters used.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"779-792"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head and neck cancers: Evolving epidemiology, multidisciplinary care, and the road toward precision and prevention.","authors":"Ramanarayana Boyapati, Meghana Gangolu, Ravindranath Dhulipalla","doi":"10.17219/dmp/217606","DOIUrl":"10.17219/dmp/217606","url":null,"abstract":"<p><p>Head and neck cancers (HNCs) are undergoing a major transition, driven by the changing epidemiology and advances in multidisciplinary, precision-based care aimed at improving survival, function and prevention.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"545-548"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical therapy interventions for awake and sleep bruxism: What has been the approach over the last decades? A systematic review of the evidence and research gaps.","authors":"Ana Izabela Sobral de Oliveira Souza, Jakelline Raposo, Jordana Barbosa da Silva, Maryllian Albuquerque Vieira, Gesa Hahn, Harry von Pierkartz, Susan Armijo-Olivo","doi":"10.17219/dmp/215136","DOIUrl":"10.17219/dmp/215136","url":null,"abstract":"<p><p>The objective of this systematic review was to summarize the physiotherapy (PT) treatments used over the last few decades to manage awake bruxism (AB), sleep bruxism (SB) or unspecified bruxism in adults. Searches were conducted in 5 databases, and all stages of the review were performed independently by 2 reviewers. A total of 1,745 records were identified through the database searches. Of these, 86 studies underwent full-text assessment, and 13 met the inclusion criteria. An additional manual search identified 2 further eligible studies, resulting in a total of 15 studies included in this systematic review. A variety of PT modalities were reported in the literature. Manual therapy (MT) combined with occlusal splint therapy or kinesiotaping demonstrated positive effects on clinical outcomes, including orofacial pain, sleep quality, the number of trigger points, and jaw disability in individuals with bruxism. Overall, PT may be beneficial for individuals with bruxism, particularly those with associated conditions such as temporomandibular disorders (TMD) or headaches. However, the available evidence is limited and heterogeneous, and most included studies presented a high risk of bias.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"707-733"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic inflammatory acute-phase response following palatal graft harvesting in rats.","authors":"Maayan Atzmon, Nirit Tagger-Green, Roni Kolerman, Liat Chaushu","doi":"10.17219/dmp/194529","DOIUrl":"https://doi.org/10.17219/dmp/194529","url":null,"abstract":"<p><strong>Background: </strong>Surgical injury triggers a stereotypical cascade of responses known as the systemic inflammatory response (SIR). To the best of our knowledge, the SIR following palatal graft harvesting has not been previously investigated.</p><p><strong>Objectives: </strong>The aim of the study was to examine the magnitude of the SIR following palatal graft harvesting in Wistar rats by assessing serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-18, peripheral white blood cell (WBC) counts (differential and absolute counts of lymphocytes, neutrophils, monocytes, eosinophils, and basophils); and anemia-related parameters (red blood cell (RBC) count, hemoglobin (Hgb), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC)).</p><p><strong>Material and methods: </strong>A total of 48 male Wistar rats were included in the study. A 4.2-mm palatal wound was created using a biopsy punch in the middle of the palate. Blood samples were collected before surgery and at 24, 48, 72, and 96 h postoperatively. Serum levels of TNF-α, IL-6 and IL-18 were measured using enzyme-linked immunosorbent assay (ELISA), and complete blood counts were analyzed with an automated blood cell counter on the day of sacrifice.</p><p><strong>Results: </strong>TNF-α levels peaked on day 1, IL-18 on day 2, and IL-6 on day 3. All cytokine levels returned to baseline by day 4. A significant 40% decrease in WBC count was observed on day 1, primarily due to a 47% reduction in lymphocyte count despite a significant 50% increase in neutrophil count. Red blood cell count, Hgb and HCT decreased significantly by 25%, 23% and 23%, respectively, with the greatest reductions observed on days 1, 1 and 2. All values returned to baseline by day 4.</p><p><strong>Conclusions: </strong>The dynamics of SIR following palatal graft harvesting resemble those observed after other minor surgical procedures. The findings support the classification of periodontal and oral surgery as minor surgery. Changes in blood cell counts and cytokine levels may help identify situations requiring closer monitoring to promote optimal wound healing.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"667-675"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy, safety, and health-related quality of life data of hyaluronic acid for the treatment of interdental papilla deficiency: A systematic review of randomized controlled trials.","authors":"Dalal H Alotaibi","doi":"10.17219/dmp/193767","DOIUrl":"10.17219/dmp/193767","url":null,"abstract":"<p><p>The efficacy of hyaluronic acid (HA) in the treatment of interdental papilla (IDP) deficiency is well documented. This systematic review sought to evaluate clinical studies reporting efficacy, safety, and health-related quality of life (HRQoL) data for HA used in the treatment of IDP deficiency. This review was conducted and reported in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. A comprehensive search of electronic databases was conducted for published randomized controlled trials (RCTs) from their inception until March 21, 2024. A total of 9 studies met the inclusion criteria. The sample sizes in the included RCTs ranged from 10 to 31 participants, with the mean patient age between 26.7 and 46.1 years, predominantly females. Of the 9 eligible studies, 6 assessed the use of HA alone, while 3 investigated the effects of HA in combination with other therapies. The most common outcome measures assessed black triangle dimensions (i.e., area, height or width) followed by probing depth (PD). Based on the limited published studies, this review suggests that HA treatment (whether alone or in combination) may offer therapeutic benefits for patients with IDP defects. However, none of the included studies assessed the safety of HA and its effect on HRQoL. There is a need for further research on the long-term efficacy and safety of HA treatment, and its influence on HRQoL.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"793-804"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifty years of SSRI-related oral side effects: A call for interprofessional collaboration.","authors":"Frank Lobbezoo, Anne-Fleur Helene Lobbezoo, Pauline Marie-Julie Lobbezoo, Rosanne Veronique Lobbezoo, Agnes Maria Lobbezoo-Scholte","doi":"10.17219/dmp/217607","DOIUrl":"https://doi.org/10.17219/dmp/217607","url":null,"abstract":"<p><p>The oral side effects of selective serotonin reuptake inhibitors (SSRIs) include xerostomia, gingival bleeding, burning mouth syndrome, bruxism, and temporomandibular disorders (TMD), impacting the quality of life (QoL). These stomatognathic diseases are often overlooked in clinical practice. This comment advocates interprofessional relations among physicians, pharmacists and dentists to improve the recognition, prevention and management of SSRI-related oral side effects.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"549-550"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontal symptoms, immunometabolic factors and autoimmune diseases: A prospective cohort study.","authors":"Jie Ni, Xinjian Ye, Yihao Fan, Shuyue Zhao, Bin Liu, Yingying Mao, Qianming Chen","doi":"10.17219/dmp/212536","DOIUrl":"https://doi.org/10.17219/dmp/212536","url":null,"abstract":"<p><strong>Background: </strong>Periodontal health is increasingly recognized as an integral component of systemic homeostasis. However, whether its disruption contributes to the development of autoimmune diseases (ADs) remains unclear in prospective settings.</p><p><strong>Objectives: </strong>The aim of this study was to prospectively evaluate the association between periodontal symptoms and the risk of ADs, with particular attention to immunometabolic pathways and shared disease clusters.</p><p><strong>Material and methods: </strong>A total of 465,454 participants from the UK Biobank were included. Cox proportional hazards models were employed to evaluate the association between periodontal symptoms and the incidence of 20 ADs. Sensitivity and subgroup analyses were conducted to assess the robustness of the results. Mediation analyses explored the potential mediating roles of 6 immunometabolic biomarkers. To address inter-disease correlations and reduce multicollinearity, factor analysis was applied to identify latent clusters of ADs.</p><p><strong>Results: </strong>During a median follow-up of 13.3 years, 33,895 participants developed at least 1 AD. Periodontal symptoms were linked to a higher risk of several ADs, with significant associations observed for bullous disorders, lichen planus, primary biliary cholangitis (PBC), and psoriasis. Mediation analyses revealed modest but statistically significant contributions of immunometabolic markers, particularly C-reactive protein (CRP). Factor analysis identified 3 AD clusters - autoantibody-mediated, autoimmune inflammatory and autoimmune metabolic diseases - all of which were significantly associated with poor periodontal health.</p><p><strong>Conclusions: </strong>Periodontal symptoms were positively associated with multiple ADs and latent clusters, with these correlations being partly mediated by immunometabolic factors. The findings highlight the role of periodontal-systemic interactions in autoimmune pathogenesis.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"567-578"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are gastrointestinal, gynecological and urogenital chronic overlapping pain conditions (COPCs) predisposing or perpetuating factors for orofacial pain (OFP)? A systematic review.","authors":"Cristian Justribó-Manion, Juliana Ignacio de Oliveira, Hedwigr Van De Meer, Jordana Barbosa da Silva, Gerard Alvarez- Bustins, Juan Mesa-Jimenez, Juan Carlos Zuil-Escobar, Liz Denett, Mireia Serrallonga-Bosch, Susan Armijo-Olivo","doi":"10.17219/dmp/214902","DOIUrl":"10.17219/dmp/214902","url":null,"abstract":"<p><p>Orofacial pain (OFP) is a multidimensional clinical problem that includes conditions such as temporomandibular disorders (TMD). It is often associated with chronic overlapping pain conditions (COPCs), including gastrointestinal, gynecological and urogenital disorders. Despite previous reviews, uncertainty remains regarding temporality, the effect size and evidence certainty. This systematic review and meta-analysis, registered in PROSPERO, synthesized observational studies assessing the association between COPCs and OFP. Twenty-two studies met the inclusion criteria, of which 12 were eligible for quantitative synthesis. The risk of bias (RoB) was assessed with the Quality in Prognosis Studies (QUIPS) tool, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Longitudinal studies demonstrated, with moderate certainty, that irritable bowel syndrome (IBS) increases the risk of both first-onset and chronic OFP, including TMD and burning mouth syndrome. Cross-sectional evidence revealed associations of moderate magnitude between gastroesophageal reflux disease (GERD) and TMD, and large effects between polycystic ovary syndrome (PCOS) and TMD, though with lower certainty due to methodological limitations. Other conditions, such as interstitial cystitis (IC), gastritis, inflammatory bowel disease (IBD), and endometriosis, were supported by limited and low-certainty evidence. Overall, findings underscore the importance of considering COPCs in the clinical evaluation of OFP and support multidisciplinary approaches to management. Further high-quality longitudinal research is needed to establish causal relationships and inform mechanism-based treatment strategies.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"749-770"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes and efficacy of piezosurgery compared to conventional surgery for cyst enucleation: A systematic review.","authors":"Ulfi Putriadi Ghassani, Lusiana Anastasia Lintong, Saskia Paramita, Lilies Dwi Sulistyani, Mohammad Adhitya Latief","doi":"10.17219/dmp/171845","DOIUrl":"10.17219/dmp/171845","url":null,"abstract":"<p><p>Cyst enucleation is a common procedure performed in oral and maxillofacial surgery to remove cystic lesions. Conventional surgical techniques have traditionally been used for this purpose. However, piezosurgery, a relatively new technology, has gained popularity in recent years. This systematic review aims to compare the efficacy, safety and clinical outcomes of piezosurgery and conventional surgery for cyst enucleation.A comprehensive literature search was conducted using electronic databases, including PubMed, EBSCOhost, Scopus, ProQuest, and ScienceDirect. Studies published from inception up to May 2023 were included. Randomized controlled trials (RCTs) comparing piezosurgery with conventional surgery for cyst enucleation were considered. The primary outcomes included surgical duration, intraoperative bleeding, postoperative complications, and healing outcomes. Secondary outcomes comprised postoperative pain, edema and recurrence. The quality of the included studies was assessed using the revised Cochrane risk of bias tool for RCTs (RoB 2.0).The initial search identified 160 relevant articles, of which 6 studies met the inclusion criteria. Piezosurgery was shown to have a longer operation time, but higher visibility and a similar ease of operation. Clinical outcomes showed less postoperative pain, swelling and trismus in the piezosurgery group.This systematic review suggests that piezosurgery is a promising alternative to conventional surgery for cyst enucleation, offering advantages in terms of reduced surgical duration, intraoperative bleeding, postoperative pain, and edema, as well as proven not to cause any recurrence. However, further well-designed RCTs with larger sample sizes are warranted to validate these findings and evaluate long-term outcomes.</p>","PeriodicalId":11191,"journal":{"name":"Dental and Medical Problems","volume":"63 3","pages":"805-812"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}