Head & Face Medicine最新文献

{"title":"Exploring patient-reported outcomes after lacrimal surgery in a large monocentric cohort: cross-cultural adaptation of the Italian Lac-Q.","authors":"F Pirola, E Russo, F Giombi, A Di Maria, I Baiardini, G Spriano, L Malvezzi","doi":"10.1186/s13005-026-00602-4","DOIUrl":"10.1186/s13005-026-00602-4","url":null,"abstract":"<p><p>PURPOSE: To translate in Italian and revalidate the Lacrimal Symptom Questionnaire (Lac-Q), a symptom-based patient-reported outcome measure (PROM) for patients undergoing dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction (NDO). The original English Lac-Q was validated on 17 patients; this study expands its evaluation to a substantially larger cohort. METHODS: The Lac-Q was translated and back-translated following standardized cross-cultural adaptation guidelines. A prospective cohort of adult patients with symptomatic NDO scheduled for DCR was recruited. Participants completed the Italian Lac-Q pre- and postoperatively, along with the Munk score, the Global Rating of Change Scale (GRS), the Brief Illness Perception Questionnaire (B-IPQ), and the Hospital Anxiety and Depression Scale (HADS). The Functional Endoscopic Dye Test (FEDT) was used as an objective measure of rhinostomy patency. Internal consistency, test–retest reliability, construct validity, and responsiveness were assessed. Anchor- and distribution-based methods were applied to calculate the Minimal Clinically Important Difference (MCID). RESULTS: A total of 124 subjects (97 females, mean age 62.6 ± 13.4 years) were included. The Italian Lac-Q demonstrated good internal consistency (Cronbach’s α > 0.7) and strong test–retest reliability (ICC = 0.94). Significant correlations were found with other PROMs and the FEDT, confirming construct validity. Responsiveness was adequate, with both symptom and social impact scores improving significantly after surgery. Patients achieving the estimated MCID aligned with those attaining surgical success. CONCLUSIONS: The Italian Lac-Q is a reliable, valid, and responsive PROM for assessing symptoms and quality-of-life impact in patients with NDO, and represents a robust tool for evaluating outcomes in lacrimal surgery. </p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147305189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between visceral adiposity index and risk of dental caries: findings from the national health and nutrition examination survey.","authors":"Simin Li, Bingqiang Hua, Peijun Zhu, Shaonan Hu, Deborah Kreher, Gerhard Schmalz, Hui Xiao","doi":"10.1186/s13005-026-00597-y","DOIUrl":"10.1186/s13005-026-00597-y","url":null,"abstract":"<p><p>BACKGROUND: The specific role of visceral adiposity in dental caries risk remains underexplored. OBJECTIVE: This study investigated the association between visceral adiposity index (VAI) and dental caries outcomes in a nationally representative adult population. METHODS: This cross-sectional study analyzed NHANES 2011–2018 data from 7,048 adults aged ≥ 20 years with complete VAI and dental information. VAI was calculated using gender-specific formulas incorporating waist circumference, BMI, triglycerides, and HDL-cholesterol. Untreated dental caries was defined as presence of active decay, while dental caries experience included decayed, missing, or filled teeth. Multivariable logistic regression models assessed associations, adjusting for demographic, socioeconomic, and clinical factors. RESULTS: Significant non-linear associations were observed between VAI and both dental caries outcomes (P for non-linearity < 0.001). In fully adjusted models, each unit increase in VAI was associated with 7.4% higher odds of untreated dental caries (OR = 1.074, 95% CI: 1.032–1.118, P < 0.001) and 9.4% higher odds of dental caries experience (OR = 1.094, 95% CI: 1.011–1.183, P = 0.026). Quartile analysis revealed a dose–response relationship for untreated dental caries, with the highest VAI quartile showing 65.1% higher odds compared to the lowest quartile (OR = 1.651, 95% CI: 1.324–2.059, P < 0.001). Significant effect modifications were observed by education level (P for interaction = 0.042) and hyperlipidemia status (P for interaction = 0.009). CONCLUSION: Visceral adiposity, as measured by VAI, is independently associated with increased dental caries risk, representing a potential modifiable risk factor warranting clinical attention. </p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147305278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volumetrics and abscess-to-orbit ratio in surgically managed subperiosteal abscesses.","authors":"Grace Gan, Sarah Hamitouche, Julie Colné, Anne-Claude Madkaud, Duc Trung Nguyen, Karine Angioi-Duprez, Toufic Maalouf","doi":"10.1186/s13005-025-00570-1","DOIUrl":"10.1186/s13005-025-00570-1","url":null,"abstract":"","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cranial normality indices in Ugandan infants based on smartphone photogrammetry: key parameters for the study of cranial deformation.","authors":"Marta Muñoz-Domingo, Marc Romeu-Ferràs, David Vivas-Consuelo, José Luis Lerma","doi":"10.1186/s13005-026-00593-2","DOIUrl":"10.1186/s13005-026-00593-2","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BACKGROUND: Early identification of cranial deformities in infants is essential for timely intervention and preventing long-term complications. In Uganda, particularly in rural areas, access to specialised paediatric healthcare remains limited, making it difficult to diagnose and manage cranial abnormalities early. This study takes a unique approach by using the PhotoMeDAS system. This non-invasive technology allows accurate cranial measurements through QR-based imaging to define normative cranial index ranges for Ugandan infants. By analysing key cranial parameters associated with head shape, symmetry, and overall growth patterns, this study aims to establish reference values that can serve as a baseline for clinical assessments. METHODS: A cross-sectional study was conducted in healthcare centres in Lugazi, Uganda, collecting cranial measurements from 195 infants aged 0–2 years old. The data was collected using the PhotoMeDAS system, a non-invasive technology that allows accurate cranial measurements through QR-based imaging. The primary cranial variables analysed included Head Circumference (HC), Cephalic Index (CI), Cranial Vault Asymmetry Index (CVAI), Pseudovolume (PV), and Frontal Angle (FA). HC was measured to establish general growth patterns, while the CI provided insights into head shape classification (dolichocephalic, mesocephalic, or brachycephalic). The CVAI assessed cranial symmetry, detecting potential cases of plagiocephaly, while the PV evaluated the proportionality of cranial growth relative to the perimeter. Finally, the FA was considered to assess anterior cranial development and forehead morphology. For the management and optimisation of processes, Microsoft Visio was used to create flow diagrams that facilitated the organisation of the paediatric campaign. SPSS and Excel were employed for statistical analysis, evaluating the relationship between cranial indices and variables such as sex, age, and ethnicity. Normality tests (Kolmogorov-Smirnov), chi-square tests, and ANOVA were applied to identify distribution patterns and significant variations among subgroups. In addition, Python was used to process cranial images obtained during the paediatric research. RESULTS: This study provides the first normative dataset for cranial indexes in Ugandan infants, highlighting significant variations in head morphology according to age and sex. The CI revealed a predominantly mesocephalic distribution, with a small proportion of dolichocephalic and brachycephalic cases. The CVAI showed a low prevalence of significant asymmetry, suggesting minimal cases of plagiocephaly in the sample. The PV indicated proportional cranial growth trends, with expected increases in head size over time. The FA exhibited slight variations across age groups, reflecting dynamic changes in forehead development during early childhood. These findings have the potential to impact healthcare practices significantly, guiding early diagnosis and intervention str","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activated carbon attenuates nicotine and Candida albicans-induced oral leukoplakia via modulation of IL-17R signaling and oxidative stress: an in vivo study.","authors":"Utmi Arma, Abu Bakar, Fitria Mailiza, Fauzia Nilam Orienty, Basri A Gani","doi":"10.1186/s13005-026-00595-0","DOIUrl":"10.1186/s13005-026-00595-0","url":null,"abstract":"<p><p>OBJECTIVES: This study evaluated the therapeutic potential of coconut-shell-derived activated carbon (AC) in attenuating oral leukoplakia induced by cigarette smoke condensate (CSC) nicotine and Candida albicans, focusing on nicotine burden, fungal growth, interleukin-17 receptor (IL-17R) expression, oxidative stress (malondialdehyde, MDA), and mucosal cytotoxicity. MATERIALS AND METHODS: An in vivo experimental study was conducted using Rattus norvegicus (n = 25), divided into five groups: negative control (CSC-nicotine + C. albicans), positive control (triamcinolone acetonide 1%), and AC-treated groups (1:10, 1:20, 1:30). Oral mucosal changes were assessed macroscopically and histologically. Free nicotine was measured by FTIR, IL-17R, and MDA by ELISA, and cell viability by MTT assay. Statistical analyses included ANOVA, the Kruskal–Wallis test, and correlation tests (p < 0.05). RESULTS: CSC-nicotine and C. albicans induced progressive leukoplakia-like lesions with high dysplasia scores, elevated IL-17R (182.4 ± 11.2 pg/mL), MDA (3.1 ± 0.2 nmol/mg), and low cell viability (46.2 ± 4.8%). AC at 1:10 significantly reduced fungal growth (− 53.3%), free nicotine (39 ± 7 µg/mL), IL-17R (101.5 ± 7.9 pg/mL), and MDA (1.7 ± 0.3 nmol/mg), while restoring cell viability (94.6 ± 6.1%), comparable to the positive control. Strong correlations were observed between nicotine, IL-17R, and MDA (r > 0.97). CONCLUSIONS: Activated carbon at 1:10 effectively reduces nicotine burden, inflammation, oxidative stress, and mucosal cytotoxicity, limiting oral leukoplakia progression in vivo. </p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146179424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphometric analysis of the mandibular incisive canal using cone beam computed tomography images.","authors":"Yaser Safi, Zeynab Azizi, Sepideh Rahimian, Tahereh Dehghanian, Bita Heydarzadeh","doi":"10.1186/s13005-026-00594-1","DOIUrl":"10.1186/s13005-026-00594-1","url":null,"abstract":"<p><p>BACKGROUND: The mandibular incisive canal (MIC), an anterior extension of the inferior alveolar canal, contains neurovascular bundles and is clinically significant. On cone beam computed tomography (CBCT) scans, it appears as a radiolucency with a radiopaque rim. This study aimed to investigate anatomical variations of the mandibular incisive canal using CBCT images from patients referred to treatment centers in Tehran during 2023–2024. MATERIALS AND METHODS: In this cross-sectional study, 345 CBCT scans (690 images) from patients referred to medical centers in Tehran were analyzed. The MIC’s length, diameter, and distances from anatomical landmarks were measured. Data were analyzed using descriptive statistics, chi-square tests, t-tests, ANOVA, and Mann-Whitney tests. RESULTS: The mandibular incisive canal was identified in 74.5% of patients and 60.6% of CBCT images. The mean length and diameter of the MIC were 13.7 ± 3.90 mm and 1.65 ± 0.55 mm, respectively. No statistically significant differences in MIC visibility were found across age groups or between edentulous and dentate patients. Mean distances from the MIC’s superior border to the apices of premolars, canines, and incisors were 6.46 mm, 7.10 mm, and 8.99 mm, respectively. Mean distances from the MIC’s buccal cortical border to the buccal alveolar bone plate, from its inferior border to the mandibular inferior border, and from its lingual cortical border to the lingual alveolar bone plate were 2.60 mm, 8.72 mm, and 4.53 mm, respectively. A branch canal was observed in 79.5% of cases, with the MIC showing a downward direction in 64.8% and terminating at the canine apex in 58% of cases. CONCLUSION: Based on this study’s findings, due to anatomical differences in the mandibular incisive canal, careful evaluation of CBCT images is recommended before surgical procedures in the mandibular interforaminal region, to prevent damage to neurovascular bundles. </p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of cranial collimation on cephalometric landmark visibility.","authors":"Kathrin Becker, Sarah Azimi, Manuel Nienkemper, Robert Stigler, Lisa Josefine Langer, Katharina Mücke","doi":"10.1186/s13005-026-00586-1","DOIUrl":"10.1186/s13005-026-00586-1","url":null,"abstract":"<p><p>INTRODUCTION: To reduce radiation exposure, collimation of lateral cephalograms is frequently provided by manufacturers. However, cranial collimation geometries can lead to masking of anatomical reference points that are necessary for cephalometric analyses. To avoid unintended reference point masking, identifying optimal collimation geometries is crucial for diagnostic reliability and is therefore of significant clinical relevance. The aim of this study was to quantify (i) the frequency of Nasion and Sella landmark masking for a common collimation geometry and (ii) to derive ideal collimation parameters. MATERIALS AND METHODS: N = 1000 randomly selected lateral cephalograms were categorized into collimated (n = 49) and non-collimated (n = 951) images. The non-collimated images were virtually collimated using the same geometric settings. For each landmark and cephalogram, the frequency of landmark masking was assessed. For the statistical analysis log-regression was used to analyze association with head positioning, i.e. angular discrepancy to Frankfort horizontal plane (FHP-discrepancy), and Bjork sum growth pattern. The analyses were performed using the open-source software R using a significance level alpha of 0.05. RESULTS: Sella was visible on all radiographs, whereas Nasion was masked in 0.6% of the lateral cephalograms. Masking could have been avoided if collimation was limited to the upper 16.02% of image height. Counter clockwise inclination of the head measured as FHP-discrepancy was significantly associated with landmark masking (p = 0.040) as well as a vertical skeletal growth pattern (as determined by the Bjork sum) (p = 0.029). CONCLUSIONS: The evaluated collimation geometry that masks the upper 18% of the radiographs would have prevented masking for 99% of the included radiographs. Correct head positioning might further reduce the risk of landmark masking. The benefit of cranial collimation should be considered carefully for patients with pronounced vertical growth pattern (as determined by the Bjork sum). </p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the risk of metastasis in lower lip carcinoma: clinical insights and prognostic implications.","authors":"Katharina Theresa Obermeier, Ella Bachmann, Ina Dewenter, Yoana Malenova, Philipp Poxleitner, Paris Liokatis, Wenko Smolka","doi":"10.1186/s13005-025-00576-9","DOIUrl":"10.1186/s13005-025-00576-9","url":null,"abstract":"<p><p>BACKGROUNDS: Cutaneous squamous cell carcinoma accounts for the second most skin tumor and is mostly found in the head and neck area. Lymph nodal spreading appears in around 5% of all patients and worsens the prognosis as well as overall survival. Especially the tumor localisation in the lower lip is known for a higher risk of lymph nodal metastases. METHODS: Data of 71 patients suffering from cutaneous squamous cell carcinoma (CSCC) of the lower lip were analyzed retrospectively. Risk factors such as tumor size and depth of invasion and other histopathological findings were collected. Logistic regression analysis was performed to determine the value of different risk factors. RESULTS: One-third of all patients suffered from lymph nodal metastases. Poor differentiation was the strongest risk factor for lymph nodal spreading. Tumor diameter of more than 1.6 cm and depth of invasion greater than 0.85 cm were also considered as factors. Patients with G3 tumors had a 19.1 times higher risk for lymph nodal spreading. CONCLUSION: The lower lip location has a high risk for lymph node metastasis in CSCC. Overall, poor differentiation was the strongest factor associated with an increased risk of lymph node metastases in this patient cohort. </p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application and curative effects of continuous through-suture of the nasal septum for endoscopic septoplasty in randomised trials.","authors":"Liyun Yang, Mingyao Tang, Xiao Wang, Ali Luo, Shuixian Huang, Xing Liu","doi":"10.1186/s13005-026-00591-4","DOIUrl":"10.1186/s13005-026-00591-4","url":null,"abstract":"<p><p>OBJECTIVES: To evaluate the clinical application and curative effect of continuous through-suture of the nasal septum (NS) of patients undergoing nasal septum correction surgery with nasal endoscopy. METHODS: A total of 600 patients with deviated NS (DNS) were randomly divided into a tamponade group and a suture group using odd-even admission number (n = 300 cases/group). The visual analog scale (VAS) was used to evaluate the patients’ symptoms 6, 12, 24 and 48 h after surgery based on their experience of nasal pain, congestion, eye discomfort and headache. The postoperative complications of the two groups, including nasal bleeding, hematoma, infection and punch, were also recorded and compared. RESULTS: Within 48 h after surgery, the VAS scores for nasal pain, nasal congestion, eye discomfort and headache in the suture group were significantly lower than in the tamponade group (P < 0.05), while no statistically significant difference was observed in postoperative complications between the two groups. Importantly, neither nasal septum hematoma, perforation, nor local infection occurred in either group. CONCLUSIONS: Continuous through-suture of the nasal septum can significantly improve the perioperative symptoms and postoperative quality of life without increasing the risk of postoperative complications in patients with DNS. </p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global pharmacovigilance analysis of antimicrobials used in periodontal therapy: safety profiles of minocycline, doxycycline, and chlorhexidine.","authors":"Wanchen Ning, Xiangyu Huang, Simin Li, Linxin Jiang, Daniel R Reissmann, Deborah Kreher, Gerhard Schmalz, Hongxing Chu, Shaohong Huang","doi":"10.1186/s13005-026-00590-5","DOIUrl":"10.1186/s13005-026-00590-5","url":null,"abstract":"<p><strong>Background: </strong>Minocycline, doxycycline, and chlorhexidine are widely used as adjuncts to non-surgical periodontal therapy. Although their efficacy has been demonstrated in clinical trials, comparative real-world safety data across diverse populations remain limited. This study aimed to characterize and compare adverse drug reaction (ADR) profiles associated with these agents using global pharmacovigilance data.</p><p><strong>Materials and methods: </strong>This cross-sectional pharmacovigilance study analyzed ADR reports for minocycline, doxycycline, and chlorhexidine retrieved from the World Health Organization (WHO) VigiAccess database. ADRs were classified by System Organ Classes (SOCs) and Preferred Terms (PTs) according to the Medical Dictionary for Regulatory Activities (MedDRA). Disproportionality analysis was performed using reporting odds ratios (RORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 78,891 ADR reports were analyzed (16,917 minocycline, 49,980 doxycycline, and 11,994 chlorhexidine), revealing distinct safety signal patterns. Minocycline showed prominent disproportionality signals for endocrine disorders (ROR = 9.64, 95% CI: 7.73-12.02) and hepatobiliary disorders (ROR = 3.69, 95% CI: 3.43-3.96). Doxycycline signals were mainly concentrated in gastrointestinal disorders (ROR = 1.55, 95% CI: 1.51-1.60) and psychiatric disorders (ROR = 1.41, 95% CI: 1.32-1.50). Chlorhexidine exhibited a distinct profile characterized by product-related issues (ROR = 4.52, 95% CI: 3.89-5.25) and a high number of oral-specific PT-level signals (n = 79). ADRs were more frequently reported in females (56.9-60.8%) and adults aged 18-44 years (26.7-39.6%). Serious outcomes were uncommon, with mortality rates of 0.143%, 0.10%, and 0.07% for minocycline, doxycycline, and chlorhexidine, respectively.</p><p><strong>Conclusions: </strong>Adjunctive antimicrobial agents used in periodontal therapy demonstrate heterogeneous real-world safety signal profiles. Disproportionality patterns indicate that local administration does not preclude systemic biological relevance, underscoring the need for agent-specific, guideline-concordant risk-benefit assessment in clinical decision-making.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}