{"title":"Effect of Pilocarpine on Salivary Flow Rate in Patients With Xerostomia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Sonali Parvatkar, Sushmita Wayadande, Manisha Khorate, Nigel Figueiredo","doi":"10.1111/odi.70548","DOIUrl":"https://doi.org/10.1111/odi.70548","url":null,"abstract":"<p><strong>Background: </strong>Xerostomia is a common clinical condition that significantly impairs oral health and quality of life. Pilocarpine, a muscarinic agonist, is frequently prescribed to stimulate salivary secretion.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered in PROSPERO. Electronic searches of PubMed, Cochrane Library, Science Direct, Scopus, Embase and Google Scholar were performed for randomized controlled trials published between January 2005 and November 2025. Trials comparing pilocarpine with placebo in patients with xerostomia confirmed by sialometry were included. Risk of bias was assessed using the Cochrane Risk of Bias (ROB) 2.0 tool. Meta-analysis was performed using StataCorp software 2025 with standardized mean differences of salivary flow rate.</p><p><strong>Results: </strong>12 randomized controlled trials involving 599 participants were included, with 7 studies contributing to the meta-analysis. Pilocarpine showed a statistically significant improvement in salivary flow rate compared with placebo (SMD = 0.15; 95% CI: 0.06-0.25; p < 0.001; I<sup>2</sup> = 98%). Subgroup analysis demonstrated a significant effect for topical pilocarpine (I<sup>2</sup> = 72%), while systemic pilocarpine did not show statistical significance (I<sup>2</sup> = 96%).</p><p><strong>Conclusions: </strong>Pilocarpine improves salivary flow rate in patients with xerostomia, particularly when residual salivary gland function is preserved, with topical formulations showing more consistent evidence of efficacy. However, given the high heterogeneity, results should be interpreted cautiously.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral diseasesPub Date : 2026-10-19DOI: 10.1111/odi.70542
Zi-Xuan Fan, Xin-Yue Wang, Chang Liu, Jie Yang
{"title":"Association Between Oxidative Stress Biomarkers and Periodontitis in Saliva and Gingival Crevicular Fluid: A Systematic Review and Meta-Analysis.","authors":"Zi-Xuan Fan, Xin-Yue Wang, Chang Liu, Jie Yang","doi":"10.1111/odi.70542","DOIUrl":"https://doi.org/10.1111/odi.70542","url":null,"abstract":"<p><strong>Aim: </strong>This systematic review aimed to synthesize current observational evidence on the association between oxidative stress (OS) biomarker levels in saliva and gingival crevicular fluid (GCF) and periodontitis.</p><p><strong>Methods: </strong>PubMed, Embase, the Cochrane Library, and Web of Science were searched from 2000 to 2026. Two reviewers independently screened studies and extracted data. Inter-rater reliability was assessed using Cohen's kappa and percent agreement. Publication bias was investigated using Egger's test.</p><p><strong>Results: </strong>Out of 1695 records, 31 prospective studies and 54 cross-sectional studies met the inclusion criteria. In the primary analyses, periodontitis was associated with higher total oxidant status (TOS), malondialdehyde (MDA), and 8-hydroxy-deoxyguanosine (8-OHdG) levels and lower total antioxidant capacity (TAC) in both saliva and GCF. In GCF, superoxide dismutase (SOD) and glutathione (GSH) levels were lower, whereas glutathione peroxidase (GPX) was higher. No significant differences were found for salivary SOD, GSH, GPX, or glutathione reductase (GR) in the primary analyses. However, after trim-and-fill adjustment, the initially significant salivary TAC and 8-OHdG associations were no longer statistically significant. Substantial heterogeneity was observed among evaluated studies.</p><p><strong>Conclusions: </strong>This meta-analysis supports an association between periodontitis and altered OS biomarker levels in saliva and GCF.</p><p><strong>Trial registration: </strong>PROSPERO: CRD420251154372.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral diseasesPub Date : 2026-10-19DOI: 10.1111/odi.70525
María Verónica San Martín Harms, Isidora Mujica Valenzuela, Danilo Fischer Prato, Diego Prieto, María Cristina Coloma Osorio, Leonardo Roldán Sánchez, Tomás Regueira, Duniel Ortuño
{"title":"Association Between Oral Health Status at Admission and Length of Hospital Stay in the Intensive Care Unit: A Retrospective Cohort Study (2024-2025).","authors":"María Verónica San Martín Harms, Isidora Mujica Valenzuela, Danilo Fischer Prato, Diego Prieto, María Cristina Coloma Osorio, Leonardo Roldán Sánchez, Tomás Regueira, Duniel Ortuño","doi":"10.1111/odi.70525","DOIUrl":"https://doi.org/10.1111/odi.70525","url":null,"abstract":"<p><strong>Background: </strong>Poor oral health is linked to prolonged hospitalization, but critical care data from Latin America remain virtually absent. This study characterized baseline oral health at intensive care unit (ICU) admission in a Chilean center and evaluated its association with ICU length of stay (LOS).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted including first-admission adults (n = 105). Bedside clinical examinations at admission assessed the WHO Decayed, Missing, and Filled Teeth (DMFT) index, gingival inflammation, and salivary hypofunction. Adjusted associations with ICU LOS were evaluated using multivariable ordinary least squares (OLS) regression.</p><p><strong>Results: </strong>At admission, gingival inflammation and salivary hypofunction were each present in 90.5% of patients. The mean DMFT was 8.87 ± 9.40. In multivariable analysis, the DMFT index was not associated with ICU LOS (β = -0.050, 95% CI [-0.187, 0.087], p = 0.477). Mechanical ventilation status emerged as the sole independent predictor of prolonged stay (β = 3.30 days, 95% CI [0.75, 5.85], p = 0.013). Results were robust across five sensitivity analyses.</p><p><strong>Conclusions: </strong>Despite a remarkably high baseline burden of oral disease at ICU admission, chronic caries experience was not independently associated with ICU LOS, which was driven primarily by ventilatory support.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral diseasesPub Date : 2026-10-19DOI: 10.1111/odi.70552
Waleed Alamoudi
{"title":"The Association Between Oral Lichen Planus and Diabetes Mellitus: A Scoping Review of the Evidence.","authors":"Waleed Alamoudi","doi":"10.1111/odi.70552","DOIUrl":"https://doi.org/10.1111/odi.70552","url":null,"abstract":"<p><strong>Objective: </strong>Oral lichen planus (OLP) is a chronic immune-mediated oral potentially malignant disorder. Three prior meta-analyses reported elevated diabetes mellitus (DM) prevalence in patients with OLP, but the evidence base has since expanded. This scoping review synthesised all available evidence on the OLP-DM association up to November 2025.</p><p><strong>Study design: </strong>PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library were searched up to November 30, 2025 with no lower date limit, supplemented by backward citation searching. No study design restrictions were applied. Findings were synthesised thematically per PRISMA-ScR.</p><p><strong>Results: </strong>Twenty-one sources from 11 countries were included, encompassing observational studies, Mendelian randomisation analyses, biochemical investigations, reviews, and case reports. DM prevalence in patients with OLP ranged from 9.7% to 24.5%, with the association specific to type 2 DM. Prediabetes was independently associated with OLP after multivariate adjustment. Mendelian randomisation provided causal evidence linking type 1 DM and elevated glycated haemoglobin to increased OLP risk.</p><p><strong>Conclusions: </strong>The OLP-DM association is consistent, biologically plausible, and extends to subclinical glycaemic dysregulation. Glycaemic assessment should be considered in patients with OLP presenting with oral or systemic features suggestive of metabolic dysregulation. Future research should prioritise longitudinal studies, intervention trials on glycaemic optimisation.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral diseasesPub Date : 2026-10-19DOI: 10.1111/odi.70497
Jing Yin, Chen Fangchun
{"title":"Evaluation of the Clinical Efficacy of High-Intensity Focused Ultrasound in the Treatment of Oral Leukoplakia.","authors":"Jing Yin, Chen Fangchun","doi":"10.1111/odi.70497","DOIUrl":"https://doi.org/10.1111/odi.70497","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the clinical efficacy of high-intensity focused ultrasound (HIFU) in treating oral leukoplakia (OLK), thereby exploring a novel therapeutic approach for this condition.</p><p><strong>Methods: </strong>17 OLK patients treated at the Department of Oral Mucosal Diseases between June 2022 and February 2023 underwent HIFU therapy. Postoperative clinical efficacy and adverse reactions were evaluated.</p><p><strong>Results: </strong>At the 6-month follow-up, the outcomes were as follows: complete remission in 9 cases (52.95%), partial remission in 6 cases (35.29%), no remission in 2 cases (11.76%). The overall response rate reached 88.24%. 2 h postoperatively, 2 patients experienced significant pain, while the remaining patients reported mild pain (VAS score: 0.88 ± 1.83, M = 0). Patients with cheeks or commissural leukoplakia showed no swelling. Except for 1 case, patients with dorsal tongue leukoplakia exhibited mild swelling that resolved spontaneously within 2 ~ 24 h. Between 24 and 72 h postoperatively, all 16 patients except one developed noticeable ulcers with mild pain (VAS score: 1.1 ± 0.84, M = 1), which healed within 2-3 weeks.</p><p><strong>Conclusion: </strong>HIFU demonstrates significant clinical efficacy in treating OLK. Postoperative reactions are localized and well-tolerated, markedly improving patients' quality of life.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral diseasesPub Date : 2026-10-19DOI: 10.1111/odi.70501
Sohaib Shujaat, Marryam Riaz, Jawaher Mohammed Alsubaie, Aljwhrah Abdulaziz Almuammar, Arun Pillai, Abdulmohsen Alfadley, Ali Anwar Aboalela
{"title":"Differential Diagnosis Performance of ChatGPT in Oral and Maxillofacial Pathology.","authors":"Sohaib Shujaat, Marryam Riaz, Jawaher Mohammed Alsubaie, Aljwhrah Abdulaziz Almuammar, Arun Pillai, Abdulmohsen Alfadley, Ali Anwar Aboalela","doi":"10.1111/odi.70501","DOIUrl":"https://doi.org/10.1111/odi.70501","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate ChatGPT (GPT-5.1) for ranked differential diagnoses in oral and maxillofacial pathology, assess image effects on diagnostic performance and examine output stability across repeated runs.</p><p><strong>Methods: </strong>This retrospective diagnostic accuracy study included 160 biopsy-confirmed cases. Cases were evaluated using a standardised prompt under two conditions: text-only and text plus clinical photographs and/or radiographs. Each case underwent three independent runs. Performance was measured using Top-1, Top-3, Top-5 and Top-10 accuracy.</p><p><strong>Results: </strong>Top-1 accuracy was 44.0% for text-only and 43.3% for text + image inputs. Accuracy increased at broader thresholds, with Top-10 accuracy reaching 80.7% and 82.9%, respectively, but no significant differences were observed between input conditions at any Top-K threshold. Top-1 performance was stable across runs, although variability was observed at broader Top-K thresholds in the text-only condition.</p><p><strong>Conclusions: </strong>ChatGPT ranked the reference diagnosis first in fewer than half of cases, while broader differential lists more often included it. Images did not significantly improve accuracy, although heterogeneous and non-standardised visual inputs may have limited detection of multimodal effects. These findings support further investigation for hypothesis generation and educational use rather than clinical decision support or replacement of expert judgement and histopathological confirmation.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral diseasesPub Date : 2026-10-19DOI: 10.1111/odi.70550
Md Omar Faruk, Lee Peng Karen-Ng, Wanninayake Mudiyanselage Tilakaratne, Thomas George Kallarakkal
{"title":"Differential Expression of P53, CDKN2A, NOTCH1, and CASP8 in Oral Epithelial Dysplasia: An In Vitro Study to Explore Potential Malignant Transformation.","authors":"Md Omar Faruk, Lee Peng Karen-Ng, Wanninayake Mudiyanselage Tilakaratne, Thomas George Kallarakkal","doi":"10.1111/odi.70550","DOIUrl":"https://doi.org/10.1111/odi.70550","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to better understand the expression of P53, CDKN2A, NOTCH1, and CASP8 proteins in progressive and nonprogressive oral epithelial dysplasia (OED) cell lines to predict malignant transformation.</p><p><strong>Materials and methods: </strong>Normal oral keratinocytes (NHOK810), nonprogressive OED (D30-mild, D25-severe), progressive OED (D20-moderate, D19-severe), and oral squamous cell carcinoma (H357, BICR31, and ORL188) were co-cultured with irradiated 3T3 fibroblasts. Western blotting was used to assess the protein expression of p53, CDKN2A, NOTCH1, and CASP8 in these cell lines. Bootstrapping, one-way ANOVA, and subsequent post hoc analyses were performed for multiple comparisons.</p><p><strong>Results: </strong>CDKN2A and NOTCH1 had low expression in progressive OED (p = 0.0008 and 0.0012) respectively relative to nonprogressive OED, indicating a negative tendency. Conversely, p53 demonstrated significantly higher expression in progressive OED (p = 0.0112) compared to nonprogressive OED, reflecting a positive trend of expression throughout disease progression. There was a significant difference in CASP8 expression between nonprogressive and progressive cell lines (p = 0.039); however, no linear pattern was observed as the disease advanced.</p><p><strong>Conclusion: </strong>The current study illustrates that the high expression of p53, combined with low expression of CDKN2A and NOTCH1, may serve as helpful markers, providing a potential molecular complement to histopathology for predicting malignant transformation in OED.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Impact of the COVID-19 Pandemic on Oral Cancer Screening: Real-World Data From Taiwan.","authors":"Yu-Hsun Kao, Ming-Nan Lin, Wu-Lin Yao, Yu-Ting Huang, Wen-Chen Wang, Yu-Wen Yang, Pei-Shan Ho","doi":"10.1111/odi.70547","DOIUrl":"https://doi.org/10.1111/odi.70547","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disrupted cancer screening services worldwide, but its impact across multiple screening indicators remains unclear.</p><p><strong>Methods: </strong>This population-based interrupted time series study evaluated the impact of COVID-19 on oral cancer screening in Taiwan. Two intervention points were defined: January 2020 and May 2021. Four indicators were assessed: screening rate, screening positivity rate, incidence, and mortality. Segmented regression analyses were performed across six National Health Insurance divisions, and changes in stage at diagnosis (2018-2022) were examined.</p><p><strong>Results: </strong>At baseline, screening rates declined, screening positivity rate and mortality increased modestly, and incidence remained stable. After the first outbreak, screening positivity rate showed a significant immediate decrease (OR = 0.86, 95% CI: 0.81-0.92, p < 0.001), whereas screening rate, incidence, and mortality showed no significant changes. Advanced-stage diagnoses increased, while early-stage diagnoses declined. Regional analyses demonstrated similar patterns. No significant slope changes after the first outbreak or level/trend changes after the second outbreak were observed. Incidence and mortality remained stable throughout the study.</p><p><strong>Conclusions: </strong>The first outbreak had the greatest impact on screening-related indicators, with findings consistent with possible delays in cancer detection. Maintaining organized screening services during public health emergencies is essential to minimize delayed cancer detection.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral diseasesPub Date : 2026-10-12DOI: 10.1111/odi.70517
Martina Ferrillo, Alfredo De Rosa, Vincenzo Quinzi, Chiara Conte, Antonio Francica, Antonio Ammendolia, Amerigo Giudice, Alessandro de Sire
{"title":"Efficacy of Physical Therapy on Maximal Mouth Opening in Patients Affected by Disc Displacement and Degenerative Temporomandibular Joint Diseases: A Systematic Review.","authors":"Martina Ferrillo, Alfredo De Rosa, Vincenzo Quinzi, Chiara Conte, Antonio Francica, Antonio Ammendolia, Amerigo Giudice, Alessandro de Sire","doi":"10.1111/odi.70517","DOIUrl":"https://doi.org/10.1111/odi.70517","url":null,"abstract":"<p><strong>Background: </strong>Among temporomandibular disorders (TMDs), the main arthrogenic entities are disc-condylar complex disorders and degenerative diseases.</p><p><strong>Objective: </strong>This systematic review aimed to evaluate the effectiveness of physiotherapy in patients with temporomandibular joint (TMJ) disorders.</p><p><strong>Methods: </strong>A systematic review was conducted across PubMed, Scopus, and Web of Science until January 2026 to search for studies including patients with a diagnosis of intracapsular TMD as participants; physical therapy or physical therapy combined to other conservative approaches as intervention; placebo, sham treatments, oral pharmacological anti-inflammatory drugs, behavioral therapy, or other conservative approaches as comparison; maximal mouth opening (MMO) as outcome.</p><p><strong>Results: </strong>Out of 1578 identified records, 10 studies were included. A total of 354 subjects were analyzed, of which 213 performed a rehabilitation technique and 141 were included in the control group. Although the randomized trials reported improvement in MMO, pain, and function, a major limitation was the lack of standardized physiotherapy protocols across trials.</p><p><strong>Conclusion: </strong>Findings from the present systematic review showed that physiotherapy (active and passive jaw exercises, associated with relaxation techniques) might improve MMO. Further studies with uniform protocols and high-quality randomized trials are needed to validate the efficacy of multimodal treatments in arthrogenic TMD subtypes.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}