Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

{"title":"Is chronological age predictable on panoramic images using the Demirjian method on third molars? Insights from a Turkish population-based study.","authors":"A Tas, N Agbulut, Y Oztoprak, K Aydin","doi":"10.4317/medoral.27651","DOIUrl":"10.4317/medoral.27651","url":null,"abstract":"<p><strong>Background: </strong>Third molars are crucial in forensic age estimation during adolescence due to their late and variable development. The modified Demirjian method employs a nine-stage classification (0-H) for assessing dental maturity. However, population-specific validation is essential for forensic accuracy. This study aims to evaluate the relationship between chronological age and M3 development stages in a Turkish population using panoramic radiographs, and to investigate the influence of gender and anatomical location, including impaction classifications (Pell-Gregory and Winter).</p><p><strong>Material and methods: </strong>A total of 1656 individuals (mean age: 13.9±3.78 years) underwent digital panoramic radiography. Developmental stages of 2770 mandibular and 2553 maxillary M3s were assessed using the modified Demirjian method. Statistical analyses included Spearman correlation, Kruskal-Wallis tests and generalized linear models.</p><p><strong>Results: </strong>Third molar development strongly correlated with chronological age. Most teeth were in stages B-E, with mandibular M3s most frequent in stages C and E, and maxillary in C and D. Age differed significantly across all stages (p<0.001). Generalized linear models confirmed age as a significant predictor (R²=0.330 mandible; R²=0.337 maxilla). Gender and impaction classifications had no main effects, but significant interactions were found (Pell-Gregory×Gender: p<0.001; Winter×Pell-Gregory: p=0.016).</p><p><strong>Conclusions: </strong>The modified Demirjian method reliably estimates age in Turkish adolescents, with high age-stage correlation. While gender and anatomical location alone do not alter developmental progression, their interaction with impaction patterns reveals complex growth dynamics. These findings support context-sensitive forensic protocols.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e160-e165"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate implant using an inverted body-shift design versus a conventional conical implant: A randomized clinical trial with 1 year follow-up.","authors":"A Galve-Huertas, S García-González, L Decadt, O Ortíz-Puigpelat, F Hernández-Alfaro, S-A Centenero","doi":"10.4317/medoral.27776","DOIUrl":"10.4317/medoral.27776","url":null,"abstract":"<p><strong>Background: </strong>Immediate implant placement is a technique-sensitive procedure, requiring precise positioning on the palatal aspect to ensure ideal prosthetic emergence and contour. Achieving primary stability is essential for the placement of an immediate provisional crown. The Inverted Co-Axis implant is uniquely designed for this purpose, featuring a 12-degree angled neck and a widened middle third, allowing central positioning within the alveolar socket while maintaining primary stability. Given its uncommon use, this study aimed to compare the performance of the Inverted Co-Axis implant with that of a conventional conical implant.</p><p><strong>Materials and methods: </strong>A randomized controlled trial was conducted with 30 patients, equally divided into two groups (n=15). Immediate implants were placed in the anterior maxilla, each restored with an immediate provisional crown and accompanied by connective tissue grafting during surgery. Outcomes included implant survival, success rates, primary stability (insertion torque, ISQ), bone remodeling, and aesthetic results. Statistical analysis comprised descriptive measures (mean, SD, median, quartiles) and appropriate inferential tests: Mann-Whitney U, Wilcoxon signed-rank, Student's t-test, Chi-square, Kruskal-Wallis, Spearman's correlation, and Brunner-Langer. Significance was set at α=0.05.</p><p><strong>Results: </strong>All implants survived (100% survival rate). Success rates were 93.3% in the control group and 73.3% in the test group, with no statistically significant difference. Insertion torque averaged 35 Ncm (control) and 42 Ncm (test), with ISQ values between 56-62 in both groups. Minimal horizontal bone loss was observed at 1mm, 3mm and 5mm. Vertical bone loss was greater on the buccal aspect in the test group, while palatal loss was higher in the control group. Aesthetic evaluation via the Pink Esthetic Score yielded comparable results.</p><p><strong>Conclusions: </strong>Both implant designs proved effective and reliable for immediate post-extraction implantation, with favorable outcomes in stability, bone preservation, and aesthetics.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e297-e306"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of topical Vitamin E in oral mucositis in patients undergoing oncology treatment. Scoping review.","authors":"V Sanmartín-Barragáns, M Vázquez-Rico, G-C Camolesi, I-B Prado-Pena, T García-Carnicero, M Pérez-Sayáns, A Blanco-Carrión, P Gándara-Vila","doi":"10.4317/medoral.27790","DOIUrl":"10.4317/medoral.27790","url":null,"abstract":"<p><strong>Background: </strong>Oral mucositis (OM) refers to lesions characterized by erythema and ulceration of the oral mucosa, commonly observed in cancer patients undergoing chemotherapy (CT) and/or radiotherapy (RT). Currently, there is no specific therapy supported by robust scientific evidence for the treatment of OM-related lesions. However, the literature suggests that antioxidants such as vitamin E may help prevent oxidative cellular damage and limit tissue injury caused by free radicals, potentially reducing the severity of OM during cancer treatment. This review aims to analyze the existing literature on the use of topical vitamin E and its effects on oral mucositis lesions induced by cancer therapy.</p><p><strong>Material and methods: </strong>This scoping review was conducted in accordance with the PRISMA-ScR guidelines. A comprehensive search was performed in Web of Science (WOS), PubMed, and Scopus databases using the keywords: \"vitamin E\", \"oral mucositis\", \"chemotherapy\", and \"radiotherapy\". Studies published between 1990 and 2025 were considered for inclusion.</p><p><strong>Results: </strong>A total of 167 articles were identified. After screening and eligibility assessment, 7 clinical trials were included in the review 4 involving pediatric populations and 3 involving adults. Six of the studies reported favorable outcomes in the vitamin E group compared to placebo, including improved healing, reduced symptom severity, and shorter duration of oral mucositis.</p><p><strong>Conclusion: </strong>Based on the studies included in this review, topical vitamin E appears to offer beneficial effects in mitigating the severity and duration of oral mucositis lesions in patients undergoing cancer treatment. However, no standardized protocol currently exists regarding dosage, mode of application (therapeutic vs. preventive), or duration of treatment. Further clinical trials are warranted to establish clear guidelines for the use of topical vitamin E in this context.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e317-e323"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descriptive transcriptomic profiling differentiates oral leukoplakia from proliferative verrucous leukoplakia and reveals distinct molecular signatures.","authors":"M Pérez-Sayáns, F-F Vieira-E-Silva, C Fernández-Rozadilla, Á Carracedo, S Carlés-González, A-I Lorenzo-Pouso, A Pérez-Jardón, P Gándara-Vila, A García-García, J-M Suárez-Peñaranda, A Blanco-Carrión, C-M Chamorro-Petronacci","doi":"10.4317/medoral.27658","DOIUrl":"10.4317/medoral.27658","url":null,"abstract":"<p><strong>Background: </strong>Oral leukoplakia and proliferative verrucous leukoplakia represent oral potentially malignant disorders. Oral leukoplakia typically presents as solitary lesions, while proliferative verrucous leukoplakia manifests as multifocal lesions with higher malignant potential. This study aimed to investigate the genetic heterogeneity between these disorders through differential gene expression, genetic variants, and microRNA profiling to identify potential biomarkers for diagnosis and prognosis.</p><p><strong>Material and methods: </strong>Biopsies and peripheral blood samples were obtained from 20 patients. Subsequently, RNA extraction, RNA-Seq libraries preparation, and bioinformatic analyses were conducted to ascertain differential gene expression, genetic variants, and microRNA expression.</p><p><strong>Results: </strong>In mRNA analysis, overexpressed genes in proliferative verrucous leukoplakia are primarily associated with inflammation and immune regulation, while underexpressed genes relate to skin barrier maintenance. Pathway analysis reveals underexpressed genes related to impaired keratinization in proliferative verrucous leukoplakia and with keratin envelope formation in oral leukoplakia, while overexpressed genes are linked to synaptic processes and protein-protein interactions. Somatic mutation drivers in proliferative verrucous leukoplakia include variants in NRXN3, SRGAP2B, INIP, MYO18A, and ATF7IP genes. Regarding variant analysis, two variants in the Syndecan 3 (SDC3) gene identified in proliferative verrucous leukoplakia have demonstrated enormous value and indicate an important biomarker for a differential diagnosis and to predict prognosis. Proliferative verrucous leukoplakia shows in miRNA analysis MIR1246 and MIR767 overexpression, with MIR135B being the most underexpressed.</p><p><strong>Conclusions: </strong>Our findings emphasize the intricate transcriptomic profiles in oral leukoplakia and proliferative verrucous leukoplakia development, laying the groundwork for future studies to enhance clinical management and patient outcomes in oral oncology. Syndecan 3 gene polymorphisms may represent a key point in proliferative verrucous leukoplakia differential diagnosis and prognostic prediction.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e166-e173"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autogenous dentin grafts in implant dentistry: A scoping review of clinical applications and processing protocols.","authors":"Y-F Braga, E-F Maferano, T-S Lopes, M-R Neto, L-E Macas, F-W Costa","doi":"10.4317/medoral.27733","DOIUrl":"10.4317/medoral.27733","url":null,"abstract":"<p><strong>Background: </strong>This scoping review aimed to systematically map and synthesize the current evidence regarding the use of autogenous dentin grafts (ADG) in bone augmentation procedures.</p><p><strong>Material and methods: </strong>The review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A comprehensive search was performed in MEDLINE (PubMed), EMBASE, CINAHL, Cochrane Library, Livivo, LILACS, Web of Science, Scopus, and ProQuest Dissertations & Theses Global Google Scholar (gray literature) using the descriptors \"Bone Regeneration,\" \"Dentin,\" and \"Dental Implants\" combined with the Boolean operator and 7,690 studies identified through Google Scholar.</p><p><strong>Results: </strong>The initial search, conducted on December 23, 2024, retrieved 2,391 records, of which 16 met the eligibility criteria and were included in the final review. The findings indicate that autogenous dentin demonstrates efficacy in bone regeneration and alveolar ridge preservation, frequently exceeding the performance of allografts and xenografts. ADG was associated with increased bone density, enhanced implant stability, and improved soft tissue outcomes, particularly when combined with growth factors. Moreover, it was found to be a cost-effective alternative, producing outcomes comparable to other biomaterials regarding new bone formation and bone quality. Its osteoinductive properties further support long-term bone regeneration.</p><p><strong>Conclusions: </strong>Nonetheless, a lack of standardization in dentin processing protocols was noted across studies. ADG represents an effective and accessible option for implant-supported rehabilitation, and future research should focus on standardizing its clinical application.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e251-e258"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the superimposition accuracy in the integration of different digital dental models into the cone-beam computed tomography: An ex vivo study.","authors":"D-A-A Marlière, M-J Calori, L Asprino","doi":"10.4317/medoral.27724","DOIUrl":"10.4317/medoral.27724","url":null,"abstract":"<p><strong>Background: </strong>Accurate virtual planning for orthognathic surgery and dental implants requires integrating cone-beam computed tomography (CBCT) images into digital dental models, but the impact of different scanning methods on the superimposition accuracy remains unclear. The aim of this study was to compare the superimposition accuracy of dental models obtained from two scanning methods using CBCT scans of dental surfaces.</p><p><strong>Material and methods: </strong>The maxilla (MX) and mandible (MD) of 4 dry skulls were scanned using CBCT and converted into 3D meshes. Dental arches were obtained using intraoral devices (IS) and by digitizing plaster models using an extraoral scanner (PM). Sixty-four digital models were produced per group. Each 3D mesh and corresponding model were imported into the Geomagic software for alignment and deviation analysis. Registration errors and mean deviations (MD+ and MD-) were assessed quantitatively, and the qualitative evaluation was performed through color maps.</p><p><strong>Results: </strong>Deviations ranged from -0.4 to 0.3mm in both groups, with 80% of the values distributed between -0.5 and 0.5mm. In both groups, Registration error, MD+ and 3D Error were below 0.5mm, and MD- was higher than -0.5mm. Statistically significant differences were found between IS and PM models for MD+, as well as for registration error and MD+ in mandibular comparisons.</p><p><strong>Conclusions: </strong>Superimpositions were not affected by the model acquisition method, and both were clinically acceptable. However, PM superimpositions showed greater deviation magnitudes, suggesting an inclination for IS to produce more accurate alignments, especially in the mandible.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e231-e242"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longevity factors for short and extra-short implants: An eight-year retrospective observational clinical study.","authors":"S-J-T Leite, M Harduin, M Rizzato, A-O Gonçalves, J-C Fernandes, G-V Fernandes","doi":"10.4317/medoral.27712","DOIUrl":"10.4317/medoral.27712","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate implants placed in the mandible and maxilla and analyze the correlation between local and systemic factors that affect the clinical and prosthetic performance of short and extra-short implants.</p><p><strong>Material and methods: </strong>Implants were analyzed based on 18 factors: Location (anterior or posterior; maxilla or mandible); presence or not of previous grafting; bone quality; prosthesis was/was not installed immediately; type of prosthetic connection (external hexagon or Morse Taper); thread type (trapezoidal, triangular, or hybrid); surface's characteristic; implant length; implant width; prosthesis installation follow-up; type of prosthesis retention (cemented or screw-retained); single prosthesis or splinted to another implant; antagonist occlusion type; presence or absence of intermediary prosthetic component; prosthetic abutment height; distance between intermediaries component; presence or absence of implant bicortilization; and implant insertion torque. Clinical intraoral analysis included dimensions of the occlusal part and the inclination of the cusps (≤15 degrees versus >15 degrees). Possible systemic influences were also evaluated. Patient satisfaction was assessed through a questionnaire. The statistical analysis considered results significant if p<0.05.</p><p><strong>Results: </strong>This study analyzed 91 dental implants (60 short/extra-short and 31 standard/long) placed in 16 patients, including individuals with diabetes (n=3), smoking (n=1), and parafunctional habits (n=7). Implants were distributed across the maxilla (43.3%) and mandible (56.7%) arches, with one short implant failure (survival rate = 98.3%). The mean peri-implant bone loss was 6.80±13.06 mm² for short/extra-short and 8.19±12.10mm² for standard/long implants. Bone loss was lower in males (3.32±6.03mm²) than in females (7.61±8.55mm²), and implant diameter influenced the osseointe-gration loss area, highlighting relevant biomechanical and risk-related factors. Significantly reduced peri-implant bone loss was observed in implants with abutments >2mm, Morse taper connections, bicorticalization, insertion torque ≤35N, anterior placement, maxillary location, and prior bone grafting (p<0.05 for all). These findings suggest that such variables may positively influence os-seointegration and support the long-term success of short implants.</p><p><strong>Conclusions: </strong>The use of short- and extra-short implants is a feasible treatment option for mid- and long-term rehabilitation of the full and partial maxillary and mandibular arches.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e205-e218"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Directed pterygomaxillary disjunction versus direct downfracture in Le Fort I osteotomy: application of a fracture quality framework using bilateral ten-point cone-beam computed tomography in a retrospective cohort of 205 patients.","authors":"Í Aragón-Niño, J-L Del-Castillo-Pardo-de-Vera, J-L Cebrián-Carretero, C López-Martinez, B Tapia-Salinas, C Zheng, C Navarro-Cuellar","doi":"10.4317/medoral.27749","DOIUrl":"10.4317/medoral.27749","url":null,"abstract":"<p><strong>Background: </strong>Control of the pterygomaxillary junction (PMJ) fracture is critical in Le Fort I osteotomy. We tested whether a directed PMJ disjunction (osteotome-assisted intermediate release) improves fracture quality, symmetry, and alignment versus direct downfracture.</p><p><strong>Material and methods: </strong>Single-center retrospective comparative cohort (January 2019-April 2025). Two hundred five consecutive patients underwent Le Fort I: directed disjunction (n=127) or direct downfracture (n=78). Postoperative cone-beam computed tomography at day 90-110 was scored with a bilateral ten-point map. Primary outcomes were per-side quality (poor/good/excellent) and a patient-level overall quality status (poor/fair/good/very good/excellent). Inclusive and strict \"clean-cut,\" symmetry, and alignment were predefined. Group comparisons used chi-square or Fisher's exact tests (two-sided α=0.05).</p><p><strong>Results: </strong>Directed disjunction shifted side-level quality toward inferior, contained patterns: \"excellent\" 59.1% vs 6.4% (right) and 48.0% vs 12.8% (left); \"poor\" 22.0% vs 91.0% and 29.9% vs 85.9% (all p<0.001). Patient-level status improved (poor 38.6% vs 98.7%; excellent 37.8% vs 1.3%; p<0.001). Perfect symmetry rose to 49.6% vs 1.3% and correct alignment to 61.4% vs 1.3% (p<0.001). Maxillary tuberosity involvement decreased from 60.3%/56.4% (right/left) without disjunction to 2.4%/5.5% with disjunction. Inclusive and strict clean-cut were higher with directed disjunction (69.3% vs 37.2% and 53.5% vs 9.6%; p<0.001).</p><p><strong>Conclusions: </strong>Within a standardized early postoperative window, directed PMJ disjunction was associated with superior fracture quality, greater bilateral coordination, and fewer undesired trajectories than downfracture. Adoption of a targeted release and standardized reporting is supported. Interpretation is limited by the retrospective single-center design and focus on fracture behavior without complication or long-term outcome analysis.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e277-e283"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of five anesthetic delivery systems for palatal infiltration: A randomized clinical trial.","authors":"S Küçükkurt, A Saadat","doi":"10.4317/medoral.27738","DOIUrl":"10.4317/medoral.27738","url":null,"abstract":"<p><strong>Background: </strong>Pain and anxiety during palatal infiltration remain barriers to patient cooperation. The anesthetic delivery system may influence subjective outcomes and physiological stress responses, yet robust comparative data are lacking.</p><p><strong>Material and methods: </strong>In this randomized, parallel-arm superiority trial, 200 healthy adults (≥18 years) were equally allocated into five groups (n=40) by block randomization with concealed allocation. Tested systems were conventional dental syringe (CDS), manual pressure syringe (MCJ), spring-activated pressure syringe (PCJ), needle-free jet injector (NFI), and computer-controlled local anesthetic delivery system (CCLAD). Each participant received 0.4 mL of 4% articaine with epinephrine (1:100,000) via standardized palatal infiltration by a single calibrated operator. The study was single-blind: outcome assessors and statisticians were blinded to allocation. The primary outcome was post-injection pain (VAS, 0-10cm). Secondary outcomes were dental fear (VAS pre/post), pulse rate, and oxygen saturation, recorded at baseline, during, and after injection.</p><p><strong>Results: </strong>Mean VAS pain did not differ significantly across groups (overall p=0.380); adjusted analyses (ANCOVA including injection duration as covariate) confirmed no clinically relevant mean differences [95% CI within ±0.5 cm; Hedges' g <0.20]. MCJ showed slightly higher discomfort. All systems significantly reduced fear (p<0.05), with PCJ showing the largest reduction (ΔVAS-2.7). Pulse rate varied across groups (p<0.001), peaking in CCLAD and remaining most stable in MCJ; oxygen saturation was unchanged. No adverse events were observed.</p><p><strong>Conclusions: </strong>All systems were clinically safe and effective but differed in psychophysiological impact. Devices that reduce fear and stabilize vital responses, particularly those targeting PCJ and CCLAD, may help improve patient cooperation and the overall treatment experience.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e259-e267"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological spectrum of non-sinonasal intestinal-type adenocarcinomas of the head and neck: Systematic review of case reports, case series, and cross-sectional studies.","authors":"G-S Vieira, M-W-A Gonçalves, P-C Tincani, A-J Tincani, C-T Chone, A Antolini-Tavares, A Altemani, F-V Mariano","doi":"10.4317/medoral.27770","DOIUrl":"10.4317/medoral.27770","url":null,"abstract":"<p><strong>Background: </strong>Intestinal-type adenocarcinomas (ITACs) most often arise in the sinonasal tract, typically associated with occupational exposures, but they rarely occur in other head and neck sites. When present in extra-sinonasal regions, their clinicopathological and molecular characteristics remain poorly understood. This systematic review aimed to clarify the clinicopathological, immunohistochemical, and molecular features of non-sinonasal intestinal-type adenocarcinomas (ITACs) of the head and neck.</p><p><strong>Material and methods: </strong>This review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD42022309841). Two reviewers independently screened, extracted data, and assessed risk of bias using the Joanna Briggs Institute tools. Sources included PubMed/MEDLINE, Scopus, Embase, Web of Science, Google Scholar, and OpenGrey. A comprehensive search identified 1,376 records. After applying eligibility criteria, 26 studies comprising 37 cases were included. Data on clinical, histological, immunophenotypic, molecular, and prognostic features were analyzed.</p><p><strong>Results: </strong>Most patients were male (73%), with a mean age of 57.9 years. The oral cavity, particularly the mobile tongue (51.4%), was the most commonly affected site. Histologically, colonic (59.5%) and mucinous (56.8%) architectures were the most frequent microscopic patterns presented. Immunohistochemistry frequently showed positivity for CK7, CK20, and CDX2, while SATB2, MUC1, and MUC5AC had variable expression. Mismatch repair proteins were intact in all cases. Molecular findings included mutations in MLL3, TP53, EGFR, and AKT1, and upregulation of PAX1, MUC5B, and EMT-related genes, suggesting a distinct profile from sinonasal ITACs. Surgical resection, often with adjuvant therapy, was the main treatment. Tumors were aggressive, with metastases being present in 35.1% and disease-specific mortality in 24.3%.</p><p><strong>Conclusions: </strong>Non-sinonasal ITACs are rare, aggressive malignancies requiring accurate diagnosis and further molecular investigation to improve management and outcomes.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e284-e296"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}