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Odontogenic maxillofacial space infections are life-threatening conditions that result from untreated dental problems, in which bacteria infect the facial fascial spaces from the affected teeth and supporting tissues. Despite their clinical severity, epidemiological data from sub-Saharan Africa and Ethiopia remain limited. Understanding their prevalence and associated factors is essential for effective management and prevention. To determine the prevalence and associated factors of odontogenic maxillofacial space infection among adult patients (aged > 18 years) admitted to the Oral and Maxillofacial Surgery Unit at Hawassa University Comprehensive Specialized Hospital over 3 years (2023-2025). A retrospective cross-sectional study using patients' medical records was conducted among patients admitted to the Oral and Maxillofacial Surgery between January 2023 and December 2025. Of these cases, 419 were deemed eligible according to predefined inclusion and exclusion criteria, and data were systematically extracted from the records. For a case to be included, there was a need to have clinical or radiographic evidence that the subject was infected and had pus drainage upon incision and drainage. Data were entered into Epi-Data 4.6, and data analysis was carried out using SPSS Version 26.0 (Windows 10). Descriptive statistics, such as frequencies and percentages, and logistic regression analysis were done. p < 0.05 was considered statistically significant. This study included 419 patient charts; 50 patients had confirmed odontogenic maxillofacial space infection. The prevalence of odontogenic maxillofacial space infection was 12.0% (95% CI: 9.0%-15.0%) among admitted patients. On multivariate analysis, rural residence (AOR = 2.70, 95% CI: 1.35-5.40), hypertension (AOR = 2.40; 95% CI: 1.15-5.00), diabetes mellitus (AOR = 3.10, 95% CI: 1.45-6.60), and delay in healthcare seeking (AOR = 4.00, 95% CI: 1.95-8.20) were independently associated. The prevalence of odontogenic maxillofacial space infections was relatively high among admitted patients in this tertiary hospital. Rural residence, hypertension, diabetes mellitus, and delay in healthcare seeking are associated with the infection. Strengthening early diagnosis and treatment of dental infections, improving access to oral health services, and encouraging timely healthcare-seeking behaviour helps reduce the burden of odontogenic maxillofacial space infections.
Histiocytoses are rare diseases and represent a heterogeneous group of pathologies with variable clinical features, determined by the tissue accumulation of cells of presumed dendritic or macrophage origin. Oral manifestations may constitute an early clinical sign and sometimes the only initial evidence of the pathology. The aim of this systematic review with meta-analysis was to investigate the prevalence of oral manifestations in patients affected by LCH, describing their clinical and histopathological characteristics. A systematic search was conducted on three major databases (PubMed, Scopus and ScienceDirect) and on Google Scholar grey literature. Relevant articles were selected based on inclusion and exclusion criteria, following the guidelines of the Cochrane handbook. The primary outcome was the prevalence of oral manifestations, calculated as the proportion of affected patients compared to the total cohort in each study. A fixed-effects meta-analysis was performed. A sensitivity analysis was also performed excluding studies with high heterogeneity and a correlation analysis between the mean age at diagnosis and the prevalence of oral lesions, weighted by sample size. 16 studies were included for a total of 2,174 patients. The aggregate prevalence of oral manifestations was 14.86% (95% CI: 11.80-18.58%), reduced to 10.57% in sensitivity analysis. The most frequently involved sites were the mandible and the gums, with osteolytic, ulcerative or periodontal lesions. The weighted correlation analysis between age and prevalence showed a very weak and non-significant correlation (r = 0.007, p = 0.991; Spearman ρ = - 0.258, p = 0.734), confirmed even after the exclusion of outliers. Oral manifestations represent a relevant clinical component in LCH and may constitute an early diagnostic sign. However, the prevalence varies widely between studies. No significant correlation was observed between age at diagnosis and the presence of oral manifestations. However, the interpretation of these findings is limited by the predominance of retrospective studies and the overall moderate methodological quality of the available evidence. Therefore, further standardized prospective studies are needed to better clarify the clinical impact of oral lesions in LCH.
Elderly oral cavity cancer patients form a unique cohort with multiple therapeutic considerations. The Oral Cancer Survival Calculator® has been used to estimate the risk of cancer-specific deaths in patients with oral cancer. The aim of our study was to evaluate surgical outcomes and cancer-specific survival in elderly oral cavity cancer patients using the calculator. Retrospective outcome analysis of elderly (>/=70 years) oral cavity cancer patients undergoing surgery at a rural-based tertiary academic institution was performed. The calculator was used to decipher health adjusted age (HAA), estimated 1-, 2- and 5-year overall survival (OS) and cancer specific deaths. Chronological age and HAA-related outcomes were analysed. Ninety-seven elderly patients (median age: 74 years) underwent surgery. Post-operative complications were noted in 18.6%, with an overall mortality of 14.4%. Presence of comorbidities (p < 0.001) and the need for tracheostomy (p < 0.001) significantly increased complication rates. Using the calculator, the estimated 1-, 2- and 5-year OS and cancer-related deaths was 84%, 71% and 37% and 14%, 26% and 37% respectively. However, the accuracy of the calculator in predicting deaths was 55.5%. HAA, obtained from the calculator, was lower than the corresponding chronological age in 57.7% of patients and was associated with lower post-operative complications (7.1%) and re-admission (1.8%) rates. HAA was predictive of lower complication and re-admission rates after surgery in elderly oral cavity cancer patients. The Oral Cancer Survival Calculator ® showed a moderate prediction for mortality. However, larger studies are needed to validate these findings.
This study characterises articulatory-kinematic strategies to differentiate the sibilants /s/ and /ʃ/ in individuals before and after tongue cancer surgery. We further evaluate whether successful differentiation can be predicted by auditory and somatosensory motor learning abilities. Acoustic and electromagnetic articulography data were collected longitudinally (pre-surgery, and 6, 12, and 18 months post-surgery) from Dutch individuals treated for T1-T3 tongue tumours (n = 12). Sex- and age-matched typical speakers (n = 11) were tested once. We analysed the Euclidean distance (ED) between the tongue's position for /s/ and /ʃ/, alongside the centre of gravity. Altered formant feedback and bite-block experiments assessed motor learning from auditory and somatosensory input. Speakers showed a reduced ED between sibilants at the tongue tip (TT) six months post-surgery compared to pre-surgery. While performance improved over time, pre-surgery levels were not regained. ED reductions were associated with changes in lip aperture and jaw positioning. No differences were found between patients and typical speakers in acoustic or kinematic measures at any time point. No robust association was found between auditory/somatosensory motor learning ability and sibilant differentiation. Together, while TT control was reduced following tongue cancer surgery, speakers compensated using the lips and jaw to preserve the sibilant contrast.
Guided bone regeneration (GBR) membranes that prevent fibroblast infiltration while promoting new bone formation are critically needed in maxillofacial surgery. In this study, a 3D-printed, resorbable GBR membrane inspired by bone extracellular matrix (ECM) components was developed using gelatin methacrylate (GelMA), alginate (Alg), and hydroxyapatite (HA) at 0, 20, 40, and 60%, denoted as GelMA/Alg, GelMA/Alg20HA, GelMA/Alg40HA, and GelMA/Alg60HA, respectively. Morphological features were examined by scanning electron microscopy and 3D profilometry, and mechanical properties, surface wettability, swelling behavior, and degradation profiles were systematically evaluated. Structural and thermal characteristics were analyzed by X-ray diffraction, Fourier-transform infrared spectroscopy, and differential scanning calorimetry. Biological performance was assessed using MC3T3-E1 osteoblasts on the bone-facing side and L929 fibroblasts on the soft-tissue side. Barrier efficacy was evaluated through fibroblast occlusion assays, and osteogenic potential was determined by total protein content and alkaline phosphatase (ALP) activity. Furthermore, osteoconductive and stem cell-regulating abilities were investigated using human bone marrow stromal cells (hBMSCs) under dynamic culture conditions. The addition of HA enhanced filament alignment, surface wettability, mechanical strength, and structural stability, forming porous structures conducive to bone integration and dense surfaces that effectively inhibited fibroblast infiltration. Among all groups, GelMA/Alg20HA exhibited the most balanced mechanical, biological, and barrier performance, highlighting its potential as a resorbable GBR membrane for maxillofacial bone regeneration.
The aim of this network meta-analysis was to collectively synthesize the evidence on computer-assisted implant surgery (CAIS), with its static, dynamic, and robotic types, for delayed implant placement in single-tooth spaces, in order to explore whether robotic surgery provides comparable accuracy to other implant placement techniques, based on homogenous data from studies with the same design and population. Literature search was performed in Scopus, MEDLINE/PubMed, and Cochrane library, screening for randomized clinical trials, in which delayed implant placement was performed in single-tooth spaces, reporting information on at least one aspect of platform, apex, and angle deviation. A frequentist network meta-analysis was performed. Eleven studies were included. All CAIS methods demonstrated significantly less deviation compared with freehand implant placement. Robotic CAIS ranked the highest among all techniques and showed significantly less apex deviation than static CAIS (MD= -0.42, 95% CI -0.71; -0.13), as well as lower angle deviation compared with both static and dynamic surgery (MD= -1.65, 95% CI -2.89; -0.40, and MD= -1.26, 95% CI -2.39; -0.13, respectively). The certainty of evidence in the outcomes of the meta-analysis ranged from very low to moderate. Robotic surgery provides high accuracy for delayed implant placement in single-tooth edentulous sites, superior to other CAIS methods. Nevertheless, the low number of studies available and limited evidence necessitate further exploration of its overall performance, in order to validate these conclusions. This study offers strong insight into the performance of robotic CAIS, and how it compares with the other well-established treatment modalities, thus demonstrating the potential of this technology to reach superior accuracy, which can be utilized in cases demanding high precision, such as immediacy with prefabricated components, or flapless surgery.
Oral cancer estimates are concerning in India, with inequalities in accessing screening services, especially in rural areas. Socioeconomic characteristics contribute to disparities in screening coverage. The current study estimates the coverage of self-reported screening, spatial patterns, differences in screening rates in urban and rural areas and determinants of screening among Indian women. We analysed data from 348,882 women (30-49 years) participating in India's fifth wave of the National Family Health Survey (NFHS-5). Self-reported oral cancer screening weighted coverage was estimated and compared per socio-demographic characteristics. Global and local spatial autocorrelation methods were applied to understand the spatial distribution of screening coverage, which was then depicted using choropleth maps. The differences in urban-rural screening were decomposed and determinants of screening were identified using the multivariable binary logistic regression. Analysis was done using Stata v17.0. Overall, at the national level, self-reported screening coverage was 0.87%, with higher rates in urban areas (1.08%) compared to rural areas (0.77%). Screening uptake increased with age, socioeconomic status and education. Scheduled Tribes and the poorest quintile had the lowest rates. 348,882 participants were included in the final analysis after all exclusions. The uptake of oral cancer screening increased with an increase in wealth Index (Middle: adjusted odds ratio: 1.35; 95% CI: 1.07-1.70), Richer (1.43; 1.12-1.84), Richest (1.60; 1.20-2.13) and in obese women (1.28; 1.02-1.63). Meanwhile, women who belonged to the Muslim religion (0.68; 95% CI: 0.56-0.84), scheduled tribes (0.70; 95% CI: 0.53-0.84) and those who were illiterate (0.66; 0.51-0.85) had lower odds of screening uptake. Women from South Indian states (9.58; 95% CI: 7.60-12.07), West Indian states (3.81; 95% CI: 2.88-5.04), Central India (2.48; 95% CI: 1.95-3.14) and North-east Indian states (1.65; 95% CI: 1.20-2.27) had higher odds of oral cancer screening uptake compared to North Indian states. The urban-rural gap was 57.76% due to factor distribution and 42.24% due to differences in factor effects. Religion, caste, education and media exposure all significantly contributed to the gap. Screening uptake varied according to socio-economic status and region of the country. Significant disparities in oral cancer screening exist among urban and rural women, driven by socioeconomic factors. Enhancing healthcare access, education and media outreach in rural areas is essential to improving screening rates and reducing disparities.
Transverse maxillary deficiency is nearly universal in patients with cleft lip and/or palate (CLP) and represents a major determinant of occlusal function, surgical accessibility, and long-term stability. Despite established principles of rapid maxillary expansion and secondary alveolar bone grafting (SABG), considerable variability persists in appliance selection, timing, and sequencing of orthodontic and surgical interventions. To develop a standardized, evidence-informed clinical algorithm for the management of transverse discrepancies in non-syndromic CLP patients, integrating orthodontic biomechanics with surgical timing considerations. This study presents an algorithm-development framework based on structured clinical reasoning and synthesis of contemporary cleft care principles. Key variables incorporated into the decision pathway included cleft phenotype, presence of anterior segment collapse, type of posterior crossbite (relative versus absolute), dental development stage, and readiness criteria for SABG. Appliance selection (Hyrax, fan-type expander, differential opening expander), rate of activation, retention strategy, and post-graft orthodontic timing were systematically organized into a stepwise protocol designed for reproducibility across multidisciplinary cleft teams. This work is principally a structured review and synthesis of the existing literature, designed to organize established knowledge into an actionable clinical framework; no novel clinical concepts or techniques are introduced for the first time. The presented algorithm provides a structured, clinically applicable framework to harmonize orthodontic and surgical management of transverse discrepancies in CLP patients, aiming to reduce treatment variability, enhance interdisciplinary coordination, and improve graft-related and occlusal outcomes.
Spinal cord ischemia-reperfusion injury (IRI), which can occur as a result of temporary aortic occlusion during resection of thoracoabdominal aneurysms, can be an unpredictable and devastating complication of aortic surgery. There are no specific medications or guidelines for the prevention and treatment of spinal cord IRI (SCIRI). It is now known that IRI not only exacerbates local tissue damage when blood flow is restored but also affects distant organs, such as the liver, lungs, and brain, through mediators released into the systemic circulation. Studies show that ozone pretreatment reduces oxidative damage by increasing antioxidant capacity, promotes anti-inflammatory signaling, improves blood circulation, and ameliorates IRI. Our study is one of the first to examine the effects of ozone on remote organs (liver, lung, and brain) when administered via different routes (intrathecal, intraperitoneal, rectal) in a spinal cord ischemia-reperfusion model. To determine whether ozone administered by different routes offers multiorgan protection in SCIRI. Thirty adult Wistar albino rats were randomly divided into five groups (n = 6, each): A control (C group), an IR group, an IR rectal ozone (IRRO) group, an IR intrathecal ozone (IRITO), and an IR intraperitoneal ozone (IRIPO). In the IR groups, the spinal cord IR models (a 30-minute ischemia period was applied to the infrarenal abdominal aorta using an atraumatic vascular clamp, and then a 120-minute reperfusion period was applied by removing the clamp) were applied. An ozone-oxygen mixture of 1 mg/kg (50 μg/mL) was administered by rectal insufflation to the IRRO group, 0.7 mg/kg (50 μg/mL) via the peritoneum to the IRIPO group, and 20 μL (20 μg/mL) intrathecally to the IRITO group 30 minutes before midline laparotomy. At the end of the reperfusion procedure, histopathological and biochemical analyses of liver, lung, and brain tissues were performed. Liver tissue malondialdehyde (MDA) levels were significantly lower, and catalase (CAT) enzyme activities were significantly higher in the IRRO, IRITO, and IRIPO groups than in the IR group. Histopathologically, we had favorable results from all three ozone applications compared to the IR group. Lung tissue MDA levels were significantly lower, and CAT enzyme activities were significantly higher in the IRITO and IRIPO groups than in the IR group. We had more positive results in the IRRO group than in the IR group, but the difference was not found to be significant. Histopathologically, we obtained significantly more positive results in the IRITO and IRIPO groups compared with the IR group regarding all the criteria we evaluated. Our results in the IRRO group were also positive. Brain tissue MDA levels were significantly lower and CAT enzyme activities significantly higher in the IRITO and IRIPO groups than in the IR group. We had positive results in the IRRO group compared with the IR group. Histopathologically, we obtained significantly more positive results in the IRITO group regarding all the criteria we evaluated. We observed histopathologically that single-dose ozone pretreatment administered intrathecally, intraperitoneally, or rectally had positive effects on liver, lung, and brain tissues compared to the IR group in an SCIRI model in rats due to its antioxidant effect. The best histopathological results were obtained with intrathecal, intraperitoneal, and rectally administered ozone, in that order, in all three tissues.
Single-system Langerhans cell histiocytosis (LCH) involving the maxillomandibular complex is rare, and optimal management remains controversial. Intralesional corticosteroid injections have been proposed as a minimally invasive alternative to surgery, radiotherapy, or systemic therapy. The aim of this study is to systematically evaluate the effectiveness and safety of intralesional corticosteroid injections for treating LCH of the maxilla or the mandible. A systematic review was conducted according to the PRISMA guidelines, in which PubMed, Embase and Scopus were searched. Eligible studies included English language case reports and case series describing LCH of the mandible and/or maxilla that had been confirmed by biopsy and treated with intralesional corticosteroid injections. Outcomes assessed included the resolution of symptoms, regression of lesions confirmed by radiography, recurrence, and adverse effects. Fifteen studies comprising 28 patients were included. Thirteen patients were treated with triamcinolone acetonide, 13 with methylprednisolone, and two with dexamethasone. Lesions were predominantly unifocal and located in the body or ramus of the mandible. Intralesional corticosteroid therapy was effective in 27 patients. Recurrence was reported in one case 12 months post treatment. Adverse effects were limited to one localised abscess that resolved without sequelae. Intralesional corticosteroid injections are associated with high rates of clinical and radiological improvement in mandibular and maxillary LCH, with minimal morbidity. While the current evidence is limited to low level studies, this approach represents a promising conservative treatment option. Prospective studies with standardised protocols are needed to define its long-term efficacy and role within treatment algorithms.
NHWD-870 HCl is a next-generation oral BET inhibitor (US Patent 10,428,071 B2). We conducted a Phase I dose‑escalation study. This multicenter, open-label, phase I study used a Bayesian optimal interval (BOIN) dose-escalation design. NHWD-870 HCl was administered once daily on an intermittent schedule (5 days on/2 days off) at doses ranging from 0.5 to 3.5 mg. The primary endpoints were safety, cycle 1 Dose-Limiting Toxicities (DLTs), the maximum tolerated dose (MTD), and the recommended phase II dose (RP2D). Secondary endpoints included Objective Response Rate (ORR), Disease Control Rate (DCR), and pharmacokinetics (PK). Thirty-one patients received NHWD-870 HCl. Overall, 93.5% (29/31) experienced at least one adverse event (AE), and 83.9% (26/31) experienced at least one treatment-related AE (TRAE). The most common TRAEs were thrombocytopenia (45.2%; grade ≥3, 25.8%), anemia (41.9%; grade ≥3, 12.9%), and increased blood bilirubin (32.3%; grade ≥3, 3.2%). Treatment-related Serious Adverse Events (SAEs) occurred in 4 patients (12.9%; thrombocytopenia, n=3; wound bleeding, n=1), and no treatment-related deaths were reported. Twenty-four patients were evaluable for DLTs, and all 3 DLTs occurred at the 2.75 mg dose level, corresponding to a cycle 1 DLT rate of 30.0%, which was within the BOIN target interval (0.18- 0.42). However, considering the concentration-dependent thrombocytopenia, the occurrence of grade 4 thrombocytopenia at 2.75 mg (2 events), the higher discontinuation rate, and the lessthan-dose-proportional increase in exposure at 2.75 mg, the RP2D was determined to be 2.0 mg on a 5-days-on/2-days-off schedule. Among the 29 response-evaluable patients, the ORR was 3.45%, and the DCR was 69.0%. Durable stable disease was observed in selected patients, including approximately 21 months in melanoma and more than 26 months in NUT carcinoma. PK analyses showed rapid absorption (median Tmax, approximately 1-2 h) and less-than-doseproportional increases in Cmax and AUC over the 0.5-2.75 mg dose range; the mean terminal half-life was approximately 11-16 h, with mild accumulation. NHWD-870 HCl showed manageable, predominantly hematologic toxicity, with thrombocytopenia demonstrating clear dose- and exposure-related trends. Although the cycle 1 DLT rate at 2.75 mg was consistent with the BOIN target interval, the occurrence of grade 4 thrombocytopenia, the higher frequency of treatment interruptions and discontinuations, and the subproportional increase in exposure supported selection of 2.0 mg (5 days on/2 days off) as the RP2D. Although the ORR was low, the durable disease control observed in BET-dependent tumors, including NUT carcinoma and DLBCL, supports further biomarker-driven studies. NHWD-870 HCl demonstrated manageable, mainly hematologic toxicity and preliminary antitumor activity, supporting further clinical evaluation, particularly in NUT carcinoma and DLBCL.
Diabetes mellitus (DM) is a metabolic condition defined by chronic hyperglycemia with serious complications, including retinopathy, neuropathy, cardiopathy, and nephropathy. DM often accelerates inflammatory responses, which traditional treatments frequently fail to control. Chronic inflammation, with an imbalance between pro-inflammatory and anti-inflammatory cytokines, causes pancreatic β-cell failure and tissue damage. Mesenchymal stem cells (MSCs) are emerging as a promising therapy because of their capacity to control immune responses and stimulate tissue repair. Interleukin-1β (IL-1β), IL-17, IL-6, and tumor necrosis factor alpha (TNF-α) have crucial roles in the diabetes-associated inflammatory environment. MSC therapies reduce levels of pro-inflammatory cytokines and increase levels of anti-inflammatory cytokines, such as IL-10, IL-4, IL-13, and transforming growth factor-beta (TGF-β), reducing inflammation and promoting wound healing. Moreover, the dual functions in inflammation and tissue repair of key cytokines, including TGF-β, IL-6, IL-2, IL-33, and IL-8, provide both challenges and opportunities in MSC therapy. This review explores innovative MSC-based therapies for treating DM, focusing on their modulation of pro- and anti-inflammatory cytokines. MSCs may help reduce diabetic complications by restoring the cytokine balance, increasing insulin sensitivity, and protecting organs. However, the unique source of MSCs and the complex cytokine milieu in DM warrant additional research to improve treatment strategies and ensure long-term safety and efficacy. By highlighting the potential of MSCs to improve DM treatment and enhance patient outcomes, this review attempts to provide a thorough understanding of the molecular mechanisms by which MSCs regulate cytokine activity.
Ensuring a consistent and valid assessment of preclinical technical skills is essential in dental education. This study evaluated the inter-rater reliability and validity of a standardized analytic rubric for staff evaluation of single all-ceramic crown preparations across multiple academic years. It compared student performance in midterm and final examinations, examined cohort variability, and investigated the correlation between academic achievement (grade point average or GPA) and practical performance. A retrospective cross-sectional study was conducted on fourth-year male dental students from three consecutive academic years (2020-2023). Two experienced double-blinded faculty members independently evaluated midterm and final crown preparations by using a validated analytic rubric. The rubric comprised six criteria: five technical domains (occlusal/incisal reduction, axial reduction, taper, finish line placement, and finishing of the preparation) scored 0-6 points and one professionalism domain scored 0-4 points, yielding a total maximum score of 40 points. Inter-rater reliability, cohort differences, and GPA correlation were assessed using Cronbach's alpha, Kruskal-Wallis tests, and Pearson's correlation, respectively, and significance was set at p < 0.05. Inter-rater reliability was high for the overall scores (midterm α = 0.881, final α = 0.899). Among the individual parameters, taper (retention and resistance) scored the highest in the midterm examination (Staff 1: 5.13/6), and finish line placement scored the lowest in the final examination (Staff 1: 3.79/6). Professionalism showed the lowest inter-rater consistency (α = -0.095). Performance considerably declined from midterm to final examinations (Staff 1 scores declined from 28.19 to 23.68). Substantial variability existed across the academic years, with the 2021-2022 cohort outperforming the others. GPA showed only one weak positive correlation with final scores from one evaluator (r = 0.287, p = 0.037) and was otherwise not significant. The analytic rubric proved reliable for standardized preclinical assessment, supporting its implementation despite the unexpected decline in the final examination scores and cohort variations with a high inter-reliability score. Academic GPA was a poor predictor of practical crown preparation performance, reinforcing that cognitive and psychomotor competencies are distinct domains in dental education.
Oral squamous cell carcinoma (OSCC) represents the most prevalent primary malignant neoplasm within the head and neck region. The elevated rates of recurrence and metastasis, coupled with resistance to conventional therapies, significantly compromise patient prognosis, thereby necessitating the identification of novel molecular regulatory targets. N6-methyladenosine (m6A) modification emerges as the most widespread post-transcriptional RNA modification in eukaryotic organisms. This modification operates through a dynamic regulatory network involving methyltransferases (Writers), demethylases (Erasers), and recognition proteins (Readers), which collectively orchestrate precise regulation of RNA functionality and are intricately involved in oncogenic processes. Current research indicates that m6A modification and its associated regulatory factors exhibit aberrant dysregulation in OSCC. By modulating critical biological processes such as tumor cell proliferation, invasion, metastasis, autophagy, ferroptosis, and the characteristics of OSCC tumor stem cells, these modifications influence both the progression and therapeutic responsiveness of OSCC. This article systematically reviews the core regulatory mechanisms of m6A modification, focusing on its functional effects and molecular pathways in the malignant progression of OSCC. It summarizes the clinical translational value of m6A regulatory factors as diagnostic and prognostic biomarkers as well as targets for targeted therapy, and outlines future research directions in this field, aiming to provide important theoretical references for the precision diagnosis and treatment of OSCC. 口腔鳞状细胞癌（OSCC）是头颈部最常见的原发恶性肿瘤，其高复发、高转移率及治疗耐药严重影响患者预后，亟须挖掘新的分子调控靶点。N6-甲基腺苷（m6A）修饰是真核生物中最主要的RNA转录后修饰方式，通过甲基转移酶、去甲基化酶与识别蛋白构成的动态调控网络，精准调控RNA功能，并广泛参与肿瘤生物学进程。现有研究表明，m6A修饰及其调控因子在OSCC中异常失调，可通过调控肿瘤细胞增殖、侵袭、转移、细胞自噬、铁死亡及OSCC肿瘤干细胞特性等关键生物学过程，影响OSCC的发生发展与治疗应答。本文系统综述m6A修饰的核心调控机制，重点阐述其在OSCC恶性进展中的功能效应与分子通路，总结m6A调控因子作为OSCC诊断、预后标志物及靶向治疗靶点的临床转化价值，展望该领域未来研究方向，旨在为OSCC的精准诊疗提供重要理论参考。.
Successful orthognathic therapies are characterised by a physiologically configured occlusion whose long-term clinical stability is mainly assessed through occlusal parameters. In the present study, long-term treatment outcomes were assessed based on occlusal changes after 5 years using digital occlusion and masticatory efficiency analysis. This study examined 33 adult patients after treatment of skeletal class II (n = 18; 12 women, median age 28.15 years; interquartile range [IQR] = 15.10) and class III malformations (n = 15; 7 women, median age 23.90 years; IQR = 4.80) 9 months (T1) and 5 years (T2) postorthognathic therapy. A total of 20 patients with neutral skeletal relation (10 women; median age 30.50 years; IQR = 7.50) served as a control group. Skeletal classification was based on sagittal jaw configuration (Wits) and habitual intercuspation was recorded using the T‑Scan Novus® (Tekscan Inc., South Boston, MA, USA) for digital occlusion analysis with the following variables: total tooth contact (TTC), occlusion time (TOC), occlusion asymmetry (OAS), anterior and posterior antagonism (ATC and PTC). In addition, masticatory performance was assessed using a standardized two-colour chewing gum bolus analysis. Five years after surgery (T2), none of the occlusal parameters differed significantly between the groups, indicating functional approximation to the control group. Longitudinal analysis revealed significant improvements within both surgical groups (T1 to T2). In class II patients, TTC, ATC and PTC increased, while TOC decreased significantly. Class III patients also showed significant increases in TTC, ATC and PTC with TOC and OAS remaining unchanged. Overall, both treatment groups demonstrated substantial recovery and long-term stabilization of occlusal function. Bolus homogeneity analysis showed no significant difference between control and treatment patients 5 years after surgery. The 5‑year observation of orthognathic treatment for sagittal jaw malformations showed significant improvements in occlusal parameters. Both masticatory efficiency and occlusal parameters measured at 5 years postoperatively did not differ significantly from the control group, indicating that the functional improvements achieved by the therapy were stable in the long term. ZIELSETZUNGEN: Erfolgreiche kieferorthopädische Behandlungen zeichnen sich durch eine physiologisch angepasste Okklusion aus, deren langfristige klinische Stabilität hauptsächlich anhand okklusaler Parameter beurteilt wird. In der vorliegenden Studie wurden die langfristigen Behandlungsergebnisse auf der Grundlage okklusaler Veränderungen nach 5 Jahren mittels digitaler Okklusions- und Kaueffizienzanalyse bewertet. In der Studie wurden 33 erwachsene Patienten nach der Behandlung von skelettalen Klasse-II-Fehlstellungen (n = 18; 12 Frauen, medianes Alter 28,15 Jahre; Interquartilsabstand [IQR] = 15,10) und Klasse-III-Fehlstellungen (n = 15; 7 Frauen, medianes Alter 23,90 Jahre; IQR = 4,80) 9 Monate (T1) und 5 Jahre (T2) nach der kieferorthopädischen Therapie untersucht. Insgesamt 20 Patienten mit neutraler skelettaler Relation (10 Frauen; Medianalter 30,50 Jahre; IQR = 7,50) dienten als Kontrollgruppe. Die skelettale Klassifizierung basierte auf der sagittalen Kieferkonfiguration (Wits), und die habituelle Interkuspidation wurde mittels T‑Scan Novus® (Tekscan Inc., South Boston/MA, USA) zur digitalen Okklusionsanalyse mit folgenden Variablen erfasst: Gesamtzahnkontakt (TTC), Okklusionszeit (TOC), Okklusionsasymmetrie (OAS), anteriorer und posteriorer Antagonismus (ATC und PTC). Darüber hinaus wurde die Kaufunktion mittels einer standardisierten Zweifarben-Kaugummi-Bolus-Analyse beurteilt. Fünf Jahre postoperativ (T2) unterschieden sich die okklusalen Parameter zwischen den Gruppen nicht signifikant, was auf eine funktionelle Annäherung an die Kontrollgruppe hindeutet. Die Längsschnittanalyse ergab signifikante Verbesserungen in beiden Operationsgruppen (T1 zu T2). Bei Patienten der Klasse II stiegen TTC, ATC und PTC an, während TOC signifikant abnahm. Auch bei Patienten der Klasse III zeigten sich signifikante Anstiege bei TTC, ATC und PTC, während TOC und OAS unverändert blieben. Insgesamt zeigten beide Behandlungsgruppen eine erhebliche Erholung und langfristige Stabilisierung der okklusalen Funktion. Die Bolus-Homogenitätsanalyse ergab 5 Jahre nach Operation keinen signifikanten Unterschied zwischen Kontroll- und Behandlungspatienten. Die 5‑jährige Beobachtung der orthognathen Behandlung bei sagittalen Kieferfehlstellungen zeigte signifikante Verbesserungen der okklusalen Parameter. Sowohl die Kaueffizienz als auch die 5 Jahre postoperativ gemessenen okklusalen Parameter unterschieden sich nicht signifikant von denen der Kontrollgruppe, was darauf hindeutet, dass die durch die Therapie erzielten funktionellen Verbesserungen langfristig stabil waren.
This cross-sectional study aimed to evaluate occlusal characteristics and masticatory performance in patients with skeletal Class II and Class III malocclusions. Both digital occlusal analysis and standardized bolus analysis were employed to assess functional outcomes in non-surgically treated, surgically treated, and control patients. A total of 133 orthognathic patients (71 female; median age 29.8 years) and 20 controls (9 female; median age 30.0 years) were included. Skeletal malocclusions were categorized as compensated, decompensated, and a separate surgically treated cohort assessed at 5-year postoperative follow-up. Digital occlusal parameters (total tooth contact (TTC), time of occlusion (TOC), occlusal asymmetry (OAS), anterior and posterior tooth contact (ATC, PTC)) were recorded and masticatory performance was assessed using a standardized two-color bolus analysis. Non-surgically treated Class II and Class III patients showed significantly reduced TTC, ATC, PTC, and prolonged TOC as well as lower bolus mixing scores compared with controls (p < 0.05). Surgically treated patients at 5-year follow-up exhibited occlusal parameters and bolus mixing scores comparable to controls, indicating normalization of occlusal parameters and masticatory efficiency. Skeletal Class II and Class III malocclusions are associated with impaired occlusal function and reduced masticatory efficiency. Orthognathic therapy effectively restores occlusal parameters as well as functional chewing ability in the long term. Combining digital occlusal analysis with bolus analysis provides a comprehensive and objective evaluation of masticatory rehabilitation in orthognathic patients. DRKS00025729.
Temporal muscle thickness (TMT) is a surrogate marker of skeletal muscle mass and has been associated with survival in patients with head and neck squamous cell carcinoma (HNSCC). However, its association with adverse events during concurrent chemoradiotherapy (CCRT) remains unclear. To evaluate the relationship between TMT and treatment-related toxicity in patients with HNSCC undergoing CCRT. This retrospective study included 96 patients with HNSCC who underwent curative cisplatin-based CCRT between 2018 and 2025. TMT was measured by three independent evaluators on pre-treatment computed tomography images. A TMT cutoff value of 6.3 mm was set for men and 5.2 mm for women; accordingly, patients were stratified into low- and high-TMT groups. Of the 96 patients, 54 and 42 were classified into the low- and high-TMT groups, respectively. Interobserver agreement was high (intraclass correlation coefficient = 0.853). The incidence of grade ≥3 leukopenia was significantly higher in the low-TMT group (p = 0.023). Multivariate logistic regression identified low TMT (p = 0.045) and BMI <18.5 kg/m2 (p = 0.044) as independent predictors of grade ≥3 leukopenia. TMT may serve as a simple imaging-based marker to aid risk stratification and guide treatment individualization in HNSCC.
Vertical bone augmentation in the posterior mandible presents significant challenges due to anatomical constraints and frequent deficiencies in soft tissue. Optimizing the soft-tissue phenotype prior to augmentation is critical to ensure stable wound closure and to provide the vascular support necessary for successful graft integration. This article introduces the pedicled masseter-buccinator periosteal flap, a novel technique that uses highly vascularized tissue to improve the quality and quantity of soft-tissue covering while also promoting graft survival. A patient presented with an edentulous site in the left mandibular molar region, exhibiting a severe combined vertical and horizontal ridge deficiency. Panoramic radiography revealed a non-restorable implant and a hopeless tooth in the premolar area, resulting in an extensive defect at this site. Following removal of the implant and tooth, a large three-dimensional ridge defect was confirmed intraoperatively. After local decontamination, a pedicled masseter-buccinator periosteal flap was dissected from the inner aspect of the cheek. A partial-thickness flap, which included limited buccinator and masseter muscle fibers along with the periosteal layer was elevated. The flap was rotated mesially and sutured to the lingual periosteum to achieve stable soft tissue augmentation. Finally, the overlying primary mucoperiosteal flap was sutured, resulting in a double-layered tissue closure. Two months later, three-dimensional ridge augmentation in the left mandibular premolar-molar region was performed using the split-bone block technique with autogenous graft harvested from the ipsilateral mandibular retromolar area. After three months, two implants were inserted in combination with a Kazanjian vestibuloplasty. After three months of healing, the implants were uncovered, allowing completion of the prosthetic rehabilitation. Radiographic follow-up at two years showed stable peri-implant bone levels and clinical examination confirmed healthy and stable soft-tissue conditions. The pedicled masseter-buccinator periosteal flap demonstrated to be a reliable and effective approach for soft tissue augmentation in the posterior mandible and support vertical bone grafting. Early clinical results indicate a high level of predictability with few complications making this technique a promising option in anatomically challenging cases.
Orbital exenteration is a radical procedure used in selected orbital malignancies, yet survival outcomes vary widely, particularly in recurrent or previously treated disease. We evaluated the association of pathological stage (nodal and/or distant metastasis status) and margin status with overall survival (OS) and disease-free survival (DFS) in patients undergoing exenteration for recurrent or previously treated orbital cancers. We retrospectively analyzed 39 patients who underwent orbital exenteration between 2017 and 2024. Patients were categorized as localized disease (pN0/pM0) or advanced disease with nodal and/or distant metastasis (pN + and/or pM+). Survival was estimated using Kaplan-Meier analysis and compared using the log-rank test. Median follow-up was 365 days. Margins were classified as R0 or R1. Of the 39 patients, 24 (61.5%) had localized disease and 15 (38.5%) had advanced disease with nodal and/or distant metastasis; 6 patients (15.4%) had positive margins. 24-month OS was 78% in localized disease versus 33% in patients with nodal and/or distant metastasis (p = 0.011). Median OS was not reached in localized disease and was 13 months in patients with nodal and/or distant metastasis. 24-month DFS was 62.5% versus 33% (p = 0.017). R1 margins were associated with markedly worse outcomes: 24-month OS 0% vs. 75.8% for R0, and all R1 patients recurred within 12 months. Sensitivity analysis excluding < 6-month follow-up confirmed these findings. Nodal and/or distant metastatic status and positive surgical margins were associated with worse survival outcomes after orbital exenteration for recurrent or previously treated orbital malignancies. Most adverse events occurred within the first postoperative year, suggesting a clinically relevant early risk period. Given the histological heterogeneity of the cohort, these findings should be interpreted as prognostic patterns in a salvage orbital oncology population and require validation in larger disease-specific series.