搜索结果：Medicina oral, patologia oral y cirugia bucal

Timely diagnosis remains a major challenge in oral cancer, with more than half of cases diagnosed at advanced stages. Although the patient interval has been suggested as a key component of the diagnostic pathway, its relative contribution and temporal evolution remain insufficiently characterized. This study aimed to quantify diagnostic and treatment intervals in oral cancer and to evaluate the relative contribution of the patient interval using the Aarhus Statement framework, comparing current data with a historical cohort recruited a decade earlier in North-Western Spain. A hospital-based ambispective observational study was conducted including consecutive incident cases of histologically confirmed oral squamous cell carcinoma diagnosed in 2025 at a tertiary referral center. Time intervals from first symptom to treatment initiation were defined according to the Aarhus Statement. Recall bias was minimized through triangulation of patient interviews, relatives' reports, and clinical records. Median intervals and interquartile ranges were calculated, and comparisons were performed with a historical cohort recruited in 2015 under identical methodological criteria. Ratios between intervals were estimated to assess the relative contribution of the patient interval. The median patient interval decreased slightly in 2025 compared with 2015 (25 vs. 31.5 days). Primary care and diagnostic intervals were shorter, whereas specialist and pre-treatment intervals increased. The total pre-treatment interval remained stable between cohorts. Ratio analyses showed that the patient interval represented a limited proportion of the total diagnostic and treatment pathway, with no significant temporal differences. Temporal changes in the oral cancer pathway were heterogeneous, suggesting a redistribution of delays toward later intervals of care. The patient interval was not the main contributor to overall time to treatment, highlighting the need for system-level strategies targeting specialist assessment and treatment initiation phases.

Antiseptic management in oral surgery remains heterogeneous, with no standardised, procedure-specific protocols guiding the perioperative use of agents such as chlorhexidine (CHX) or cetylpyridinium chloride (CPC). This consensus document aims to integrate the best available evidence with structured expert judgement to generate evidence-based clinical practice guidelines for the use of oral antiseptics across dentoalveolar and implant surgical scenarios. A structured two-round expert consensus process was employed, combining a systematic literature search of PubMed/MEDLINE with a structured expert panel discussion conducted in December 2025. Seven oral surgeons and implantologists from four leading Spanish universities participated. Consensus was organised around five thematic blocks regarding the use of oral antiseptics: indications and safety, preoperative preparation, postoperative care, management of complications, and future research priorities. Following independent duplicate screening, 69 studies were included in the qualitative synthesis. CHX 0.12-0.2% (in monotherapy or in combination with CPC) was established as the reference perioperative antiseptic, with evidence supporting its efficacy in reducing postoperative complications (RR=0.66; 95% CI 0.55 to 0.80). A risk-stratified postoperative protocol was formulated, incorporating gel, rinse, and spray formulations adapted to individual patient profiles. Povidone-iodine and CPC were identified as evidence-supported alternatives. Complication-specific recommendations were generated for wound dehiscence, alveolar osteitis, and localised postoperative infection, ranging from conservative antiseptic irrigation and intra-alveolar gel application to escalating surgical and systemic antibiotic management based on severity. All recommendations were explicitly classified as evidence-based, expert consensus-derived, or a combination, reflecting the variable quality of supporting data across clinical scenarios. CHX constitutes the gold standard oral antiseptic for perioperative use in oral surgery. The expert panel recommends CHX+CPC combination formulations (e.g., 0.12% CHX+0.05% CPC) as an alternative perioperative antiseptic option, offering comparable antimicrobial efficacy with an improved tolerability profile relative to CHX monotherapy. Individualised, risk-stratified protocols, which account for procedural complexity, patient comorbidities, and antiseptic tolerability, are recommended to optimise clinical outcomes while minimising adverse effects.

This study analyzed the immunoexpression of programmed death receptor 1 and its ligands in oral cavity squamous cell carcinoma and correlated the findings with histomorphological parameters. Forty cases of oral cavity squamous cell carcinoma (10 in the floor of the mouth, 10 in the palate, 10 in the lower lip, and 10 in the tongue) were selected. The percentages of cytoplasmic/membrane immunopositivity for programmed death receptor 1 and its ligands in neoplastic and stromal cells were evaluated at the tumor invasion front. Programmed death-ligand 1 presented high immunoexpression in all subsites, especially at the parenchyma level. Compared to floor of the mouth and palate, lower lip and tongue exhibited higher expression of programmed death receptor 1 and programmed death-ligand 2 in parenchymal cells and of programmed death receptor 1 in stromal cells, with statistically significant differences for programmed death receptor 1 expression in lower lip (p<0.05). Tongue presented the highest median percentages of positivity for programmed death-ligand 2, with statistically significant differences when compared to floor of the mouth (neoplastic cells and stromal cells) and lower lip (stromal cells) (p<0.05). Regarding histomorphological aspects, the inflammatory infiltrate appears to be an important factor for the immunoexpression of these proteins in oral cavity squamous cell carcinoma. The study suggests location-dependent differences in the antitumor immune response to oral cavity squamous cell carcinoma. Inflammatory infiltrate is key to protein immunoexpression. These findings are crucial for developing new immunotherapeutic strategies for oral cancer.

The aim of this study was to evaluate oral changes in patients admitted to an intensive care unit (ICU). Retrospective, cross-sectional, descriptive study. The following data were collected at a high-complexity referral centre in northeastern Brazil between 2021 and 2024: gender, age, ventilatory support, dental condition, and type of oral change. A total of 2,692 patients admitted to the ICU were evaluated; 52.1% of these patients were male and the mean age was 69.98 years (&#xb1;19.53). Oral changes were identified in 58.41% of the patients, with odontogenic infections being the most prevalent (61.49%), followed by clinical conditions suggestive of salivary changes (15.05%) and soft-tissue lesions (9.85%). The presence of oral changes was significantly associated with males (p<0.001) aged from 50 to 59, and from 60 to 69 years (p<0.001), ventilatory support (p=0.037), being partially dentate (p<0.001), and the number of teeth (p<0.001). These data permit a characterization of the oral health status of this patient profile, reinforcing the importance of the dentist as a member of the multidisciplinary team.

Up to 50% of patients with inflammatory bowel disease (IBD) have associated oral extraintestinal manifestations (OEIMs). We aim to describe the prevalence of OEIMs in IBD and propose a therapeutic algorithm. Electronic health records of adult patients with IBD who presented with at least one oral symptom between January 2017 and November 2021 at a tri-state tertiary academic medical center were retrospectively reviewed. Data included demographics, IBD history, oral diagnoses, OEIM treatments, clinical outcomes, and comorbidities. A total of 116 patients were included; 67 (57.8%) had Crohn's disease (CD) and 49 (42.2%) had ulcerative colitis (UC). Aphthous ulcers were the most common OEIM (80.2%). Frequently used treatments included compounded or mixed mouthwashes (51.7%), topical corticosteroids (33.6%), systemic corticosteroids (20.7%), and topical anesthetics (19.8%). In CD, colchicine was significantly associated with OEIM improvement (p=0.009). In UC, systemic corticosteroids (p=0.03), colchicine (p=0.048), and topical tacrolimus (p=0.048) were significantly associated with improvement. OEIMs are common in IBD and can influence treatment decisions. Colchicine and topical agents demonstrated benefit in selected cases. These findings support multidisciplinary care and inform a therapeutic algorithm for OEIM management in IBD.

Oral squamous cell carcinoma (OSCC) accounts for approximately 90% of malignant neoplasms of the oral cavity. At early stages, the treatment of choice is surgical resection with clear margins, commonly defined as &#x2265;5mm of tumor-free tissue. However, the optimal surgical margin in relation to recurrence and survival remains controversial. The objective of this study was to evaluate the impact of surgical margin status on local recurrence and overall survival in patients with OSCC through a meta-analysis. An electronic search was conducted in Medline-PubMed, Web of Science, and Scopus up to January 2025. Two investigators independently selected the studies according to the inclusion criteria. The study included prospective and retrospective studies assessing patients with oral squamous cell carcinoma who underwent surgical treatment and reported data regarding surgical margin status, recurrence rates, and survival outcomes. The Newcastle-Ottawa Scale was used for non-randomized observational studies. Odds ratios were estimated with 95% confidence intervals, and forest plots were generated using random-effects or fixed-effects meta-analyses depending on heterogeneity. Sensitivity analyses and publication bias analyses were performed using funnel plots and Egger's test. All statistical analyses were conducted using Comprehensive Meta-Analysis software, version 3.0. Positive margins (<5mm) were significantly associated with a higher rate of local recurrence (OR=2.72; 95% CI: 2.04-3.62; p<0.001), while negative margins (&#x2265;5mm) were linked to a 1.58 -fold increase in the probability of 5-year survival (RR=0.63; 95% CI: 0.55-0.74; p<0.001). Surgical margin status is a prognostic factor for locoregional control and overall survival in OSCC. A cutoff value of &#x2265;5mm is proposed as the optimal surgical margin.

Choosing analgesics after third molar surgery requires balancing efficacy with safety. This network meta-analysis (NMA) aimed to compare and rank the safety profiles, measured by adverse events (AEs) related to medication use, of various single-dose oral analgesic regimens. Electronic databases were searched for randomized controlled trials (RCTs) assessing single-dose oral analgesics following third molar surgery. The primary outcome was the incidence of any AE reported before discharge. A frequentist NMA was performed to estimate relative risks (RR) and SUCRA-based probabilistic rankings. The certainty of the evidence was assessed using CINeMA. Twenty-eight RCTs involving 5306 patients were included. NSAID monotherapy demonstrated a significantly higher risk of AEs compared to other non-opioid analgesics and opioid analgesics alone. Conversely, few significant differences were found between most active drugs and placebo. Probabilistic ranking indicated that both nonsteroidal anti-inflammatory drugs (NSAIDs) and placebo had a higher probability of ranking among the least safe options. Significant global inconsistency was detected across the network, and the certainty of the evidence was generally very low to low. The safety profile of single-dose analgesics in this model is complex. While pairwise comparisons and rankings suggested that NSAIDs might be associated with a higher frequency of adverse events, these findings are based on very low to low certainty evidence and likely reflect minor, transient events such as nausea. Additionally, the high incidence of events in the placebo group suggests that the nocebo effect plays a predominant role in event perception. Therefore, results regarding the comparative safety of NSAIDs should be interpreted with caution, balancing this potential risk against their superior analgesic efficacy.

This retrospective study analyzed the frequency of oral and maxillofacial lesions in a pediatric population from an oral pathology service in southeastern Brazil (2015-2024). We reviewed all histopathological reports from this period, which included the COVID-19 pandemic. Demographic and clinicopathological data were collected and summarized using descriptive statistics. Associations were assessed using Pearson's chi-squared, Fisher's exact, Cramer's V, and multinomial logistic regression tests. Among 1,578 pediatric biopsies (patients aged 0-19 years), which represented 8.78% of the service's total caseload, adolescents were the predominant group (76.68%), with a balanced gender distribution. A significant decrease in pediatric cases was observed following the COVID-19 pandemic, although the most frequent lesion types remained consistent. Of the 1,414 conclusive diagnoses, salivary gland pathologies were most common (31.12%), followed by odontogenic cysts (18.74%) and mucosal pathologies (12.02%). Mucocele was the single most prevalent lesion (25.67%), followed by dentigerous cyst (8.17%). Statistical analysis revealed a significant association between patient age and diagnostic category, indicating distinct, developmentally dependent patterns. Our findings confirm the predominance of benign, reactive, and cystic lesions in pediatric patients, including during the COVID-19 pandemic, underscoring the value of current epidemiological data to guide clinical practice and preventive strategies.

Laminin 332 (LM332) is a primary component of the epithelial BM. During malignant transformation, loss of continuity and cytoplasmic redistribution have been documented during tumor progression. This study aimed to evaluate LM332 expression at the basement membrane (BM) and in the cytoplasm of oral squamous cell carcinoma (OSCC) and to investigate its association with histopathological characteristics. A cross-sectional study was conducted on 130 patients utilizing immunohistochemical techniques to examine LM332 expression. In OSCC, LM332 expression at the BM was frequently fragmented in 62% of cases and absent in 18%. Conversely, LM332 was significantly overexpressed in the cytoplasm, with 95% of cases exhibiting positive staining (&#x2265;1+ based on the semi-quantitative scoring system). A statistically significant difference was observed between LM332 expression and the histological grade of OSCC (p<0.05). LM332 immunohistochemical expression patterns may serve as an adjunctive marker reflecting histopathological progression in malignant oral epithelium.

Histopathological parameters significantly impact the prognosis and treatment strategies of oral squamous cell carcinoma (OSCC). Various risk assessment scores and grading systems have been proposed in the past, primarily based on subjective assessment of microscopic features. To modify Brandwein-Gensler risk score by including the worst pattern of invasion-5, perineural invasion and percentage stromal tumor infiltrating lymphocytes(TILs) and evaluate the relationship of the modified score with clinicopathological variables. This retrospective observational study was conducted on 58 OSCC patients. The density of stromal TILs was determined on routine microscopic sections using image analysis software, thereby quantifying lymphocytic host response as percentage stromal lymphocytes. Furthermore, the modified Brandwein-Gensler risk score was derived from the assessment of the worst pattern of invasion-5, perineural invasion and percentage stromal tumor infiltrating lymphocytes. Chi-square test and Univariate analysis were used to find the association of categorical and continuous variables. The Kaplan-Meier and log-rank tests were used to estimate the survival rates. A significant positive association of modified Brandwein-Gensler score was observed with pathological node (p=0.005), tumor grading (p=0.025), depth of invasion(p=0.016) and overall survival (p=0.03), signifying that high score tumors showed poor differentiation, invasive features and lower survival time. A modified, simplified and objective version of Brandwein Gensler histological risk assessment score is derived, revealing a significant association with tumor differentiation, depth of invasion and lymph node involvement.

Non-odontogenic bone tumors of the jawbones constitute a heterogeneous group of tumors that may arise in various regions of the maxillofacial complex and present as chondroid or bone-forming tumors (BFTs). Therefore, this 53-year retrospective study aimed to evaluate the clinical, radiographic, and histopathological characteristics of BFTs (osteoma-OT, osteoblastoma-OB and osteosarcoma-OS) diagnosed at a single oral pathology referral center in Brazil. Gender, age, symptoms, clinical diagnosis, lesion duration, anatomical site, size of the lesion, and radiographic characteristics were collected from all cases previously diagnosed as BFTs, and all histological sections were reviewed. Among 19.596 cases diagnosed at the service during the study period, 74 (0.37%) were identified as OTs, OBs or OSs, with OTs being the most common (55.4%). There was a predominance of female patients (70.2%), and the mandible was the most affected gnathic bone (84.7%). Radiographically, OTs typically presented as well-delimited, radiopaque lesions (68.4%), whereas OBs (68.4%) and OSs (75.0%) frequently exhibited mixed radiolucent patterns. Histopathologically, OTs were predominantly classified as compact, and OBs were commonly typical. Osteosarcomas were frequently of osteoblastic subtype. Awareness of clinical, radiographic and histopathological characteristics is essential for improving recognition of the distinct profiles of BFTs.

Metastasis significantly decreases survival in oral cavity squamous cell carcinoma (OSCC). Even patients initially staged as cN0 may develop cervical or distant metastases during follow-up. Risk factors contributing to metastasis in this group are not fully understood. A retrospective cohort study was conducted on patients with primary cN0 OSCC treated between 2016 and 2020. Of the 195 N0 OSCC patients included, 19 (9.7%) developed metastasis. Heavy alcohol use (HR 4.05, 95% CI:1.38-11.92, p=0.011) and depth of invasion (DOI) (HR 1.10, 95% CI:1.01-1.20, p=0.021) were significantly associated with the development of metastasis. Age, gender, site, neck procedure, radiotherapy, and T-class were not statistically significant predictors in this analysis. Metastases occurred in nearly 10% of c/pN0 patients. Alcohol use and DOI were independent predictors, highlighting the need for individualized follow-up strategies and further research into alcohol-related OSCC.

Oral sedation is widely utilized in dental surgical practice for anxiety management during third molar extractions. Midazolam is one of the most frequently employed drugs; however, the clinical benefits of its association with promethazine have not yet been clearly established. This is a randomized, double-blind, split-mouth clinical trial. Eighteen anxious patients were included, all with indications for bilateral extraction of impacted or semi-impacted mandibular third molars, presenting similar surgical difficulty on both sides. In one session, patients received 15mg of midazolam alone (Group A), and in another, 15mg of midazolam combined with 25mg of promethazine (Group B). Sedation levels (Ramsay scale), anxiety (Corah scale), and physiological parameters were evaluated. There was no statistically significant difference in the depth of sedation between the groups (p>0.05). Oxygen saturation and heart rate showed slight, statistically significant variations at specific time points in Group B (p<0.05), although without relevant clinical repercussions. Blood pressure and respiratory rate remained stable across both protocols. The association of promethazine with midazolam did not increase sedative efficacy compared to midazolam alone. However, it demonstrated clinical safety, proving to be a viable alternative in sedative drug protocols.

Consistent geographical disparities in oropharyngeal cancer (OPC) mortality rates have been observed across Europe, with distinct trends emerging among men and women. This study provides a detailed subnational analysis of OPC mortality in Spain between 1999 and 2023, categorised by gender and administrative region. We conducted an ecological analysis using ICD-10 C10 mortality data for all 50 Spanish provinces and the two autonomous cities (Ceuta and Melilla). Hierarchical Bayesian spatio-temporal Poisson models, fitted via INLA, were employed to decompose variance and identify gender-specific risk patterns. Gender-specific patterns were markedly distinct. Male mortality showed a strong spatial structure (88.1% of variance), with persistent high-risk clusters in Northern Spain (Asturias, A Coru&#xf1;a, Cantabria) and the Canary Islands. Despite a modest national decline, risk often remained stable or increased in these high-risk areas; for instance, Cantabria's relative risk (RR) peaked at 2.62 in 2023. This pattern is consistent with entrenched traditional risk factors (tobacco and alcohol use). Conversely, female mortality was dominated by a strong national temporal increase (17.2% of variance), likely reflecting a growing HPV-associated burden. Risk escalated nearly uniformly across the country, rising from RR 0.62 in 1999 to 1.54 in 2023. Localised temporal deviations were significant for men (10.2% interaction), but negligible for women (0.4%), confirming a synchronised, nationwide female trend. OPC mortality dynamics demand dual intervention strategies. Deep-rooted gender disparities in the northern and island provinces suggest strengthening tobacco and alcohol control campaigns. The rapid and widespread increase in female mortality highlights the need of expanding HPV vaccination programmes nationwide.

Diabetes mellitus (DM) is a common metabolic disorder, and persistent hyperglycemia may impair oral health through various immunological and inflammatory mechanisms, particularly by influencing the onset and healing of apical periodontitis (AP). This systematic review and meta-analysis aimed to evaluate whether poor glycemic control (PGC) is associated with the presence and progression of AP. This study was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive search of PubMed, Embase, Google Scholar, and Scopus was performed to identify relevant English-language studies published up to June 2025. Cross-sectional and longitudinal studies examining the association between glycemic control status-defined by glycated hemoglobin (HbA1c) levels-and AP-related outcomes were included. Data were synthesized using RevMan 5.3 software to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Heterogeneity and publication bias were also assessed. A total of 18 studies comprising approximately 51,070 patients were included. The relationship between PGC and AP was examined across three domains: AP prevalence, the persistence of apical periodontitis in root-filled teeth (AP-RFT), and alterations in local or systemic immune responses. Meta-analysis of AP prevalence (6 studies) revealed that individuals with PGC had a significantly increased risk of developing AP compared to controls (OR=2.38, 95% CI: 1.98-2.86, P<0.00001). Furthermore, meta-analysis of AP-RFT persistence (8 studies) showed that patients with PGC had a significantly higher risk of AP-RFT (OR=2.74, 95% CI: 2.03-3.70, P<0.0001). Several studies also reported elevated levels of inflammatory cytokines and bacterial load in patients with PGC. PGC appears to negatively influence both the development and healing of AP, possibly through immune-inflammatory pathways. PGC is closely associated with the occurrence of AP and the failure of periapical healing following endodontic treatment. PGC may aggravate periapical tissue damage and inflammation through proinflammatory immune pathways. Clinicians should consider comprehensive evaluation and individualized management of DM patients during endodontic therapy to improve treatment outcomes and oral health.

Tooth extraction initiates a regulated inflammatory healing response. Diabetes mellitus may alter this early tissue response; however, data on early salivary cytokine and chemokine changes after extraction in diabetic individuals remain limited. Therefore, this study aimed to compare early postoperative salivary interlukine-4 (IL-4) and CXC motif chemokine ligand 6 (CXCL6) dynamics following tooth extraction in diabetic and non-diabetic individuals. A prospective cohort study was conducted including 30 participants, comprising 20 individuals with controlled type 2 diabetes mellitus and 10 healthy controls. Unstimulated whole saliva was collected at three time points: Before extraction, 1 hour post-extraction and 2 days post-extraction. Salivary IL-4 and CXCL6 concentrations were measured using a Luminex multiplex assay. A two-way repeated-measures ANOVA was applied to examine within-subject temporal effects and between-group differences, as well as their interaction. IL-4 levels did not show significant changes over time (p=0.453) and did not differ between diabetic and non-diabetic participants (p=0.221), with no significant time-by-group interaction (p=0.526). In contrast, CXCL6 demonstrated a significant effect of time (p=0.035) and a significant time-by-group interaction (p=0.043), indicating distinct temporal response patterns between groups, although overall CXCL6 levels did not differ significantly between diabetic and control participants. Early post-extraction healing in diabetes demonstrates altered inflammatory kinetics. While salivary IL-4 remained stable within the first 48 hours, CXCL6 exhibited significant time and group-dependent modulation, indicating dysregulated early inflammatory responses.

Cemento-ossifying fibroma (COF) is a benign odontogenic fibro-osseous neoplasm with the proliferation of a cellular fibrous stroma. This study aimed to characterize the clinicodemographic, radiographic, and therapeutic profile of COF in Brazil, Colombia and Venezuela. Eight oral pathology and oral medicine services participated. Clinical, radiographic and treatment-related data were retrieved from patient records. Diagnoses were established according to the 5th edition of the WHO classification of odontogenic and maxillofacial bone tumors. Data were analyzed descriptively. A total of 112 cases were included; 44.6% were from Brazil and 27.7% each from Venezuela and Colombia. Most individuals were female (n=97; 86.6%), with a mean age of 35.6&#xb1;12.6 years. Posterior mandibular involvement predominated (n=47; 65.3%). Mixed radiographic patterns were most frequent (n=46; 50.0%), and cortical expansion was observed in 52.7% (n=48). Complete surgical removal of the lesion without prior incisional diagnosis and enucleation/curettage were the most common management approaches (n=69; 61.6%). Recurrence occurred in 8.3% of individuals with the available follow-up. The study offers the first multicenter documentation of COF in South America, corroborating prior literature regarding its predilection for women in the third to fourth decades of life and for posterior mandibular sites. Subtle clinicodemographic variants were noted across the three countries.

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. 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. 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%. Non-sinonasal ITACs are rare, aggressive malignancies requiring accurate diagnosis and further molecular investigation to improve management and outcomes.

Pain management in dentistry, particularly in procedures such as mandibular third molar surgery, poses a significant challenge due to the transient efficacy of traditional local anesthetics. To address this, adjunctive therapies such as dexamethasone have been explored to prolong anesthesia and alleviate postoperative pain. However, the efficacy and safety of this approach in mandibular third molar surgery remain underexplored. This study assessed the efficacy and safety of combining articaine with perineural dexamethasone for inferior alveolar nerve block in patients undergoing mandibular third molar extraction. Sixty patients aged 18-35 years were enrolled and randomly assigned to three groups receiving different anesthesia protocols. Anesthesia duration, postoperative pain scores, and adverse events were evaluated. The incorporation of dexamethasone into articaine-based anesthesia significantly prolonged the duration of analgesia compared to articaine alone, underscoring its potential as an effective adjunctive therapy. While no significant differences were observed in the duration of operation, analgesic consumption, or incidence of adverse events among the groups, trends favoring the articaine-dexamethasone cohorts were noted in postoperative pain scores. Combining articaine with perineural dexamethasone for inferior alveolar nerve block prolongs postoperative analgesia in mandibular third molar surgery. While additional research using larger sample sizes and longer follow-up durations is needed, these findings imply that this combination could be beneficial for improving pain management during oral surgery.