Journal of Applied Cosmetology

Precise Extraction of Impacted Supernumerary Teeth in the Mandibular Anterior Region: A Case Report

Mon, 25 Aug 2025 00:00:00 +0000

The presence of supernumerary teeth is frequently identified as an incidental radiographic finding: the majority are reported to remain unerupted and asymptomatic, even though they may be either erupted or impacted. Supernumerary teeth in the premolar region, unlike other types of supernumeraries, are more frequently found in the mandible, where they are typically of the supplemental type. Occasionally, they may present as conical in shape or smaller than normal. These teeth may occur as single or multiple anomalies. The prevalence of supernumerary premolars has been estimated to range from 0.01% to 1%, depending on the population studied. The aim of the present article is to describe a surgical technique to remove impacted supernumerary teeth in the premolar region with maximal precision and preservation of the adjacent anatomical structures.

Gout of the Temporomandibular Joint: A Case Report

Mon, 25 Aug 2025 00:00:00 +0000

Gout is a disorder caused by hyperuricemia, consisting of the deposition of monosodium urate crystals in joints and soft tissues. Although gout primarily affects lower extremities, especially the first metatarsophalangeal joint, it can also involve atypical sites, including the temporomandibular joint (TMJ) (1, 2). Patients with TMJ gout often present with acute or chronic pain, swelling, tenderness, and restricted jaw movement, which may mimic temporomandibular disorders such as osteoarthritis, rheumatoid arthritis, or septic arthritis (1, 2). Temporomandibular joint disorders can present with a full range of symptoms that can overlap with several other conditions. A comprehensive differential diagnosis is essential for accurate identification and appropriate treatment.

Rare Localization of Actinomyces israelii: Clinical, Radiological, and Histopathological Insights from a Lingual Case

Mon, 25 Aug 2025 00:00:00 +0000

Actinomycosis is a rare, chronic infection caused by Actinomyces israelii, a Gram-positive anaerobic bacterium that commonly inhabits the human oral cavity. Lingual involvement is extremely uncommon, accounting for less than 3% of reported cases, and poses a diagnostic challenge due to its ability to mimic both benign and malignant lesions. The present paper reports the case of a 38-year-old male presenting with a six-month history of swelling in the posterior region of the tongue, which exhibited cyclical size variation and fistula formation. Clinical and radiological evaluation revealed a solid mass extending into the mylohyoid and genioglossus muscles. Surgical excision was performed, followed by histopathological analysis, which confirmed the diagnosis of lingual actinomycosis. Postoperative antibiotic therapy was administered, and the patient showed complete recovery without recurrence. Lingual actinomycosis is a rare but important differential diagnosis for submucosal tongue lesions. A multidisciplinary approach involving imaging, surgical intervention, histological examination, and appropriate antibiotic therapy is essential for accurate diagnosis and effective treatment. Surgical excision combined with antibiotic therapy provides optimal outcomes, with long-term follow-up recommended to monitor for recurrence.

Atrophic and Erosive Types of Oral Lichen Planus and the Risk of Oral Squamous Cell Carcinoma: A Retrospective Study at the University Hospital of Modena

Mon, 25 Aug 2025 00:00:00 +0000

This retrospective study draws on the experience of the Department of Maxillofacial Surgery at the Policlinico of Modena in managing Oral Lichen Planus (OLP) cases diagnosed between 2019 and 2024. We examined 60 cases of OLP, comprising 37 women and 23 men. The mean age was 61.28, and the median was around 62 years. We included smoking and alcohol consumption, gender, and clinical presentation as significant risk variables with high predictive power. It is crucial to note that individuals from our study population have advanced, unusual, or suspicious forms of OLP. We specifically chose to extrapolate the patients with erosive OLP diagnoses. According to the results, patients between the ages of 45 and 75 upon diagnosis had a higher chance of developing malignant transformation, and risk factors like drinking, smoking, and specific clinical patterns such as atrophic or erosive OLP were found to be significant. All the patients with SCC progression in our clinic were female.

Quality of Life in Patients with Temporomandibular Joint Disorders Following Arthrocentesis and Hyaluronic Acid Injection: A Retrospective Study

Mon, 25 Aug 2025 00:00:00 +0000

This retrospective study aims to assess the clinical efficacy and quality of life outcomes in patients with temporomandibular joint disorders (TMDs) who underwent arthrocentesis combined with hyaluronic acid (HA) injection. A total of 30 patients diagnosed with TMDs were treated with single-needle arthrocentesis followed by intra-articular HA injection. Clinical evaluations included spontaneous mouth opening, pain assessment, and patient-reported outcome measures using a modified quality of life questionnaire adapted from the SF-36. Pre- and post-treatment measurements were compared using paired Student’s t-tests. Post-treatment, 70% of patients showed improved mouth opening (mean increase: 1.5 mm; SD: 3.9), although the change did not reach statistical significance (p = 0.056). Pain levels decreased markedly, with 40% of patients reporting complete pain relief and 50% reporting only mild discomfort. Significant improvements were also observed in chewing function, recreational activity, and overall quality of life. Arthrocentesis with HA injection appears to be a safe, minimally invasive, and clinically effective treatment option for patients with TMDs, particularly those with early to moderate joint degeneration. Improvements in both objective and subjective outcomes support its role as a valuable therapeutic approach in cases unresponsive to conservative management.

Effectiveness, Outcomes, and Safety of Piezocision Compared to Corticotomies in Accelerating Tooth Movement: A Narrative Review

Mon, 25 Aug 2025 00:00:00 +0000

The duration of orthodontic treatment often affects patient compliance and increases the likelihood of complications. Evaluation of the clinical uses, safety, and effectiveness of corticotomy and piezocision as surgical adjuncts for accelerating orthodontic tooth movement is the goal of this narrative review. A thorough search of the literature was done for research published between January 2019 and March 2025 using PubMed, Embase, and Scopus. Information about patient demographics, dental sectors treated, length of therapy, and degree of tooth movement was extracted. Because techniques and results varied, studies were narratively summarized. The included studies showed significant variation in treatment procedures, patient ages, and sample sizes. The intervention that was examined the most was canine retraction. Piezocision and corticotomy both demonstrated efficacy in accelerating tooth movement, with treatment times ranging from two weeks to two years and movement values ranging from 0.53 mm to 6.48 mm. Despite occasional temporary postoperative swelling, piezocision was linked to lower surgical morbidity and demonstrated higher patient satisfaction. Piezocision is a successful and minimally invasive technique for accelerating orthodontic tooth movement. Although there is evidence of its therapeutic advantages, conclusive findings are limited by the heterogeneity of study designs and outcome measures. Additional long-term, standardized research is required to improve procedures and validate its benefits over traditional corticotomy.

A Narrative Review of Clinical Trials Comparing Root-End Filling Materials in Endodontic Surgery

Mon, 25 Aug 2025 00:00:00 +0000

This narrative review assesses the clinical performance of root-end filling materials used in endodontic microsurgery, with a particular focus on randomized controlled trials (RCTs) published over the last decade. The goal is to determine whether material choice has a significant impact on surgical outcomes or if other procedural factors play a more decisive role. An electronic search was conducted in PubMed (MEDLINE) and Scopus for RCTs published from January 2015 to March 2025. Studies were eligible if they compared at least two root-end filling materials in human patients undergoing apicoectomy and retrograde filling, with a minimum follow-up of six months. Six RCTs met the inclusion criteria. Data were extracted and synthesized narratively due to heterogeneity in study design, outcome reporting, and small sample size. Success rates for evaluated materials, including MTA, iRoot BP Plus, EndoSequence RRM, TotalFill, and Super EBA, ranged from 75% to 96%. While MTA remains a well-established material, newer bioceramic sealers demonstrated comparable outcomes with improved handling. No definitive superiority was observed among materials. Instead, surgical factors such as microsurgical technique, retrocavity depth, use of CBCT imaging, and operator experience emerged as primary determinants of success. The evidence suggests that modern calcium silicate-based materials are all clinically effective when used within an appropriate and dedicated protocol. Given the procedural complexity and multifactorial nature of success in endodontic surgery, material selection should be based on handling preference and clinical familiarity. The absence of standardized application protocols for newer bioceramics highlights an unmet need in clinical practice. While root-end filling material selection remains relevant, procedural precision and surgeon expertise have a more significant influence on outcomes. Further long-term studies are needed to develop consensus protocols for bioceramic materials in endodontic microsurgery.

Hyaluronic Acid in Dentistry: A Narrative Review

Mon, 25 Aug 2025 00:00:00 +0000

Biocompatibility, anti-inflammatory properties, and regenerative potential. It plays a crucial role in enhancing wound healing, reducing inflammation, and supporting tissue repair. This review aims to evaluate the clinical efficacy of HA in various dental applications, including periodontal therapy, oral surgery, implantology, and the management of oral mucosal lesions. A systematic literature review was conducted following PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, and Cochrane Library databases, focusing on studies published in the last 5 years. Inclusion criteria comprised clinical trials, cohort studies, and systematic reviews assessing HA’s effects on oral lichen planus, oral ulcers, periodontal disease, and post-surgical healing. Studies were evaluated for quality using the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale. The review identified five key studies demonstrating HA’s beneficial effects in dentistry. HA was shown to reduce pain and lesion size in oral lichen planus, enhance postoperative healing following third molar extractions, and improve alveolar ridge preservation when combined with demineralized bovine bone. Additionally, HA gel applications accelerated gingival healing post-gingivectomy, and its combination with photobiomodulation therapy further optimized wound repair. HA has proven to be a valuable adjunct in various dental treatments, promoting tissue regeneration and reducing postoperative complications. Its combination with other biomaterials and regenerative therapies enhances its clinical efficacy. However, further research is needed to standardize its application protocols and assess long-term outcomes. As advancements in biomaterials continue, HA is poised to play an increasingly significant role in modern dentistry.

Oral Cavity Pigmented Lesions: A Narrative Review on Clinical and Diagnostic Perspectives

Mon, 25 Aug 2025 00:00:00 +0000

The human oral mucosa exhibits a wide array of color variations, influenced by both genetic and environmental factors. These variations range from physiological differences in individuals with lighter or darker skin tones to pathological changes caused by trauma, inflammation, hormonal fluctuations, and exposure to pharmacological agents. Pigmented lesions in the oral cavity present a diagnostic challenge due to their diverse etiologies, which include benign conditions such as melanotic macules and smoker’s melanosis, as well as more serious pathologies like oral melanoma and systemic disorders such as Addison’s disease and Peutz-Jeghers Syndrome. The differential diagnosis is further complicated by multifactorial causes, including both endogenous factors, such as nevi, and exogenous ones, such as amalgam tattoos. This review provides a comprehensive examination of the causes, diagnostic challenges, and clinical management of oral mucosal pigmentation. It underscores the importance of distinguishing between physiological and pathological states, highlighting the need for a detailed understanding of the underlying mechanisms and careful diagnostic evaluation in clinical practice.

Applications of Hyaluronic Acid in Soft Tissue Management: A Narrative Review of Recent Insights from Contemporary Periodontology

Mon, 25 Aug 2025 00:00:00 +0000

Hyaluronic acid (HyA) is a naturally occurring glycosaminoglycan with notable anti-inflammatory, antimicrobial, and regenerative effects. In periodontology, its applications have extended across a spectrum of soft tissue-related procedures, including post-extraction socket healing, interdental papilla reconstruction, root coverage, keratinized gingiva (KG) augmentation, and periodontal therapy. Despite its growing application in clinical practice, the use of HyA in periodontal soft tissue management lacks standardized protocols and long-term clinical validation. This review aims to synthesize recent evidence and address this gap by categorizing current applications and evaluating their specific outcomes. A narrative review was conducted by searching PubMed (Medline) for relevant studies published between January 1, 2014, and February 28, 2025. The search followed the PCC framework and was complemented by manual exploration through Google Scholar. The PRISMA statement 2020 was followed to select the included studies. A total of 104 records were identified through electronic and manual searches. After removing one duplicate, 103 records were screened. Following title and abstract screening, 22 articles were assessed for full-text eligibility. Of these, one article could not be retrieved, and two were excluded, resulting in 19 studies being included in the final review. Included studies were thematically categorized into five clinical applications: post-extraction healing, interdental papilla regeneration, root coverage procedures, keratinized gingiva augmentation, and periodontal therapy. Across these contexts, HyA demonstrated varying degrees of clinical benefit, particularly in enhancing early healing and esthetic outcomes. HyA represents a biologically active adjunct in periodontal soft tissue management, with context-specific benefits. Standardization of protocols and long-term trials is necessary to define their optimal clinical use.

Minimally Invasive Techniques and Emerging Diagnostics in Mandibular Third Molar Surgery: A Narrative Review

Mon, 25 Aug 2025 00:00:00 +0000

The extraction of impacted mandibular third molars is a common oral surgical procedure often associated with postoperative conditions, including pain, edema, trismus, and inferior alveolar nerve (IAN) injury. In recent years, the introduction of advanced technologies, namely piezoelectric surgery and artificial intelligence (AI), has transformed diagnostic and surgical approaches, offering new possibilities to enhance safety, precision, and treatment outcomes. A narrative review was conducted by searching PubMed (Medline) for relevant studies published between January 1, 2015, and January 31, 2025. The search followed the PCC framework and was complemented by manual exploration through Google Scholar. The PRISMA 2020 statement was followed to select the included studies. A total of 58 records were identified through electronic and manual searches. No duplicates were identified, and no records were excluded before screening; therefore, 58 records were screened. Following title and abstract screening, 23 articles were assessed for full-text eligibility. Of these, seven were excluded, resulting in 7 studies being included in the final review. The reviewed studies highlight that artificial intelligence enables accurate and predictive assessment of the anatomical relationship between impacted third molars and critical anatomical structures, particularly the inferior alveolar nerve. Concurrently, piezoelectric surgery demonstrates clear advantages over conventional rotary instruments by reducing postoperative complications and enhancing both patient comfort and bone healing. The diagnostic performance of artificial intelligence varies based on the type of imaging data provided, the design of the deep learning model, and the use of semantic annotation. While AI can match expert-level accuracy on panoramic radiographs, particularly when semantic segmentation is employed, its most valuable role may be in identifying cases that would benefit from CBCT imaging, rather than replacing advanced imaging altogether. Piezoelectric techniques, on the other hand, offer a safer and more conservative surgical alternative, contributing to reduced morbidity and improved clinical outcomes. Surgical Navigation serves as a valid tool, but its applicability remains limited to selected cases due to increased costs and operating times. Overall, the integration of these technologies represents a step forward toward safer, more personalized, and minimally invasive approaches in third molar surgery.

Piezosurgery and Genioplasty: A Literature-Based Assessment of Surgical Efficacy and Outcomes

Mon, 25 Aug 2025 00:00:00 +0000

Genioplasty is a well-established ancillary surgical procedure used to correct aesthetic and functional deficiencies of the chin. With the evolution of surgical technologies, piezoelectric bone surgery (piezosurgery) has emerged as a promising technique for performing osteotomies with improved precision and reduced soft tissue trauma. This study aims to narratively evaluate the current literature on the application of piezosurgery in genioplasty and to compare its clinical efficacy, safety, and outcomes with those of conventional bone-cutting methods using rotary or reciprocating instruments. An electronic search was conducted across PubMed, Scopus, and Cochrane CENTRAL databases, following a PICO-based strategy. Peer-reviewed articles published between 2017 and 2024, focusing on human genioplasty procedures performed with either piezoelectric or traditional techniques, were included and critically analyzed. Piezosurgery demonstrated superior intraoperative precision, minimized neurovascular risk, and reduced postoperative morbidity. It was associated with lower blood loss, fewer complications, faster recovery, and higher patient satisfaction. Its microvibrational mechanism enables selective cutting of mineralized tissue, sparing adjacent soft structures and enhancing surgical visibility. Piezosurgery represents a valuable advancement in genioplasty, particularly in cases requiring meticulous bone reshaping and soft-tissue preservation. Its clinical advantages support its integration as a standard tool in contemporary mandibular contouring procedures.

Why Has Distraction Osteogenesis Disappeared From Clinical Practice in Vertical Ridge Augmentation?

Mon, 25 Aug 2025 00:00:00 +0000

Artificial Intelligence in Oral Medicine: Current Potential and Future Scenarios

Mon, 25 Aug 2025 00:00:00 +0000

Is Conventional Osteotomy Still a Winning Technique in Rhinoplasty? Our Personal Experience

Mon, 25 Aug 2025 00:00:00 +0000

Precise osteotomy of nasal bones is a critical component in rhinoplasty, enabling correction of deformities and enhancement of both functional and aesthetic outcomes. Piezoelectric instruments are renowned for their atraumatic bone-cutting abilities; however, traditional osteotomes remain in use. This study aims to assess the safety and efficacy of conventional osteotome techniques in rhinoplasty and compare postoperative outcomes with those documented for piezosurgery. This retrospective cohort study conducted at Verona University Hospital included 24 patients who underwent primary or revision septorhinoplasty between June 2021 and October 2024. A senior surgeon performed all osteotomies using an endonasal approach with a conventional osteotome and standardized technique. Postoperative eyelid edema and ecchymosis were evaluated on postoperative days 1, 3, and 7 utilizing the Kara-Gokalan scoring system. Complication rates, surgical duration, and length of hospital stay were also recorded. The mean scores for edema and ecchymosis were comparable to those associated with piezoelectric techniques, suggesting that precise use of conventional osteotomes, including subperiosteal tunnelling, can achieve similarly favorable outcomes. Additionally, operative time was reduced. Comparative literature indicates that periosteal elevation and soft tissue management may be more influential on outcomes than the choice of instrument. The positive results observed may be attributed to the use of the endonasal approach for osteotomies combined with subperiosteal tunneling. Traditional osteotomes present a safe, reliable, and cost-effective alternative to powered devices, achieving postoperative outcomes comparable to piezosurgery when employed with standardized surgical protocols and careful handling. Surgical expertise and standardization of techniques remain vital.

Occlusal Bite in Reconstructive Surgery of the Oral Cavity

Mon, 25 Aug 2025 00:00:00 +0000

In the context of oral cavity cancer surgery, free flap reconstruction is considered the standard procedure. However, mechanical trauma resulting from occlusion can lead to complications such as ulcers and necrosis. This case series investigates the application of custom-made occlusal splints in three patients undergoing free flap reconstruction for oral cavity squamous cell carcinoma, with the aim of preventing complications and supporting rehabilitation. This retrospective case series comprises three patients who underwent free flap reconstruction at a tertiary care referral hospital. Each patient received a preoperative maxillofacial and orthodontic assessment, followed by the application of a custom-made occlusal splint immediately postoperatively to protect the flap and facilitate rehabilitation. Reconstructing the oral cavity presents significant challenges due to its intricate anatomy and the associated risks of flap failure and infections. The use of custom-made splints has demonstrated potential in mitigating occlusal trauma and facilitating recovery. Despite their promise, the application of custom-made oral splints remains insufficiently explored. Further research is needed to assess their potential in reducing complications and improving recovery outcomes. It is essential to validate their efficacy, optimize their usage, and integrate them into clinical guidelines for oral cavity reconstruction.

Improving Home Oral Hygiene in Patients with Fixed Orthodontic Appliances. Evaluating Educational and Motivational Interventions

Mon, 25 Aug 2025 00:00:00 +0000

Fixed orthodontics presents significant challenges in maintaining proper at-home oral hygiene. The presence of irregular surfaces, which favor bacterial accumulation, makes it difficult to control plaque effectively, thereby increasing the risk of developing various oral diseases. In this context, education and motivation are crucial for improving at-home oral hygiene in patients undergoing fixed orthodontic treatments. This systematic review aimed to evaluate the effects of education and motivation on the plaque index of patients with fixed orthodontic appliances. A search was conducted using the PubMed and Cochrane Library databases. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and included randomized controlled trials (RCTs). They had to assess treatment with fixed and home oral hygiene protocols. The p-value was analyzed by comparing the experimental and control groups, as well as the Plaque Index (PI) of the two groups at each follow-up. After a careful selection process, nine studies met the inclusion and exclusion criteria and were included in the review. The results from these studies show that repeated educational and motivational strategies, delivered through both traditional and digital methods, lead to a reduction in the plaque index among patients who received support compared to control groups. In fact, six out of nine studies show a statistically significant difference in terms of PI for the experimental group. This systematic review highlights the importance of educational and motivational interventions in helping patients maintain effective plaque control, a crucial aspect of oral health for individuals wearing fixed orthodontic appliances. Digital tools offer a promising avenue for enhancing adherence among orthodontic patients and reducing the risk of plaque-related conditions.

Comparing Guided Biofilm Therapy and Traditional Approaches in Professional Dental Hygiene: A Systematic Analysis

Mon, 25 Aug 2025 00:00:00 +0000

Air polishing therapy, utilizing advanced technologies such as erythritol- or glycine-based powders and air-jet devices, is an innovative method for managing oral biofilms without damaging dental surfaces. This systematic review compares Guided Biofilm Therapy (GBT), which combines air polishing followed by ultrasonic calculus removal, with conventional oral hygiene methods, such as ultrasonic debridement followed by rubber cup polishing. The analysis focused on reducing biofilm, improving gingival health, enhancing patient comfort, and reducing treatment duration. This study followed the PICO method to formulate a research question. A bibliographic search was conducted using the PubMed and Cochrane databases, focusing on randomized controlled trials (RCTs) published over the past 10 years. The 2020 PRISMA guidelines were applied, resulting in the selection of six studies published between 2015 and 2025. Only studies that directly compared GBT with conventional methods were included and assessed for methodological quality. The findings indicated that GBT is as effective as traditional methods for reducing oral biofilms. Additionally, GBT improves patient comfort, reduces treatment duration, and is associated with fewer side effects than conventional techniques. Guided Biofilm Therapy represents a promising alternative to conventional oral hygiene methods, offering comparable clinical efficacy with added benefits in terms of patient comfort and treatment efficiency.

The Role of Hyaluronic Acid in Pulp-Dentin Regeneration: A Review of Current Advances

Mon, 25 Aug 2025 00:00:00 +0000

Regenerative Endodontic Procedures (REP) have emerged as a promising approach to treating necrotic immature teeth by promoting tissue regeneration rather than conventional obturation. Hyaluronic acid (HA) has garnered attention for its potential role in endodontic tissue engineering due to its biocompatibility, bioactivity, and ability to modulate cell behaviour. This review explores the application of HA in regenerative endodontics, focusing on its properties, scaffolding potential, and ability to enhance pulp-dentin complex regeneration. HA is a naturally occurring glycosaminoglycan present in the extracellular matrix (ECM), with significant roles in cell proliferation, differentiation, and angiogenesis. These properties make it a suitable candidate for enhancing pulp regeneration, particularly when combined with other biomaterials. Studies have demonstrated that HA-based hydrogels and sponges provide a conducive microenvironment for stem cell adhesion, proliferation, and differentiation, thereby supporting the regeneration of the dentin-pulp complex. Additionally, HA has been shown to have antimicrobial properties and the ability to modulate inflammation, making it particularly useful in preventing bacterial contamination in endodontic treatments. Despite these advantages, challenges remain in optimizing HA-based scaffolds for clinical use. The rapid degradation of HA in physiological conditions necessitates modifications such as crosslinking or combination with other biomaterials to improve its mechanical properties and longevity. Preclinical and clinical studies have investigated the efficacy of HA in regenerative endodontics. In vitro studies indicate that HA enhances odontogenic differentiation of dental pulp stem cells, while in vivo research demonstrates its ability to promote angiogenesis and tissue integration. Clinical applications of HA in endodontics remain limited, and further controlled trials are needed to establish standardized protocols for its use in REP. Future perspectives in the field of HA-based biomaterials in regenerative endodontics include the development of bioactive and multifunctional scaffolds that can provide controlled release of growth factors, enhance cellular responses, and integrate seamlessly with the host tissue. Additionally, optimizing HA formulations for clinical application will require further research on their degradation kinetics, long-term stability, and interaction with other biomaterials. HA represents a promising biomaterial in regenerative endodontics due to its biological properties and potential to improve treatment outcomes. However, further research is needed to refine its applications, improve scaffold formulations, and validate its efficacy through long-term clinical studies.

Impact of Biomaterials on GBR Procedures Simultaneous to Implant Placement: A Systematic Review and Meta-Analysis

Mon, 25 Aug 2025 00:00:00 +0000

This systematic review evaluates the effectiveness of various bone biomaterials and barriers used in Guided Bone Regeneration (GBR) procedures performed simultaneously with implant placement. The study aims to compare bone augmentation outcomes achieved with different materials and assess the incidence of barrier exposure. From an initial pool of 881 publications two independent reviewers selected 30 studies to be included in the final analysis. The review revealed significant data heterogeneity, allowing for only three meta-analyses on pairs of studies. Results: Despite this limitation, key findings emerged: all evaluated biomaterials (autologous, homologous, heterologous, engineered, and synthetic) and barriers (collagen, expanded polytetrafluoroethylene (PTFE), polyelectrolyte complex (PEG), poly (lactic-co-glycolic acid) (PLGA), and titanium mesh) were effective in achieving positive bone regeneration outcomes. Among the meta-analyses, collagen membranes showed a statistically significant superiority over PTFE membranes, while no significant differences were observed between heterologous and engineered bone or between collagen and PEG membranes. Barrier exposure was consistently associated with reduced bone augmentation. While this review confirms the suitability of various biomaterials and membranes in GBR procedures it emphasizes the need for additional high-quality comparative studies to address current data gaps and better inform clinical decision-making. From the results of the current literature review it appears that GBR outcomes are independent from the specific materials used, and the right biomaterials to be employed should be balanced based on the surgeon’s preferences and specific clinical scenarios.

Comparing the Effectiveness of Surgical Techniques for Accelerating Orthodontic Movement: A Systematic Review

Mon, 25 Aug 2025 00:00:00 +0000

Various surgical procedures have been proposed in orthodontics to accelerate tooth movement, aiming to reduce treatment time and improve patient outcomes. These surgical procedures include corticotomy (CO/TC), piezocision (PZ), flapless corticotomy (FC), periodontally accelerated osteogenic orthodontics (PAOO), and micro-osteoperforations (MOPs). This systematic review aimed to determine if one surgical technique for accelerating tooth movement in orthodontics is more effective than others in accelerating orthodontic movement or reducing treatment time. The study adhered to PRISMA guidelines and searched PubMed and Scopus for randomised clinical trials (RCTs) comparing two or more surgical techniques to facilitate orthodontic movement. The Cochrane Risk of Bias tool (RoB 2.0) was used to assess the risk of bias in the randomised trials. Thirteen RCTs were included in the systematic review. Only four studies reported a statistically significant difference between the tested surgical techniques. Specifically, Abbas found a higher rate of canine displacement with CO versus PZ, Chandra reported a shorter treatment duration with PAOO versus CO, Fernandes showed a higher rate of canine retraction with CO versus PZ, and Khlef's 2022 study statistically reported a higher rate of mass retraction with traditional corticotomy (TC) versus FC, though the author questioned its clinical significance. This lack of significant difference was supported by eight other studies, and in Bahammam et al., p-values was not calculated. The review concluded that no major differences emerged between the various surgical techniques in increasing tooth displacement. In most studies, the procedures appeared valid and comparable in accelerating tooth movement, with no clinically significant differences in efficacy or side effects.

Oral Candidiasis: Manifestations, Treatment and Management in Immunocompromised Patients

Mon, 25 Aug 2025 00:00:00 +0000

Oral candidiasis is a common condition in immunocompromised patients, such as those with HIV and diabetes. It manifests in acute forms, for example, pseudomembranous candidiasis and erythematous candidiasis, as well as in chronic forms, including chronic hyperplastic candidiasis and prosthesis-induced candidiasis. The aim of this article is to provide an overview of oral candidiasis manifestations and treatment, and to highlight the importance of appropriate management of the disease in immunocompromised patients. The authors conducted a literature review on oral candidiasis to summarize clinical information and treatment indications. Median rhomboid glossitis, once considered a congenital malformation, is now recognized as a form of chronic candidiasis. Angular cheilitis is often caused by mixed infections with Candida and Staphylococcus aureus, particularly in the elderly population. Antifungal agents used in treatment include polyenes (nystatin and amphotericin B) and azoles (fluconazole and itraconazole), which act by inhibiting ergosterol biosynthesis in fungi. Antiretroviral therapy showed beneficial effects in reducing oral candidiasis in HIV-positive patients. In patients undergoing radiation therapy for oral carcinoma, the risk of candidiasis is increased, requiring preventive measures, such as proper oral hygiene and local antifungal therapies. Early diagnosis and targeted treatment are essential for managing oral candidiasis, especially in at-risk patients. A personalized therapeutic approach is crucial for reducing complications and preventing the malignant progression of such an unpleasant infection.

Vascular Complications in Orthognathic Surgery: A Literature Review

Mon, 25 Aug 2025 00:00:00 +0000

The aim of this literature review is to outline bleeding complications in orthognathic surgery, to define their clinical presentation in terms of timing and frequency, and to eventually highlight indications for prevention and management. This literature review was conducted in accordance with the PRISMA guidelines for systematic reviews. To fulfill the research enquiries, two electronic databases (PubMed and Scopus) were searched using the PICO protocol and relevant keywords related to bleeding in orthognathic surgery. A total of 130 scientific articles written in English were retrieved from PubMed and Scopus, without any time limitation. After removing duplicates and excluding ineligible records, 22 papers were excluded. Finally, 25 articles were included in the study. Vascular complications following orthognathic surgery, although rare, can lead to severe and potentially life-threatening outcomes. A thorough knowledge of the maxillofacial district vascular anatomy and intraoperative awareness is key to managing these complications effectively, such as maintaining a high suspicion during the postoperative period, due to the variability in clinical presentation and timing.

Updates On the Management Strategies for Retained Teeth

Mon, 25 Aug 2025 00:00:00 +0000

Tooth eruption is the final step of a complex sequence of genetically regulated events. Any disruption in this process can lead to dental impaction, one of the most challenging conditions in clinical dentistry. Dental impaction is not limited to third molars; it can affect any tooth and significantly impact oral function, aesthetics, and long-term prognosis. Understanding the etiopathogenesis, diagnostic parameters, and available surgical strategies is essential for optimal treatment outcomes. This review aims to examine the current concepts in the diagnosis and surgical-orthodontic management of impacted teeth, excluding third molars, highlighting evidence-based clinical approaches, innovations in minimally invasive techniques, and the role of soft tissue management and digital technologies in improving therapeutic outcomes.

Coronoidectomy with Piezosurgery: Indications and Technical Note

Mon, 25 Aug 2025 00:00:00 +0000

The aim of the present article is to describe a surgical technique consisting of the execution of coronoidectomy with piezosurgery by intraoral approach. In this technical note, the authors describe the appropriate approach to the coronoid process, providing a step-by-step illustration of the intraoral procedure; moreover, the authors define the clinical scenarios in which coronoidectomy is indicated. Two cases are then presented to enrich the description. Surgical treatment with coronoidectomy might be indicated for functional or pathological conditions: coronoid hyperplasia, temporomandibular joint (TMJ) ankylosis, closed lock trismus, post-traumatic restriction of mouth opening, lockjaw, surgical access to expand the surgical field when the procedure has to reach the medial part of masticator space, tumors or pathological conditions of the coronoid process, e.g. osteochondroma, osteoma, fibrous dysplasia, pseudo-joint in Jacob’s disease or oral submucosal fibrosis. Coronoidectomy might also be performed for prophylactic reasons, as it happens in oral cancer treatment.

Retrospective Analysis of Asian Nose and Chin Defects Treated with High G’ Hyaluronic Acid

Mon, 25 Aug 2025 00:00:00 +0000

Non-surgical rhinoplasty using injectable fillers is gaining popularity as a minimally invasive alternative for nasal reshaping, particularly in patients seeking correction of post-surgical deformities or enhancement of nasal projection. The choice of filler is crucial for achieving optimal aesthetic outcomes and ensuring safety, particularly in high-risk vascular areas. This study evaluates the efficacy and safety of VYC-25L, a high G’ and high cohesivity hyaluronic acid filler, in treating nasal deficiencies in Asian patients. This retrospective analysis included 25 Asian patients treated with VYC-25L for nasal augmentation. Injections were performed using a standardized grid-based protocol with a supra-periosteal technique, emphasizing midline placement and slow, small-volume injections to mitigate vascular risks. Aesthetic outcomes were assessed using a 10-point Visual Analog Scale (VAS) by independent surgeons, while patient satisfaction was recorded via a three-degree questionnaire. Safety was evaluated through the monitoring of adverse events over 12 months. All patients demonstrated significant improvement in nasal projection and contour, with 100% scoring 8 or higher on the VAS at 2 weeks post-treatment. Patient satisfaction was high, with 92% rating the correction as “adequate.” Results remained stable at 3, 6, and 12 months. Minor complications included transient bruising (12%) and a single case of nasal dorsum hematoma (4%), both resolving without intervention. No instances of vascular occlusion, necrosis, or infection were observed. VYC-25L is a safe and effective option for non-surgical rhinoplasty in Asian patients, providing durable aesthetic results with minimal downtime. The grid-based injection protocol enhances standardization and reproducibility, making it a valuable tool for optimizing outcomes. Further prospective studies with long-term follow-up are warranted to confirm these findings.

Oral Cancer In the Elderly Population: A Retrospective Observational Study in a Sample of 386 Patients

Mon, 25 Aug 2025 00:00:00 +0000

The aim of the present study is to conduct a descriptive epidemiological analysis of clinical and histopathological data related to the treatment of squamous cell carcinoma of the oral cavity in a population of elderly patients. To address the research inquiries, a population of patients diagnosed with oral cancer at the Maxillofacial Unit of Verona University between 1997 and 2017 was considered. To create the descriptive statistics of the sample population, the following parameters were collected: sex, age, site of the tumor, frequency and type of surgical reconstruction, frequency of pathological staging (pTNM), postoperative hospitalization duration, disease recurrence, overall survival, disease-specific survival, and disease-free survival. Three hundred eighty-six patients met the inclusion criteria; the population was divided into two groups: patients aged <75 years and patients aged ≥75 years. The male-to-female ratio in the overall population was 1.41:1. In the entire sample, the primary site of localization of disease was found to be the tongue. A total of 37.3% of patients underwent microvascular flap reconstruction. Reconstruction with a pedicled flap was used in 27.7% of patients under 75 years old and in 11% of patients over 75 years old. Minor reconstructions using local flaps were performed in 14% of cases. Globally, the average length of postoperative hospital stay (LOS) was 15.8 days for patients aged <75 years and 14.5 days for patients aged ≥75 years. Cancer recurrence was registered in 50% of patients under 75 years and 45% of patients over 75 years. Overall survival in patients aged <75 years was 74%, 65,7%, 50.3% at 3, 5, and 10 years, respectively. Overall survival in patients aged ≥75 years was 63.6%, 50.1%, and 23.2% at 3, 5, and 10 years, respectively. The findings of the present study show that squamous cell carcinoma of the oral cavity in patients aged 75 years or older is a relatively frequent pathology that has been increasing in recent decades, likely due to the progressive aging of the general population. The disease is more prevalent in women, who have greater longevity, and in this subgroup, cancer primarily affects the gingiva. Age alone was not found to be a determining factor, whereas the difference observed in overall survival highlights the importance of comorbidities in elderly patients, which must be carefully evaluated and managed before initiating any therapeutic pathway. Finally, the results of this study emphasize the importance of early diagnosis to ensure that patients receive the most appropriate treatment while minimizing invasiveness.

Midface: A Comprehensive Review of Surgical Techniques for Youth Restoration Over the Past Decade

Mon, 25 Aug 2025 00:00:00 +0000

The aim of the present article is to conduct a comprehensive literature review that identifies the most commonly used surgical techniques in midface rejuvenation, compares their indications, ease of execution, complication rates, and long-term stability. A scoping review on midface lift surgical procedures was conducted following the PRISMA Extension for Scoping Reviews (PRISMA-Scr) guidelines. To address the research questions, three reviewers with varying levels of expertise in facial plastic surgery were selected. A search string was developed following the PICOS table. Three databases (PubMed, Scopus, and Cochrane) were searched for articles in English published between 2015 and 2025. Subsequently, the Rayyan online platform was used to screen titles and abstracts in a blinded manner, reaching the final pool. From an original set of 460 articles retrieved from the databases, the reviewers reached consensus on 23 articles. The literature conveys that midface lift techniques are primarily indicated to correct tear trough deformity, nasolabial folds, loss of cheek volume, and orbital hollowing. However, for upper, lower, and neck ageing, a more invasive classic facelift is often required. More obvious results are achieved with suborbicular (subSMAS) or subperiosteal approaches that release the midface ligaments, whereas subcutaneous techniques are much less effective. The choice of technique depends on several factors, including the patient's needs, previous surgical history, and the surgeon's experience. Complications are comparable between suborbicular (subSMAS) and subperiosteal techniques, as is invasiveness. Standard additional procedures to harmonize may include upper and lower blepharoplasty and malar projection augmentation. Patient satisfaction is subjective mainly due to the lack of a standardised scale, highlighting the need for further outcome studies and objective assessment of results. The midface plays a central role in overall facial aesthetics, and techniques targeting this area are essential for effective rejuvenation and beautification. The decision to employ a sub-SMAS versus a subperiosteal approach often hinges on the surgeon’s preference. However, the absence of a systematic evaluation method and long-term follow-up data limits our ability to determine the superiority of one technique over the other definitively. However, both techniques are comparable in terms of invasiveness and complication rates. The development of an objective scale to assess midface rejuvenation outcomes would greatly enhance standardization and facilitate future studies.