Oral diseases最新文献

Objective: This study evaluated the efficacy and safety of hypericin-mediated photodynamic therapy (PDT) for oral Candida albicans (C. albicans) infections and explores how C. albicans reduction mediates clinical improvement.

Methods: A total of 107 patients (March 2023-March 2025) were assigned to a control group (n = 51, conventional antifungal therapy) or a study group (n = 57, hypericin + PDT). Post-treatment assessments included oral microbiota structure, α-diversity (Chao1, Shannon, Simpson), community differences (via PCoA and hierarchical clustering), and a mediation model to test C. albicans' role in lesion improvement.

Results: Chao1 (species richness) showed no significant difference, but the study group had lower Shannon/Simpson (microbial diversity). Opportunistic pathogens (e.g., C. albicans, Fusobacterium) decreased, while beneficial bacteria (e.g., Lactobacillus) increased. PCoA/clustering confirmed distinct community structures. C. albicans reduction mediated 53.1% of lesion size reduction (indirect effect = -2.656; 95% CI: 0.178-5.755).

Conclusion: Hypericin + PDT effectively treats oral C. albicans infections safely. C. albicans is the core mediator for lesion area reduction, providing a basis for targeted clinical therapy.

Objective: To map the literature on management of surgical margins for oral leukoplakia (OL) and proliferative verrucous leukoplakia (PVL).

Methods: Searches were performed in five electronic databases and gray literature. Studies involving patients undergoing any type of surgical excision of OL or PVL were included. Data extraction focused on surgical technique, margin size, method of margin delineation, and recurrence outcome. Margin size was categorized in centimeters.

Results: Ninety-one studies were included. More than half of the studies (54.9%) did not report the width of surgical margins. Among those that did, margins between > 2 and < 3 mm were the most frequently reported (19.7%). Notably, 94.5% of the studies did not specify the criteria used to determine the margin width. Furthermore, 76.9% failed to describe the method used to delineate lesion margins. High recurrence was observed in 15.1% of OL cases with surgical margins ≤ 2 mm and in 40% of PVL cases with margins > 2 to ≤ 3 mm. Lesions with margins between 3 and 5 mm showed a lower recurrence rate.

Conclusion: We identified a lack of standardization in the reporting of surgical margins. Excision with 5 mm of clinically healthy tissue should be considered the optimal approach for the surgical management.

Background: Oral lichen planus (OLP) is a chronic immune-mediated inflammatory disease with malignant potential, and its local inflammatory microenvironment is closely related to mucosal-associated invariant T cells (MAIT). Our prior work established OLP-associated fibroblasts (OLP/AFs) in creating the inflammatory milieu, but their interaction with MAIT cells remains unexplored. This study aims to investigate how OLP/AFs interact with MAIT cells.

Materials and methods: Oral mucosal samples from OLP patients and healthy controls were selected for flow cytometry to detect MAIT cells. MR1 expression on fibroblasts was quantified via RT-qPCR, Western blot, immunohistochemistry, and immunofluorescence. For functional assays, OLP/AFs were stimulated with formaldehyde-fixed Escherichia coli (E. coli) to induce MR1 surface expression, then co-cultured with PBMCs±anti-MR1 blocking antibody and evaluated the activation status of MAIT.

Results: MR1 expression and MR1⁺ fibroblast density were significantly elevated in OLP lesions compared to healthy controls. OLP/AFs demonstrated higher baseline MR1 expression than normal fibroblasts, which was further enhanced following E. coli stimulation. Co-culture of E. coli-stimulated OLP/AFs with peripheral blood mononuclear cells induced marked activation of MAIT cells. This was evidenced by significantly increased frequencies of CD69⁺ MAIT cells and elevated secretion of pro-inflammatory cytokines and cytotoxic molecules.

Conclusion: OLP/AFs activate MAIT cells via an MR1-dependent mechanism.

Objective: To summarize current understanding of the roles of AMP-activated protein kinase (AMPK) in maintaining salivary gland (SG) homeostasis and its therapeutic potential in SG disorders characterized by acinar atrophy and fibrosis.

Methods: Recent studies and reviews on AMPK signaling, salivary gland pathology, and tissue regeneration were collected from PubMed, Medline, and Scopus databases. The evidence was synthesized to elucidate the regulatory functions of AMPK in SG injury and recovery.

Results: SG homeostasis relies on a balance between cell death and renewal, which is disrupted by severe damage. AMPK functions as a pivotal regulator in this process, promoting acinar cell survival, activating resident stem cells, inhibiting fibrosis, and modulating immune responses. AMPK activation attenuates inflammation and fibrogenesis, enhances tissue regeneration, and fosters a reparative immune microenvironment conducive to glandular recovery.

Conclusion: AMPK serves as a central hub linking metabolic regulation, immune modulation, and tissue repair in SG disorders. Understanding its molecular mechanisms and optimizing AMPK activation strategies may provide novel therapeutic approaches to restore both function and structure in damaged salivary glands.

Introduction: Hypoparathyroidism, an endocrine disorder causing hypocalcemia from inadequate PTH secretion, affects multiple systems and may correlate with salivary dysfunction and poor oral health. This study aimed to investigate the effects of hypoparathyroidism on salivary calcium levels, flow rate, and parotid gland structure, exploring the implications for oral health of this patient population.

Materials and methods: Conducted as a case-control study between January and June 2024, our research included 86 participants: 43 with hypoparathyroidism and 43 in a healthy control group. We compared participants' salivary calcium, phosphorus, and magnesium levels alongside salivary gland ultrasonography features, sialometry results, and oral health questionnaire outcomes.

Results: Salivary calcium levels were significantly lower in the hypoPT group [5.43 (4.13-9.65) mg/dL] compared to the control group [7.06 (4.02-13.18) mg/dL] (p < 0.001). No significant differences were observed in salivary phosphorus (p = 0.112) or magnesium (p = 0.938) levels. Despite similar parotid volumes, ultrasonography detected significantly higher prevalence of parenchymal heterogeneity in the hypoparathyroidism cohort (p = 0.025). Scores from the Multidisciplinary Salivary Gland Society questionnaire were significantly higher in the hypoparathyroidism group (p < 0.05), while sialometry measurements were significantly lower (p < 0.05).

Conclusion: These results collectively suggested that hypoPT is a clinical condition with demonstrable effects on both oral health and salivary gland functions.

Objective: To evaluate the training, clinical experience, and attitudes related to oral biopsy among dental students from Latin America.

Materials and methods: The study included 326 final-year dental students from universities in Argentina, Brazil, Colombia, Mexico, and Venezuela. Participants completed a structured, anonymous 35-item online questionnaire addressing demographic data, exposure to oral biopsy procedures, self-perceived knowledge and skills, and attitudes towards biopsy practice. Data were analyzed using descriptive statistics, Fisher's exact test, and the Wilcoxon test, with a significance level of 5%.

Results: Most students reported having received formal theoretical training in oral biopsy (89.9%). Only 53.4% had performed at least one biopsy during their undergraduate studies, with excisional biopsies being the most common. Despite a high level of agreement regarding the relevance of oral biopsy to clinical practice (p < 0.001), students demonstrated low self-confidence in performing incisional and excisional biopsies (p < 0.001 for both), particularly in lesions suspected of malignancy (p < 0.001). Prior practical experience was significantly associated with higher levels of confidence and more favorable attitudes towards performing biopsies (p < 0.001).

Conclusion: Oral biopsy training among Latin American dental students is heterogeneous and largely theoretical, with limited practical experience contributing to reduced diagnostic autonomy and clinical confidence.