MedNEXT Journal of Medical and Health Sciences

Major management of urethroplasty after trauma: a systematic review

2026-06-13T02:38:35+00:00

Introduction: In the context of urethroplasty, epidemiological data show that urethral trauma accounts for approximately 4.5% of all genitourinary traumas. Most urethral traumas, both blunt and penetrating, result in complete urethral rupture, while the remaining 1/3 result in at least a partial urethral laceration. Urethroplasty remains a significant challenge in urethral and penile reconstruction, and the use of robotics and artificial intelligence is a significant tool for improving urethroplasty. Objective: This study aimed to present the main surgical approaches for urethroplasty after trauma or subsequent comorbidities, highlighting the use of robotic surgery and artificial intelligence to optimize surgical techniques. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from February to April 2026 in the Scopus, Embase, PubMed, Science Direct, SciELO, and Google Scholar databases. The quality of the studies was based on the GRADE instrument, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 117 articles were found, and 35 articles were evaluated in full, and 12 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 27 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=81.1%>50%. It was concluded that, regardless of the urethral injury pattern and treatment options, well-planned, rigorous follow-up with a urologist is of utmost importance for accurate assessment of outcomes and proper management of complications. Patient characteristics and needs should be considered before developing a surgical plan. The tube-in-tube technique is the first choice for single-stage penile and urethral reconstruction for thinner patients. For other patients, a different flap can be used as a substitute for urethral reconstruction. Superficial circumflex iliac artery, pudendal-thigh, and pedicled scrotal flaps can be used to reconstruct the urethra. The tubularized superficial circumflex iliac artery flap and the pudendal-thigh flap are reliable, simple, and suitable for revision urethroplasty. Finally, buccal mucosal grafts with auxiliary maneuvers, such as flap interposition or transfer of adjacent tissue, in robotic reconstruction of the lower urinary tract are durable, safe, and comparable to open surgical approaches, especially when aided by the use of artificial intelligence to enhance urethroplasty.

Cancer stem cell niche in oral squamous cell carcinoma and its surgical margins: an immunohistochemistry study

2026-06-04T12:22:40+00:00

Introduction: With almost 350,000 cancer deaths each year in developed countries, head and neck cancer (HNC) the sixth most frequently noted malignancy [1]. Oral malignancies account for the vast majority of HNC (85%), with oral squamous cell carcinoma (OSCC) being the most common kind. Objective: Oral squamous cell carcinoma (OSCC) has a lower survival range and poor prognosis despite the existing advanced treatment modalities due to the formation of metastasis and ‘drug resistance’ of the tumor cells. The objective of this research was to analyze the cancer stem cell (CSC) niche in lesional tissue of OSCC and it’s all surgical margins with the help of CD44, CD133, OCT-4 markers through immunohistochemistry (IHC) study. Methods: A total of 11 excisional biopsy tissues of OSCC with four surgical margins (anterior, posterior, lateral and medial) each were selected. The immunoreactivity of CSCs in lesional tissue and surgical margins of OSCC was evaluated with the help of CD133, CD44 and Oct-4 markers. The immunoreactivity was then compared between the lesional tissue and surgical margins, and the outcome were related with patient survival of patient over a time of 3 years. Results: CD44 and CD133 in most of the cases showed moderately positive in higher grade OSCC, the weak expression of OCT4 was also expressed in higher grade tumors. Conclusion: The increased expression of CD133 and CD44 in advanced grades would be the important result for OSCC cases could suggesting the characterization of CD133 and CD44 in oral mucosal carcinogenesis oral mucosa.

Importance of physical exercise on macrophage polarization: a relation to disease concern

2026-06-04T12:12:04+00:00

Macrophages are specialized cells, originated from blood monocyte, differentiate in tissues, and involved in the destruction of foreign pathogens. They also can release cytokines and activate other cells and initiate inflammation. Macrophage polarization from M1 type to M2 –type has been found to be related to various diseases including cancer, diabetes, coronary artery diseases (CAD), etc. Here we did a brief review to convince that regular light to intense type physical exercise can induce polarization of macrophage from its one form (M1) to the other form (M2), and can improve the various disease conditions. The cellular as well as the molecular events that are found with the physical exercise (PE) indicate that the PE could be a non-pharmacological management for various diseases with minimal side effects.

Major considerations of sealing materials in parendodontic surgery: a concise systematic review

2026-05-29T19:44:27+00:00

Introduction: Parendodontic surgery or periapical surgery has been described in the literature for several decades as a treatment option for endodontic failure. Several techniques have been described; however, we can currently say that the success of periapical surgery is directly linked to new technologies, such as operating microscopy, ultrasonic inserts for proper decontamination of the region, and new materials that provide adequate sealing of the retrograde filling cavity. Objective: It was to conduct a concise systematic review on the main considerations of sealing materials in periapical surgery. Methods: The PRISMA Guidelines were followed. The search was conducted from January to February 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneous results, with X² = 78.7% > 50%. A total of 126 articles were found and submitted for eligibility analysis, with 30 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2 standards. Among the desired properties of new materials for sealing the retrograde filling cavity, low cytotoxicity, good radiopacity, ease of handling, and the ability to seal and adhere to dentin stand out. With the discovery of MTA in the 1990s, a new class of materials, bioceramics, has been developed for this purpose.

Major clinical approaches on the bone regeneration with bone morphogenetic protein and platelet-rich plasma: a systematic review

2026-05-26T11:18:08+00:00

Introduction: The production or regeneration of any tissue is a complex biological process in itself, since it requires intrinsically regulated interactions between cells, the action of systemic hormones, the participation of extracellular matrix components, and the local action of so-called growth factors. Objective: It was to review the concepts related to growth factors, as well as in relation to platelet rich plasma and bone morphogenetic protein as an adjuvant in bone regeneration therapies directed to implant dentistry. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from January to March 2026 across the Embase, Scopus, PubMed, Web of Science, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneous results, with X²=81.7% > 50%. A total of 134 articles were found and submitted for eligibility analysis, with 45 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 14 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that the greatest advantages of the use of platelet-rich plasma are its ability to accelerate the process of bone regeneration by increasing the number of growth factors present in human platelets. On the other hand, it is observed that one of its major disadvantages is the low life expectancy of these platelets in the recipient or graft bed. However, it is also known that the PRP technique would only accelerate a process of bone regeneration that normally already occurs, and this process follows its path until the formation of mature bone.

Cross-Sectional Study on the Assessment of Awareness Regarding Nutritional Diet, Physical Activity, and Obesity: A Pre- and Post-Intervention Survey

2026-05-20T12:08:08+00:00

Introduction: The increasing number of university students who suffer from obesity and other lifestyle-related health issues has highlighted the necessity of successful health awareness campaigns. Objective: The purpose of this study was to assess how a structured awareness program affected pharmacy students at Marathwada Mitra Mandal's College of Pharmacy in Pune's eating patterns, levels of physical activity, obesity-related factors, and health awareness. Material and Method: A survey-based study involving 300 pharmacy students, ages 17 to 24, was carried out for three months before and after the intervention. Five components of a standardized, validated questionnaire were used to gather data: demographics, physical activity, nutritional diet, obesity and health-related factors, and behavior and awareness. For continuous variables, a paired t-test was used, and for categorical data, chi-square tests; a P-value of less than 0.05 was deemed statistically significant. Results: The mean scores for body weight satisfaction, physical activity, health behaviour and awareness, and nutritional diet all showed significant improvements (p<0.05). Chi-square analysis showed a decrease in weight-related health problems and a substantial increase in participation in weight management programs and prior weight management attempts. Conclusion: At Marathwada Mitra Mandal's College of Pharmacy, the awareness intervention program effectively improved students' knowledge of body weight control, physical activity, health-related behaviours, and nutritional practices. These findings emphasize how crucial it is to put in place organized health education programs at pharmacy schools in order to encourage young adults to lead better lifestyles.

Main clinical considerations in restorative dentistry and aesthetic rehabilitation of implant-supported prostheses: a systematic review

2026-04-29T11:27:39+00:00

Introduction: In the field of restorative dentistry and aesthetic rehabilitation, the long-term success of a dental implant depends on the prosthesis. The key to obtaining perfect dentures depends on the passive seating between its connector and the implant itself. The compromised fit between the contact surfaces of implant-supported prostheses creates uncontrolled tensions in the peri-implant components and tissues, evoking biological and mechanical complications. Objective: Considering that choosing the most precise technique and material for each particular case has become a challenging task for professionals, this study aimed to review the literature on the types of impression used in implant prostheses for the best aesthetic rehabilitation. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from December 2025 to January 2026 in the Web of Science, Embase, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 228 articles were found, and 84 articles were evaluated in full, and 29 were included and developed in the present systematic review study. According to the GRADE instrument, most studies presented homogeneity in their results, with an X2 = 85.8% > 50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 90 studies that did not meet GRADE and AMSTAR-2. The choice of closed tray or open tray impression techniques depends on the number, depth, angulation, and relative parallelism of the implants. The materials of choice for making impressions, following the closed-tray and open-tray printing techniques, were polyether and polyvinylsiloxane. Most studies reported more accurate impressions with the splinting technique than with the non-splitting technique. Acrylic resin was the most frequently used material. Therefore, minimizing contraction appears to be the most important factor in ensuring an accurate impression for this technique. Digital printing has achieved high patient acceptance, reduces possible impression and master mold errors, reduces time in the chair, provides a three-dimensional image of the preparation, and ease of communication between the clinician and the laboratory. However, there is a dearth of scientific data regarding implant fingerprints and their accuracy. Research on implant fingerprinting has been limited to a few in vitro studies and case reports.

Major clinical considerations regarding the drug-induced gingival overgrowth: a systematic review

2026-04-16T11:49:08+00:00

Introduction: Some systemic medications can affect the periodontal tissues, modifying their inflammatory response and promoting gingival growth, which causes gingival hyperplasia (GH). This can be intensified when two drugs are used synergistically, worsening the GH picture. Objective: It was to perform a systematic review on the incidence of gingival hyperplasia and its relation to the predictors of phenytoin, nifedipine and cyclosporine A. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from December 2025 to January 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. A systematic review of the incidence of gingival hyperplasia and its relationship to the predictor phenytoin, nifedipine and cyclosporine A. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results: According to the GRADE instrument, most studies presented homogeneous results, with X²=70.8% > 50%. A total of 62 articles were found and submitted for eligibility analysis, with 20 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 02 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2 standards. It was found that gingival growth in patients with kidney transplantation was associated with a significant increase in gingival hyperplasia (GH) and also with other pathologies leading to the use of drugs such as phenytoin, nifedipine and cyclosporin A. However, G H can be mistakenly mistaken for gingival hyperplasia. The name "gingival growth and / or gingival hypertrophy" is a function of histological study, the occurrence of increased extracellular matrix synthesis, mainly in collagen, and increase in the size and number of fibroblasts present in the tissue. Scientific research has shown that Ciclosporin A can modify the metabolism of the gingival and bone tissue and the composition of the oral biofilm, the flow and composition of the gingival fluid. Conclusion: The surgeon-dentist should be aware during the anamnesis to the cases of patients who use medications that induce gingival hyperplasia, such as anticonvulsants. It is imperative for the dentist to understand the general condition and the limitations of each patient, so that he can control and cure the most varied oral manifestations, in order to maintain a good quality of life in his patient.

Importance of clinical evaluation for successful bone elevation for immediate implant placement: a systematic review

2026-04-16T11:43:55+00:00

Introduction: Early implant follow-up studies laid the scientific foundation for modern implantology. Early loading was identified as a critical factor; therefore, various waiting times were explored until a period of at least three months was established for the mandible and five to six months for the maxilla. Thus, an immediate dental implant (IDI) was defined as the placement of a prosthetic element on the implant without osseointegration occurring. Objective: This systematic review aimed to analyze the importance of clinical evaluation and bone elevation for the success of the immediate implant technique, presenting criteria for the indication and follow-up of these procedures. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from December 2025 to January 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneous results, with X²=71.7% > 50%. A total of 132 articles were found and submitted for eligibility analysis, with 22 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 33 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that the high success rate is a consequence of correct surgical and prosthetic planning, and the harmony between the implant system, the patient, and the dentist. Immediate dental implant placement in total jaw rehabilitation is a procedure with high success rates that should and can be applied in all cases where the technique is efficient in providing adequate primary stability to the implants.

Nutrological care for athletes in overtraining: a brief systematic review

2026-03-31T18:32:36+00:00

Introduction: Training can cause stress to an athlete, changing their physical and psychological well-being, and progressing from acute to chronic fatigue (overtraining). Athletes must be monitored closely to ensure training can deliver the desired effects on the athlete's well-being and performance. In this sense, physiological, biochemical, metabolic, and subjective performance measures are all options for monitoring the athlete, including prioritizing the relationship between metabolism and functional nutrition. Objective: It was to carry out a systematic review to elucidate and describe the importance of metabolic tracking and nutrological care in athletes. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from October to November 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found, and 46 articles were evaluated, and 34 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 14 studies with a high risk of bias and 33 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X² =69.5%>50%. The biases did not compromise the scientific basis of the studies. It was concluded that subjective well-being responded consistently to training stress, deteriorating with increased and chronic training and improving with reduced training. Athletes need to consume adequate energy in the quantity and timing of intake during periods of high-intensity and/or long-duration training to maintain health and maximize training outcomes. Low energy availability can result in unwanted loss of muscle mass, menstrual dysfunction, hormonal disturbances, suboptimal bone density, an increased risk of fatigue, injury and illness, impaired adaptation, and a prolonged recovery process.

Dental management in children with autism spectrum disorder: a systematic review

2026-03-18T11:21:08+00:00

Introduction: In the context of autism spectrum disorder (ASD), this condition represents a complex neurodevelopmental disorder in children and adults. Anxiety and fear of dental treatment are frequently observed in children with ASD, manifesting through difficult behaviors and uncooperative reactions during treatment. Objective: It was to develop a concise systematic review study to highlight the main clinical approaches to dental care in autistic children. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from December 2025 to January 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneous results, with X² = 79.5% > 50%. A total of 80 articles were found and submitted for eligibility analysis, with 09 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 05 studies with a high risk of bias and 12 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that children with autism spectrum disorder face unique challenges in maintaining oral health due to sensory sensitivities, communication difficulties, and behavioral barriers. Culturally adapted dental visual aids have demonstrated effectiveness in modifying behavioral patterns in children diagnosed with autism spectrum disorder during dental appointments. Furthermore, it is necessary for children with ASD to undergo a pre-operative psychological evaluation to investigate parental expectations and cooperation and to determine if appropriate dental treatment should be initiated.

Major clinical approaches and treatment in malocclusion: a systematic review

2026-03-18T11:11:18+00:00

Introduction: Malocclusion has been an aggravating factor in the development of caries, and may not be the main factor for the development of some temporomandibular dysfunction, but it is an untreated cofactor when diagnosed. The use of orthodontic restraint in the post-treatment phase is of great importance so that there is no recurrence of tooth movement that may occur during the period of remodeling of the dental structures. Objective: It was to explore the literary findings about the importance of knowing the advances in orthodontics in order to better understand the main treatments of malocclusions and the importance of their use for rehabilitation in the functional, aesthetic and psychological aspects of the patient. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from December 2025 to January 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneity in their results, with X2=72.7%>50%. A total of 138 articles were found and submitted for eligibility analysis, with 28 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 27 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2 standards. Due to the aging of the stomatognathic apparatus the orofacial functions can be modified, such as malocclusion, therefore for greater effectiveness and longevity of the final result of the orthodontic treatment the indefinite use of fixed inferior containment should be established and accompanied by the professional.

Main considerations of the immune system and caries disease: a systematic review

2026-03-01T02:41:54+00:00

Introduction: According to the World Dental Federation, the hypothesis that more than 90.0% of the world population will have any oral disease in their lifetime. The discovery of an immunoenzymatic mucosal defense system, coupled with the advances of immunology, demonstrate the need to know their concepts and their possible interrelations with the installation and progression of the cariogenic process. Objective: Therefore, the present work carried out a literature review to verify the main approaches regarding the influence of the immune system on caries disease. Methods: Experimental and clinical studies were included (case reports, retrospective, prospective and randomized trials) with qualitative and/or quantitative analysis. Initially, the keywords were determined by searching the DeCS tool (Descriptors in Health Sciences, BIREME base) and later verified and validated by MeSh system (Medical Subject Headings, the US National Library of Medicine). Series of Articles And Eligibility: A total of 27 articles were found involving. Initially, it was held the exclusion existing title and duplications in accordance with the interest described this work. After this process, the summaries were evaluated and a new exclusion was held. A total of 22 articles were evaluated in full, and 18 were included and discussed in this study. Conclusion: There are an important network and cascade of defense events between immunological processes and caries disease. Thus, it is necessary to have a healthy immune response to reduce the incidence of caries.

Metabolomic and transcriptomic effects of melatonin and gut microbiota through microbes and exosomes on muscle regeneration and enhancement of sports performance: a systematic review

2026-02-24T22:41:23+00:00

Introduction: Sleep and recovery are essential for optimizing exercise performance. However, the effectiveness of melatonin supplementation in improving sleep quality and next-day physical performance remains uncertain. Research has demonstrated the ergogenic effect of melatonin (N-acetyl-5-methoxytryptamine) (MEL) in increasing exhaustive aerobic activity. Associated with the effects of MEL, adult tissue stem cells (mesenchymal stem cells) mediate homeostasis and regeneration of tissues and organs, integrating signaling cues and metabolic inputs with the release of exosomes and microRNAs to enhance athletic performance. Objective: It was demonstrated through a systematic review study the regulation of melatonin and gut microbiota by cellular and molecular metabolic pathways, such as microRNAs and exosomes, in the process of muscle regeneration and increased sports performance. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from July to August 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 136 articles were found, and 55 articles were evaluated in full and 29 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 12 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=82.9%>50%. It was concluded that administering 6 mg of melatonin at night improved performance during high-intensity exercise the following day and enhanced perceived recovery up to 72 hours after exercise. Melatonin intake during training has beneficial effects on physical performance and protects tissues against the deleterious effects of reactive oxygen species and cellular damage. Furthermore, nocturnal melatonin supplementation during an athlete's intense training session alleviated oxidative stress, leukocytosis, and cellular damage, and improved performance recovery. Melatonin plays important roles in regulating the regenerative activities of mesenchymal stem cells, which, along with nutrients, modulate the activities of exosomes and microRNAs in the muscle regeneration process.

Early skin cancer screening using digital dermatoscopy and artificial intelligence: a systematic review

2026-02-12T14:33:37+00:00

Introduction: The development of computer-aided diagnostic solutions based on Artificial Intelligence (AI) has enabled the diagnosis of skin cancer. Objective: To discuss advances in dermatoscopic and AI-based digital image solutions for the diagnosis of skin cancer, along with some future challenges and opportunities to improve these AI systems, in order to support dermatologists and increase their ability to diagnose skin cancer. Methods: The systematic review guidelines of the PRISMA Platform were followed. The search was conducted from September to October 2025 in the Web of Science, Scopus, PubMed, Science Direct, SciELO, and Google Scholar databases. The quality of the studies was based on the GRADE and AMSTAR-2 instruments, and the risk of bias was adequately analyzed according to the Cochrane instrument. Results and Conclusion: 87 articles were found. A total of 18 articles were qualitatively evaluated, and 13 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 5 studies with a high risk of bias and 50 studies that did not meet the GRADE and AMSTAR-2 criteria. It was concluded that accumulating evidence suggests that computer-aided diagnostic systems can offer their greatest benefit as assistive systems, as studies indicate that the combination of humans and machines achieves the best results. Artificial intelligence-based diagnostic systems are capable of detecting morphological characteristics quickly, quantitatively, objectively, and reproducibly, thus providing a more objective analytical basis to complement medical expertise.

Clinical considerations in hospital-based palliative dentistry for critically ill or cancer patients: a systematic review

2026-02-11T12:20:18+00:00

Introduction: Palliative care (PC) in dentistry consists of providing dental care to patients who are in the terminal phase of an illness, mainly cancer. This care aims to reduce the pain and suffering of these patients. Objective: To list the main clinical considerations of hospital palliative dentistry in critically ill patients or those with cancer. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from October to December 2025 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneity in their results, with X²=82.3%>50%. A total of 90 articles were found and submitted for eligibility analysis, with 16 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 11 studies with a high risk of bias and 20 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that the understanding of palliative dental care has changed and redefined oncological treatment by dentists. Currently, palliative dental care is defined as the comprehensive care of a patient experiencing intense health-related suffering due to a serious, life-threatening illness. The goal of palliative dental care is to improve the quality of life of patients, their families, and their caregivers. Based on the literature reviewed, it can be concluded that the most common oral conditions among palliative patients are cancer, xerostomia, candidiasis, mucositis, dysphagia, and dysgeusia. These conditions reduce the patient's quality of life, causing pain and discomfort. Furthermore, xerostomia has proven to be an important factor in the development of other conditions. It was possible to conclude that the presence of a dental surgeon on the palliative care team is indispensable for improving the patient's quality of life.

The role of fibronectin in malnutrition and immunity in ICU patient: a mini-review

2026-02-06T02:17:59+00:00

Plasma fibronectin is a sensitive marker for nutritional status, rapidly decreasing during starvation and protein-energy malnutrition, making it a useful indicator for monitoring short-term nutritional status. As a glycoprotein, it is reduced in malnourished patients, often before albumin decreases, due to decreased hepatic synthesis and potential increased clearance. Plasma fibronectin levels have been shown to correlate with reticuloendothelial function and are reduced in critically ill patients, such as those with burns, shock, trauma, and sepsis. Patients failing to show an increase in fibronectin levels after stress have been shown to do poorly. Starvation studies in human volunteers have demonstrated decreasing plasma fibronectin levels until feeding was resumed

Major approaches and clinical studies on the relationship between inflammatory bowel diseases and nutrients, gut microbiota and exosomes/microRNAs: a systematic review

2026-02-06T01:49:27+00:00

Introduction: Inflammatory bowel diseases (IBDs) are multifactorial diseases characterized by chronic inflammation of the gastrointestinal tract. Nutrients, gut microbiota, exosomes, and microRNAs play crucial roles in the pathophysiology of IBD. Objective: It was to carry out a systematic review of the main approaches and clinical studies on the relationship between inflammatory bowel diseases and nutrients, intestinal microbiota, and exosomes/microRNAs. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from August to September 2025 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 177 articles were found, and 58 articles were evaluated in full, and 30 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 06 studies with a high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=77.7%>50%. It was concluded that inflammatory bowel diseases are associated with various gastrointestinal symptoms and, therefore, affect patients' quality of life. Although intestinal bacteria and the host's immune response are considered important factors in its pathogenesis, a sufficient explanation of their role in its pathophysiological mechanism has not been presented. Exosomes and microRNAs, together with nutrients and gut microbiota, participate in the molecular interactions of inflammatory bowel diseases. Recent studies have confirmed the important role of miRNAs in targeting certain molecules in signaling pathways that regulate intestinal barrier homeostasis, inflammatory reactions, and autophagy of the intestinal epithelium. Several studies have identified specific miRNAs associated with inflammatory bowel diseases in colon tissues. The correlation between the gut microbiota and cytokines suggests that exosomes and microRNAs can modulate intestinal immunity by influencing the gut microbiota.

Major clinical outcomes of dietary therapy in patients with lipedema in the preoperative period of plastic surgery: a systematic review

2026-01-23T01:33:19+00:00

Introduction: The first clinical study on dietary therapy in lipedema showed improvement in general body composition and in specifically affected areas (upper and lower limbs) with the consumption of a low-carbohydrate diet and foods high in antioxidants inspired by the Mediterranean diet. Objective: It was to explore the main directions of dietary therapy in patients with lipedema as a pre-operative management tool for plastic surgery. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from August to September 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found, and 33 articles were evaluated in full, and 23 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 15 studies with a high risk of bias and 29 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=71.5%>50%. It was concluded that in the pre-operative phase of plastic surgery for lipedema, the ketogenic diet effectively induced weight loss and fat mass, including in the limbs, areas considered unresponsive to dietary therapy in patients with lipedema. The best results were obtained with the combination of the ketogenic diet and carboxytherapy, which showed both an improvement in body composition and a reduction in pain, as well as an improvement in sleep quality. Healthy eating patterns for lipedema can be whole foods, enzyme-rich, plant-based, or ketogenic. Research favors plant-based low-carb diets, which correlate with decreased all-cause mortality relative to animal-based diets. Furthermore, vitamin D levels must be monitored and normalized in people with lipedema. A low-calorie diet based on foods rich in anti-inflammatory and antioxidant nutrients could contribute to the well-being of patients with lipedema, improving quality of life, and reducing asthenia, pain, and anxiety. Selenium can reduce oxidative stress, which plays an important role in lipedema. MicroRNAs produced by the stromal vascular fraction of lipedema represent important therapeutic targets for the treatment of lipedema. Precision nutrition is an emerging branch of nutrition science that aims to use omics technologies (metabolomics) to better target the nutritional treatment of lipedema.

Major considerations of common and zygomatic implants in patients using bisphosphonates and the risk of osteonecrosis: a concise systematic review

2026-01-19T19:53:34+00:00

Introduction: In the context of dental implants and bone strengthening, bisphosphonates (BPs) are antiresorptive agents. However, prolonged use of BPs may increase the risk of medication-related osteonecrosis of the jaw (MRONJ), impairing the placement of common and zygomatic implants. Objective: This study aimed to analyze the major considerations of common and zygomatic implants in patients using bisphosphonates, as well as the risk of osteonecrosis. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from September to October 2025 in the Web of Science, Scopus, Embase, PubMed, Science Direct, SciELO, and Google Scholar databases. The quality of the studies was based on the GRADE instrument, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneity in their results, with X²=81.2%>50%. A total of 81 articles were found and submitted for eligibility analysis, with 07 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 27 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. It was concluded that current evidence does not suggest a strong association between antiresorptive therapy in patients with osteoporosis and failure of common and zygomatic dental implants. Low-certainty evidence suggests that antiresorptive treatment for osteoporosis reduces dental implant failure. Bisphosphonates are associated with medication-related osteonecrosis of the jaw in patients with osteoporosis receiving dental implants, with moderate certainty.

General approaches and surgical treatment on the temporomandibular joint dysfunctions: a systematic review

2026-01-07T02:10:52+00:00

Introduction: Temporomandibular dysfunction (TMD) encompasses a group of disorders of the masticatory system, broadly divided into muscle conditions and those that affect the temporomandibular joint (TMJ). TMD is a common condition whose signs appear in up to 60 to 70% of the population. The peak incidence is observed in adults aged 20 to 40 years. Orofacial pain is a common presentation in general practice contexts. For most patients, a conservative approach to managing TMD should be adopted. Up to 40% of symptomatic patients have spontaneous resolution of their symptoms without treatment, and 14 and 50-90% of patients have relief with conservative therapy. Objective: To present the main current considerations on temporomandibular dysfunctions, through a systematic literature review. Methods: The present study followed a model of systematic literature review presenting and discussing case series, prospective, retrospective, randomized, double-blind, placebo-controlled trials in humans with a publication time of the last ten years were selected and analyzed, with a total of 15 articles, following the rules of PRISMA. Major findings and conclusion: TMJ can be affected by infectious and inflammatory processes, vitamin or hormone deficiencies, and changes in shape caused by trauma or parafunction. Also, chewing teeth and muscles may be involved in common pathological manifestations that together constitute the symptoms of TMD. TMD is multifactorial, being associated with muscle hyperactivity, trauma, emotional stress, malocclusion, and numerous other predisposing, precipitating, or prolonged factors of this condition. The occlusal plates are used as a reversible therapy, to temporarily promote an orthopedically more stable joint position and provide a more adequate muscular function. They can be used as protection for teeth and support structures against abnormal forces or of great intensity and duration.

Major considerations of minimally invasive orthognathic surgery in Class III malocclusions: a systematic review

2026-01-07T01:46:59+00:00

Introduction: In Brazil, malocclusion is found in the ages between 7 and 15 years old with a prevalence of 6%. In this scenario, Class III malocclusion affects between 5% and 15% of the entire Brazilian population. Orthodontics stands out due to the strong aesthetic impairment and unfavorable treatment prognosis, especially when there is a hereditary component. It is suggested that most cases of Class III malocclusion have retrusion or maxillary hypoplasia, which may or may not be associated with mandibular prognathism. Thus, several treatment modalities are proposed to correct Class III malocclusion. Objective: It explored the literary findings on the importance of knowing the advances in orthodontics for the treatment of class III malocclusion. Methods: Clinical studies (case reports, retrospective, prospective and randomized) with qualitative and / or quantitative analysis were included, following the rules of the systematic review-PRISMA. 134 articles were found initially and, after selection, 37 articles were used to compose the present study. Results and conclusion: According to the literary findings, the treatment of Class III must be fundamentally based on the diagnosis so that the treatment is installed in order to correct the compromised structures instead of being compensated in places not affected by this malocclusion. In other words, the degree of involvement of the maxilla and mandible should be evaluated so that the treatment is directed to that bone base and really reaches its objectives and impacts of facial improvement. Growth redirection in Class III cases is indicated as soon as the anomaly is diagnosed, since the displacement processes that occur on the middle face can only be affected with treatment as long as the growth zones are able to respond to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the effects of facial correction.

A rare case of Capmatinib/Pikray sensitive metastatic intimal cardiac sarcoma

2026-01-06T18:34:05+00:00

Primary cardiac tumors are infrequently encountered, with a higher prevalence of secondary tumors. Among primary cardiac tumors, myxomas are benign and more commonly observed, while angiosarcomas constitute the most frequently encountered malignant tumors. Intimal sarcomas, the least prevalent among primary cardiac tumors, are seldom reported. This case report details the unique instance of a patient diagnosed with spindle cell neoplasm, a type of intimal sarcoma mimicking atrial myxoma with distant metastases, manifesting complications such as new onset atrial fibrillation and heart failure. A male in his 70s, presented with subacute Dyspnea on minimal exertion, orthopnea, paroxysmal nocturnal dyspnea. Initial investigations, revealed new onset AFIB, heart failure with cardiomegaly and atrial masses suggestive of thrombi. Echocardiograpgy findings was consistent with atrial myxoma. Subsequent PET scan indicated malignancy with metastases to the spine. The patient opted for chemotherapy and palliative resection, which was incomplete with positive margins. Tumor biopsy revealed intimal sarcoma (spindle cell neoplasm) which was sensitive to Capmatinib and Pikray. Patient expired nine months later

Major clinical considerations of parendodontic surgery in patients with comorbidities: a systematic review

2025-12-03T04:02:03+00:00

Introduction: In the context of patients with chronic comorbidities, parendodontic surgery (or apical or endodontic surgery) becomes a challenge, requiring increased care. Parendodontic surgery is performed in the periapical region or bordering areas, aiming to solve problems that have not been successfully treated with conventional endodontic treatment. Objective: It was to present major clinical considerations of parendodontic surgery in patients with comorbidities. Methods: The systematic review rules of the PRISMA Platform were followed. The research was conducted from September to October 2025 using the Scopus, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: A total of 177 articles were found, 36 of which were evaluated in full, and 11 were included in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 27 studies with a high risk of bias and 33 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that periapical surgery constitutes a viable, safe, and effective alternative for eliminating bacteria from within the root canal system, even in patients with chronic comorbidities. Periapical surgery is increasingly used to repair problems that have not been resolved through conventional endodontic treatment. Through a correct diagnosis and the chosen surgical technique, success and an excellent prognosis are possible. Thus, the success rates of periapical surgeries depend on the surgical modality indicated, retrograde filling materials, the previous quality of root canal obturation, treatment of the surgical site, execution of the surgical technique, and periodontal conditions. Associations have been observed between the most severe clinical presentations (Ludwig's angina and submandibular infection) and the complexity of clinical care.

Major aesthetic considerations of bichectomy: a systematic review

2025-11-29T13:06:15+00:00

According to the Brazilian Society of Plastic Surgery, Brazil is one of the world leaders in plastic surgery, with approximately 2 million procedures performed annually, according to 2023 estimates, and about 0.5% of the total are represented by aesthetic surgeries such as bichectomy. Bilateral cheek symmetry is necessary, with the upper part limited by the infraorbital sulcus and zygomatic arch, and the lower part by the inferior border of the mandible. In this context, bichectomy is based on the partial removal of the adipose body (Bichat's Fat Pad) located in the cheek area. The main indication for this procedure is for patients with a marked linea alba or trauma to the buccal mucosa; however, this technique is increasingly sought for aesthetic purposes. Thus, BF removal has become increasingly popular among dental surgeons. The removal of the buccal fat allows safe results in the volumetric reduction of the lower facial third and definition of the contours and aesthetically pleasing angulations of this region. However, the main risks of bichectomy are listed as infection, bleeding, hematoma (due to some clot in some vessel or lack of external compression in the postoperative period), nerve damage, and injury to the duct of the parotid gland, which is the saliva channel. In addition, the patient may have excessive cavities in the cheek region and early facial aging.

Sympathetic nervous system and stellate ganglion block under ultrasound for the control of visceral pain: a systematic review

2025-11-21T20:05:03+00:00

Introduction: Peripheral nerve blocks are becoming increasingly used as adjuvant treatment modalities for a variety of conditions refractory to medical treatment. Right or left stellate ganglion blocks are a specific type of peripheral nerve block that targets the sympathetic blockade of neuronal impulses by injecting local anesthetic and steroids into nerve bundles in the cervical area. Objective: It was to present the primary evidence from clinical studies of visceral pain mediated by the sympathetic nervous system through resolution with stellate ganglion block under ultrasound. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from January to February 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 104 articles were found. A total of 28 articles were assessed and 25 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=89.5% >50%. It was evident that stellate ganglion block is an emerging treatment modality for many sympathetically managed processes, resulting in complete resolution of pain. Although promising in the current literature, large multicenter randomized clinical trials are needed in the future to further validate the efficacy of stellate ganglion block. Additional research is also needed to elucidate the timing, laterality, and repetition of blocks for these conditions.

Major clinical results on the dental bleaching: a systematic review

2025-11-13T02:23:24+00:00

Introduction: It is lived in a society where the media induces our patient's standards of aesthetics and beauty. Patients are seeking more and more offices for a completely aesthetic smile. Toothpaste whiteners consist of surfactants, polyphosphates, enzymes, peroxides, citrate, pyrophosphate, hexametaphosphate, blue covarine, and abrasive agents. Objective: It was to conduct a systematic review to present the main considerations and outcomes of clinical studies on dental bleaching. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from July to August 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 175 articles were found, and 40 articles were evaluated in full, and 30 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies with a high risk of bias and 25 that did not meet the GRADE and AMSTAR-2 criteria. According to the GRADE instrument, most studies presented homogeneity in their results, with X²=94.7%>50%. It was concluded that after analyzing and comparing the literature results obtained before and after the use of toothpastes and mouthwashes, it can be observed that the products did not promote teeth bleaching. Also, external root resorption in internal tooth whitening is one of the disadvantages of whitening; the etiology is unknown. External cervical resorption is the loss of hard tissue of the dental structure, such as cementum and dentin, resulting in an odontoclastic action, its onset usually occurring in the cervical region of the root surface, and is asymptomatic.

Forensic odontology: human identification through dental evidence

2025-11-04T02:00:21+00:00

Forensic dentistry is a branch of dentistry that assists the justice system in solving cases by identifying bodies, contributing significantly to criminal and civil investigations. It is especially used in situations where the body is already in an advanced state of decomposition, carbonization, or skeletonization, or when there is no known identity for the corpse. This specialty analyzes dental evidence, such as teeth and the DNA present in them, comparing ante-mortem and post-mortem records, analyzing the dental arch, bite marks, and dental prostheses, which are often customized and unique. Forensic dentistry can also assist in cases of violence, mass disasters, accidents, and in identifying missing persons. The use of well-filled dental records, X-rays, and other clinical records is essential in this process, allowing for accurate and reliable analysis. This article includes literature reviews and case reports in which forensic dentistry has proven to be extremely important for resolving each situation, using different methods of human identification. The role of the dental surgeon as an expert or technical assistant has proven to be indispensable for the elucidation of various cases, reinforcing the relevance of this area in the field of forensic medicine.

Preserving alveolar ridge after tooth extraction to promote tissue aesthetics and dental implants: a systematic review

2025-10-27T12:07:46+00:00

Introduction: In dental extractions, the preservation of bone and dental sockets should be the preferred option in patient treatment. In this regard, the width and height of the alveolar ridge after extraction can decrease by 3.87 mm and 1.67 mm, respectively, after three months, and by 63% and 22% after six months. Therefore, alveolar ridge preservation procedures have been introduced to prevent alveolar ridge atrophy and preserve sufficient bone dimensions to allow for the placement of implants. Objective: The aim was to address the primary clinical considerations for preserving dental sockets after tooth extraction, thereby promoting tissue aesthetics and facilitating the successful placement of dental implants. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from July to August 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 125 articles were found, and 30 articles were evaluated in full and 15 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 24 studies that did not meet GRADE and AMSTAR-2. According to the GRADE instrument, most studies presented homogeneity in their results, with X²=87.8%>50%. It was concluded that preserving bone volume after tooth extraction is a challenge in implant rehabilitation, aiming for functional and aesthetic results. An extraction socket filled with xenograft resulted in better preservation of alveolar bone dimensions, less ridge resorption, and provided better healing of both soft and hard tissues, yielding more satisfactory results. Furthermore, the use of photobiomodulation appeared to improve alveolar bone healing after tooth extraction and implant stability in cases of immediate extraction and implantation.

Provisional restorations: a literature review

2025-10-23T02:43:05+00:00

Introduction: Minimally invasive dentistry advocates the use of dental materials with adhesive properties; aims to provide means for remineralization of dental tissue damaged by caries and to prevent the progression of initial caries in order to promote maintenance and longevity of dental elements in the mouth. Glass ionomer cement is a prominent material in the current dentistry, because it added favorable physical and biological properties, which were not obtained with other materials. Thus, one of the main objectives of restorative dentistry is the preservation of healthy dental tissues as well as the restoration of lost tissue seeking, through the use of suitable materials and well-conducted techniques, to avoid recurrences or even the appearance of new caries. Objective: It was to provide a literature review on the main findings of the use of glass ionomer cement in dental restorations. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from July to August 2025 in the Web of Science, Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneity in their results, with X²=88.5%>50%. A total of 126 articles were found and submitted to eligibility analysis, with 26 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 29 studies that did not meet GRADE and AMSTAR-2. It was concluded that the objectives of restorative treatment in deciduous teeth with glass ionomer cements are to repair or limit damage caused by caries disease, protect and preserve dental structures, restore proper function, restore aesthetics (when appropriate), and provide a condition that facilitates the maintenance of good oral hygiene. It is imperative that the dental surgeon remembers that pulp vitality should be maintained whenever possible.