Finding a protocol that could prevent bone resorption and be implemented in clinical practice would be crucial in providing sufficient bone to replace missing teeth with implants. The study aimed to determine the effectiveness of different centrifugation platelet-rich fibrin (PRF) protocols in new bone formation and bone regenerative markers. This randomized clinical trial was conducted at Izmir Katip Çelebi Research Hospital, a population-based facility in Izmir. Study subjects were composed of patients who required extraction of anterior teeth. Exclusion criteria included periodontal disease, resorption of alveolar bone, defects, smoking, alcoholism, and systemic diseases. The independent variable was the PRF protocol. The subjects were randomly assigned to one of three groups: Leukocyte Platelet-Rich Fibrin (L-PRF), Advanced Platelet-Rich Fibrin (A-PRF) and control groups (healing naturally). The primary outcome of interest was the percentage of new bone formation, determined by analyzing the staining intensity in histomorphometric assessments of bone samples collected 8weeks after extraction. The secondary outcomes were regenerative effects measured by the immunohistochemical expression of markers such as osteocalcin, alkaline phosphatase, and proliferating cell nuclear antigen. Potential benefits were evaluated by clinical observations of pain, swelling, membrane visibility and healing. Age, sex and health conditions. Histologic comparative staining intensities and biomarkers expression between groups were evaluated by one way analysis of variance. A difference of P<.05 was considered statistically significant. The study included 57 subjects, with a mean age of 45years (±5.6); 29 were male (51%) and 28 female (49%). The control group had a mean new bone formation of 32.68% (±2.5), the A-PRF group 61.37% (±3.0), and the L-PRF group 70.74% (±3.5) (P<.001). The A-PRF group showed significantly higher osteocalcin expression than the control group (P=.013). Alkaline phosphatase and proliferating cell nuclear antigen expression scores for PRF groups were significantly higher than the control group's (P=.001). Both groups demonstrated significantly lower pain scores, reduced gingival swelling, better membrane visibility, and healing compared to the control group. PRF enhanced bone formation rates, with L-PRF showing the most significant effect.

Adequate and transparent reporting is necessary for critically appraising research. Yet, evidence suggests that the design, conduct, analysis, interpretation, and reporting of oral health research could be greatly improved. Accordingly, the Task Force on Design and Analysis in Oral Health Research-statisticians and trialists from academia and industry-empaneled a group of authors to develop methodological and statistical reporting guidelines identifying the minimum information needed to document and evaluate observational studies and clinical trials in oral health: the Oral Health Statistics Guidelines. Drafts were circulated to the editors of 85 oral health journals and to task force members and sponsors and discussed at a December 2020 workshop attended by 49 researchers. The final version was subsequently approved by the task force in September 2021, submitted for journal review in 2022, and revised in 2023. The checklist consists of 48 guidelines: 5 for introductory information, 17 for methods, 13 for statistical analysis, 6 for results, and 7 for interpretation; 7 are specific to clinical trials. Each of these guidelines identifies relevant information, explains its importance, and often describes best practices. The checklist was published in multiple journals. The article was published simultaneously in JDR Clinical and Translational Research, the Journal of the American Dental Association, and the Journal of Oral and Maxillofacial Surgery. Completed checklists should accompany manuscripts submitted for publication to these and other oral health journals to help authors, journal editors, and reviewers verify that the manuscript provides the information necessary to adequately document and evaluate the research.

BackgroundArtificial Intelligence, by answering questions about disease prevention strategies, can contribute to making diseases more treatable in their early stages. PurposeThis study aims to evaluate the quality of patient information by assessing the responses of the Chat Generative Pre-trained Transformer (ChatGPT, Open Al, USA) artificial intelligence model to questions related to medication-related osteonecrosis of the jaw (MRONJ). Study design, setting, sampleThe study was prospective cross-sectional design. The study was conducted within the Department of Oral and Maxillofacial Surgery. The study's questions were prepared by an experienced oral and maxillofacial surgeon and directed to the artificial intelligence platform. The responses were evaluated by oral and maxillofacial surgeons using the Global Quality Scale (GQS). Predictor variableThe predictor variable is question type. A total of 120 questions were categorized into six groups, which encompassed general information about MRONJ (Group 1), queries from patients about to initiate medication therapy (Group 2), questions from patients currently undergoing medication treatment (Group 3), inquiries from patients who had completed medication usage (Group 4), general treatment-related information (Group 5), and case scenarios (Group 6). Main Outcome VariablesThe main variable is the GQS score. The GQS rates the quality of information and its utility for the patients. The scores are as follows: Score 1: Poor quality, Score 2: Generally poor quality, Score 3: Moderate quality, Score 4: Good quality, Score 5: Excellent quality. CovariatesNot applicable. AnalysesKruskal-Wallis and Mann-Whitney-U tests were applied for intragroup and intergroup analyses. The statistical significance level was determined as p<0.05 and p<0.01. ResultsThe average score for all questions was calculated to be 3.9±0.8, which is above the "moderate quality" threshold. Group 1 had a mean score of 3.4±1.1; Group 2 had 4.1±0.7; Group 3 had 3.8±0.8; Group 4 had 4.3±0.6; Group 5 had 4.2±0.7; and Group 6 had 4.1±0.5. The variations in mean scores among these groups did not exhibit statistical significance (p>0.05). Conclusions and RelevanceThe artificial intelligence model has generated responses of moderate quality to questions about MRONJ. The use of the artificial intelligence platform may assist in patients gaining a fundamental understanding of MRONJ.

BackgroundSeveral measures have been implemented to minimize the side effects of impacted third molar (M3) removal including the use of platelet-rich fibrin (PRF). PurposeThis study compared the effects of three modifications of PRF (Leukocyte-PRF, Advanced-PRF, and Advanced-PRF+) on the side effects of impacted M3 removal. Study design, setting, and sampleThis double-blinded randomized controlled trial was conducted at the Oral Surgery department of Kashan University between September 2022 and May 2023 on patients undergoing mandibular impacted M3 removal. Exclusion criteria were age over 30, local inflammation and infection, medication usage, and systemic disease. Independent variableThe independent variable was the PRF product grouped into four categories (control, leukocyte-PRF, advanced-PRF, and advanced-PRF+). Study subjects were randomly distributed among the four groups. Main outcome variablesThe main outcome variables were postoperative sequelae including measures of soft tissue healing, pain, analgesic use, alveolar osteitis, trismus, and swelling. Subjects were assessed at baseline and on days 1, 2, 3, and 7 post-surgery. CovariatesAge, sex, duration of surgery, and side of surgery were the covariates. AnalysesChanges at different time points were analyzed using repeated-measures ANOVA. Pairwise comparisons were performed if significant. P-values≤.05 were considered statistically significant. ResultsThe sample consisted of 64 subjects (16 per group). All three modifications of PRF yielded significantly better soft tissue healing index than the control group on days 2, 3, 7, and 14 postoperatively (P>.05). A-PRF and A-PRF+ had significantly better healing index than L-PRF on the third day (P=.02, P=.01). All the study groups significantly reduced VAS pain score than the control group on days 1, 2, and 3. A-PRF and A-PRF+ had significantly lower VAS scores than L-PRF on the second day (P=.003, P=.02). No significant difference was found in maximum mouth opening during follow-up sessions (P=.2). Study groups had less facial swelling on days 2 and 3 than the control group (P<.05). ConclusionL-PRF, A-PRF, and A-PRF+ can improve postoperative outcomes after M3 removal, but may not impact trismus. A-PRF and A-PRF+ may be more effective than L-PRF in promoting soft tissue healing and reducing pain. A-PRF and A-PRF+ have comparable results.

BackroundVascularized fibula free flap remains gold standard for reconstruction of bony defects of the maxilla or mandible. Research and publications in recent years essentially focused on the evolution and improvement of the recipient reconstructed area but very few concerning the donor site morbidity. PurposeThe aim of this study was to analyze walking ability of patients following vascularized fibula free flap (VFFF) operation and to determine if there are long term walking disabilities. Study designThe retrospective cohort study involved healthy controls and patients who had undergone VFFF between 2012 and 2019 at the oral and maxillo-facial department of the University Hospital in Lausanne, Switzerland. Patients with cardiovascular, pulmonary, neuromuscular or musculoskeletal pathologies that could impair walking were excluded from the study. Predictor/exposure/independent variablesPrimary predictor is the reconstruction status, vascularized fibula free flap (VFFF) vs healthy patients (controls) Main outcome variablesMain outcomes were gait parameters. Objective evaluation of walking abilities was assessed using the Gait up ® system (Gait Up SA, EPFL Innov’Park-C, Lausanne Switzerland), which are wearable motion sensors that provides 3D analytics of the gait. CovariatesCovariates implied patient characteristics such as age, sex, time after surgery and subjective evaluation of the gait obtained with two orthopedic validated questionnaires. ResultsThis study implied 10 healthy controls and 11 patients who had undergone VFFF. Results showed statistically significant differences in the speed [m/s] (1.3 vs 1.1 for a p-value of 0.001) , the stride length [m] (1.4 vs 1.2 for a p-value of 0.003), the flat foot phase [%] (55.0 vs 63.3 for a p-value of 0.006) and the pushing phase [%] (34.1 vs 25.1 for a p-value of 0.008). Conclusion and RelevanceReconstruction using vascularized autograft in maxillofacial surgery is substantial and well described. Our attention focusing on donor site morbidity has demonstrated subjective and objective long-term alterations. These results will have to be confirmed with gait analysis in a prospective project including pre-operative and post-operative analysis of the gait of the patient acting himself as his own control, with a larger scale of patients.

Injections using buffered lidocaine may decrease discomfort, have a quicker onset, and be a more efficacious local anesthetic. Previous studies have been inconclusive in the oral context. To address if bicarbonate buffered 2% lidocaine can decrease pain from the use of local anesthesia, has a quicker onset time, and is more efficacious. The design was a single-center double-blinded randomized control trial, set in an outpatient oral and maxillofacial clinic housed in the University of Cincinnati Medical Center. Inclusion criteria for the study were patients requiring a single tooth extraction due either to caries or periodontal disease. The predictor variable was the local anesthetic used either nonbuffered 2% lidocaine with 1:100,000 epinephrine (control) or bicarbonate buffered 2% lidocaine with 1:100,000 epinephrine (study) was randomly assigned. Primary outcome variables were injection pain score, and postoperative pain, time to anesthetic onset, and the number of rounds of injections required to achieve adequate anesthesia. The covariates were jaw involved, age, sex, and race, American Society of Anesthesiologists score, body mass index, current tobacco use, history of psychiatric illness, chronic pain, and preoperative pain score. Test statistics were calculated using Wilcoxon rank-sum test, Kruskal-Wallis test, Spearman rank correlation test, χ2 test for bivariate analyses, and Fisher's exact test. P values≤.05 were considered statistically significant. The final sample was 114 subjects. The mean age of the sample was 42.97years, standard deviation ±13.43years. The sample was 39.47% male. The racial demographics were Caucasian (62.28%) and African American (33.33%). Buffered lidocaine did not have a statistically significant relationship with any of the outcomes. The jaw involved had a statistically significant association to the injection pain score (P value=.006), and the number of rounds of anesthetic required (P value=.047). Age showed a statistically significant association to injection pain score (P value=.032), and the number of rounds of anesthetic required (P value=.027). Finally, preoperative pain had a statistically significant relationship with injection pain score (P value= < .001). In this study, bicarbonate buffered lidocaine did not exhibit any discernible advantages over nonbuffered lidocaine for any study outcomes.