Periodontitis is a chronic inflammatory disorder characterized by tissue degradation and bone loss. Lipopolysaccharide (LPS) accelerates disease progression by host immune activation, inducing localized inflammatory infiltration and osteoclastogenesis, and disrupting bone metabolic homeostasis. Adipose-derived mesenchymal stem cells (ADSCs) exert anti-inflammatory, anti-apoptotic, and regenerative effects via paracrine signaling. ADSCs were isolated using collagenase digestion and characterized by flow cytometry for surface markers and multilineage differentiation potential (assessed by Oil Red O and Alizarin Red S staining). ADSC-Exos were isolated via size-exclusion chromatography and ultrafiltration and characterized by transmission electron microscopy, nanoparticle tracking analysis, and immunoblotting. In a Pg-LPS-induced invitro periodontitis model, PKH26-labeled ADSC-Exos were internalized by cells, as shown by confocal microscopy. Their effects on osteoclastic markers (TRAP, MMP-9, and COX-2) and signaling mediators (RANK and TRAF6) were evaluated using real-time PCR and western blotting. ADSCs-Exos suppressed early osteoclast differentiation in Pg-LPS-induced invitro periodontitis model. Mechanistic studies revealed that ADSCs-Exos mitigated inflammation by modulating the COX-2/TRAF6/RANK signaling axis. This study investigated the effects of ADSCs-Exos on the early proliferation and differentiation of osteoclasts. Furthermore, in a periodontitis cell model, ADSCs-Exos regulate bone resorption by downregulating the mRNA and protein expression levels of COX-2, RANK, and TRAF6.

To develop India-specific consensus guidelines for accurate and uniform OLP diagnosis by integrating clinical and histopathological criteria, addressing regional disease burden, reducing diagnostic variability, and supporting early detection and improved patient outcomes. The Indian Consensus on diagnosis and management of ORal Lichen Planus (INCORP) used a modified Delphi methodology involving 11 multidisciplinary experts. Three iterative rounds were conducted to review and refine diagnostic statements, with ≥ 80% agreement required for consensus. After three rounds of a modified Delphi process, consensus (≥ 80% agreement) was achieved for 40 out of 41 statements. ORal lichen planus (OLP) was defined as a chronic, immune-mediated mucosal disorder with bilateral, symmetrical reticular, atrophic, erosive, or plaque-like lesions. Consensus was reached on epidemiology, pathogenesis, clinical variants, investigations, and malignant transformation risk. OLP was recognised as potentially malignant. Biopsy with histopathological evaluation was recommended for all suspected cases, supported by adjunctive immunofluorescence and cytological smears in selected presentations. This first Indian consensus provides a clinicopathological framework for accurate OLP diagnosis, early malignancy detection, and improved epidemiological reporting, ensuring uniformity in clinical practice and enhancing patient outcomes.

Oral appliance (OA) therapy has gained wide acceptance for the management of obstructive sleep apnea (OSA). Although various types of OAs have been developed, the efficacy of the newer devices in patients with mild to moderate OSA remains unclear. This systematic review aimed to evaluate the clinical efficacy of customized titratable OAs in improving sleep in adults with mild-to-moderate OSA. A comprehensive literature search of the Medline, Embase, Scopus, the Cochrane Library, and Web of Science databases for relevant randomized controlled trials (RCTs), published between 2000 and 2025, was performed. The primary outcomes were the apnea-hypopnea index (AHI), oxygen desaturation index (ODI), Epworth Sleepiness Scale (ESS) score, and mean oxygen saturation (SpO2). The secondary outcomes included sleep efficiency and the percentage of total sleep time. Of the 1316 articles retrieved in the literature search, 122 fulfilled the inclusion criteria, including 32 RCTs that compared OAs with control interventions. Most studies reported significant improvements in AHI, with mandibular advancement devices demonstrating consistent efficacy across multiple trials. Improvements in the ESS, ODI, and SpO2 were also observed in several studies. Customized, titratable OAs are effective in reducing AHI and improving sleep-related outcomes in patients with mild-to-moderate OSA.

To investigate the role of mastication on the salivary nitrate transport and elucidate the underlying mechanisms. Systemic nitrate levels were clinically compared between individuals with masticatory dysfunction and healthy individuals. Behavioral assessments were performed in mice with reduced masticatory activity to examine the impact on anxiety-like behavior. Mechanical stimulation was applied to salivary gland epithelial cells and tissues to explore the expression, localization, and translocation mechanisms of Sialin, a nitrate transporter encoded by the Slc17a5. Individuals with impaired mastication exhibited significantly lower systemic nitrate levels compared to healthy controls. In mice, decreased masticatory activity was associated with increased anxiety-like behavior. Invitro, mechanical force stimulated the upregulation and apical translocation of Sialin in human salivary gland epithelial cells (HSGs). Sialin was predominantly localized within lipid rafts, and its force-induced translocation was mediated by activation of the Piezo1 channel, which facilitated the movement of lipid rafts to the apical membrane, thereby enhancing nitrate secretion. Mastication sustains nitrate homeostasis and mitigates anxiety-like behavior in mice by mechanically activating the Piezo1 channel, thus facilitating the lipid raft-mediated translocation of Sialin to the apical membrane in salivary gland cells.

To examine the determinants of acute pain following tooth extraction, within a set of factors belonging to different domains: biometry, dental nosology and anatomy, psychology toward pain and surgery, and surgical procedure. Participants were recruited in two centres in France and Lebanon. A 'simple extraction' (161 patients) and a 'wisdom teeth/tooth' group (at least mandibular) (115 patients) were studied separately. Postoperative pain and total analgesic drug intake (over 5 days) were both expressed as a composite score. Both scores were ranked within each surgery group, and their sum was the primary outcome, which was analysed by multivariable linear mixed models after a factor selection. In the simple extraction group, the primary outcome was predicted positively by preoperative fearfulness (defined by a composite of various phobias) and preoperative dental pain, and negatively by age (≥ 60) and a previous tooth extraction. In the wisdom teeth/tooth group, it was predicted positively by preoperative fearfulness and pain catastrophising, and negatively by a local inflammatory context and preoperative dental pain. Whereas postoperative pain was constantly favoured by psychological distress, age and other dental factors had different influences on postoperative pain depending on the type of extraction. ClinicalTrials.gov identifier: NCT05405088.

Eosinophilic sialodochitis is an uncommon, chronic inflammatory disorder of the major salivary glands characterized by intermittent pain, swelling, and mucous plugging containing eosinophils. Despite increasing reports, optimal diagnostic criteria and management remain unclear. PubMed, ScienceDirect, Google Scholar, and Ovid databases were searched to August 2025. Data were collected from eligible studies published after 2000 in English, noting that some significant reviews also summarize the Japanese literature. Twenty-four studies (n = 309 patients) were included. The mean age was 39 years, with a male: female ratio of 1:2.5. The parotid gland was most often affected (50.8%), with bilateral involvement in 43.4% of cases. Most patients (87.4%) had atopy, particularly allergic rhinitis (75.4%). Swelling (94.5%), mucous plugs (46.0%), and pain (24.6%) were the most common symptoms. IgE was elevated in 66.3%, peripheral eosinophilia in 36.0%, and both in 6.5%. Imaging revealed ductal ectasia and stenosis, while histopathology demonstrated periductal fibrosis and eosinophilic infiltration. Endoscopy-assisted ductal irrigation and dilation were the most effective treatments, followed by conservative surgical excision. Medical treatments such as antihistamines, corticosteroids, and leukotriene receptor antagonists achieved variable treatment success. Future multicenter studies may eventually establish a definitive diagnostic algorithm based on combinations of clinical findings, IgE/eosinophils, and imaging.

To pilot the feasibility, diagnostic accuracy, and repeatability of the Takano NBI-based IPCL classification when applied by novice raters after short formal training. Ten dental students classified 90 oral lesions shown as paired white-light and NBI images in two sessions, 4 weeks apart. Scores were recorded on an ordinal scale (0-4), where category 0 denoted hyperplasia or clinically normal mucosa, while categories 1-4 represented increasing degrees of epithelial dysplasia or invasive disease. Histopathology served as the reference standard. The 90 lesions comprised 38 hyperplastic/normal, 29 dysplastic, and 23 invasive carcinomas. Mean agreement with histology was 18.8% at T1 and 21.0% at T2, with weighted kappa values of 0.080 and 0.093, respectively. Agreement with the expert rater was 22.2% at T1 and 20.4% at T2, with weighted kappa values of 0.170 and 0.127. A short lecture-based training is insufficient for reliable NBI interpretation by novice raters. These findings support the necessity for structured, competency-based training and supervised case libraries before Takano-based NBI assessment can be recommended in clinical practice for inexperienced practitioners.