Clinical results of the importance of zygomatic implant by guided surgery in bone elevation loss: a systematic review of safety and efficacy

Introduction: Severe maxillary atrophy represents a burden on aesthetic recovery in patients with trauma and tooth loss. Treatment planning for guided prosthetic rehabilitation of the maxilla with Zygomatic Implant (ZI) can be performed digitally. The surgical and prosthetic plan, position, emergence, implant shape, temporary prosthesis position, interarch relationships, and surgical templates can be designed in a fully virtual environment. Objective: The purpose was to present the clinical results of a systematic review demonstrating the importance of zygomatic implants by guided surgery in bone elevation loss. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 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: 111 articles were found, 25 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 25 studies with a high risk of bias and 31 studies that did not meet GRADE. Most studies did not show homogeneity in their results, with X2=78.5%>50%. It was concluded that the use of virtual tools enables the precision of implant positioning, validating its safety, reliability, and precision of guided surgery for the placement of zygomatic implants. The use of specialized implant planning software is an important tool to achieve predictable results for zygomatic implants and allows a good visualization of the implant-anatomical structures relationship

Anesthetic types and techniques in robotic surgery: a systematic review

Introduction: In the context of robotic surgery (RS), approximately 1.5 million robotic surgeries have been performed worldwide in the last decade. Different anesthetic techniques can modify coagulation factors. Studies have investigated the effects of established anesthesia types on procoagulant, anticoagulant, and fibrinolytic factors in prostate cancer patients undergoing robotic surgery. Objective: It was to present a systematic review of the main approaches to anesthetic practices and types in robotic prostate surgery. Methods: The PRISMA Platform systematic review guidelines were followed. The search was conducted from March to May 2025 across the Scopus, Embase, PubMed, ScienceDirect, Scielo, and Google Scholar databases. Study quality was assessed using 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. A total of 64 articles were fully evaluated, and 31 were included in this systematic review. Considering the Cochrane risk of bias tool, the overall assessment resulted in 12 studies with a high risk of bias and 15 studies that did not meet the GRADE criteria. The reported scientific evidence points to some potential benefits of robotically assisted surgery compared to open surgery and laparoscopic surgery. Outcomes related to reduced blood loss and consequent reduced need for blood transfusions, as well as the preservation of sexual function, appear to be the most significant advantages over comparators. Improved urinary continence and shorter hospital stays due to lower perioperative complication rates are also noted in the studies. Furthermore, a single spinal injection of morphine and bupivacaine provided adequate analgesia in the early postoperative period and reduced the need for additional IV opioids in patients undergoing RALP. Despite this, the anesthetic techniques, total intravenous anesthesia with target-controlled infusion and balanced inhalation anesthesia, appear to significantly increase the risk of thrombosis in prostate cancer patients undergoing LRP, particularly when the robotic device was used, encouraging the use of perioperative thromboembolic prophylaxis in these patients. Finally, in robotic cystectomy, anesthesiologists should consider the changes in the cardiopulmonary system that occur when patients are placed in the Trendelenburg position and when pneumoperitoneum is created

Clinical considerations of sedation in dental surgery: a systematic review

Introduction: In dental surgical procedures such as dental implants, extractions, and dental repairs, the demand for sedation has increased in an attempt to improve surgical quality and patient comfort, especially for those requiring longer surgeries and experiencing anxiety. Objective: It was to analyze the key clinical considerations of sedation in dental procedures to improve surgical conditions and patient comfort. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from March to May 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 120 articles were found. A total of 18 articles were evaluated in full and 10 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. It was concluded that intranasal and sublingual midazolam significantly reduces anxiety levels during dental procedures in children. Pregabalin coadministered with dexamethasone demonstrated significant efficacy in controlling postoperative pain and anxiety, as well as sedative effects. Ketamine-propofol may be a better option due to reduced episodes of vomiting and nausea in patients and higher levels of dental surgeon satisfaction. High doses of remifentanil can be safely used in multiple dental surgeries on the same day. The use of diazepam, midazolam, and nitrous oxide as preoperative sedation techniques for anxious patients undergoing third molar extractions is effective in controlling anxiety, with little effect on vital signs and retrograde amnesia. Patients under sedation for dental procedures frequently experience obstructive apnea/hypopnea events

Major clinical outcomes of pulsed-dye laser treatment for vascular melasma: a concise systematic review

Introduction: In recent years, dermatology has advanced in its treatments with the introduction of laser technology. In particular, the pulsed-dye laser (PDL) has a wavelength of approximately 595 nm and is used to destroy hemoglobin in blood vessels. Melasma is an important target for PDL treatment. Objective: It was carried out a concise systematic review to highlight the major clinical studies on the use of pulsed-dye lasers in the treatment of melasma. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to April 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: 87 articles were found, 19 articles were evaluated in full and 09 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 27 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=87.7%>50%. It was concluded that the combination of pulsed dye laser with low-fluence Q-switched Nd: YAG laser can be considered a safe and effective treatment for patients with melasma who present visibly dilated capillaries on dermoscopy. Both pulsed dye laser and intense pulsed light were effective and safe treatment modalities for the lightening of melasma. Furthermore, melasma lesions that present subtle or subclinical telangiectatic erythema can be improved by combining targeted vascular laser therapy and low-level fractional diode laser therapy. A parallel improvement in telangiectatic erythema suggests a relationship between the underlying vasculature and hyperpigmentation

Importance of computed tomography for identifying the second mesiobuccal canal in endodontic procedures: a systematic review of clinical studies

Introduction: Endodontists must have detailed knowledge of the typical anatomy of the dental structure and the atypical forms of external and internal root canals. The first permanent maxillary molar and the second permanent maxillary molar are the teeth with the greatest complexity of root canals, presenting higher rates of endodontic failure. Cone beam computed tomography (CBCT) has made it possible to visualize anatomical structures that are difficult to access in three dimensions, and has become a valuable aid as a complementary examination for endodontic diagnosis and treatment. Objective: This study aimed to address the main considerations and outcomes of clinical studies on the use of cone beam computed tomography in the identification and treatment of second mesiobuccal canals. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to November 2024 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 112 articles were found, 14 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 46 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=91.5%<50%. Results and Conclusion: It was concluded that endodontic treatment success can be increased and clinicians’ time can be saved by using the newly developed AI-based models to identify variations in root canal anatomy before treatment. Patient gender, tooth type, and treatment modality play essential roles in identifying the MB2 canal. Furthermore, the availability of preoperative CBCT images was associated with a greater ability to localize the MB2 canal. Understanding the incidence of MB2 canals and the distribution pattern of canal orifices in the pulp floor can help clinicians quickly identify and locate MB2 canals

Major considerations on the gingival graft on dental implant: a concise systematic review

Modern implant dentistry uses gingival grafts to promote tissue regeneration around dental implants, ensuring the stability and aesthetics of oral rehabilitation. This study addresses the main types of gingival grafts used, including connective-subepithelial grafts, free gingival tissue grafts, and allogeneic grafts, comparing their clinical indications, advantages, and disadvantages. The connective-subepithelial graft stands out for offering superior aesthetic results, being indicated in visible areas, but requires a donor area, which can increase patient discomfort. Free gingival tissue grafts are effective in increasing keratinized gingiva, essential for peri-implant health, while allogeneic grafts, obtained from tissue banks, eliminate the need for additional surgery, becoming a less invasive option. In addition to the characteristics of the grafts, the study also explores the biomaterials used, such as autogenous, xenogeneic, and allogeneic, analyzing their biocompatibility, osteoconduction, and resorption rate properties, which influence graft integration. Autogenous grafts have high biocompatibility and osteoinductive capacity, while xenogeneic and allogeneic grafts have advantages in terms of accessibility and reduced procedures. The cost and accessibility of graft procedures are important factors in choosing the treatment since the value varies according to the type of graft and the technique applied. Procedures with autogenous grafts tend to be more expensive due to the need for additional surgery, while xenogeneic and allogeneic grafts, which are more accessible, present a balance between cost and effectiveness, especially in health systems with limited coverage. This study provided a comprehensive overview of the indications and limitations of the types of gingival grafts, offering support for the choice of treatments that reconcile health, aesthetics, and cost-effectiveness

Major relationships among polyphenols, gut microbiota and sports performance: a systematic review

Introduction: Among the various phytochemicals, polyphenols represent a heterogeneous class of compounds with marked antioxidant and anti-inflammatory properties. One of the biggest challenges is to understand the mechanisms of the interrelationship between polyphenols and the human body, also considering the fundamental role played by the gut microbiota in their absorption and bioavailability to improve sports performance. Objective: It was to present the main relationships between polyphenols, gut microbiota, and sports performance. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from September to October 2024 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 126 articles were found, and 72 articles were evaluated in full, and 61 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 08 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=75.7%>50%. The Funnel Plot graph showed symmetrical behavior, not suggesting a significant risk of bias in studies with smaller sample sizes. Dietary polyphenols exert several beneficial effects on sports performance, demonstrated in vivo and in human studies. The health-related mechanisms of polyphenols mainly concern the modulation of mitochondrial biogenesis and the stimulation of stress-related enzymes or transcription factors, as well as a nutritional deficiency, which regulates gene expression of essential antioxidant proteins (SOD, Catalase, Glutathione system, etc.). Overall, these mechanisms promote athletic performance by improving cardiometabolic functions, reducing recovery times and post-exercise pain, maintaining a low degree of oxidative stress, and preventing dysregulated inflammatory processes. Therefore, polyphenols are able, through their interaction with the gut microbiota, to favor the proliferation of bacterial genera of great importance for metabolic and cognitive functions, such as Akkermansia, Lactobacilli, and Bifidobacteria. The microbiota, on the other hand, metabolizes polyphenols in the colon to produce small bioactive molecules that exert epigenetic mechanisms on biochemical pathways modulating gene expression

Significance and clinical highlights of bone augmentation using fibrin-rich plasma and Bio-Oss®: a systematic review

Introduction: The number of dental implant procedures has been increasing worldwide, reaching about one million yearly. In Brazil, in the last decades, there has been a very rapid evolution in implant dentistry with high success rates. The development of biomaterials for use in dental clinics in recent years has represented a powerful therapeutic tool in the correction of bone defects. Objective: This study aimed, through a systematic literature review, to show the processes that involve bone formation for dental implants, with the use of biomaterials such as fibrin-rich plasma and Bio-Oss®. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 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 175 articles were found, and 65 articles were evaluated in full, and 56 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 20 that did not meet the GRADE and AMSTAR-2 criteria. According to the GRADE instrument, most studies presented homogeneity in their results, with X2=89.5%>50%. Literary findings have shown that Bio-Oss® and PRF work are essential for bone formation processes for dental implants, mainly in joint action

Clinical considerations of regenerative processes in bucomaxillofacial surgery using stem cells from exfoliated deciduous teeth: a systematic review

Introduction: The World Health Organization forecasts that road accidents will be the third cause of facial trauma worldwide by 2025. To catalyze regenerative processes in oral and maxillofacial surgery, human oral mesenchymal stem cells (Stem Cells from Exfoliated Deciduous Teeth - SHEDs) have been discovered near the oral mucosal tissues and primary teeth. Objective: It was to analyze the main clinical considerations of regenerative processes in bucomaxillofacial surgery using stem cells from exfoliated deciduous teeth. 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=78.7%>50%. A total of 122 articles were found and submitted to eligibility analysis, with 14 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 AMSTAR2. The conclusion was that the integration of SHED cells with scaffolds consistently improves alveolar and maxillary bone regeneration compared to scaffold-only approaches, resulting in increased bone volume, density, osteogenesis, and angiogenesis. Thus, SHEDs have emerged as a promising alternative in regenerative and reconstructive medicine. These stem cells exhibit high differentiation potential and self-renewal capacity. These stem cells can be easily harvested from accessible and numerous sources, such as molars and extracted baby teeth, with minimal invasiveness, playing essential roles in clinical applications and pointing to the overcoming of complex challenges in restorative and reconstructive medicine

Major integrated orthodontic-surgical approaches in Cass III malocclusion: a systematic review

Introduction: Skeletal class III malocclusion in adults is one of the most serious and difficult to correct maxillofacial deformities. The prevalence of Class III malocclusion in Caucasians ranges from 0.8 to 4% and up to 12% in Chinese and Japanese populations. It has been shown that more than 60% of cases of Class III malocclusion are due to skeletal discrepancies, requiring an integrated orthodontic-surgical treatment approach. Objective: It was to carry out a systematic review of literary findings on the main approaches and outcomes of clinical studies of orthodontic-surgical treatment in patients with class III malocclusion. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to March 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 125 articles were found, and 58 articles were evaluated in full and 56 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 07 studies with a high risk of bias and 15 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=74.7%>50%. It was concluded that orthodontic-surgical treatment in Class III patients must be based on the diagnosis so that the treatment is implemented to correct the compromised structures instead of being compensated in places not affected by the malocclusion. The degree of involvement of the maxilla and mandible must be assessed so that the treatment is directed to that bone base and truly achieves its objectives and impacts of facial improvement. Redirecting growth in Class III cases is indicated as soon as the anomaly is diagnosed, as the displacement processes that occur in the midface can only be affected with treatment as long as the growth zones are capable of responding to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the facial correction effects will be