Improving buccomaxillofacial surgical techniques and minimally invasive: a systematic review

Introduction: In minimally invasive there are several clinical studies with increasing expectations to establish treatment guidelines. Recently, advanced technology in the reconstruction of three-dimensional models based on computed tomography (CT), such as cone beam CT, has opened a new axis in the application of personalized and accurate diagnosis and has been increasingly used in the field of dentistry. Objective: This study aimed to analyze the evolution and consequent importance of improving surgical techniques and minimally invasive treatments in dentistry. It was hypothesized that there were statistically significant results on advances in minimizing trauma, providing patients with quality of life, and better aesthetics. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from June to July 2024 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 139 articles were found. 26 articles were fully evaluated 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 49 studies with a high risk of bias and 34 that did not meet GRADE and AMSTAR-2. Most studies presented homogeneity in their results, with X2=83.8%>50%. The maximum preservation of the integrity of the soft tissues (papillae and free and inserted gingival band) adjacent to the prosthetic spaces should be sought; as preservation of the alveolar bone ridge level. Based on the histological concept living tissues are formed by cells joined by thin elastic tissue and with nerve fibrils, capillaries, lymphatic and blood vessels. The disruption of these cells by surgical trauma provides the release of enzymes that delay healing. For this reason, surgical trauma should be minimized. There are many attempts to minimize the professional effort, reduce surgical time, and alleviate bleeding and inflammatory processes, edema, pain, and ecchymosis that can affect patients. Thus, the maximum preservation of the integrity of the soft tissues adjacent to the prosthetic spaces and the preservation of the level of the ridge of the alveolar bone to achieve a minimization of surgical trauma must be sought

Endometriosis according to the female population: a prospective observational cross-sectional study

Introduction: One of the problems that affects the female population of childbearing age or post-menopause is endometriosis, which is a chronic condition that affects between 2 and 17% of women of reproductive age. Objective: This study was conducted to verify the knowledge that female participants, from private practices or health insurance and the Unified Health System (SUS), have about endometriosis, aiming to obtain data that can support educational actions in public health policies. Methods: This study followed a prospective observational and cross-sectional model, following the STROBE rules. This study was carried out through an electronic questionnaire. It was carried out with a random sample of 204 female participants, 18 years of age or older. The form applied consisted of a questionnaire validated by the reliability of Cronbach's alpha coefficient. Pearson's Chi-Square test was performed, and the statistically associated variables presented p<0.05 (rejecting H0). The project was submitted to the Research Ethics Committee of the Unilago University, located in the city of São José do Rio Preto, São Paulo, Brazil. After approval under numbers 6,901,539. Through the analysis of a standardized research questionnaire, the aim is to obtain quantitative data that elucidate the objective of the research. Results and Conclusion: Knowledge of endometriosis among women showed a statistically significant difference between the variables public health (SUS) versus private health. A better understanding of the pathophysiology of endometriosis is imperative for the development of new therapeutic strategies that are continuous for both the diagnosis and treatment of endometriosis. A brief education program on menstrual health and endometriosis can improve knowledge and attitudes among women. Artificial intelligence can be an important tool for educating and informing patients about endometriosis, providing accurate and comprehensive answers to common questions, and facilitating a better understanding of the condition

Levomepromazine-induced priapism: a description of clinical cases

Introduction: Priapism is defined as a persistent and painful erection without sexual stimulation that lasts at least 4 hours. Although rare, it can be triggered by some factors such as hemoglobinopathies, paraneoplastic syndromes, and the use of recreational drugs and antipsychotics, with atypical and typical antipsychotics being responsible for half of the medication-induced priapisms. Objective: The present study aimed to record two clinical cases of priapism after the administration of a typical antipsychotic, levomepromazine, in two patients who were hospitalized in a psychiatric institution. It is important to recognize this manifestation to guide patients about prolonged and pathological erection, to prevent not only possible complications but also to ensure good medication adherence. Clinical cases: This study was analyzed and approved by the Research Ethics Committee according to a substantiated opinion number 6.949.882, and the patient's consent through the Informed Consent Form. Patient 1: Upon admission, he was prescribed thiamine, lorazepam, and levomepromazine. After eight days of regular use of the medication, he presented with prolonged (>4h) painful penile erection without the presence of sexual stimulation or excitement and was diagnosed with priapism. Patient 2: In the final phase of treatment, stable, when after withdrawal of benzodiazepines he presented with initial insomnia, it was decided to optimize the dose of levomepromazine (already being used) from 75 mg to 100 mg at night. One day later, he presented with priapism and was referred to the emergency room and administered local analgesia. Final considerations: Based on the two clinical case reports described, it is possible to infer that priapism was generated as a consequence of the use of levomepromazine, since this type of adverse reaction can already be expected, although not so frequently, from the use of antipsychotics based on the existing literature

Main clinical findings on the use of the zygomatic implant for compromised maxillary bone: a systematic review

Introduction: In the dental implant scenario, the graft to treat severely reabsorbed jaws is currently the gold standard procedure. Still, there are flaws in this procedure until 30.0 % are reported in the literature. Zygomatic implants have shown, in many cases, improved clinical outcomes compared to bone grafts and represent an essential alternative for compromised maxillary bone. Objective: It was analyzed the main literary findings on the use of the zygomatic implant as a necessary alternative for a dental implant. 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: 122 articles were found, 36 articles were evaluated in full and 34 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 24 studies with a high risk of bias and 38 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=83.7%>50%. It was concluded that the zygomatic implant is revolutionizing the procedure of implants in the posterior atrophic maxilla, eliminating the complications of bone augmentation and sinus elevation with delayed cicatrization. Zygomatic implants have, in many cases, shown better clinical results compared to bone grafts and represent a possible gold standard for dental implants

Major clinical findings on the types of impressions used in implant-supported prostheses: a systematic review

Introduction: The key to obtaining perfect prostheses depends on the passive fit between its connector and the implant itself. The compromised fit between the contact surfaces of implant-supported prostheses creates uncontrolled stresses in the components and peri-implant tissues, evoking biological and mechanical complications. Objective: It was to review the scientific literature on the types of impression used in implant prostheses. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from July to August 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 111 articles were found, and 44 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 06 studies with a high risk of bias and 31 studies that did not meet GRADE. 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

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

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

Major clinical outcomes of the endodontic infections and gut microbiota axis: a systematic review

Introduction: Endodontic therapy aims to shape, clean, and disinfect the root canal, and is performed by removing all pulp tissue or necrotic remains and microorganisms present in the root canal system. The gut microbiota or specific microbial metabolites not only locally influence the host's inflammatory responses, nutritional intake, or intestinal barrier function, but are also related to the immune and metabolic systems. In addition to antimicrobial activity, calcium hydroxide has properties such as dissolution of organic remnants, anti-inflammatory action, inhibition of inflammatory resorptions, and physical barrier function. Objective: To present the main considerations and clinical outcomes of the relationship between gut microbiota and endodontic infections and highlight endodontic treatment with calcium hydroxide, showing the mechanisms of antibacterial action. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted 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: 102 articles were found, 25 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 35 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=79.2%<50%. It was concluded that, in the setting of endodontic therapy, the presence of microorganisms, particularly gramnegative anaerobes, in the root canal system and cementum resorption gaps after root canal treatment is considered one of the main causes of persistent periapical lesions and, therefore, of endodontic treatment failure. The gut microbiota or specific microbial metabolites not only locally influence the patient's inflammatory responses, nutritional intake, or intestinal barrier function, but are also related to the immune and metabolic systems. The change in the microbiota of the oral-gut axis and its interactions with Helicobacter pylori may be potential targets for the diagnosis and infectious treatment of Helicobacter pylori. Calcium hydroxide in endodontics is the most widely used medication to combat pathology-causing bacteria, but when used alone it may not be able to eliminate these microorganisms. The combination of other medications incorporated into calcium hydroxide contributes to positive results with the elimination of more resistant bacteria

Comparative analysis between plate and cannulated screw in fracture of the posterior malleolus: a retrospective observational cross-sectional study

Introduction: Ankle fractures account for approximately 4% of all fractures, with an annual incidence of 124 in 100,000 people in the United Kingdom. More than a third of these contain involvement of the posterior malleolus. Objective: It was to analyze and compare the anteroposterior screw (PAS) and posterior support plate (PSP) techniques in postoperative results and percentage of complications, comparing radiographic and functional results in the surgical treatment of the posterior malleolus. Methods: The present study followed a retrospective observational and cross-sectional model (STROBE). The Kolmogorov Smirnov test, Student-t test, Wilcoxon Rank test, Mann-Whitney test, Pearson Chi-Square test, and binary and predictive logistic regression analysis were used, adopting a confidence risk of 0.05. Results and Conclusion: A total of 18 patients were included (12 PAS and 6 PSP). For the PAS group, the mean time to fracture healing on radiography was 9.92 weeks, and for the PSP group, it was 11.83 weeks. Using predictive logistic regression analysis, PAS and PSP consolidation times showed a statistically significant difference in data distribution (with p=0.888>0.05), and Haraguchi's classifications for PAS and PSP did not show a statistically significant association, with p>0.05. The two techniques, anteroposterior screw fixation posterior support plate, have advantages and disadvantages inherent to the procedure, as well as the surgeon's aptitude for each technique can be a confusing factor for the study. Little discrepancy was observed in the clinical and radiographic outcomes of the patients analyzed

Major approaches and scientific relevance of virtual surgery in implant dentistry: a systematic review

Introduction: Dental implant procedures have increased worldwide, reaching approximately one million dental implants per year the optimization of faster and more accurate techniques by dentists and postoperative surgeons with better results and quality of life stimulated the development of numerous software and hardware for performing computer-guided surgeries, the so-called Guided Surgeries (GS). Objective: The present study carried out a systematic review to highlight the optimization of the safety and effectiveness of digital dental implants. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from November 2024 to January 2025 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. 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. A total of 42 articles were fully evaluated and 14 were included in the systematic review. A total of 32 studies were excluded because they did not meet the GRADE criteria, and 20 studies were excluded because they had a high risk of bias. Preoperative virtual planning and reconstruction of the mandible guided by dental implants through preoperative designs provide high success rates for the implant and dental rehabilitation, benefiting also prosthetic restorations supported by fixed implants. Still, the concept of using personalized implants with the help of 3D virtual treatment planning, stereolithographic models, and computer-assisted design greatly improves mandibular restoration and helps to obtain a good facial profile, and aesthetic and dental rehabilitation, avoiding complications with autologous grafts

Clinical significance of laser therapy and osseointegration in implant dentistry: a systematic review

Introduction: Dental implants are widely used and have a success rate of around 96%. Good bone density is an essential factor for implant stability to resist mechanical forces against dental implants. As a treatment, low-level laser treatment (LLLT) is a type of phototherapy where infrared is absorbed by adjacent tissues, thus reducing the inflammatory response, stimulating osteoblastic activity around the application site, and increasing bone production. Objective: It was to carry out a concise systematic review of the main clinical findings of the use of laser therapy to improve dental implant practices through the optimization of osseointegration. 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 155 articles were found, and 23 articles were evaluated in full and 13 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 42 studies that did not meet GRADE and AMSTAR-2. According to the GRADE instrument, most studies presented homogeneity in their results, with X2=82.7%>50%. It was concluded that low-intensity laser irradiation can significantly promote bone consolidation and accelerate the osseointegration process, emphasizing the biostimulating effect of the laser. The application of the 808 nm infrared laser for bone tissue and 630 nm for mucosal tissue in two sessions is considered an effective way to reduce inflammation and improve early healing. Literary findings point to the safety and effectiveness of low-power intravascular lasers in dental implant treatments. The low-power intravascular laser enables local and systemic treatment, optimizing the benefits of its use by dentists, mainly to improve the stabilization of osseointegrated implants and avoid or eliminate contamination