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

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

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

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

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

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

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

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 resume

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

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

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

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

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

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

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

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

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

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