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 June to July 2024 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

Major considerations of nutrology, adult stem cells, and gut microbiota in the process of muscle regeneration in athletes: a systematic review

Introduction: Regular physical training associated with nutritional health has broad benefits for the health of the gut microbiota, acting positively on almost all organic systems in the body. In this sense, microRNAs (miRs) have emerged as critical regulators of numerous biological processes, modulating gene expression at the post-transcriptional level. Objective: It was to carry out a systematic review to elucidate the main considerations of nutrology, microRNAs, adult stem cells, and gut microbiota in the process of muscle regeneration in athletes. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to September 2024 in 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 237 articles were found, and 107 articles were evaluated in full, and 52 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 47 studies with a high risk of bias and 70 studies that did not meet GRADE. miRs play an important role as regulatory molecules during the muscle healing process. Myoblasts are known to secrete exosomes enriched with miRs into the inflammatory environment, whereby miR-224 is transferred to macrophages to inhibit M2 polarization. Additional data demonstrate that WNT-9a may be a direct target of miR-224 for macrophage polarization. The results showed that miR-122 and myogenic markers were down-regulated in C2C12 cells after TGF-β stimulation, and overexpression of miR-122 can restore myogenesis inhibited by TGF-β. Evidence suggests that the exosome derived from mesenchymal stem cells exhibits functions similar to mesenchymal stem cells with low immunogenicity and without tumorization. High rates of intestinal self-renewal are enabled by intestinal stem cells (LGR5+) at the base of intestinal crypts. LGR5+ activity, including proliferation and differentiation rates, is affected by large shifts in nutrient availability, as occurs on a high-fat diet or fasting. The practice of physical activity, endogenous metabolites, and dietary nutrients can directly influence epigenetic enzymes. Dietary manipulations and metabolites can affect tissue stem cell fate decisions. Self-renewal and differentiation of mesenchymal stem cells can be regulated by manipulating vitamin C, A, or D levels and valine restriction

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

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

Behind bars and under the influence: understanding substance use among prison inmates in Sri Lanka

Introduction: Substance use among prison inmates is a challenge for many countries around the world and this problem has imposed great waste of human, financial capital which leads to several health costs and social harm to the general community. Objective of this study is to determine the pattern of substance use among prison inmates in Sri Lanka. Methods: The study design was a descriptive cross-sectional study. This study was conducted in 22 selected prison institutions in Sri Lanka covering the entire country. Multi-stage probability proportionate to size stratified cluster sampling method was used. The total sample used for the study was 1730 prison inmates. A validated interviewer administrated questionnaire was used for the data collection. Results: Among the 1730 prison inmates the response rate was 98.7%. The total study sample (1708) was consisted with 938 (55%) convicted prison inmates and 770 (45%) un-convicted prison inmates. The mean age of the study sample was 39.2 years, with a standard deviation of 13.6 years. The highest educational qualification of the majority (36.9%) of the study sample was passing grade 9-11. More than four fifths (1373, 80.4%) of prison inmates had ever used a substance while 335 (19.6%) prison inmates had never used a substance. Among ever users of substances 760 (55.3%) were convicted prison inmates. The most prevalent (81.6%) substance used by prison inmates before imprisonment (82.3%) as well as after imprisonment (19.2%) was cigarettes. Almost four fifth (79.3%) of prison inmates had used alcohol before imprisonment followed by betel (47.6%) and heroine (35.2%). Usage of all the types of substances have declined after imprisonment. More than one tenth (10.8%) of prison inmates had used heroine after imprisonment followed by betel (10.8%) and cannabis (2.7%). Thirteen prison inmates (0.9%) had used injectable non prescribed drugs following imprisonment. Among study participants 14.9% had newly started substance use after imprisonment. Conclusions: The habits of substance use among prison inmates before imprisonment shows a higher value compared to the general population. Significant number of prison inmates had continued their habits substance use even after being imprisoned considering the restricted environment within the prison institutions. Among prison inmates a significant number has started the use of substances for the first time in their life while they were imprisoned

Approaches and clinical outcomes of indirect onlay, overlay, and inlay restorations in dental aesthetics: a systematic review

Introduction: In the dental aesthetics scenario, there has been an increase in the indication of indirect restorations such as inlays, onlays, and overlays in ceramics and resins. Objective: This study aimed to examine the clinical outcomes of indirect onlay, overlay, and inlay restorations in dental aesthetic through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from March 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: A total of 125 articles were found. A total of 37 articles were evaluated in full and 28 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 18 studies with a high risk of bias and 20 studies that did not meet GRADE. It was concluded that there was an increase in the indication of indirect restorations inlays, onlays, and overlays in ceramics and resins. The restoration of posterior teeth, with loss of a large amount of tooth structure, using indirect restorations, aimed to overcome some problems associated with direct restorations, such as low mechanical and wear resistance, and difficulty in reestablishing proximal or occlusal morphology. Indirect Restorations are most indicated when there is loss of cusps, the need to reinforce the remaining teeth, and difficulty in reconstructing the anatomy directly in the mouth. Zirconia is a crystalline ceramic that has minimal or practically no glass phase and is available in powder (layered or sintered) or block (CAD/CAM). Another material option is laboratory composite resins, which have also been used to create indirect restorations, being an alternative to ceramics. Failures can be considered as events occurring after final cementation requiring some intervention or complete replacement of the restoration

State of the art of occlusion in dental implants: a systematic review

Introduction: Dental implants are a regular feature in daily clinical practice and there is a need to perform routine evaluation and maintenance of implants and their restorations. Occlusal checks form an important part of the maintenance regimen to preserve the integrity of implants, their restorations, and the health of peri-implant tissues. The risks attributable to occlusal forces mainly affect implant restorations and are elevated in the presence of bruxism. Objective: This study presented the main clinical considerations of occlusions in dental implants. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted 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: 102 articles were found, 45 were evaluated in full and 24 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 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=82.2%>50%. It was concluded that occlusion is a factor directly responsible for the success or failure of treatments performed with dental implants. It directly interferes with the distribution and absorption of loads resulting from mandibular movement. Understanding how these loads work requires the clinician to seek multiple knowledge, mechanical and biological so that prosthesis planning is well executed

Positive clinical effect of ozone therapy in dentistry through randomized clinical studies and meta-analysis: a systematic review

Introduction: In dental treatment and oral health, ozone in low concentrations has been used successfully due to its oxidizing and antimicrobial properties. It also has anti-inflammatory and immunological action. Objective: A systematic review was developed to demonstrate the positive clinical effect of ozone therapy in dentistry through randomized clinical studies and meta-analysis. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted 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, 38 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 23 studies with a high risk of bias and 30 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=75.8%>50%. It was concluded that ozone therapy is an alternative to accelerate healing and reduce pain in traumatic and autoimmune ulcers. Ozone offers a painless alternative to conventional treatment for dental caries and has been shown to arrest primary root caries, primary pit, and fissure caries, and clinically reverse the lesion. Its antimicrobial action on endodontic microbiota is quite promising. Ozone gel is suggested as an adjunctive therapy in diabetic patients to improve periodontal health. Oxygen-ozone therapy has been shown to enhance post-extraction healing in patients at risk for MRONJ. As for reducing the microbial load for patients undergoing root canal treatment, ozone therapy has inferior results when compared to conventional chemomechanical techniques using NaOCl

State of the art in the treatment of knee osteoarthritis using platelet-rich plasma alone or in combination: a systematic review

Introduction: Bone diseases comprise a large group of common diseases, including fractures, osteoporosis, and osteoarthritis that affect a large number of individuals. Knee osteoarthritis (KOA) refers to a chronic joint disease characterized by degenerative lesions of the knee cartilage, causing pain, swelling, dyskinesia, and other symptoms of the knee joint. According to the World Health Organization (WHO), KOA has an incidence of approximately 10-15%, with the elderly population accounting for 95%. Objective: This was to conduct a systematic review to present state of the art, through randomized clinical trials and meta-analyses, of the treatment of knee osteoarthritis using platelet-rich plasma alone or in combination with bone marrow aspirate concentrate (stem cells and other cells), mesenchymal stem cells, hyaluronic acid, and corticosteroids. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted 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 126 articles were found, of which 39 articles were fully evaluated and 11 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 31 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=79.9%>50%. The symmetrical funnel plot suggests no risk of bias among studies with small sample sizes. Based on the results, platelet-rich plasma demonstrated a significant advantage over hyaluronic acid, as well as improved symptom relief, lower reintervention rates, and pain improvement. At a minimum follow-up of 6 months, platelet-rich plasma has been shown to significantly improve pain and function in patients with knee osteoarthritis compared with placebo. Furthermore, platelet-rich plasma exhibited the highest values compared to bone marrow aspirate concentrate, hyaluronic acid, and corticosteroids. Furthermore, arthroscopically guided high-dose subchondral injection of primary synovial mesenchymal stem cells cultured in platelet-rich plasma and hyaluronic acid medium can regenerate cartilage defects, improving clinical outcomes. Meta-analyses have shown that the benefits of platelet-rich plasma injections are primarily apparent in the medium- to long-term management of clinical symptoms, including pain relief, improved quality of life, increased activities of daily living, and improved sports capabilities. Clinical outcomes of platelet-rich plasma injections for knee osteoarthritis may be related to the higher dose of platelets

State of the art of surgical techniques with PDO thread in facial aesthetics: a concise systematic review

Introduction: The fascination with beauty attracts optimizations of surgical techniques through the use of PDO (polydioxanone) threads. In recent years, the use of barbed tensor threads has gained popularity as a means of rejuvenating the face. Objective: This study presented the main clinical and aesthetic approaches to optimizing techniques using PDO threads for facial rejuvenation. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from December 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 101 articles were found. A total of 17 articles were evaluated and 14 were included in this systematic review. Considering the Cochrane risk of bias tool, the overall assessment resulted in 38 studies with a high risk of bias and 35 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2=65.7%>50%. It was concluded that the combination of lower blepharoplasty and midface lift using PDO threads is a comprehensive and effective approach for facial rejuvenation. It significantly improves wrinkle reduction, midface lift, and patient satisfaction. Ultrasound-guided thread lift, a method of evaluating and performing midface lift, proves to be safe and efficient. This approach holds promise as a future option in anti-aging cosmetic surgery, presenting a minimally invasive alternative with natural-looking results and reduced downtime. The Cartesian Technique™ with Smart PDOs™ is an effective protocol for skin resurfacing that enhances cellular biostimulation through the release of bioactive drugs. Using PDO threads for midface lifting is simpler, faster, and less invasive than conventional surgical methods, and this method simultaneously achieves satisfactory results. The combination of hyaluronic acid fillers and PDO threads was effective in achieving and maintaining long-term improvements in facial volume and contour. Thread lifting with short, wedge-shaped PDO sutures is safe and effective for facial rejuvenation. The vertical lifting technique has shown advantages over current approaches. Wedgeshaped PDO sutures in a folded configuration are a promising treatment option for deep static wrinkles in the upper face. The “Half Moon Base” incision and use of 4.0 PDO threads have shown significant aesthetic results in the eyebrow