Nikolaos Christidis

Background: Orofacial pain (OFP) is a common clinical problem. It may present as acute or chronic pain and involves different biological and psychosocial factors. Acute OFP is often related to odontogenic causes and short-term nociceptive activation, whereas chronic OFP, particularly temporomandibular disorder (TMD), is frequently associated with stress, depression, and other psychosocial symptoms. Salivary alpha-amylase (sAA) reflects autonomic nervous system activity and has been suggested as a non-invasive biomarker of stress-related pain. However, its role in OFP and its relation to psychosocial burden remains unclear. Objectives: To investigate sAA activity and psychosocial factors in women with acute and chronic OFP compared with pain-free controls. Methods: A total of 144 women were included: 47 with acute OFP, 47 with chronic OFP diagnosed according to diagnostic criteria for TMD, and 50 pain-free controls. Psychological variables were assessed using the Perceived Stress Scale (PSS-14) and the Symptom Checklist-90-Revised short version (SCL-32-R). Unstimulated saliva samples were collected and analysed for sAA activity using a kinetic enzyme assay. Results: Significant group differences in sAA activity were observed (p = 0.038). Patients with acute OFP showed higher sAA activity compared with controls (p < 0.05), whereas no significant differences were found between chronic OFP and controls. Across all participants, a weak positive pooled correlation was observed between sAA activity and current pain intensity (r_s = 0.23, p < 0.007). Chronic OFP patients reported higher levels of non-specific physical symptoms and current stress compared with controls (p < 0.01). Within the chronic OFP group, depressive symptoms, perceived stress, and non-specific physical symptoms were strongly correlated. Conclusions: Acute and chronic OFP were associated with different patterns: acute OFP was associated with higher sAA activity than in controls, whereas chronic OFP was associated with higher current stress and non-specific physical symptoms, but not with higher sAA activity. These cross-sectional findings should be interpreted cautiously and do not establish that the observed differences are attributable to pain duration alone.

Background: Adhesive capsulitis is a common and disabling shoulder condition with substantial impact on pain and function, yet the role of platelet-rich plasma (PRP) injections remains uncertain. Objective: This umbrella review aimed to synthesize the evidence on the effects of PRP on pain, shoulder range of motion, and function in adults with adhesive capsulitis. Methods: A search of MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL was conducted from inception to June 2025. Systematic reviews and meta-analyses were included and appraised using the Joanna Briggs Institute umbrella review methodology, and only reviews meeting predefined methodological quality criteria were included in the synthesis. The review was registered in PROSPERO (CRD420251024935). Results: Six systematic reviews meeting the predefined critical methodological criteria were included. Across reviews, PRP was generally associated with greater improvements in pain, shoulder range of motion, and functional outcomes at intermediate- and long-term follow-up compared with control treatments. In contrast, short-term outcomes were generally comparable between PRP and control treatments. Reported adverse events were infrequent and typically mild and transient. Conclusion: PRP appears to be associated with beneficial effects at intermediate and longer follow-up compared with commonly used interventions. However, the overall strength of evidence remains limited by heterogeneity in PRP protocols, comparator interventions, and outcome reporting, while incomplete and variable reporting of adverse events precludes firm conclusions regarding safety. These findings suggest that PRP may represent a adjunct treatment-option in adhesive capsulitis when longer-term outcomes are prioritized, although standardization of PRP protocols and further high-quality research are needed.

Background: This study examined how screen use, physical and mental health, and 3-question temporomandibular disorders (3Q-TMD) screening status relate to self-perceived academic performance among Swedish undergraduate dental and nursing students. Methods: Ninety-one first-semester dental and nursing students completed a survey comprising sociodemographic items, estimated daily screen use by purpose, and twelve self-report instruments. Self-perceived academic performance was measured with the Academic Performance Scale (APS) and analyzed as a continuous score. Bivariate group comparisons between lower and higher self-perceived academic performance used the Mann-Whitney U test or Welch’s t-test with effect sizes, and the Holm-Bonferroni procedure to control the family-wise error rate within families of outcomes. The primary analysis was a hierarchical linear regression on the continuous APS score, entering demographics, then total screen time, then purpose-specific screen use, then a psychological symptom burden composite and 3Q-TMD screening status. Results: Total screen time was unrelated to academic performance in every analysis. Purpose-specific screen use added 19.0% of explained variance beyond total duration (F(3,81) = 6.78, p < 0.001), whereas total duration added 2.2% beyond purpose and was not significant (F(1,81) = 2.37, p = 0.127). In the full model (R2 = 0.341, adjusted R2 = 0.266), academic screen use was positively associated with performance (β = 0.426, p < 0.001), while work-related screen use (β = -0.299, p = 0.003) and psychological symptom burden (β = -0.361, p = 0.001) were negatively associated with performance. Students reporting lower performance also reported poorer health-related quality of life in five of eight RAND-36 domains and were more likely to have a positive 3Q-TMD screening result, although the latter association did not survive adjustment for oral parafunctional behavior. Conclusions: Self-perceived academic performance was associated with the purpose of screen use and with psychological symptom burden, but not with total screen-time duration.

Methodological considerations in bibliometric retrieval for ultrasound-derived skeletal muscle research

Background/Objective: Oral health and nutritional status are closely interlinked through biological, functional, and behavioural pathways, yet the global research landscape connecting these domains has not previously been systematically mapped. This study aimed to provide a comprehensive bibliometric assessment of worldwide research linking oral health and nutritional status, identify influential publications, and analyze thematic developments over time. Materials and methods: Data were retrieved from the Science Citation Index Expanded (SCI-EXPANDED) within the Web of Science Core Collection. Publications from 1991–2024 were identified using a structured search strategy incorporating primary and extended terminology. Document characteristics, citation performance, authorship patterns, and publication indicators ( TP , IP , CP , FP , RP , and SP ) were analyzed alongside citation indicators ( C _year , TC _year , CPP _year ). Author keywords were examined across three balanced time periods to identify major research foci. Results: A total of 10,074 publications were identified, including 8747 articles. Global research activity increased steadily, with citation maturity typically reached after 13 years. The USA, UK, Japan, and China led in publication output, while international collaboration was associated with higher citation impact. The ten most-cited articles reflected epidemiological surveillance, methodological standardization, global oral disease burden, and clinical nutrition guidelines. Keyword analysis revealed five overarching subjects: epidemiology, nutrition-related determinants of oral function and disease, clinical and quality-of-life outcomes, intervention strategies, and vulnerable populations. Conclusions: This study provides the first global bibliometric overview of research linking oral health and nutritional status. Findings highlight an expanding, interdisciplinary field with growing methodological sophistication and public health relevance.

As bibliometric research continues to expand across the health sciences, the precision of data retrieval remains a critical determinant of study validity (Donthu et al., 2021;Moral-Muñoz et al., 2020). One methodological development that has received increasing attention is the "front page" filter, which restricts retrieval to information contained in the Title (TI), Abstract (AB), and Author Keywords (AK) fields. This approach has been proposed as a more precise alternative to conventional Topic (TS) searches that include Keywords Plus (KP). Beyond issues of retrieval accuracy, discussion of the front-page filter raises broader questions regarding retrieval strategy selection, methodological transparency, and scholarly attribution. While bibliometric studies frequently discuss database selection, indicators, and analytical tools, less attention has been given to how retrieval-field selection itself may influence dataset composition, reproducibility, and interpretation of results (Donthu et al., 2021;Moral-Muñoz et al., 2020). This opinion article aims to discuss the role of the front-page filter within this broader methodological context and to highlight the importance of transparent reporting and attribution of methodological developments.The Front-Page Filter and Its Methodological ImplicationsRetrieval precision has long been recognized as an important methodological consideration in bibliometric research (Donthu et al., 2021). The front-page filter represents one such methodological development and has been empirically evaluated in several previous investigations (Wang and Ho, 2011;Fu et al., 2012). The current TI-AB-AK framework is not merely a search refinement but a documented methodological contribution that has been described and further developed in the bibliometric literature (Usman and Ho, 2021). Consistent citation of these foundational studies would strengthen methodological transparency and provide appropriate recognition of the framework's development.Historically, many Web of Science retrieval strategies relied on the Topic (TS) field because of database interface limitations and common search practices. The TS field includes Keywords Plus (KP), a retrieval component generated from cited references rather than from author-supplied descriptors (Garfield, 1990). A recognized limitation of TS-based retrieval is the inclusion of records in which the search term is peripheral to the main focus of the study, thereby reducing dataset precision. Such imprecision may affect the validity, reproducibility, and interpretability of bibliometric findings.The front-page filter was developed to address these limitations by restricting retrieval to authordefined metadata, namely the Title (TI), Abstract (AB), and Author Keywords (AK) fields. By excluding Keywords Plus, this framework places greater emphasis on author-defined relevance and reduces the inclusion of algorithm-generated retrieval noise. Initially proposed by Wang and Ho (2011) and subsequently evaluated in SCI-EXPANDED studies (Fu et al., 2012), the approach evolved into the current TI-AB-AK framework described by Usman and Ho (2021). Its application in medical and health-science bibliometric studies (Yang et al., 2022;Ho et al., 2023;Peng et al., 2024;Rao et al., 2025;Christidis and Ho, 2026) suggests that it can serve as a useful approach for improving retrieval precision in certain research contexts. However, its suitability may depend on the objectives of the study and the balance sought between retrieval precision and retrieval comprehensiveness.Comparative studies have demonstrated that omission of the front-page filter may result in substantial differences in bibliometric outputs, particularly within the health sciences. Reliance on TS-based retrieval may introduce peripheral literature that obscures central research themes and influences the interpretation of publication trends. The substantial differences in publication counts presented in Table 1 illustrate the potential impact of retrieval strategy on bibliometric outcomes and support the value of high-precision search approaches. At the same time, higher precision may be accompanied by lower recall. Restricting retrieval to title, abstract, and author keywords may exclude publications in which the topic is relevant but not explicitly represented in these fields. Consequently, the optimal retrieval strategy may vary depending on the purpose of the bibliometric analysis and the desired balance between precision and comprehensiveness. Similar trade-offs between precision and comprehensiveness have been discussed more broadly in methodological studies of bibliometric retrieval and dataset construction (Donthu et al., 2021).Applications of the TI-AB-AK framework have appeared in an increasing number of bibliometric studies (Wu et al., 2025;Yang et al., 2026). However, citation of the methodological studies that established and refined this framework has not always been uniform across the literature. As Noè and Batten (2006) emphasized, appropriate acknowledgment of conceptual and methodological contributions remains an important aspect of research integrity. By contrast, other authors have appropriately cited the methodological foundations of the TI-AB-AK framework when applying similar approaches (Peng et al., 2024;Hu et al., 2024).The evidence discussed here suggests that the front-page filter represents one approach for improving dataset precision in bibliometric research. Nevertheless, inconsistent citation of foundational methodological studies may weaken intellectual continuity and obscure the developmental trajectory of widely adopted bibliometric approaches. Maintaining clear links between methodological innovations and their original empirical descriptions promotes transparency, reproducibility, and appropriate scholarly recognition. As bibliometric methods continue to evolve, consistent reporting and citation of methodological...

BACKGROUND AND OBJECTIVE: Trigeminal neuralgia (TN) and postherpetic neuralgia (PHN) are severe peripheral neuropathic pain conditions associated with substantial functional impairment. Although pharmacological treatments are available, many patients experience insufficient efficacy or poor tolerability. Botulinum toxin type A (BoNT-A) has emerged as a potential treatment, but uncertainties remain regarding its efficacy, safety, and clinical positioning. This umbrella review aimed to synthesise evidence from systematic reviews evaluating BoNT-A in TN and PHN. A systematic search was conducted in MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL from inception to November 2025. Systematic reviews with or without meta-analysis evaluating BoNT-A in adults with TN or PHN were included. Methodological quality was assessed using AMSTAR-2, and only moderate- or high-quality reviews were included. Primary outcomes were pain intensity reduction and responder rates (≥ 50% pain reduction). Secondary outcomes included quality of life and adverse events. Ten systematic reviews (2015-2024) met the inclusion criteria. Botulinum toxin type A was consistently associated with reductions in pain intensity and higher responder rates than placebo, particularly in TN. In PHN, evidence was more limited but supported short-term (1-3 months) improvements in pain intensity. Evidence on quality of life was scarce and inconclusive. Botulinum toxin type A was well tolerated, with mostly mild and transient adverse events. Botulinum toxin type A appears to provide short-term pain relief in selected patients with TN and PHN and is generally well tolerated. Current evidence supports its role as an adjunctive third-line option for focal peripheral neuropathic pain, although heterogeneity and limited long-term data warrant cautious interpretation.

Background/objectives: Botulinum toxin is widely used across medical specialties, with expanding indications in neurology, pain management, urology, and aesthetic medicine. Highly cited publications can reflect influential evidence and clinical priorities within healthcare. This study aimed to identify and characterize highly cited research on botulinum toxin as indicators of influential evidence within the field, with a focus on clinical trends, collaboration patterns, and healthcare-relevant applications. Methods: A bibliometric analysis was conducted using the Science Citation Index Expanded (SCI-EXPANDED) within the Web of Science Core Collection. Publications from 1991 to 2022 with ≥100 citations (TC₂₀₂₄ ≥ 100) were included. Data on publication characteristics, authorship, institutional and country contributions, and citation impact were extracted. Bibliometric indicators, including total publications, citations per publication, and the Y-index, were applied. Keyword and title analyses were used to identify major research themes. Results: A total of 643 highly cited articles were identified, with 118,175 citations. The United States was the leading contributor, and industry-linked research, particularly from Allergan, demonstrated high citation impact. Five major clinical themes emerged: spasticity management, dystonia and movement disorders, chronic pain, urinary disorders, and cosmetic applications. Highly cited research was predominantly produced through collaborative teams, most commonly involving two to six authors, and international collaborations were associated with higher citation impact. Conclusions: Highly cited botulinum toxin research may partially reflect evolving clinical demand and interdisciplinary use across healthcare fields. The prominence of collaborative and industry-linked research highlights the role of translational and practice-driven innovation. These findings provide insight into influential evidence and may support future research prioritization, interdisciplinary collaboration, and evidence-based decision-making in clinical and healthcare contexts.

Background/Objectives: Dental implant research has expanded substantially over recent decades, yet the characteristics of its most influential publications remain insufficiently defined. This study aimed to analyze highly cited dental implant research to identify global publication patterns, leading contributors, and major research themes. Methods: Publications indexed in the Web of Science Core Collection (SCI-EXPANDED) up to 1 May 2025 were retrieved. The analysis was restricted to WoSCC and used a fixed citation threshold; citation normalization and network analyses were not performed. Highly cited publications were defined as those with TC₂₀₂₄ ≥ 100 citations. A total of 1599 highly cited publications were identified; after application of the “front page” filter, 1324 implant-related documents remained, and 1016 original research articles were included in detailed bibliometric analyses. Citation indicators (TC₂₀₂₄, CPP₂₀₂₄) and authorship metrics (FP, RP, IP, CP, SP, and APP) were evaluated. Temporal trends, keyword frequency, and Y-index analysis were applied to assess research development and author contributions. Results: Publication output demonstrated steady growth, with peak citation impact observed after approximately 16 years. Research was primarily concentrated within dentistry, oral surgery, and biomedical-related fields. The United States and several European countries accounted for the majority of highly cited publications, with internationally collaborative articles showing higher citation impact than single-country publications. Keyword analysis identified four major research themes: biological integration, implant materials and surface characteristics, clinical treatment strategies, and peri-implant diseases. Conclusions: Highly cited dental implant research is characterized by strong representation of biological, material, and clinical domains. These findings should be interpreted as WoSCC-based citation patterns rather than definitive evidence of clinical impact, methodological quality, or global research priorities.