Irene Lafuente‐Ibáñez de Mendoza

Background/Objectives: In our previous systematic review, we found no convincing evidence to support rapid maxillary expansion (RME) as a treatment for pediatric obstructive sleep apnea (OSA). Subsequent clinical guidelines and expert opinion have continued to recommend this orthodontic treatment. We aimed to update our search to determine whether new controlled prospective evidence alters this conclusion. Methods: We updated our previous systematic review, searching for controlled prospective studies on RME efficacy for pediatric OSA published up to 1st February 2026. Results: Three new randomized clinical trials (RCTs) were identified in addition to the five original studies. Critically, none of the new RCTs included a watchful waiting or supportive care control arm, leaving the sole available comparison against watchful waiting unchanged: a single RCT that found no significant difference in AHI change between RME and observation. Of the remaining new RCTs, two found marginal AHI improvement with RME and one found no significant AHI reduction. Conclusions: The observed AHI improvements in studies lacking an untreated comparator cannot be distinguished from the known potential for spontaneous improvement in growing children. Extreme caution is warranted before recommending RME as a treatment for pediatric OSA.

Epstein–Barr virus (+) mucocutaneous ulcer (EBVMCU) is an uncommon benign lymphoproliferative lesion that develops in immunocompromised patients. We present a special case of EBVMCU located in the peri‐implant mucosa and we review the oral cases published to date. An 88‐year‐old man with no medical history of interest was attended in the dental clinic due to an ulcerated tumor located in the peri‐implant mucosa. The lesion showed an atypical lymphoid proliferation, positive for CD3, CD20, CD30, PAX‐5, and MUM1. Positive EBV and favorable patient evolution confirmed the final diagnosis of EBVMCU. Oral EBVMCU reports related to immunosenescence mainly develop in the gingiva of advanced age patients. Our case highlights the importance to perform a complete clinicopathological study of all peri‐implant lesions. Although most peri‐implant pathologies are inflammatory‐reactive disorders, sometimes they can also correspond to other entities.

Objective: To analyze the characteristics of a series of oral reactions to injectable soft tissue fillers.Materials and Methods: Cases diagnosed as oral reactions to injectable soft tissue fillers were selected from eight Pathology laboratories. Information was retrieved from the laboratory charts and from the review of the hematoxylin and eosin‐stained histological slides.Results: The 151 patients showed a mean age of 54.9 years, and 136 (90.1%) were females. Mean time of onset was 20.4 months, and the lips were the most frequent location (72.8%). Most cases presented as asymptomatic isolated nodules, with a mean size of 17.4 mm. Silicone (38.5%), polymethylmetacrylate (33%), and hyaluronic acid (11.9%) were the three most common fillers. Granulomas, foamy macrophages, and multinucleated giant cells were observed in 44%, 51.5%, and 65.3% of the cases, respectively. Time of onset was shorter for males (p = 0.033), and symptoms were common in the upper lip, buccal mucosa, and lower vestibule (p = 0.010). Foamy macrophages were more common in association with silicone and collagen (p < 0.001), whereas multinucleated giant cells were more common in association with polymethylmetacrylate, hydroxiapatite, and polylactic acid (p = 0.012).Conclusion: Clinicians should consider reactions to injectable soft tissue fillers when evaluating asymptomatic submucosal nodules affecting the lips of adult/older females.

Background: Peri-implantitis (PI) is a frequent inflammatory disorder characterised by progressive loss of the supporting bone. Not all patients with recognised risk factors develop PI. The aim of this study is to evaluate the presence of single nucleotide polymorphisms (SNP) of inflammatory and bone metabolism related proteins in a population treated with dental implants from the Basque Country (Spain). Methods: We included 80 patients with diagnosis of PI and 81 patients without PI, 91 women and 70 men, with a mean age of 60.90 years. SNPs of BMP-4, BRINP3, CD14, FGF-3, FGF-10, GBP-1, IL-1α, IL-1β, IL-10, LTF, OPG and RANKL proteins were selected. We performed a univariate and bivariate analysis using IBM SPSS® v.28 statistical software. Results: Presence of SNPs GBP1 rs7911 (p = 0.041) and BRINP3 rs1935881 (p = 0.012) was significantly more common in patients with PI. Patients with PI who smoked (> 10 cig/day) showed a higher presence of OPG rs2073617 SNP (p = 0.034). Also, BMP-4 rs17563 (p = 0.018) and FGF-3 rs1893047 (p = 0.014) SNPs were more frequent in patients with PI and Type II diabetes mellitus. Conclusions: Our findings suggest that PI could be favoured by an alteration in the osseointegration of dental implants, based on an abnormal immunological response to peri-implant infection in patients from the Basque Country (Spain).

The aim of this research is to evaluate the periodontal health of patients with Parkinson Disease (PD) in a Spanish cohort. A cross-sectional study was performed on 104 patients with PD (mean age: 66.19+9.3 years) and 106 controls (mean age: 59.26+14.11 years). A pre-designed clinical protocol was implemented, which included a standardized epidemiological index for periodontal disease (CPITN), clinical attachment loss (CAL), tooth-loss, full mouth plaque index (FMPI), and oral hygienic habits. Univariate descriptions and comparative analysis were performed. The majority of PD patients presented good oral hygienic habits. There were no significant differences in relation to CPITN, periodontitis, gingival recessions and tooth loss. However, moderate/severe CAL (p=0.027) and FMPI (p=0.003) was higher in the PD group. There were no differences on periodontitis and tooth loss between both groups. The higher number of advanced CAL and presence of biofilm in the PD group could be related to the difficulties to perform an effective tooth brushing due to this neurological disorder. Key words:Parkinson’s disease, periodontal disease, clinical attachment loss, oral hygiene.

Background: Oral erythroplakia has been classically considered as the potentially malignant disorder with the highest rate of malignant development into squamous cell carcinoma. This critical systematic review and meta‐analysis aim to estimate the malignant development rate of oral erythroplakia and identify the associated risk factors.Methods: We performed a bibliographic search in PubMed, Scopus, Web of Science, Embase, and LILACS, with keywords “erythroplakia,” “erythroplasia,” “malignant transformation,” “malignant development,” “malignization,” “carcinogenesis,” “oral cancer,” “oral squamous cell carcinoma,” “mouth neoplasm,” and “prognosis.” Meta‐analysis was conducted using a random‐effects model.Results: Ten observational studies with 441 patients met the inclusion criteria, whose mean malignant development rate was 12.7% and with a mean follow‐up period of patients of 6.66 years. In the initial biopsy, 42.8% of oral erythroplakia were already squamous cell carcinoma. The buccal mucosa was the most frequent location of oral erythroplakia, but the floor of the mouth was the most common site of malignant development. All patients who underwent malignant development showed epithelial dysplasia on the initial diagnostic biopsy.Conclusion: Overall malignant development rate of OE in the meta‐analysis was 19.9%. We could not associate any specific clinicopathological feature with the malignant development. The presence of epithelial dysplasia in the initial biopsy remains the worst prognostic factor. Further observational studies on OE are needed, with well‐established diagnostic criteria and good clinical follow‐up, in order to identify the true risk of malignant development of oral erythroplakia and the related risk factors.