Julia Grzegorczyk

Background: CAR T-cell therapy and T-cell–engaging bispecific antibodies have transformed the treatment of relapsed or refractory hematological malignancies, but their oral and dental consequences remain incompletely characterized. Objective: To synthesize open-access evidence on oral complications associated with CAR T-cell therapy and bispecific antibodies and to propose a practical dental-management algorithm. Methods: A structured narrative search of open-access literature published from 2015 through July 28, 2026 was conducted, with emphasis on PubMed/MEDLINE, PubMed Central, open-access publisher platforms, and reference-list screening. Evidence was synthesized according to treatment mechanism, molecular target, oral manifestation, and phase of care. Results: CAR T-cell therapy and BCMA-targeting bispecific antibodies are primarily relevant to dental care because of cytopenias, hypogammaglobulinemia, impaired immune recovery, and infection risk. GPRC5D-targeting treatment, particularly talquetamab, is additionally associated with dysgeusia, oral dryness, swallowing difficulties, mucosal changes, dietary restriction, and weight loss. Direct oral evidence after CAR T-cell therapy remains sparse. Conclusions: Dental care should be individualized according to treatment phase, molecular target, immune status, blood counts, infection risk, and functional effects of oral toxicity. The proposed algorithm is expert-informed and requires prospective validation.

Antibiotic prescribing in dentistry represents an important component of antimicrobial stewardship because dental professionals contribute substantially to community antibiotic exposure. Acute endodontic conditions are frequently encountered in urgent dental care, although systemic antibiotics have a limited role in most localized pulpal and periapical diseases. This narrative review examined evidence concerning antibiotic indications in acute endodontic conditions, international prescribing recommendations, reported prescribing practices, determinants of inappropriate prescribing, and potential stewardship interventions. The evidence was synthesized qualitatively. Current recommendations consistently prioritize definitive local treatment and source control and discourage antibiotics for symptomatic irreversible pulpitis, symptomatic apical periodontitis, and localized acute apical abscesses without systemic involvement. Antibiotics are mainly indicated when infection is spreading or accompanied by systemic manifestations such as fever, diffuse swelling, cellulitis, progressive trismus, dysphagia, or other signs of significant infection. Nevertheless, inappropriate prescribing remains common and is associated with diagnostic uncertainty, fear of complications, patient expectations, time pressure, limited access to urgent operative treatment, and organizational barriers. Evidence from stewardship programmes suggests that education alone is less effective than multimodal interventions incorporating guidelines, decision-support tools, audit and feedback, and patient communication. Antimicrobial stewardship in endodontics should therefore be considered not only a clinical issue but also a public-health and healthcare-system challenge.

Skeletal Class III malocclusion presents substantial therapeutic challenges because of its heterogeneous skeletal and dentoalveolar components and the limitations of conventional orthodontic and orthopedic approaches. This narrative review aimed to critically summarize the available evidence on the use of orthodontic microimplants as temporary skeletal anchorage in the treatment of skeletal Class III malocclusion. A literature search was conducted in PubMed, Scopus, and Google Scholar for English-language publications from 2015 to 2026 using terms related to skeletal Class III malocclusion, microimplants, skeletal anchorage, MARPE, and maxillary protraction; additional studies were identified through reference screening. The reviewed evidence indicates that microimplant-assisted protocols can improve anchorage control, reduce unwanted dentoalveolar compensation, and facilitate maxillary protraction, hybrid expansion, intermaxillary elastic therapy, and mandibular distalization. The greatest clinical benefit appears to occur in growing patients with maxillary deficiency, whereas in nongrowing patients microimplants mainly support orthodontic camouflage. Outcomes depend on skeletal maturity, appliance design, implant location and stability, force direction, anatomical conditions, and patient cooperation. Although short-term skeletal, dental, and soft-tissue effects are generally favorable, microimplants do not predictably restrict mandibular growth and cannot replace orthognathic surgery in severe skeletal discrepancies. Current evidence remains limited by heterogeneous protocols, small samples, and insufficient long-term follow-up. Microimplants should therefore be regarded as an adjunctive anchorage method within individualized biomechanical treatment planning.

Pathological tooth migration (PTM) is a common complication of advanced periodontitis that can impair aesthetics, function, and quality of life. Management frequently requires interdisciplinary collaboration between periodontics and orthodontics; however, several aspects of treatment remain controversial. Aim: This narrative review aimed to summarise the current evidence on the relationship between periodontal disease and PTM, evaluate the role of orthodontic treatment in periodontally compromised patients, and highlight key clinical considerations for interdisciplinary management. Materials and method: A narrative literature review was conducted using PubMed, Scopus, and Google Scholar. English-language publications published between 2015 and 2026 were identified using the keywords periodontics, orthodontics, and pathological tooth migration. Additional relevant studies were identified through manual screening of reference lists. Conclusions: Current evidence indicates that periodontal stabilization is the cornerstone of PTM management. Although spontaneous correction may occur following successful periodontal therapy, orthodontic treatment is frequently required to restore function and aesthetics. Orthodontic tooth movement can be performed safely in patients with stabilized periodontal disease when inflammation is controlled, plaque control is maintained, and light, carefully planned biomechanical forces are applied. Long-term success depends on supportive periodontal care, appropriate retention, and patient compliance. However, evidence regarding the optimal timing of orthodontic intervention, biomechanical protocols, and long-term stability remains limited.

Background: Oral manifestations of Sjögren’s syndrome, particularly xerostomia caused by salivary gland hypofunction, impair oral function, increase the risk of dental and mucosal complications, and reduce quality of life. Symptomatic management remains the mainstay of treatment, although several emerging therapies have recently been investigated. Aim: To review current evidence on established and emerging treatments for the oral manifestations of Sjögren’s syndrome. Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar. Publications from January 2015 to July 2026 were analyzed to evaluate conventional management, pharmacological and physical therapies, prevention of oral complications, and systemic immunomodulatory approaches. Results: Conventional management, including patient education, saliva substitutes, topical fluoride, dietary modification, and preventive dental care, remains the cornerstone of treatment. Pilocarpine and cevimeline are the most effective secretagogues in patients with preserved salivary gland function but are limited by cholinergic adverse effects. Sialendoscopy and intraductal irrigation show the strongest evidence among minimally invasive therapies. Current evidence does not support hydroxychloroquine, conventional immunosuppressants, rituximab, or abatacept for isolated oral dryness. Emerging targeted therapies, including ianalumab, dazodalibep, and nipocalimab, have shown promising preliminary results. Conclusions: Management should be individualized and multidisciplinary, combining symptomatic relief, preservation of residual salivary gland function, prevention of oral complications, and appropriate treatment of systemic disease. Targeted therapies are promising but require confirmation in larger clinical trials..

Background: Burning mouth syndrome (BMS) is a chronic pain disorder with a complex etiopathogenesis. Its diagnosis is based on the exclusion of local and systemic causes of burning sensations affecting the oral mucosa. Despite advances in current knowledge, the diagnosis and treatment of BMS remain significant clinical challenges. Objective: To present the current state of knowledge regarding the etiopathogenesis, diagnosis, and contemporary treatment strategies for burning mouth syndrome. Materials and Methods: A narrative literature review was conducted, including 24 full-text publications published between 2015 and 2025 and identified through searches of the PubMed/MEDLINE, Scopus, and Web of Science databases. The analysis included clinical trials, randomized controlled trials, observational studies, and selected review articles addressing the diagnosis and treatment of BMS. Results: Current evidence indicates that BMS is a multifactorial disorder in which neuropathic mechanisms play a predominant role. Comprehensive differential diagnosis and the exclusion of secondary causes of oral burning symptoms remain fundamental to the diagnostic process. Available therapeutic strategies, including pharmacological and non-pharmacological interventions such as photobiomodulation and neuromodulation, may reduce symptom severity in some patients. However, the quality of the available evidence is limited by substantial heterogeneity among studies. Conclusions: Effective management of BMS requires an individualized therapeutic approach and multidisciplinary collaboration. Further well-designed clinical studies employing standardized diagnostic criteria, treatment protocols, and outcome measures are needed to develop reliable evidence-based recommendations for the management of BMS.

Introduction: Dental anxiety is a common barrier to effective dental care and may lead to avoidance of visits, deterioration of oral health, and reduced cooperation during treatment. Growing interest in non-pharmacological methods has increased attention to virtual reality and other supportive interventions. Objective: This review assessed current evidence on the effectiveness of virtual reality and other non-pharmacological approaches in reducing dental anxiety and pain and improving patient cooperation. Materials and Methods: A narrative review of full-text English-language articles published between 2019 and 2025 was conducted using PubMed and reference list screening. Search terms covered dental anxiety, virtual reality, distraction, behavioral interventions, and other non-pharmacological techniques. Results: Virtual reality generally reduced dental anxiety and improved cooperation, particularly in pediatric patients. Some studies also reported beneficial effects on physiological stress indicators, while evidence for pain reduction remained inconsistent. Audiovisual distraction, breathing techniques, and behavioral preparation were also associated with favorable outcomes. Conclusions: Virtual reality is a useful adjunct in managing dental anxiety, especially in pediatric dentistry. Evidence is strongest for anxiety reduction and improved cooperation, whereas its effect on pain requires further research. Other non-pharmacological interventions may also support anxiety management.

Vital pulp therapy (VPT) is a modern approach to conservative treatment aimed at preserving and regenerating vital dental pulp. Its success largely depends on biomaterial scaffolds that support cell migration, differentiation, and proliferation, as well as angiogenesis and dentin regeneration. An electronic database search of PubMed, Scopus, and Google Scholar databases was conducted for publications from 2015 to 2025 using the following key words: “vital pulp therapy,” “natural scaffolds,” “regene­rative endodontics,” “dental pulp regeneration,” and “pulp capping.” This paper reviews current research on select natural biomaterials used in VPT, including methacrylated gelatin, chitosan, alginate, platelet-rich fibrin, and demineralized dentin matrix. Their biological, mechanical, and antibacterial properties are discussed, alongside their potential in regenerative endodontics. Special attention is given to their biocompatibility, modifiability, and capacity for controlled bioactive agent delivery. The paper also highlights the clinical limitations of these materials, such as a lack of standardization, high costs, and technical challenges. Despite promising in vitro and in vivo results, most of these biomaterials remain in the preclinical research phase. Consequently, the need for additional clinical trials and strategies that enable their routine clinical use is emphasized.

Oral cavity and lip cancers are the 16th most common cancer in the world. It is widely known that a lack of public knowledge about precancerous lesions, oral cancer symptoms, and risk factors leads to diagnostic delay and therefore a lower survival rate. Risk factors, which include drinking alcohol, smoking, HPV infection, a pro-inflammatory factor-rich diet, and poor oral hygiene, must be known and avoided by the general population. Regular clinical oral examinations should be enriched in an oral cancer search protocol for the most common symptoms, which are summarized in this review. Moreover, new diagnostic methods, some of which are already available (vital tissue staining, optical imaging, oral cytology, salivary biomarkers, artificial intelligence, colposcopy, and spectroscopy), and newly researched techniques increase the likelihood of stopping the pathological process at a precancerous stage. Well-established oral cancer treatments (surgery, radiotherapy, chemotherapy, and immunotherapy) are continuously being developed using novel technologies, increasing their success rate. Additionally, new techniques are being researched. This review presents a novel glance at oral cancer—its current classification and epidemiology—and will provide new insights into the development of new diagnostic methods and therapies.