Oronasal fistula (ONF) is an epithelialized tract between the oral and nasal cavities, for which various flaps are used in surgical closure. ONF may lead to regurgitation of food into the nasal cavity, nasal obstruction, halitosis, and other symptoms that contribute to patient discomfort and impaired quality of life. Surgical closure is challenging, occasionally requiring multiple procedures and carrying a risk of recurrence. The nasolabial flap (NLF) is a well-established local flap for soft tissue reconstruction in the orofacial region; superiorly based flaps are typically used for defects of the nasal dorsum, tip, and ala, while inferiorly based flaps are applied to defects of the nasal floor, lips, and buccal mucosa. The NLF provides dependable vascularity and favorable donor-site esthetic outcomes. Although superiorly based NLFs are not commonly used for intraoral reconstruction, this case report suggests that they can serve as a feasible option for ONF closure in carefully selected patients when the flap lies within an appropriate distance from the maxilla.

We describe a simple technique in which traction sutures placed at the palatal flap margin are passed through interdental embrasures and stabilized against adjacent teeth in the contra-lateral arch. This technique was used for 10 patients with impacted maxillary canines.In our clinical use, the technique eliminated the continuous demand of manual retraction, slippage of retractors during the procedure, palatal flap tear due to uneven distribution of retraction forces. Self-stabilizing interdental traction sutures are a practical, reproducible, and minimally invasive adjunct for palatal flap retraction during surgical exposure of impacted canines in selected clinical situations. The technique is particularly advantageous in single-surgeon procedures, resource-limited settings, and cases requiring prolonged palatal exposure for adjunctive orthodontic procedures, including button or attachment placement.

Objectives: Titanium platelet-rich fibrin (T-PRF) usage as sustained drug delivery system (SDDS) has been recently started. Hence present study aimed to evaluate hard tissue regenerative efficacy of T-PRF clots incorporated with amoxiclav (AMX)/metronidazole (MET)eem (NE) gels individually in osseous defects created in Wistar rats. Materials and Methods: In this in vivo animal model trial, 12 female Wistar rats were procured and subjected to ligature induced periodontitis.Bone defects were created and incorporated with T-PRF plain, T-PRF clots+AMX/MET/NE gels individually. Rats were sacrificed after 2 months and checked under light microscopy and micro (µ)-computed tomography analysis for bone regeneration. Frequency distribution percentages, chi-square test, ANOVA and un-paired t-test were used for conducting the statistical analysis. Results: Inflammatory response was reported in T-PRF+MET Group followed by AMX Group and no inflammatory response was recorded for T-PRF plain with statistical significance (P=0.008), for mineralized and un-mineralized bone formation there was no significant difference (P=0.133). Mean comparisons of bone density there was no significant difference (P=0.545) among all (AMX=551.00±18.68, MET=578.00±18.25, NE=569.00±24.58, T-PRF plain=507.67±118.50). For gene expression significantly (P<0.001) higher alkaline phosphatase and bone morphogenetic protein-2 levels were recorded for T-PRF+NE Group (7.60±3.04, 10.85±1.28) followed by MET (4.65±1.52, 4.64±0.45)>AMX (2.47±0.84, 1.89±0.18)>T-PRF plain (1.00±0.00, 1.00±0.00). Conclusion Research results showed that T-PRF can be a SDDS and addition of antibiotics or herbal extract didn’t alter the hard tissue healing property of T-PRF and resulted in new bone formation.

Objectives: To assess the efficacy of salmon calcitonin spray on postoperative pain, serum calcitonin levels, and bone healing after surgical removal of impacted mandibular third molar. Materials and Methods: This prospective study included 100 patients who required surgical removal of impacted mandibular third molars under local anesthesia. Group I included 50 patients who received intranasal serum calcitonin spray, and Group II included 50 patients who did not receive serum calcitonin spray. The postoperative pain was evaluated on the 1st, 3rd and 7th days. The serum osteocalcin levels were assessed at 1 month, and bone density was evaluated at the 3rd month postoperatively. Results: The severity of pain was less in Group I on days 3, and 7 postoperatively compared to Group II (P<0.05). The postoperative serum calcitonin level was higher in Group I compared to Group II (P<0.05), and the bone density was greater in Group I when compared to Group II evaluated at the 3rd month postoperatively (P<0.05). Conclusion The results of our study delineate that Group I patients had better efficacy in controlling pain and improved bone healing with calcitonin nasal spray when compared to Group II patients.

Approximately 25% of patients with chronic rhinosinusitis (CRS) have recurrence after endoscopic sinus surgery (ESS). The goal is to analyze and integrate research on individual and genetic factors of recurrence in CRS patients following ESS. A systematic review and meta-analysis were performed using PRISMA criteria. Various databases were searched from January 2008 to May 2025. ESS studies with adults with CRS reported results based on clinical or genetic factors. The Newcastle–Ottawa Scale and five dimensions of bias were examined study quality. Pooled odds ratios with 95% confidence intervals were estimated using a random-effects DerSimonian–Laird model. Heterogeneity was assessed using I 2 , publication bias using funnel plots and Egger test, and evidentiary certainty using GRADE. A total of 17 trials with 40,059 individuals were examined. Asthma, non-steroidal antiinflammatory drug (NSAID) intolerance, allergy, and higher Lund–Mackay scores (LMSs) were significant clinical predictors of recurrence. TAS2R38 polymorphisms had poorer outcomes, but only 4 trials were included. Asthma, NSAID intolerance, allergy, higher LMS, and TAS2R38 polymorphisms are significant predictors of recurrence in CRS following ESS. These results support the use of comorbidities, radiologic severity, and genetic biomarkers in preoperative risk classification, emphasizing the need for larger, standardized, and multi-ethnic research.

Peri-implant oral malignancy (PIOM) refers to malignant tumors arising around dental implants and is an increasingly reported complication of implant therapy. PIOM may follow distinct pathophysiological mechanisms, including chronic peri-implant inflammation and implant-related factors that contribute to carcinogenesis. This current review aims to explore the potential role of peri-implantitis (PI) as a risk factor for PIOM, discussing the proposed pathogenic mechanisms, histological findings, and clinical implications. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science databases. Relevant case reports, clinical studies, and reviews on the keywords “PIOM” and “PI” published from 2019 up to 2025 were included and qualitatively analyzed. Clinicopathologic characteristics are summarized as location and morphology, disease progression, histopathology, and degree of differentiation, and pathophysiological hypotheses involve inflammatory and electrochemical pathways, epithelial barrier dysfunction, molecular alterations, microbiome dysbiosis, and immune dysregulation. Current evidence remains limited and primarily anecdotal. Several studies suggest that chronic inflammation, titanium particle exposure, corrosion byproducts, and sustained tissue damage in peri-implant tissues may contribute to oncogenesis. While a direct causal link between PI and PIOM remains unproven, chronic peri-implant inflammation may contribute to malignancy development in predisposed individuals. Clinicians should consider a biopsy when peri-implant lesions exhibit atypical features, promptly.