Introduction: Rhino-orbital-cerebral mucormycosis (ROCM) following COVID-19 frequently necessitates extensive, life-saving maxillectomies, resulting in massive anatomical defects that severely compromise masticatory function, speech, and health-related quality of life (HRQoL). Conventional obturator-based rehabilitation is often unpredictable in this cohort due to fungus-induced avascular necrosis of the residual tissue and inadequate basal bone volume. Zygomatic implants (ZIs), by anchoring into the dense, viable cortical bone of the zygomatic arch—anatomically distant from the necrotic maxillary zone—offer a promising graftless reconstructive solution. This systematic review aims to evaluate the survival rate, functional efficacy, and short-term clinical outcomes of ZIs in the rehabilitation of post-COVID-19 mucormycosis maxillary defects. Materials and Methods: A comprehensive systematic search was conducted across PubMed, Scopus, Web of Science, and Embase, covering publications up to December 2024. Studies were selected based on predefined inclusion and exclusion criteria, focusing on zygomatic implant-based rehabilitation in post-COVID-19 mucormycosis patients. Study selection, data extraction, and qualitative synthesis were performed in accordance with PRISMA 2020 guidelines. Methodological quality of primary clinical studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal tools, while review articles were evaluated using a modified AMSTAR-2/SANRA framework. Results: Twelve studies met the inclusion criteria, comprising 6 primary clinical studies, 4 review articles, and 2 finite element analysis (FEA) studies. The synthesized evidence indicated high primary stability and favorable short-term survival rates for ZIs placed in zygomatic bone anatomically distant from the necrotic maxillary zones. ZIs facilitated rapid functional restoration and demonstrably improved HRQoL in post-mucormycosis survivors. Reported complications included soft tissue dehiscence, oroantral fistulas, and recurrent sinusitis, underscoring the necessity of meticulous surgical planning and structured postoperative follow-up. Conclusion: Zygomatic implants represent a viable and promising graftless modality for the prosthetic rehabilitation of extensive post-COVID-19 mucormycosis maxillary defects. While short-term functional and biomechanical outcomes are encouraging, the current evidence base is constrained by small sample sizes, predominantly retrospective study designs, and limited follow-up durations. Rigorous, long-term prospective cohort studies are warranted to establish standardized clinical protocols and definitively evaluate the long-term survival of ZIs in this specific patient population. Keywords: Zygomatic implant; Mucormycosis; Post-COVID mucormycosis.

Introduction: This systematic review and meta-analysis evaluated the primary digital accuracy outcomes, including trueness and precision, and the secondary clinical adaptation outcome, prosthetic fit, of conventional, digital, and stereophotogrammetric (SPG) impression techniques in implant-supported restorations. This review proposes that digital and SPG techniques offer higher accuracy relative to conventional techniques. Materials and Methods: Following PRISMA 2020 guidelines, five databases were searched between December 2024 and September 2025. Of 28,922 screened records, 13 in vitro studies met inclusion criteria. Data extraction was independently conducted by two reviewers. Methodological quality was assessed using the QUIN tool, and random-effects meta-analyses (RevMan and CMA) were performed to calculate standardized mean differences (SMD, 95% CI). Results: For the primary digital accuracy outcomes, SPG generally achieved the highest trueness and precision, with significant advantages in several comparisons (SMD = –1.60 to –3.80, p < 0.05). For the secondary clinical adaptation outcome, digital impressions showed significantly improved prosthetic fit compared with conventional techniques (SMD = –1.65, p = 0.001). Conclusion: In vitro evidence suggests that digital impressions provide better fit than conventional techniques, while SPG achieves the highest overall accuracy. High-quality clinical studies are needed to confirm these  findings and determine their long-term prosthetic and biological implications. Keywords: Dental implants; Dental prosthesis; Dental impression technique; Stereophotogrammetry.

Introduction: Mandibular angle and condylar fractures are highly prevalent maxillofacial injuries. The presence of impacted third molars may influence fracture patterns by weakening mandibular biomechanics, though the literature remains controversial. Deeper impactions, angulation, and root morphology have been variably associated with fracture risk. This study aims to investigate the effect of the presence of impacted third molars and their characteristics on mandibular fracture. Materials and Methods: Panoramic images of 300 patients with mandibular fractures were examined. The presence of impacted third molars, position, angle, number of roots, and distance from the inferior border of the mandible were considered as independent variables, while the location of the fracture was considered as the dependent variable.Results: The presence of impacted third molars increased mandibular angle fracture odds by 11.15-fold but decreased condylar fracture odds by 0.28-fold. Class B and Class 3 impactions had higher angle fracture odds compared to Class A and Class 1, respectively. Distoangular or horizontal molars increased angle fracture odds 5.09 and 4.22. The odds of angle fracture in mandibular quadrants with a single conical root third molar and in those with a tooth bud without root formation were 2.60 and 3.32 times higher. Conversely, Class C impactions decreased condylar fracture odds. Conclusion: The existence of impacted third molars, along with a deeper impaction within the mandibular bone and a closer proximity to the inferior border of the mandible, heightens the probability of mandibular angle fracture while diminishing the occurrence of mandibular condyle fracture. Furthermore, in cases where third molars possess a single conical root and are positioned distoangularly or horizontally, the risk of mandibular angle fracture is elevated. Keywords: Mandibular fracture; Impacted mandibular third molar; Mandibular angle. 

Introduction: To compare the accuracy of implant placement on mandibular models fabricated from different materials using a single digitally designed surgical guide, and to identify which model provided the highest precision and cost-effectiveness for research and training applications. Materials and Methods: Nine identical mandibular models were fabricated with missing teeth at the right lateral incisor, right first molar, and left first premolar. Three cast models were used: porous polyethylene (MedPor), photopolymer resin (SprintRay), and photopolymer resin (MAZIC® D MODEL). A single CAD/CAM surgical guide was designed in REALGuide 5.3 and printed with SprintRay technology. Using standardized protocols, 27 demo implants (three per model) were placed. Postoperative CBCT scans were digitally superimposed with planned positions to assess angular and linear deviations (coronal, apical, mesial, distal, and labial). The data were analyzed via descriptive statistics, one-way ANOVA, and Tukey’s HSD tests. Results: Analysis revealed a statistically significant deviation at the lateral apical position (ANOVA, p = 0.0011). Porous polyethylene (MedPor) demonstrated greater error than did photopolymer resin (SprintRay) (p = 0.0107) or photopolymer resin (MAZIC® D MODEL) (p = 0.0009), whereas no significant difference was detected between the two resin-based models (p = 0.0775). Although the photopolymer resin (SprintRay) resulted in greater mean deviations at premolar sites, these differences were not statistically significant. Intragroup analysis indicated site-dependent variation within photopolymer resin (MAZIC® D MODEL) (p = 0.0313), whereas porous polyethylene (MedPor) and photopolymer resin (SprintRay) exhibited more consistent error distributions across sites. Conclusion: Photopolymer resin models presented the highest apical accuracy at lateral incisor sites, outperforming porous polyethylene. Resin-based models (SprintRay and MAZIC® D MODEL) proved accurate and cost-effective, whereas porous polyethylene produced larger deviations despite being more than ten times more costly. The two photopolymers also differ in their mechanical properties. Keywords: Apical deviation; Dental implant; Digital implantology; Mandibular model; Surgical guide.

Introduction: Chronic obstructive pulmonary disease (COPD) is associated with persistent airway inflammation and an increased risk of adverse outcomes following coronavirus disease 2019 (COVID-19). While the lower airways have been the primary focus of most studies, the upper respiratory tract plays a critical role in SARS-CoV-2 entry and early symptom development. Inflammatory mediators, including interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and C-reactive protein (CRP), as well as the viral entry–related protease TMPRSS2, are involved in both COPD-associated inflammation and COVID-19 pathogenesis. This study investigated the expression of these markers in COVID-19 patients with underlying COPD. Materials and Methods: In this case–control study, peripheral blood samples were collected from COVID-19 patients with a documented history of COPD and from age- and sex-matched healthy controls. Total RNA was extracted, reverse transcribed into cDNA, and relative mRNA expression levels of IL-6, MCP-1, CRP, and TMPRSS2 were quantified using real-time polymerase chain reaction. Statistical analyses were performed using parametric tests, with statistical significance defined as p < 0.05. Results: Compared with healthy controls, COVID-19 patients with COPD demonstrated significantly higher mRNA expression levels of IL-6, MCP-1, and CRP (p < 0.05). TMPRSS2 expression was also elevated in the patient group, indicating a potential contribution to enhanced viral entry. Overall, the findings revealed a distinct inflammatory expression profile in patients with COPD during SARS-CoV-2 infection. Conclusion: The increased expression of IL-6, MCP-1, CRP, and TMPRSS2 in COVID-19 patients with underlying COPD suggests a combined effect of chronic inflammation and viral entry mechanisms. These markers may be valuable as accessible blood-based indicators of disease severity, although further studies are needed. Keywords: COVID-19; COPD; Gene expression; IL-6; MCP-1; TMPRSS2; C-reactive protein.

Introduction: Type 1 diabetes mellitus is associated with several oral complications, including salivary gland dysfunction and alterations in salivary composition. Adrenergic pathways are involved in the regulation of salivary secretion; however, salivary β1-adrenergic receptor-related immunoreactivity has not been well investigated in children with type 1 diabetes mellitus. This exploratory case-control study aimed to compare salivary β1-adrenergic receptor immunoreactivity between children with type 1 diabetes mellitus and systemically healthy controls. Materials and Methods: This observational case-control study included 66 children aged 7-13 years, comprising 33 children with type 1 diabetes mellitus and 33 systemically healthy controls within the same age range. Children with type 1 diabetes mellitus were clinically stable at enrollment and had acceptable metabolic control based on screening records and pediatric endocrinology evaluation. These glycemic criteria were used only for eligibility screening and were not included as analytic variables. Unstimulated whole saliva was collected using the spitting method after a minimum fasting period of 2 hours. Salivary β1-adrenergic receptor immunoreactivity was measured using a sandwich enzyme-linked immunosorbent assay. Data normality was assessed using the Shapiro-Wilk test, and the between-group comparison was performed using the Mann-Whitney U test. Results: Salivary β1-adrenergic receptor immunoreactivity was significantly higher in children with type 1 diabetes mellitus than in healthy controls. The median salivary β1-adrenergic receptor immunoreactivity was 81.56 ng/L (IQR: 62.12-92.31) in the type 1 diabetes mellitus group and 36.43 ng/L (IQR: 27.56-45.92) in the control group. The between-group difference was statistically significant (Mann-Whitney U = 137.0, p = 1.79 × 10⁻⁷). The range of values was wider in the type 1 diabetes mellitus group (19.96-615.28 ng/L) compared with controls (4.67-188.29 ng/L). Conclusion: Children with type 1 diabetes mellitus showed higher salivary β1-adrenergic receptor-related immunoreactivity than systemically healthy controls. This finding should be interpreted as preliminary evidence of altered salivary biomarker profiles rather than direct evidence of increased adrenergic receptor expression, receptor function, or sympathetic nervous system activity. Further studies with larger samples, community-based or matched controls, salivary flow rate measurement, oral health indices, and detailed diabetes-related variables are required to clarify the biological source and clinical relevance of this finding. Keywords: Type 1 diabetes mellitus; Pediatric diabetes; Saliva; Salivary biomarkers; β1-adrenergic receptor; Immunoreactivity; ELISA.

Introduction: To provide a preliminary assessment of patient-reported satisfaction with single-tooth implant restorations in the maxillary esthetic zone and, as an exploratory objective, to evaluate the inter-rater reliability of clinician-rated Pink Esthetic Score (PES) and White Esthetic Score (WES) assessments. Materials and Methods: This preliminary analytical cross-sectional study included 20 adults with a single implant-supported crown in the maxillary esthetic zone. The originally calculated sample size was 27 participants, but recruitment was curtailed to 20 due to COVID-19-related restrictions. Patient satisfaction was assessed using a six-item questionnaire adapted from a previously published instrument. Standardized clinical photographs were independently scored by two experienced prosthodontists using PES/WES. Inter-rater reliability was assessed using Cohen’s kappa coefficients. Because the ratings did not demonstrate adequate reliability, PES/WES scores were treated as exploratory and were not used for clinical classification or confirmatory correlation analyses. Results: Fourteen participants (70%) reported very high overall satisfaction, three (15%) reported high satisfaction, and three (15%) reported moderate satisfaction. No participant selected the very low or low category for any questionnaire item. Overall satisfaction did not differ significantly between women and men (p = 0.750). Kappa coefficients for the individual PES/WES parameters ranged from -0.30 to 0.29, and none demonstrated statistically significant agreement beyond chance. Conclusion: Patient-reported satisfaction with single-tooth implant restorations in the maxillary esthetic zone was generally high. However, PES/WES scoring showed inadequate inter-rater reliability in this sample and could not support conclusions about clinician-rated esthetic outcomes or their relationship with patient satisfaction. These preliminary findings should be interpreted as hypothesis-generating rather than definitive. Future studies should use calibrated evaluators, prespecified reliability criteria, and validated patient-reported outcome measures. Keywords: Dental implants; Esthetics; Dental; Patient satisfaction; Patient-reported outcome measures; Reproducibility of results.

Introduction: The American Academy of Pediatric Dentistry (AAPD) recommends improving oral health behaviors as essential for the prevention of Early Childhood Caries (ECC), and several studies have evaluated different approaches to explaining human behavior through behavioral and cognitive-behavioral theories. This study aimed to explain predictors of mothers’ behavioral intention regarding the oral health of their under-6-year-old children in Iraq based on the Theory of Planned Behavior using structural equation modeling. Materials and Methods: This cross-sectional study was conducted using a multistage random sampling method, including 926 mothers of under-six-year-olds in Iraq in 2023. A valid questionnaire based on the Theory of Planned Behavior evaluated attitude, perceived behavioral control, subjective norms, and behavioral intention. Descriptive analysis and structural equation modeling (SEM) were used to describe the data and examine the association among the variables. Results: Out of 926 children, 59.5% were girls. The mean age of the children was 4.0 (SD = 0.9) years, and the mean age of the mothers was 30 (SD = 5.2) years. The mean scores of the attitude, subjective norms, perceived behavioral control, and behavioral intention were 17.5 out of 20, 14.8 out of 20, 18.7 out of 32, and 20.4 out of 24, respectively. Subjective norm score (estimation = 0.12, p-value < 0.001), perceived behavioral control score (estimate = 0.06, p-value < 0.001), and attitude score (estimation = 0.15, p-value < 0.001) positively predicted behavioral intention, with perceived behavioral control being the strongest predictor. Conclusion: The TPB was supported for predicting behavioral intention in our study population. The health holders should consider the TPB constructs, in particular perceived behavioral control, for improving behavioral intention. Keywords: Children; Preschool; Intention; Oral health; Theory of planned behavior.

Introduction: The eyes are the most visually prominent features of the face; therefore, orbital rehabilitation is one of the most demanding procedures in maxillofacial prosthetics, requiring exceptional skill to achieve a natural appearance. Despite its critical importance, the complexity of fabricating an orbital prosthesis often poses challenges for less experienced clinicians. This paper presents a detailed, step-by-step procedural guide designed to demystify the construction process and make it accessible even to beginners in the field. Materials and Methods: The fabrication protocol follows a sequential workflow, including impression-taking, sculpting the prosthetic form, modeling the ocular component, and mold preparation with appropriate dental and silicone materials. The coloration process is divided into intrinsic (internal) pigmentation during curing and extrinsic (surface) characterization with medical-grade silicone pigments to replicate skin tones, vascular details, and transitional blending. The entire stepwise sequence was systematically documented and applied in a clinical case, with emphasis on replicable techniques for contouring, positioning, and finishing. Results: Application of the sequential guide significantly reduced procedural complexity, enabling a more predictable fabrication process. The resulting orbital prosthesis demonstrated excellent s aesthetic integration with the surrounding facial tissues. Clinical follow-up over four years confirmed sustained functional stability, color retention, and patient satisfaction, with no notable deterioration in the prosthetic fit or appearance. Conclusion: Adhering to a structured, step-by-step methodology is essential for optimizing outcomes in orbital prosthesis fabrication. This approach not only minimizes technical difficulties for practitioners of all experience levels but also ensures durable, natural-looking results, as evidenced by the long-term success observed in the presented case. Keywords: Impression technique; Ocular prosthesis; Orbital prosthesis.

Maxillary osteoblastoma in children is exceptionally rare, accounting for fewer than 5% of all craniofacial cases. This benign bone tumor can closely mimic intraosseous hemangioma both clinically and radiographically due to its highly vascular stroma, leading to diagnostic pitfalls. We report a 5-year-old girl whose maxillary lesion exhibited soft, fluctuant swelling, reddish discoloration, bleeding on touch, and post-extraction hemorrhage—features strongly suggestive of hemangioma. A multidisciplinary approach involving maxillofacial surgery, radiology, and pathology was essential for definitive diagnosis. This case underscores that osteoblastoma must remain in the differential diagnosis of vascular-appearing pediatric maxillary masses, and multidisciplinary collaboration is critical to avoid misdiagnosis. Keywords: Osteoblastoma; Maxilla; Hemangioma.

Tooth transposition poses a significant challenge in dental clinics when it comes to treatment. The exact cause of tooth transposition remains a topic of debate and is still not fully understood. Approximately 20% of transpositions that occur in the upper arch involve the canine and lateral incisor. Although relatively uncommon, transpositions can also affect the upper central and lateral incisors. Among all transpositions, the mandibular lateral incisor-canine transposition is exceptionally rare, with a prevalence rate as low as 0.03%. Tooth transposition in the posterior side of the mandible is an uncommon occurrence. However, the present case report with complete transposition of the mandibular right second premolar erupted in the distal of the mandibular right first molar in a 12-year-old male patient with class II malocclusion is a rare case entity for clinical consideration. The current study proposed a factor or etiology, which is the correlation between the position of the tooth and inadequate growth of the mandible, as a potential explanation for complete transposition involving the mandibular second premolar. Further research and clinical studies are necessary to validate this etiology and gain a better understanding of the underlying mechanisms of tooth transposition. Keywords: Mandibular premolar; Transposition; Mandibular deficiency; Malocclusion; Angle class II.

Odontomas are benign odontogenic tumors classified as either complex or compound, depending on the organization of dental tissue. Complex odontomas are typically located in the posterior mandible and anterior maxilla, whereas compound odontomas are more commonly found in the anterior maxilla. It is rare for both types to be present simultaneously. These tumors usually manifest during the first two decades of life and are evenly distributed between genders. Often asymptomatic, they are frequently discovered during routine dental check-ups, especially when over-retained primary teeth or delayed eruption of permanent teeth are noted. Early diagnosis is crucial, as odontomas can interfere with the normal formation and eruption of teeth. Given these lesions’ benign nature and characteristic appearance, clinical and radiographic evaluations are generally sufficient for initial diagnosis and treatment. However, histopathological analysis and follow-up are advisable to confirm the diagnosis and ensure appropriate management, particularly for younger patients. This study presents an unusual case of complex and compound odontomas in an 8-year-old boy. The odontoma was located in the anterior mandible, an atypical site. Clinical examination revealed slight intraoral swelling in the anterior mandible, an over-retained right primary mandibular central incisor, and an unerupted right permanent mandibular central incisor. Surgical enucleation of the lesion was performed, and histological examination confirmed the diagnosis. Subsequent clinical and radiological assessments did not indicate any recurrence. Keywords: Compound odontoma; Complex odontoma; Odontogenic tumor; Impacted tooth; Delayed tooth eruption.

Polymorphous adenocarcinoma is an uncommon neoplasm of the salivary glands, exhibiting a strong predilection for the minor salivary glands. It is distinguished by its characteristic polymorphous histologic appearance, infiltrative growth pattern, and relatively low potential for metastasis. A 45-year-old male presented with pain and swelling in the posterior palate persisting for two months, accompanied by difficulty in mastication and swallowing. Intraoral examination revealed a well-defined, ovoid swelling on the right side of the palate, displaying a nodular surface and erythematous margins. An excisional biopsy was performed, and histopathological evaluation confirmed the diagnosis of polymorphous adenocarcinoma. Keywords: Polymorphous adenocarcinoma; Polymorphous low-grade adenocarcinoma; Salivary gland neoplasm.

Multiple idiopathic apical root resorption (MIARR) is a rare condition that affects multiple teeth of unknown etiology. This phenomenon is usually identified in clinical examinations or routine radiographs, is painless, and is sometimes accompanied by tooth mobility. Involvement of all permanent dentition is extremely rare. It is mostly seen in females and is usually asymptomatic. Diagnosis and treatment of these resorptive lesions are challenging for clinicians, and usually, the only available treatment is the extraction of all involved teeth. The prognosis for affected teeth is often poor; no treatment or prevention method is known for this phenomenon. The present report describes a 28-year-old male patient who had all his permanent teeth involved. This case is unique in that all teeth are involved in the absence of any systemic disease or local factors. Keywords: Idiopathic root resorption; Multiple root resorption; Root resorption.

Lipomas are the most common benign soft tissue tumors, but they occur only rarely in the oral cavity. Fibrolipoma, an uncommon variant, features mature adipose tissue with a prominent fibrous component, presenting as a slow-growing, asymptomatic mass. This article reports a rare case of hard palate fibrolipoma in a 73-year-old male, initially appearing as a small, asymptomatic, sessile nodule clinically suspected to represent a benign palatal lesion, including irritation fibroma, pleomorphic adenoma, mucocele, and lymphoepithelial cyst. Surgical excision was performed, with histopathology confirming fibrolipoma. No recurrence was observed during 20 months of clinical follow-up. Fibrolipoma of the hard palate is exceptionally rare and may present a diagnostic challenge because of its nonspecific clinical appearance. Histopathological examination remains essential for definitive diagnosis, and complete surgical excision is associated with an excellent prognosis and a very low risk of recurrence.  Keywords: Lipoma; Fibrolipoma; Oral mucosa; Hard palate; Oral neoplasm.