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Osteonecrosis of the jaw is a condition in which bone cells die due to various causes. It is classified as drug-induced jaw osteonecrosis, osteoradionecrosis, traumatic, non-traumatic, and spontaneous osteonecrosis. Antiresorptive or antiangiogenic drugs cause drug-induced osteonecrosis. The combination of medications, microbial contamination, and local trauma induces this condition. Osteoradionecrosis is a severe radiation therapy side effect that can affect people with head and neck cancer. It is described as an exposed bone area that does not heal for longer than three months after the end of radiation treatment with the absence of any indications of an original tumor, recurrence, or metastasis. Trauma (tooth extraction), tumor site, radiation dose that the patient receives, the area of the bone which is irradiated, oral hygiene, and other factors are risk factors for the development of osteonecrosis. Less frequently, osteonecrosis can also be induced by non-traumatic and traumatic causes. Non-traumatic osteonecrosis is brought on by infections, acquired and congenital disorders, as well as the impact of chemicals. Traumatic osteonecrosis is brought on by thermal, mechanical, or chemical damage. The treatment of osteonecrosis can be conservative, which aims to be beneficial for the patient’s quality of life, and surgical, which involves debridement of the necrotic bone.

This study aims to evaluate the potential benefits and challenges of integrating oral microbiome research into the clinical management of oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC). The oral microbiome has gained significant attention for its role in the pathogenesis and progression of these conditions, with emerging evidence suggesting its value as a diagnostic and prognostic tool. By critically analyzing current evidence and methodological considerations, this manuscript examines whether microbiome analysis in biopsy samples can aid in the early detection, prognosis, and management of OPMD and OSCC. The complexity and dynamic nature of the oral microbiome require a multifaceted approach to fully understand its clinical utility. Based on this review, we conclude that studying the oral microbiome in this context holds significant promise but also faces notable challenges, including methodological variability and the need for standardization. Ultimately, this manuscript addresses the question, “Should such research be undertaken, given the intricate interactions of various factors and the inherent obstacles involved?”, and also emphasizes the importance of further research to optimize clinical applications and improve patient outcomes.

Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology which affects the oral mucosa. OLP varies in its clinical features from a reticular form that is, in most cases, asymptomatic, to atrophic–erosive, and is accompanied by symptoms of burning sensation and pain followed by difficulty in eating. Given the fact that OLP is a disease of unknown etiology, the treatment is symptomatic and involves suppressing the signs and symptoms of the disease using various topical and systemic drugs. The first line of therapy for treating symptomatic OLP is topical corticosteroids, whereas systemic corticosteroids are used for treating persistent lesions that do not respond to local treatment. However, the lack of convincing evidence on the efficacy of previous therapies, including topical corticosteroids, and numerous side effects that have appeared over recent years has resulted in the emergence and development of new therapeutic options. Some of the therapies mentioned are tacrolimus, efalizumab, dapson, interferon, retinoic acid, photochemotherapy with psoralen and ultraviolet A rays (PUVA), aloe vera, antimalarials, antibiotics and others. These therapies only partially meet the properties of efficacy and safety of use, thus justifying the continuous search and testing of new treatment methods.

Antibiotic prophylaxis in dentistry has been recommended for different groups of patients, such as patients with impaired immunologic function, patients at risk of developing infective endocarditis or prosthetic joint infection, patients previously exposed to high-dose irradiation of the head and neck regions, and patients receiving intravenous bisphosphonate and antiangiogenic treatment. The guidelines have been changed over the years, and the list of medical conditions requiring antibiotic prophylaxis has been shortened considerably in the context of antibiotic resistance and unnecessary antibiotic prescription.

Background/Objectives: Epidermoid cysts are benign lesions originating from germinative epithelium, characterized by a keratin-filled cavity. They are histopathologically classified as epidermoid, dermoid, or teratoid. Intraoral cases are exceedingly rare, comprising less than 0.01% of all oral cystic lesions, most frequently affecting the floor of the mouth. While usually asymptomatic, they may become painful due to infection or growth. Because of their rarity in sites such as the upper lip, they may be clinically misdiagnosed, making awareness crucial for accurate management. Methods: Diagnosis is primarily clinical and histopathological, with imaging reserved for complex or deep-seated lesions. Complete surgical excision is the standard treatment to prevent recurrence. In this case, diagnostic evaluation included careful clinical inspection, assessment of consistency and mobility, and excisional biopsy with subsequent histopathological confirmation. Results: We report a rare case of a 68-year-old female presenting with a painless, slow-growing swelling of the upper lip. Clinical examination revealed a solitary, whitish, mobile lesion. Histopathological analysis confirmed an epidermoid cyst. The lesion was surgically excised under local anesthesia, with no recurrence observed at six-month follow-up. The outcome highlights the success of surgical management and the importance of monitoring even when the lesion appears benign. Conclusions: Although uncommon in the upper lip, epidermoid cysts should be considered in the differential diagnosis of submucosal swellings. Complete surgical excision offers a favorable outcome and prevents recurrence. Reporting such rare presentations expands clinical awareness and assists in differentiating these lesions from other pathologies of the oral cavity.

Desquamative gingivitis (DG) is a clinical presentation characterized by erythema, epithelial desquamation, and mucosal fragility, commonly associated with immune-mediated diseases such as oral lichen planus (OLP), mucous membrane pemphigoid (MMP), and pemphigus vulgaris (PV). While traditionally viewed as a manifestation of immune dysregulation, growing evidence suggests that the oral microbiome may modulate disease onset, persistence, and severity. This review summarizes current knowledge on the oral microbiota in DG and its underlying diseases, explores mechanistic links between dysbiosis and immune activation, and discusses clinical and research implications. A narrative literature review was conducted using PubMed and Scopus, focusing on studies analyzing the oral microbiome in OLP, MMP, and PV. Emphasis was placed on molecular microbiology techniques, immune profiling, and functional or longitudinal approaches. In OLP, microbial dysbiosis is consistently reported, including reduced diversity and increased abundance of pro-inflammatory genera such as Fusobacterium, Prevotella, and Capnocytophaga. These shifts correlate with epithelial barrier disruption and inflammatory cytokine production. Although data on MMP and PV are limited, early findings suggest microbial involvement in sustaining inflammation, delaying healing, and possibly amplifying autoimmune responses. Dysbiosis may activate Toll-like receptors, skew T cell responses, and contribute to the breakdown of immune tolerance. DG may reflect a dynamic interplay between immune mechanisms and microbial ecology. While evidence is strongest for OLP, preliminary data suggest broader microbial contributions across DG-associated diseases. Microbiome-informed approaches could enhance diagnostic accuracy and support the development of adjunctive therapies.

Objectives: Burning mouth syndrome (BMS) is a chronic, painful, idiopathic condition of the oral cavity, characterized by the absence of visible pathological changes on the oral mucosa and normal laboratory findings. Recent evidence from the literature supports the classification of BMS as a neuropathic condition. It has been proposed that oxidative stress may contribute to neuropathic pain. N-acetylcysteine (NAC) is an antioxidant that exhibits neuroprotective properties. The aim of the study was to evaluate the efficacy of N-acetyl cysteine in the treatment of burning mouth syndrome (BMS). Methods: Eighty female patients with previously diagnosed BMS were randomly assigned to one out of two groups. One group received N-acetyl cysteine (600 mg/twice a day) and the other received placebo, for an eight-week period. The outcome was measured by the Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire and Numeric Pain Rating Scale, for burning and discomfort, both before and after completing the therapy. Results: Both groups experienced a significant reduction in burning and discomfort sensations, along with a significant improvement in oral health-related quality of life. However, the difference between the treatment and control group was not statistically significant. Conclusions: NAC does not significantly improve the oral health-related quality of life, burning sensations, and discomfort in BMS subjects compared to placebo.

Objectives: The aim of the study was to investigate caries experience in correlation with self-reported oral health-related habits in a sample of blind and low-vision individuals in Croatia. Methods: The study is a part of the research in the “Project for Oral Health Promotion in Blind and Visually Impaired Persons” conducted at the Zagreb University School of Dental Medicine from 2014 to 2018. The final sample consisted of 85 adults: 42 females and 43 males; 50 blind and 35 low-vision individuals, age range 18–98. The assessment included dental examination and a questionnaire. Results: The median DMFT (Decayed, Missing, and Filled Teeth) index score was 17.0 (IQR = 12.5–22.0), with no significant difference between sexes or between blind and low-vision individuals. The occurrence of untreated caries was low (median D-component = 1.0), while the median F-component was 6.0. There was a significant increase in M-component and DMFT in older age groups. The number of untreated caries (D-component) was significantly correlated with consummation of soft drinks and smoking. Total DMFT did not correlate with frequency of tooth brushing, time since last dental visit, smoking, or level of education. Conclusions: This study revealed high caries experience among blind and visually impaired individuals that did not correlate with factors that normally influence oral health. Similar results were found in the control group, reflecting a 30-year post-war period without organized preventive care. The low number of decayed teeth reflects the availability of public dental care in Croatia; however, preventive care should be provided for both this vulnerable group and the general population.

The objective of our study was to investigate salivary levels of estradiol, progesterone and dehydroepiandrosterone (DHEA), and quality of life, in female postmenopausal women with burning mouth syndrome. The study included new patients diagnosed with burning mouth syndrome and excluded local and systemic causes. Unstimulated saliva samples were taken in the morning from 9 AM and 11 AM and immediately frozen for hormone analysis. The patients filled out a self-perceived quality of life questionnaire Oral Health Impact Profile-14 and determined the intensity of mucosal symptoms according to the visual-analog scale grading 0 to 10. A total of 40 patients were included. The study group had significantly lower levels of salivary estradiol. No difference was observed in levels of progesterone and DHEA between the groups. The levels of salivary hormones did not exhibit a significant correlation according to the Spearman correlation test with a self-perceived quality of life questionnaire (OHIP-14) in the study group or in the control group. Further research on a larger number of patients is needed to verify these results. This information might help to enable more precise and efficient treatment.

Objectives: Oral mucositis (OM) occurs in more than 95% of patients irradiated in the head and neck area. This paper aims to determine the occurrence and characteristics of OM in patients with head and neck cancer (HNC), as well as the involvement of dentists/oral medicine specialists in treating such patients. Methods: This study was conducted at the Department of Otorhinolaryngology and Department of Oral Medicine, University Hospital Center Zagreb, from April to August 2022, on patients irradiated in the head and neck area. A unique OM questionnaire was created on the incidence, characteristics, oral care, and involvement of dentists in the overall care. Results: Thirty patients filled out the questionnaire. Of the 22 patients who had developed OM, 14 had grade-three OM. Ten patients were treated for OM in line with the instructions of an oral medicine specialist, eight based on the instructions of a specialist responsible for monitoring of the underlying disease, and four were not treated at all. Sixteen patients had not been referred to a dentist before the start of RT. Conclusions: These results showed insufficient care and treatment of OM, as well as insufficient involvement of dentists in the oncology team.