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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.

Objective: The aim was to evaluate the diagnostic accuracy and temporal reproducibility of multimodal large language models (LLMs) in the image-based diagnosis of oral mucosal lesions. Materials and Methods: The study included 100 anonymized clinical photographs of oral mucosal conditions obtained from the archive of the Department of Oral Medicine, School of Dental Medicine, University of Zagreb. Images were categorized into four subgroups: physiological variations, benign mucosal lesions, oral potentially malignant disorders, and oral cancer (25 images each). Three multimodal LLMs (ChatGPT-5.1 Plus, Gemini 3 Pro, and Perplexity Pro) analyzed each image using an identical prompt and were required to provide a single most probable diagnosis based solely on visual features. To evaluate temporal reproducibility, the entire evaluation was repeated in three independent testing cycles conducted at one-month intervals. Diagnostic accuracy was compared using chi-square tests, while intra-model agreement across cycles was assessed using Fleiss’ kappa. Results: Gemini demonstrated the highest diagnostic accuracy, reaching 78% correct responses in cycles 2 and 3, significantly outperforming ChatGPT (55–57%) and Perplexity (28–31%) (p < 0.00001). Subgroup analyses showed similar trends, with Gemini achieving the highest accuracy across most lesion categories. Intra-model agreement across cycles was moderate for ChatGPT (κ = 0.525), fair for Gemini (κ = 0.338) and Perplexity (κ = 0.409). Gemini also showed the highest proportion of responses that remained correct across all three cycles (51%). Conclusions: Multimodal LLMs demonstrate promising diagnostic capabilities in the image-based assessment of oral mucosal lesions; however, variability in reproducibility highlights the need for cautious clinical implementation and further validation.

Background: Artificial intelligence (AI) is expected to play an increasingly important role in medicine and dentistry. While its diagnostic potential has been tested in various medical fields, limited research exists on its applications within oral medicine diagnoses using clinical images. Objective: This pilot study aimed to evaluate the diagnostic accuracy of ChatGPT, Gemini, and Copilot in identifying benign, potentially malignant, and malignant oral lesions. Methods: A cross-sectional study was conducted using clinical images from three categories: benign oromucosal conditions, oral potentially malignant disorders, and malignant oral lesions. Results: ChatGPT evaluated all images and consistently outperformed Copilot—and in some cases Gemini—across multiple diagnostic questions, with statistically significant advantages particularly in the cancer subgroup. Copilot showed the weakest performance, with high rates of missing evaluations and significantly lower proportions of correct responses in several analyses. Across both full-dataset and adjusted analyses, ChatGPT demonstrated the highest diagnostic performance overall. Diagnostic accuracy metrics for malignancy suspicion was similar for ChatGPT and Gemini. Several limitations such as sample size, lack of reproducibility testing and inability of some AI models to process images must be taken into account when interpreting the results. Conclusions: AI tools show promise but cannot yet replace clinical expertise. Further research and development are needed to improve the accuracy and applicability of AI diagnostic tools.

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.

Introduction: Oral cancer (OC) is a disease with a high mortality rate due to its late recognition. Since the oral cavity is easily accessible for visual inspection, enabling early diagnosis, the education of healthcare workers about preventive oral examinations is critical. This research aimed to assess the level of participants’ OC knowledge, as well as to raise awareness about this diagnosis. Materials and methods: The research was conducted as an online survey among students of dental medicine, students of medicine, doctors of dental medicine and doctors of medicine. The questionnaire was designed solely for the purpose of this study and consisted of 29 questions. The first part of the questionnaire consisted of general questions about the participants, whereas the questions in the second part addressed their knowledge and attitudes towards OC. Results: The surveyed population comprised of 140 dental students, 105 medical students, 159 doctors of dental medicine and 100 medical doctors. The level of knowledge about OC among the participants is not yet satisfactory. The group of dental medicine students scored highest, while medical doctors showed the weakest knowledge. Conclusion: Additional education about OC for doctors of dental medicine and medical doctors is needed. This step will improve prevention and increase chances for early detection.

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.

Background: The objective of this study was to determine the most effective treatment option for burning mouth syndrome. Methods: Informative treatment alone, B vitamin injections, oral cavity probiotics, and low-level laser therapy were evaluated and compared. The study included new patients diagnosed with burning mouth syndrome, who were randomly allocated into one of four treatment groups. The primary outcome was improvement in patient’s quality of life as determined by a self-perceived Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire before and after therapy. The secondary outcome was determination of mucosal symptom intensity according to visual analog scale (VAS) grading from 0 to 10. Data were submitted to statistical analysis. Results: A total of 62 patients completed the study. Oral cavity probiotics and LLLT scores for OHIP-14 resulted in a statistically significant difference before and after therapy. Standardized effect sizes between OHIP scores before and after treatment were the greatest for patients who had received oral cavity probiotics. Conclusions: Oral cavity probiotics and LLLT were the most effective treatment for improvement in quality of life. Further investigation on a larger group of patients is required.

Discussion Within published literature, many adverse effects due to azithromycin are reported on the various organs, mainly on the cardiovascular system but also on the gastrointestinal.5 However, regarding dermatological disturbances Nappe et al.6 reported in the year 2016 that azithromycin is not frequently associated with SJS, toxic epidermal necrolysis or other cutanous reactions.A skin biopsy showed evidence of spongiotic lichenoid dermatitis with eosinophils and neutrophils, compatible with a systemic drug-induced hypersensitivity reaction.Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) syndrome associated with azithromycin presenting like septic shock: a case report.ISMP Adverse Drug Reactions: Acute Disseminated Intravascular Coagulation Due to Oxaliplatin Azithromycin-Induced Stevens-Johnson Syndrome Acute Jugular Vein Thrombosis with Rituximab Hemorrhagic Bullae of the Fingers Induced by Furosemide.