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Elevated C-reactive Protein Levels and Malignant Transformation Risk in Patients With Oral Mucosal Diseases

2026-08-01T00:00:00Z

Title: Elevated C-reactive Protein Levels and Malignant Transformation Risk in Patients With Oral Mucosal Diseases Authors: Kang, Jeong-Hyun Abstract: Introduction and aims: Chronic inflammation is recognised as a hallmark of cancers. This multicentre cohort study investigated the influence of elevated serum C-reactive protein (CRP) levels on the malignant transformation risk of oral inflammatory diseases and lesions with malignant potential utilising the Observational Medical Outcomes Partnership Common Data Model. Methods: This retrospective, observational cohort study included the data from 9 medical centres. CRP levels recorded within 30 days of oral diseases diagnosis were analysed. A meta-regression identified 0.269 mg/dL as the optimal threshold for predicting malignancy. Patients were classified into elevated CRP (CRP >= 0.269 mg/dL) and control (CRP <0.269 mg/dL) groups. Cox proportional hazard models were applied to estimate risk of developing oral squamous cell carcinoma (OSCC), followed by 1:1 and 1:2 propensity score matching and pooled meta-analyses. Results: In total, 10029 individuals with oral diseases and available CRP data were included, comprising 4142 and 5887 in the elevated CRP and control groups, respectively. Overall, 204 individuals (2.03%) progressed to OSCC, with higher incidence in the elevated CRP group (2.32%) compared with controls (1.83%). Elevated CRP was significantly associated with increased OSCC risk in both 1:1 (HR = 1.79 [95% CI 1.08-2.95]), and 1:2 propensity score matching models (HR = 1.55 [95% CI 1.01-2.38]). Conclusions: Elevated CRP levels, indicative of systemic inflammation, were linked to an increased risk of malignant progression in patients with inflammatory oral conditions and lesions with malignant potential. Understanding the role of inflammation may help assess OSCC risk and improve prevention. (c) 2026 The Authors. Published by Elsevier Inc. on behalf of FDI World Dental Federation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Clinical utility of biofluorescence imaging for detecting secondary caries beneath esthetic restorations

2026-06-01T00:00:00Z

Title: Clinical utility of biofluorescence imaging for detecting secondary caries beneath esthetic restorations Authors: Kang, Gwen Woung; Kim, Sang-Kyeom; Lee, Eun-Song; Kim, Baek-Il; 김상겸 Abstract: Secondary caries represents a major cause of failure in esthetic restorations; however, early lesions beneath restorations are difficult to detect using conventional visual and radiographic examinations. This case report presents two clinical cases in which Quantitative light-induced fluorescence (QLF) imaging with Qraypen C (AIOBIO, Seoul, Republic of Korea) was used to overcome the limitations of traditional diagnostic methods and to effectively diagnose and manage secondary caries beneath esthetic restorations. In the first case involving tooth #27 of a 34-year-old female patient, distinct red fluorescence in the QLF image corroborated the presence of deep secondary caries suspected on radiographs and facilitated the treatment planning for root canal therapy. In the second case involving tooth #16 of a 31-year-old female patient, localized red fluorescence detected exclusively on the QLF image guided early preventive intervention, confirming a previously undetectable subclinical lesion and preserving pulp vitality. QLF technology enables the early visualization of secondary caries that are difficult to detect clinically or radiographically, thereby improving diagnostic accuracy. By providing information on lesion activity, QLF supports clinical decision-making across a range of treatment strategies, from early intervention to endodontic therapy, and serves as a valuable tool for enhancing communication with patients.

Hyperdiluted triamcinolone injection therapy for infraorbital herniated fat pads

2026-05-01T00:00:00Z

Title: Hyperdiluted triamcinolone injection therapy for infraorbital herniated fat pads Authors: Semenovych, Tamara; Rosellini, Isabella; Min, Jessie Lim Jia; Layrenshia, Belinda; Sobchyshyn, Mariya; Kim, Jin-Hyun; Yi, Kyu-Ho; 이규호 Abstract: Background: Infraorbital herniated fat pads are a frequent aesthetic concern and are commonly corrected surgically. Some patients prefer minimally invasive options, yet robust non-surgical volume-reduction approaches remain limited. Intralesional triamcinolone acetonide (TAC) is widely used in dermatology and other fields, and localized cutaneous/subcutaneous atrophy and lipoatrophy are recognized adverse effects. Objective: To report outcomes after treating infraorbital herniated fat pads with hyperdiluted TAC prepared at a 1:20 dilution with normal saline and to discuss steroid-related mechanisms affecting adipose tissue. Materials and methods: We conducted a retrospective case series of nine non-aesthetic-treated patients with infraorbital fat pad protrusion requesting non-surgical management. TAC was hyperdiluted 1:20 with 0.9% normal saline and injected as micro-aliquots into the target fat pad at the lid-cheek junction. Patients received 1-3 sessions at 4-week intervals. Standardized photographs were obtained at baseline and follow-up. Two independent physicians graded improvement using the Global Aesthetic Improvement Scale (GAIS), and patients rated satisfaction using a 5-point Likert scale. Adverse events were recorded. Results: Visible reduction of infraorbital bulging was observed in all patients (9/9). Improvement typically became apparent over several weeks and progressed through follow-up. Mild-to-moderate protrusion generally responded after one or two sessions, whereas more advanced bulging required up to three sessions with partial residual fullness. No serious complications were observed; transient edema, erythema, and tenderness resolved spontaneously. Conclusion: Hyperdiluted TAC (1:20 with normal saline) may provide a conservative, minimally invasive approach to reduce small-volume infraorbital fat protrusion, plausibly through controlled steroid-associated adipose atrophy. Given the known risk of unwanted atrophy, dyspigmentation, and contour irregularity with corticosteroid injections, this approach should be considered investigational and applied cautiously with appropriate anatomical expertise and follow-up. (c) 2026 The Authors. Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Alteration in oral and non-oral tissues in ligature-induced periodontitis mice with the Alzheimer's disease risk factor APOE4

2026-04-01T00:00:00Z

Title: Alteration in oral and non-oral tissues in ligature-induced periodontitis mice with the Alzheimer's disease risk factor APOE4 Authors: Kim, Ae Ri; Yoo, Yun-Jung; Bak, Eun-Jung; 김애리 Abstract: The APOE4 gene, particularly the epsilon 4 allele, is linked to susceptibility to Alzheimer's disease, and periodontitis can cause pathological changes in multiple organs, but combined effects of these conditions and the impact of tumor necrosis factor (TNF)-alpha regulation on the combined effects remain unclear. We examined the alterations in oral and non-oral tissues in APOE4-knockin mice with periodontitis and evaluated the effects of infliximab, a TNF-alpha inhibitor. Mice were grouped as control, periodontitis, APOE4-knockin, APOE4-knockin with periodontitis, infliximab-treated periodontitis, and infliximab-treated APOE4-knockin with periodontitis. There were no differences in alveolar bone volume and periodontal inflammatory cells among all periodontitis-induced groups. The APOE4-knockin with periodontitis group showed a decrease in hippocampal Cornu Ammonis 1 neurons (p < 0.05) and increased renal and hepatic fibrosis (p < 0.05) compared to control group. The infliximab-treated APOE4-knockin with periodontitis group had even greater neuronal loss (p < 0.001) and renal fibrosis (p < 0.01). Glial fibrillary acidic protein mRNA expression, a marker of astrocyte activation, was higher in the infliximab-treated APOE4-knockin with periodontitis group than in the control group. These suggest that APOE4 with periodontitis worsens neuronal loss and renal and hepatic fibrosis, and TNF-alpha inhibition in this coexistence may have harmful effects on both the brain and kidney.