The topography and composition of dental implant surfaces directly impact mesenchymal cell adhesion, proliferation, and differentiation, crucial aspects of achieving osseointegration. However, cell adhesion to biomaterials is considered a key step that drives cell proliferation and differentiation. The aim of this study was to characterize characterize the topography and composition of commercial titanium dental implants manufactured with different surface treatments (two sandblasted/acid-etched (SLA) (INNO Implants, Busan, Republic of Korea; BioHorizons^TM, Oceanside, CA, USA) and two calcium phosphate (CaP) treated (Biounite^®, Berazategui, Argentina; Zimmer Biomet, Inc., Warsaw, IN, USA)) and to investigate their influence on the process of cell adhesion in vitro. A smooth surface implant (Zimmer Biomet, Inc.) was used as a control. For that, high-resolution methodologies such as scanning electron microscopy (SEM), X-ray dispersive spectroscopy (EDX), laser scanning confocal microscopy (LSCM), and atomic force microscopy (AFM) were employed. Protein adsorption and retromolar gingival mesenchymal stem cells (GMSCs) adhesion to the implant surfaces were evaluated after 48 h. The adherent cells were examined by SEM and LSCM for morphologic and quantitative analyses. ANOVA and Tukey tests (α = 0.05) were employed to determine statistical significance. SEM revealed that INNO, BioHorizons^TM, and Zimmer implants have an irregular surface, whereas Biounite^® has a regular topography consisting of an ordered pattern. EDX confirmed a calcium and phosphate layer on the Biounite^® and Zimmer surfaces, and AFM exhibited different roughness parameters. Protein adsorption and cell adhesion were detected on all the implant surfaces studied. However, the Biounite^® implant with CaP and regular topography showed the highest protein adsorption capacity and density of adherent GMSCs. Although the Zimmer implant also had a CaP treatment, protein and cell adhesion levels were lower than those observed with Biounite^®. Our findings indicated that the surface regularity of the implants is a more determinant factor in the cell adhesion process than the CaP treatment. A regular, nanostructured, hydrophilic, and moderately rough topography generates a higher protein adsorption capacity and thus promotes more efficient cell adhesion.

Background: Older adults in rural or underserved settings face persistent access barriers. Digital and remote health interventions may mitigate these gaps. Objective: The aim of this study is to assess technologies, effectiveness, and implementation challenges of digital or remote health interventions for adults ≥60 years old in rural or underserved contexts. Methods: A systematic search was conducted in 4 electronic databases, such as PubMed, Scopus, Web of Science, and Embase (inception: April 2025), under dual screening by 2 reviewers. The tool Cochrane Risk of Bias 2.0 was used to assess the risk of bias for randomized trials, and Risk Of Bias In Non-randomized Studies–of Interventions (ROBINS-I) was used for nonrandomized trials. For observational studies, we used the National Institutes of Health quality assessment tool, and a narrative synthesis was performed. Results: Fourteen studies met the inclusion criteria (randomized and nonrandomized designs; median follow-up ~12 mo). Ten of 14 (71%) reported significant improvements in at least 1 clinical end point (eg, hemoglobin A _1c , blood pressure, and weight), 11 of 14 (79%) improved behavioral or psychosocial outcomes, and 5 of 9 (56%) reduced hospitalizations or acute episodes. Risk-of-bias concerns most frequently related to missing data and selective reporting. Digital literacy and broadband access were the most consistent barriers, while multicomponent, nurse-supported models achieved higher adherence. Equity-related dimensions (place, gender, and socioeconomic status) were variably reported, with limited attention to language, cultural tailoring, or social capital. No study included a formal cost-effectiveness analysis. Conclusions: Digital and remote health interventions can benefit older adults in rural and underserved settings by improving selected clinical and behavioral outcomes. However, heterogeneity, small sample sizes, and the absence of economic evaluations temper certainty. Importantly, gaps in equity reporting and persistent barriers to digital inclusion highlight the need for future trials to integrate PROGRESS-Plus (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other context-specific determinants of health equity) dimensions, embed cost-effectiveness assessments, and design interventions that are both sustainable and accessible to the most underserved populations.

Background: Children living in underserved and rural areas experience significant barriers to healthcare access due to geographic isolation, health workforce shortages, and systemic inequities. Digital and remote health interventions such as telehealth, telemental health (TMH), and mobile health (mHealth) offer promising strategies to improve pediatric health outcomes in these contexts. However, the extent of their effectiveness remains insufficiently examined through high‐quality evidence. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and structured using the PROPS framework. Five databases (PubMed, Scopus, Web of Science, Embase, and Cochrane Library) were searched for randomized controlled trials (RCTs) published until May 2025. Eligible studies targeted children (0–17 years) in underserved or rural settings and evaluated digital or remote interventions versus standard care. Data were extracted on study design, population, intervention modality, outcomes, and implementation characteristics. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Results: Eleven RCTs were included, covering interventions for obesity, asthma, ADHD, diabetes, oral health, and neonatal care. Telehealth interventions improved behavioral and biometric outcomes (e.g., BMI z ‐score, and adherence), particularly in the United States. TMH showed high fidelity and effectiveness for ADHD management. mHealth interventions in low‐ and middle‐income countries enhanced referral rates, service coverage, and caregiver engagement. Most studies were rated low risk of bias, though few incorporated economic or equity analyses. Conclusions: Digital health interventions are effective and feasible for improving pediatric outcomes in underserved settings. Future research should emphasize long‐term impact, cost‐effectiveness, and equitable access to ensure sustainable and inclusive digital healthcare delivery.

Laser acupuncture, defined as photobiomodulation or low-level laser therapy applied to specific acupuncture points, has been proposed as a non-invasive adjunctive strategy in oral and dental care. This umbrella review aimed to synthesize and critically appraise systematic reviews evaluating laser acupuncture in dental and orofacial conditions. The review followed PRISMA 2020 recommendations and was prospectively registered in PROSPERO. PubMed, Embase, Scopus, Web of Science, and the Cochrane Library were searched from inception to 12 May 2026. Systematic reviews with or without meta-analysis were included. Methodological quality was assessed using AMSTAR 2, and findings were narratively synthesized considering methodological quality, overlap, consistency, dosimetric heterogeneity, and clinical applicability. From 263 records identified, six systematic reviews published between 2021 and 2024 met the eligibility criteria. The included reviews addressed three main domains: temporomandibular disorders, dental-related neuropathies, and pediatric dental outcomes. Laser acupuncture protocols used red to near-infrared wavelengths, mainly between 690 and 980 nm, but varied substantially in fluence, energy delivery, irradiation time, session frequency, and acupoint selection. The most consistent signal was observed for short-term pain reduction in temporomandibular disorders, although comparative evidence did not support laser acupuncture as superior to established conservative therapies. Evidence for dental-related neuropathies was associated with possible improvements in neurosensory and motor outcomes, while pediatric evidence suggested possible short-term changes in gag reflex, procedural pain, and bruxism-related outcomes; however, both domains were supported by only one systematic review each and should be considered preliminary and hypothesis-generating. No serious adverse events were reported, but harm reporting was limited. Overall, this umbrella review should be interpreted as an evidence map rather than as a source of high-certainty clinical recommendations. Laser acupuncture may represent an emerging adjunctive approach for selected dental and orofacial indications; however, current evidence remains limited and heterogeneous and does not support standardized protocols, stand-alone use, or definitive clinical recommendations.