Even if the relationship between immunosuppression and increased incidence of systemic cancers is well known, there is less awareness about the risk of developing oral cancer in immunosuppressed patients. The aim of this review was to evaluate the association between immunosuppression and the development of oral cancer. Two authors independently and, in duplicate, conducted a systematic literature review of international journals and electronic databases (MEDLINE via OVID, Scopus, and Web of Science) from their inception to 28 April 2023. The assessment of risk of bias and overall quality of evidence was performed using the Newcastle–Ottawa Scale and GRADE system. A total of 2843 articles was identified, of which 44 met the inclusion criteria and were included in either the qualitative or quantitative analysis. The methodological quality of the included studies was generally high or moderate. The quantitative analysis of the studies revealed that immunosuppression should be considered a risk factor for the development of oral cancer, with a percentage of increased risk ranging from 0.2% to 1% (95% CI: 0.2% to 1.4%). In conclusion, the results suggest that a constant and accurate follow-up should be reserved for all immunosuppressed patients as a crucial strategy to intercept lesions that have an increased potential to evolve into oral cancer.

Background: Oral lichen planus (OLP) is a chronic autoimmune disease of the oral mucosa, classified among potentially malignant oral disorders (OPMDs). It is characterized by keratinocyte apoptosis and persistent inflammation. Standard treatments involve topical corticosteroids administered via mouthwashes, gels, or ointments, but these require frequent application, have limited retention, and may cause side effects. To address these limitations, this study aimed to develop an innovative dexamethasone delivery system targeting the oral cavity, based on poly(lactic acid) (PLA) fibers coated with chitosan (CS) and poly(lactic-co-glycolic acid) (PLGA) nanoparticles. Methods: CS-coated PLA fibers were characterized for their mucoadhesive and cytocompatibility properties, while PLGA nanoparticles were analyzed for size, shape, encapsulation efficiency, cellular uptake, drug release efficiency, and cytocompatibility. Results: Both polymers demonstrated cytocompatibility, and chitosan-coated PLA fibers exhibited mucoadhesive properties. PLGA nanoparticles were effectively internalized by the cells and successfully released the drug into the cytoplasm. The combination of CS-coated PLA fibers and PLGA nanoparticles provided dual benefits: mucoadhesion and efficient cellular uptake, even under conditions simulating salivation. Conclusions: These findings highlight the potential of the proposed system to improve mucoadhesive drug delivery. Further optimization is needed to enhance patient compliance and therapeutic efficacy.

Objectives: This multicentre case–control study aimed to investigate the potential association between oral lichen planus (OLP) and extraoral cancers. The secondary objective included the identification of risk factors for this association. Methods: The study was conducted between January 2023 and June 2024 and included 21 Italian Oral Medicine centres affiliated with the Italian Society of Oral Medicine (SIPMO). The study protocol was approved by the Ethics Committee of Università Cattolica del Sacro Cuore (Prot. ID 4073) and registered at clinicaltrials.gov (ID NCT06449248). Results: In total, 1650 participants were enrolled (550 OLP and 1100 non‐OLP patients) matched for age and sex. OLP patients showed a significantly higher prevalence of extra‐oral cancers (19.8%) compared to controls (12.4%) with a 1.79 OR (1.34–2.39, p < 0.05). Moreover, erosive OLP ( n = 32/120, 26.7%, p < 0.01) and plaque‐like variants ( n = 27/114, 23.7%, p < 0.04) seem to have a slightly increased risk of extra‐oral cancer. Conclusions: Patients with OLP had a higher risk of developing extraoral cancer; moreover, erosive and plaque‐like forms could be considered at higher risk. Potential pathogenic mechanisms involve an interplay between chronic inflammation, immune dysregulation and carcinogenesis. Therefore, the directionality of such association remains unclear, underscoring the need for prospective studies to clarify causality and temporal dynamics.

Glioblastoma (GB) is an extremely aggressive, highly invasive brain tumor of astrocytic or oligodendrocyte glial origin. This tumor often infiltrates adjacent healthy brain tissue and can migrate significant distances from the primary tumor site. Given the poor overall survival of GB patients and the limited efficacy of current local and systemic treatments, new therapeutic strategies are needed to improve outcomes, reduce side effects, and enhance patients’ quality of life. In recent years, the potential chemotherapeutic effects of natural molecules have been investigated, either as primary agents or in combination with established chemotherapies in various types of cancer. Melatonin (MLT, N-acetyl-5-methoxytryptamine) is an endogenous indolamine primarily secreted by the pineal gland. MLT appears to discriminate between normal and tumoral cellular contexts and to modulate appropriate actions, thereby acting as a “smart killer” against cancer cells; however, further studies are needed to clarify this apparently paradoxical behavior. This review aims to summarize recent findings on the potential regulatory role of MLT in the modulation of key intracellular pathways in GB, underlining its potential role as a complementary adjuvant to conventional therapies. The clinical advantage of MLT in GB patients has not been demonstrated in randomized controlled trials; therefore, multicenter studies with well-defined objectives, appropriate dosage schedules, and clear patient classification are needed.

Objectives: The aim of this observational case‒control study was to compare the oral health (OH) status of Bone metastatic cancer (BMC) patients (case Group 1), head and neck cancer HNC patients (case Group 2) and systemically healthy patients (control group). The secondary objective was to identify any risk factors associated with poor OH status. Methods: This study was conducted from 2018–2024, and all patients were evaluated at the Oral Medicine, Head and Neck Department—Fondazione Policlinico Universitario A. Gemelli—IRCSS, Rome. The OH status was clinically and radiographically evaluated using the DMFT index, a full periodontal chart and a radiological examination (orthopantomography). The OH status was defined as “poor” in patients with stage III or IV periodontitis and/or a DMFT score ≥ 13. The study protocol was approved by the Ethics Committee of the Università Cattolica del Sacro Cuore (ID-5746). Univariate statistical analysis was performed to detect associations between different clinical variables and OH. The associated variables were subjected to multivariate logistic regression to retrieve the independent risk factors for poor OH. Results: A total of 510 (170 per group) patients were analyzed. Logistic regression analysis revealed that HNC patients showed significantly worse oral conditions when compared to BMC patients and controls. HNC patients showed an OR of 2.36 (95% CI: 1.35–4.13, p = 0.003) for poor OH when compared to control group. No differences were found between BMC patients and control group. Smoking habits (OR: 3.22, 95% CI: 1.93–5.35, p < 0.0001), and age > 70 years (OR: 17.44, 95% CI: 8.78–34.66, p < 0.0001) were other significant risk factors for poor OH. The risk decreased for younger patients: for patients aged 60–69 years, the OR was 5.17 (95% CI: 2.74–9.75, p < 0.0001); for patients aged 50–59 years, it was 4.22 (95% CI: 2.30–7.76, p < 0.0001). Conclusions: HNC patients exhibit significantly poorer OH than BMC patients and healthy controls, highlighting the need for enhanced dental care in oncologic management. Nevertheless, smoking habits and age remain important risk factors.

Background/Objectives: To evaluate whether mandibular third molar germectomy is associated with differences in neurosensory injury, postoperative complications, and patient-centred outcomes compared with delayed extraction. Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, Cochrane Library, LILACS, and Google Scholar. Comparative studies including pediatric or adolescent patients undergoing mandibular third molar germectomy were included. Primary outcomes were inferior alveolar nerve (IAN) injury and overall postoperative complications; secondary outcomes included postoperative morbidity and patient-reported outcome measures (PROMs). Random-effects models were used for quantitative synthesis. Results: Ten studies met the inclusion criteria, including two randomized controlled trials and eight observational studies. Comparative evidence suggested that early removal at an immature developmental stage was associated with a lower risk of IAN injury (pooled RR = 0.05, 95% CI 0.01–0.37) and fewer overall postoperative complications (pooled RR = 0.29, 95% CI 0.20–0.42) compared with delayed extraction. However, certainty of evidence was limited due to heterogeneity, risk of bias, and potential confounding. PROMs consistently showed a short-term increase in pain and temporary quality-of-life impairment after germectomy, while delayed-onset infections were reported several weeks after surgery. Conclusions: Germectomy may reduce neurosensory risk and overall postoperative morbidity in selected developmental-age patients but entails a measurable short-term symptom burden. Decisions should therefore rely on individualized risk assessment and shared decision-making rather than routine preventive removal. Further prospective comparative studies with standardized outcome reporting are required to support definitive clinical recommendations.