Large language models (LLMs) have become increasingly integrated into healthcare communication, including dentistry. However, the extent to which they are

Patients prescribed anticoagulants, even a seemingly uncomplicated extraction can pose a significant clinical risk of protracted or substantial bleeding. The aim of this study was to evaluate postoperative bleeding, pain scores, and oral healing parameters in patients undergoing tooth extractions while continuing direct oral anticoagulant (DOAC) therapy, compared to healthy controls. A prospective, single-blind case-control study was conducted involving 211 patients receiving DOAC therapy (apixaban, dabigatran, edoxaban, rivaroxaban) and 219 healthy control participants without anticoagulant therapy. Postoperative bleeding was assessed using a five-level bleeding grade on day 7, alongside pain evaluation via the Visual Analog Scale (VAS) and clinical assessment of erythema, edema, suppuration, and bone exposure. The data were analysed using Chi-square, Kruskal-Wallis H and Mann-Whitney U tests. Significance level was considered as 0.05. Minimal postoperative bleeding was observed in most patients, regardless of anticoagulation status. However, higher bleeding grades were more common in the DOAC group, particularly among rivaroxaban (grade 2–2 in 6.9% and grade 3 in 13.8%) and edoxaban (3.6% and 7.3%, respectively) takers. Pain scores were similar across groups (mean VAS: case group 4.01 ± 2.01, control group 3.95 ± 2.04; p = 0.848). Erythema/edema rates did not significantly differ between groups (p = 0.930), whereas bone exposure was more frequent in the DOAC group (p = 0.039). No significant differences in suppuration rates were found (p = 0.548). Continuing DOAC therapy during tooth extractions appears clinically safe when meticulous surgical techniques and local hemostatic measures are employed. Although bleeding severity may vary among different DOACs, overall outcomes remain manageable. These findings support an individualized, risk-based perioperative approach rather than routine anticoagulant discontinuation.

Temporomandibular disorders (TMD) are common among undergraduate dental students and have been associated with sleep disturbances. Dental students may be particularly vulnerable due to the academic and clinical demands of their education. This study aimed to evaluate the association between TMD-related clinical signs and sleep quality among undergraduate dental students. This cross-sectional study included 210 undergraduate dental students classified as TMD-positive (≥ 1 clinical sign: TMJ pain, clicking, or functional limitation, n = 115) or TMD-negative (no clinical signs, n = 95). Students with a history of temporomandibular joint treatment, current orthodontic treatment, diagnosed psychiatric disorders, chronic systemic diseases, or regular use of medications affecting sleep were excluded. TMD status was determined based on clinical findings, including joint pain, clicking, and functional limitation. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Total PSQI scores were analyzed as both continuous and categorical variables (cut-off > 5). Data were analysed using non-parametric tests and Chi-Square/Fisher's Exact tests and associations with poor sleep quality (PSQI > 5) were examined using modified Poisson regression with robust standard errors to estimate aPRs (95% CIs) including a TMD×sex interaction (two-sided α = 0.05). Poor sleep quality (PSQI > 5) was more frequent among students with TMD than those without TMD (100% and 93.68%, respectively; p = 0.008) and in females than in males (100% and 92.86%, respectively; p = 0.004). PSQI scores increased across academic years and proportion of students classified as poor sleepers differed by year (p = 0.0008). In modified Poisson regression adjusted for sex, academic year and age, TMD was independently associated with poor sleep (aPR = 1.04, 95% CI 1.006-1.075; p = 0.019). A significant TMD×sex interaction indicated effect modification by sex; the association was evident among males (male-stratified aPR = 1.11, 95% CI 1.02-1.21; p = 0.015), while estimation within females was not feasible due to universal poor sleep. TMD-related clinical signs were associated with poorer sleep quality among dental students. These findings indicated that sleep disturbances and TMD-related symptoms frequently co-occur in this population. Given the cross-sectional design, causal inferences cannot be drawn, and longitudinal studies are warranted.

This study compared the wound-healing response and osteogenic gene expression profile of osteoblasts exposed to pediatric-equivalent concentrations of dexmedetomidine (DXMT) and propofol (POF). Human osteoblast-like SAOS-2 cells were assigned to control, low- and high-dose DXMT and POF groups based on pharmacokinetically derived free-drug levels. Scratch-wound closure was quantified over 24 h, and expression of osteogenesis- and cytoskeleton-related genes (RANKL, RUNX2, SP7, BMP2, VIM, VCL, OCN, ALP) was measured by SYBR Green quantitative Polymerase Chain Reaction (qPCR). Normality was assessed using the Shapiro–Wilk test, and group differences were analyzed with two-way ANOVA followed by Tukey’s multiple comparisons test (p < 0.05). All groups demonstrated complete scratch closure by 24 h, with no differences at 6 h. At 18 h, POF did not differ from the control, whereas DXMT significantly accelerated closure at both doses in a dose-dependent fashion. High-dose DXMT significantly increased VIM (3.95 ± 3.12, p = 0.0144) and BMP2 (2.28 ± 0.70, p = 0.0002) expression, while RUNX2, SP7, and RANKL remained comparable to controls. ALP (1.68 ± 0.40, p = 0.0005) and OCN (3.31 ± 0.35, p = 0.0108) were significantly elevated only in the high-dose DXMT group, whereas POF showed no significant effects. At clinically relevant concentrations, DXMT was associated with enhanced scratch closure and increased expression of selected osteogenesis- and cytoskeleton-related genes in SAOS-2 cells, whereas POF showed limited effects under the tested conditions. These findings suggest that DXMT may influence early in vitro cellular responses relevant to bone healing and should be further validated in functional differentiation models and in vivo studies.

Purpose:To investigate the prevalence and radiographic characteristics of migrated mandibular second premolars byusing panoramic radiography.Materials & Methods:The previously taken 27758 panoramic radiographs were evaluated regarding the determining theprevalence of mandibular second premolar migration. Thirty-six radiographs were excluded from the study due to notproviding the inclusion criteria. 27722 radiographs were evaluated retrospectively by the same operator. In the diagnosisof migrated teeth, radiographic features and demographic characteristics were recorded.Results:Nine migrated second premolar teeth were detected in the evaluation of all the radiographs (%0.03). The meanage of the cases was 37 years. All the migrated teeth were impacted, unilateral and the average distance between normaland migrated location was 41 mm. In most of migration case (in 6 case) absence of first permanent molar tooth wasobserved.Conclusion:It is concluded that, if the mandibular second premolar tooth are not located at physiologic position on thedental arch, a panoramic radiographic examination should be recommended to view all the jaws and related structures.Early detection of dental migration may be beneficial to prevent the possible further complications.