Background: Mandibular advancement devices (MADs) are widely used for mild-to-moderate obstructive sleep apnea (OSA). We aimed to synthesize recent evidence on their clinical effectiveness and tolerability. Methods: A systematic review was conducted. Ten studies were included, evaluating MAD therapy in adults with mild-to-moderate OSA. The review reported on standard outcomes, including the apnea-hypopnea index (AHI), oxygenation, daytime sleepiness (Epworth Sleepiness Scale, ESS), quality of life, adherence, and adverse events. Risk of bias was also assessed. Results: Across the included studies, MADs consistently reduced AHI from baseline and improved ESS and/or snoring. In head-to-head comparisons, MADs generally yielded smaller reductions in AHI than CPAP but achieved comparable improvements in symptoms and quality of life, with higher nightly adherence. Reported adverse effects were mostly mild and transient. Conclusions: MAD therapy is an effective and generally well-tolerated option for adults with mild-to-moderate OSA and for the patients intolerant to CPAP, although average AHI reduction is smaller than with CPAP. Given the low certainty and heterogeneity of current evidence, high-quality randomized trials with objective adherence tracking and standardized titration are needed.

Background: Implant surface characteristics have been extensively investigated for their potential influence on osseointegration and peri-implant tissue stability. However, their actual clinical relevance in the prevention and progression of peri-implant diseases remains controversial. This systematic review aimed to synthesize the available clinical and microbiological evidence on the impact of different implant surface characteristics and surface modifications on peri-implant outcomes. Materials and Methods: Conducted according to PRISMA and registered in PROSPERO, an electronic search of PubMed, Scopus, and Web of Science (2015–2025) identified clinical studies assessing associations between implant surface characteristics/modifications and peri-implant clinical, radiographic, microbiological, or biomolecular outcomes. Risk of bias was evaluated using ROBINS-I. Results: Thirteen studies (randomized, controlled, and cohort designs) were included. Most trials reported minimal differences in marginal bone loss and peri-implant parameters across surfaces. Potential advantages were mainly observed during early healing or in compromised bone. Long-term evidence emphasized the predominance of patient- and site-related risk factors. Microbiological outcomes were scarce and heterogeneous. Conclusions: Implant surface modifications appear to exert a limited and context-dependent influence on peri-implant outcomes. Long-term peri-implant health is primarily driven by multifactorial interactions involving host, microbial, and clinical factors rather than surface characteristics alone.

Background: Ankyloglossia is a congenital condition characterized by restricted tongue mobility, which may influence oral functions such as speech, swallowing, and oral motor coordination. This systematic review aimed to evaluate oral functional outcomes following surgical and/or myofunctional interventions in individuals with lingual hypomobility. A secondary aim was to assess variability and consistency of functional improvements across different therapeutic approaches. Methods: This systematic review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Web of Science were searched between 15 June 2025 and 10 August 2025. Eligible clinical studies (randomized controlled trials, cohort studies, and case series/reports) evaluated lingual frenotomy, frenulectomy, or frenuloplasty, alone or combined with orofacial myofunctional therapy, and reported oral functional outcomes, including tongue mobility, oral posture, swallowing-related tasks, neuromuscular measures, and patient-reported function. Risk of bias was assessed using validated tools (ROBINS-I and RoB 2). Due to heterogeneity in study design and outcome measures, a narrative synthesis was performed. Results: Ten studies involving more than 1,300 participants across pediatric, adolescent, and adult populations were included. The evidence comprised randomized controlled trials, observational studies, and case series. Surgical intervention alone was primarily associated with immediate anatomical and mobility-related improvements. In contrast, combined surgical and myofunctional approaches were more consistently associated with improvements in functional outcomes, including tongue mobility, resting posture, and swallowing-related functions. However, the consistency of these improvements varied across age groups, intervention protocols, and outcome assessment methods. Risk of bias was variable and frequently influenced by heterogeneous diagnostic criteria, nonstandardized interventions, and nonuniform outcome measures. Discussion: Combined surgical and myofunctional interventions appear to be associated with improvements in oral functional outcomes compared with stand-alone approaches. However, due to substantial methodological heterogeneity and limited high-quality evidence, these findings should be interpreted with caution and are primarily applicable to the specific functional domains evaluated.