Background: Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disorder that is well documented in adults but remains relatively uncommon in the pediatric population. Due to its rarity, knowledge regarding its epidemiology, etiology, clinical behavior, diagnosis, and management in children remains limited. Objective: To review the current literature regarding epidemiology, pathogenesis, clinical presentation, diagnosis, histopathological characteristics, treatment, and outcomes of OLP in pediatric patients. Materials and Methods: An electronic search of the literature was conducted in the PubMed, Scopus, and Cochrane Library databases to identify OLP-associated case reports in the pediatric population. The search was limited to English-written publications of the past decade. The initial PubMed search yielded 228 publications. Following restriction to studies published between 2016 and 2026, 97 records remained. Limiting the search to English-language publications resulted in 95 studies. Screening for patients younger than 18 years identified 51 potentially relevant publications. After title, abstract, and full-text review, 10 studies fulfilled the inclusion criteria. To ensure comprehensive literature coverage, supplementary searches were subsequently conducted in the Scopus and Cochrane Library databases, identifying three additional eligible studies after excluding the duplicates. Consequently, a total of 13 studies were included in the final review. Results: Pediatric OLP is considerably less common than adult disease. The available evidence suggests an immune-mediated pathogenesis, although the exact mechanism remains unclear. Clinical presentations include reticular, erosive, plaque-like, linear, and severe mucocutaneous forms, with the reticular subtype being the most frequently reported. Histopathological findings consistently demonstrate basal cell degeneration and a dense subepithelial lymphocytic infiltrate. Topical corticosteroids remain the most commonly prescribed treatment and are generally associated with favorable clinical outcomes. Conclusions: Although relatively uncommon, OLP should be considered in the differential diagnosis of persistent oral white lesions in children. Early diagnosis and appropriate management are essential for symptom control and prevention of complications. Additional research is needed to better understand disease pathogenesis and establish evidence-based treatment protocols for pediatric patients.

Background: N6-methyladenosine (m6A) is the most abundant mRNA internal modification in eukaryotes and regulates inflammatory and regenerative processes. Many studies relate the dysregulation of m6A-related pathways to periodontal inflammation, imbalance in cell homeostasis, impaired tissue regeneration, and remodeling of the alveolar bone. However, the mechanisms of the relationship between the m6A pathway and periodontitis have not been elucidated clearly yet. Objective: The objective of the current narrative review is to integrate the information related to the role of m6A RNA modification in the pathogenesis of periodontitis by focusing on inflammatory signaling, osteoimmune regulation, periodontal cell activity, bone remodeling, and its possible applications as a diagnosis and treatment approach. Methods: A literature search was conducted in PubMed to identify original research studies investigating the role of m6A RNA methylation and its regulators in periodontitis and periodontal tissues/cells. Out of 49 publications reviewed, 34 original research articles fulfilled the predetermined inclusion criteria. Results: The current literature suggests that N6-methyladenosine (m6A) modification is involved in various interconnected biological processes contributing to the development of periodontitis, including inflammatory responses, inflammasome activation and pyroptosis, osteoimmune reactions by macrophages, osteogenic differentiation, osteoclast formation, cellular senescence, and periodontal cells homeostasis. METTL3 has been reported to be the most widely investigated regulator, but its roles are not consistently harmful or beneficial. Depending on the RNA target, cellular environment, and state of inflammation, some of the m6A-associated pathways have been linked to periodontal inflammation and alveolar bone resorption, while others were linked to osteogenesis and regeneration. Several studies have highlighted the possibility of therapeutic interference in pathways leading to the formation of m6A, while human transcriptomic and gingival/salivary studies suggested that m6A could be used as a biomarker. Conclusions: The m6A modification of RNA is an emerging epitranscriptomic effect relating periodontal inflammation, immune responses, cellular differentiation, and bone remodeling. Even though target molecules and signaling pathways have been experimentally identified as points of potential therapeutic interference, the available evidence remains predominantly preclinical. Future work is expected to validate the diagnostic and therapeutic involvement of the m6A modification in periodontitis.

Background: The Mediterranean diet (MD) represents a nutritionally balanced eating pattern characterized by high consumption of fruits, vegetables, legumes, nuts, whole grains, olive oil, fish, and extra-virgin olive oil as the principal fat source and limited intake of red meat and refined sugars. Emerging evidence indicates that the MD’s anti-inflammatory and antioxidant properties extend beyond systemic health, potentially reducing the risk and severity of periodontitis. This narrative review aimed to synthesize current evidence on the relationship between adherence to the MD and periodontal health outcomes. Methods: A comprehensive electronic literature search was conducted in PubMed without restrictions on publication date. Fourteen studies, ranging from 2019 to 2025, were included, encompassing human, clinical, experimental, and review designs that examined MD adherence and its effects on periodontal parameters. Eligible studies included cross-sectional, cohort, randomized controlled trials; systematic reviews; and animal models assessing clinical periodontal indices, inflammatory biomarkers, or microbial composition. Extracted data included study design, population characteristics, dietary assessment methods, and primary periodontal findings. Results: Most studies demonstrated that greater adherence to the MD was associated with improved periodontal parameters, including reduced probing pocket depth, clinical attachment loss, and bleeding on probing. Interventional trials showed significant reductions in systemic inflammatory markers such as IL-1β, TNF-α, and CRP, along with decreased counts of periodontopathogenic bacteria. Experimental studies further revealed the protective role of oleic acid and polyphenols in regulating macrophage activity, suppressing osteoclastogenesis, and enhancing IL-10 expression via epigenetic modulation. However, heterogeneity in dietary scoring systems, sample characteristics, and follow-up duration limited direct comparison, and not all associations reached statistical significance. Conclusions: Current evidence supports a beneficial association between MD adherence and periodontal health, mediated through anti-inflammatory, antioxidant, and microbiome-stabilizing mechanisms. Further standardized longitudinal and interventional studies are needed to confirm causality and refine nutritional strategies for periodontal disease prevention and management.

Background: Oral leukoplakia is a clinically important oral potentially malignant disorder with variable risk of progression to oral squamous cell carcinoma. Histopathological grading of oral epithelial dysplasia remains the primary method for risk assessment; however, its predictive accuracy is limited by sampling variability, lesion heterogeneity, and interobserver variation. DNA aneuploidy and abnormal DNA ploidy status have therefore been investigated as objective biomarkers of genomic instability and potential predictors of malignant transformation. Aim: This narrative review evaluates whether DNA aneuploidy or abnormal DNA ploidy status predicts malignant transformation of oral leukoplakia to oral squamous cell carcinoma compared with diploid DNA status, and whether DNA ploidy should be interpreted as a stand-alone prognostic marker or as part of combined risk-assessment models. Materials and Methods: A structured PubMed/MEDLINE search (last performed on 12 July 2026) identified 162 records using terms related to oral leukoplakia, oral potentially malignant disorders, DNA ploidy, DNA aneuploidy, cytometry, malignant transformation, and oral squamous cell carcinoma. After screening and full-text eligibility assessment, 45 studies were included and organised according to their evidential role as core prognostic studies, PVL-specific subgroup evidence, and supporting/background evidence addressing diagnostic relevance, dysplasia correlation, treatment monitoring, genomic instability, and methodological development. Results: Most core prognostic studies showed that DNA aneuploidy, abnormal DNA content, or chromosomal instability was associated with increased malignant transformation risk compared with diploid or non-aneuploid status. Several studies reported higher transformation rates, hazard ratios, or improved prediction when DNA ploidy was combined with dysplasia grading, lesion site, clinical heterogeneity, or other biomarkers. However, predictive performance varied across studies, and DNA ploidy alone often showed modest sensitivity, specificity, or positive predictive value. Diploid or non-aneuploid status appeared more useful for identifying lower-risk lesions, although it did not completely exclude malignant transformation. PVL evidence suggested frequent aneuploidy and aggressive genomic behaviour, but DNA ploidy appeared less reliable for discriminating risk within PVL. Conclusions: DNA aneuploidy and abnormal DNA ploidy status are meaningful markers of genomic instability and are associated with increased malignant transformation risk in oral leukoplakia. However, when used alone, DNA ploidy often shows only modest predictive performance, and prediction improves consistently when it is combined with dysplasia grading and other clinicopathological factors. Their strongest clinical value is therefore as adjunctive biomarkers within combined clinicopathological and molecular risk models, rather than as stand-alone replacements for histopathological assessment; routine clinical implementation is not yet supported by the current evidence.

Background: Oral potentially malignant disorders (OPMDs) comprise clinically and histologically heterogeneous lesions associated with an increased risk of oral squamous cell carcinoma (OSCC). Histopathological grading of oral epithelial dysplasia (OED) remains central to risk estimation but has limited predictive precision. Podoplanin and selected cancer stem cell (CSC) or stemness-associated markers may capture complementary biological processes involved in progression. Objective: To synthesize evidence on podoplanin and selected CSC or stemness-associated markers as indicators of malignant transformation and risk stratification across a prespecified OPMD spectrum, while distinguishing longitudinal prediction from cross-sectional, diagnostic, and mechanistic evidence. Methods: Three original PubMed searches covered database inception to 13 July 2026. A post hoc recall audit against three key evidence syntheses identified one eligible longitudinal report missed during the initial selection; this report was added by backward citation checking. A broader supplementary sensitivity query was run during revision and reported separately without being merged into the original selection counts. In total, 47 publications were included. Study design, effect measure, threshold provenance, internal validation, and possible cohort overlap were charted and synthesized narratively. Results: Among the biomarkers reviewed, podoplanin had the most developed longitudinal evidence, including a pooled hazard ratio (HR) of 3.72 (95% confidence interval [CI] 2.40–5.76) in one meta-analysis. A separate diagnostic-accuracy synthesis reported sensitivity of 78.9% and specificity of 55.0%, corresponding to a positive likelihood ratio (LR+) of 1.75 and a negative likelihood ratio (LR−) of 0.38. Predictive values varied materially with baseline transformation risk. CD133, BMI1, and ABCG2 showed large associations in individual cohorts, but independent replication and external validation were limited. Cross-sectional expression gradients were not treated as evidence of prospective prediction. Conclusions: Within the defined OPMD scope, podoplanin has the most developed longitudinal evidence, but its predictive values are prevalence-dependent and no marker is sufficiently validated for stand-alone clinical use. Prospective multicenter studies should compare prespecified biomarker models with established clinical, histopathological, and molecular predictors and should evaluate calibration, clinical utility, and external validity before management decisions are altered.

Background: Pemphigus is a rare group of autoimmune blistering diseases characterized by autoantibody-mediated loss of keratinocyte adhesion, resulting in intraepithelial blister formation involving the skin and mucous membranes. Pemphigus Vulgaris (PV) is the most common type of pemphigus, which usually presents in adulthood and has a prevalence rate of about 2.83 cases per million person years worldwide. The prevalence rate in children and adolescents is relatively uncommon; however, it accounts for about 1.4 to 3.7 percent of all cases of pemphigus vulgaris reported worldwide. The involvement of oral cavity is clinically significant since it can present prior to the disease or as its predominant feature. Hence, this narrative review seeks to review literature on pemphigus with involvement of oral cavity in children and adolescents. Objective: The objective of this study was to review the current literature regarding epidemiology, pathogenesis, clinical presentation, diagnosis, histopathological characteristics, treatment, and outcomes of pemphigus with oral involvement in children and adolescents. Materials and Methods: A literature search was conducted using the PubMed/MEDLINE, Scopus, and Cochrane Library databases to identify relevant studies published between 2015 and 2026. The search strategy included terms related to pemphigus, pediatric patients, and oral manifestations. Articles involving patients younger than 18 years of age with oral involvement were screened according to predefined inclusion criteria. Following database screening, duplicate removal, and full-text assessment, 25 studies comprising a total of 51 patients with documented oral or orofacial involvement were included in the final review. Results: Pemphigus vulgaris was the predominant subtype, with oral lesions representing the initial or sole manifestation in the majority of patients. The gingiva, mucosa, tongue, lip, and palate were the most common affected areas in the mouth. The lesions in these areas usually appeared as painful erosion, ulcers, and desquamative gingivitis. Histopathology with the presence of acantholysis in the suprabasal area and direct immunofluorescence was the most definitive test for diagnosis. Systemic corticosteroids were the mainstay of treatment in conjunction with steroid sparing agents in some cases, with good results in difficult cases using rituximab. Overall, most patients achieved partial or complete clinical remission following appropriate treatment, although relapses were occasionally reported. Conclusions: Pemphigus in children and adolescents is rarely encountered; however, it should be included as a differential diagnosis of erosive/ulcerative lesions. Early identification, diagnosis, and treatment through a collaborative approach from dental practitioners are critical. Further research is required at multiple centers to gain a better understanding of the disease and to develop evidence-based guidelines for diagnosis and treatment of pediatric patients.