Periodontitis is a chronic, progressive inflammatory disease characterized by the gradual destruction of the supporting structures of the teeth, including the periodontal ligament and alveolar bone. This condition primarily originates from microbial dysbiosis in the oral cavity, further influenced by the host’s immune responses and a variety of environmental and behavioral factors. As the leading cause of tooth loss and edentulism among adults, periodontitis also has far-reaching systemic consequences. An expanding body of scientific evidence has established strong associations between periodontitis and numerous systemic conditions, including cardiovascular disease, diabetes mellitus, respiratory disorders, thyroid dysfunction, and obstructive sleep apnea (OSA). This review examines the potential biological and clinical connections between periodontitis and these systemic diseases by first providing an overview of the normal physiological functions and pathological changes of each condition. It then explores the shared immunological and pathophysiological pathways, with particular focus on inflammatory mediators, immune system dysregulation, and microbial translocation. By integrating perspectives from disciplines such as microbiology, immunology, and clinical research, this review underscores the integral role of oral health in systemic well-being. It also highlights the necessity of early detection, interdisciplinary cooperation, and preventive strategies—including lifestyle modifications—to manage common risk factors and improve comprehensive patient outcomes.

Introduction: Regenerative endodontic procedures (REPs) have been widely used to manage a range of pulpal pathologies, particularly in immature permanent teeth. The development of bioactive calcium silicate–based materials has led to a paradigm shift in vital pulp therapy (VPT) and REPs. Conventional clinical and radiographic criteria used to assess the healing ability of teeth diagnosed with irreversible pulpitis (IP) may be inadequate. Emerging evidence suggests that a proportion of pulps diagnosed as ‘irreversibly’ inflamed retain the capacity to recover normal function following VPT. The aim of this scoping review was to evaluate the current evidence supporting the possible use of REPs to preserve and regenerate vital pulp tissue in teeth diagnosed with IP. Methods: A comprehensive literature search was conducted using MEDLINE (via PubMed), Web of Science, the Cochrane Library, Google Scholar and Scopus to identify studies that met predefined inclusion and exclusion criteria. In addition, manual citation searching was undertaken to ensure comprehensive coverage of the relevant literature. Results: Four individual case reports describing moderately successful pulp regeneration using REPs in immature permanent teeth diagnosed with IP were identified. In addition, two case series and two case reports reported comparable outcomes following REPs in mature permanent teeth with the same pulpal diagnosis. Conclusions: Based on the results of this scoping review, the current clinical evidence supporting REPs for pulp regeneration in teeth diagnosed with IP is remarkably limited. However, biological plausibility is conceptually strong, and the potential focus of future investigations to achieve true pulp regeneration. Currently, VPT remains the preferable option for pulp preservation in teeth diagnosed with IP.

Periodontitis (PD) and rheumatoid arthritis (RA) are chronic inflammatory disorders that impose substantial individual and societal burdens worldwide. PD is characterized by progressive destruction of the periodontal ligament and alveolar bone, leading to tooth loss, impaired oral function, and sustained systemic inflammatory burden. RA, affecting approximately 0.5–1% of the population, is a chronic autoimmune disease marked by persistent synovial inflammation, progressive joint destruction, disability, and reduced quality of life. Increasing evidence indicates that these conditions are biologically and clinically interconnected. Both diseases share key pathogenic pathways, including microbial dysbiosis, immune dysregulation, chronic inflammation, genetic susceptibility, and aberrant autoantibody responses. Particular attention has focused on keystone periodontal pathogens such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, which may promote protein citrullination and the formation of anti-citrullinated protein antibodies (ACPA), thereby providing a plausible mechanistic bridge between periodontal infection and systemic autoimmunity. Shared genetic risk factors, including HLA-DRB1 susceptibility alleles, further support a common host predisposition. Clinical, epidemiological, and translational studies increasingly support a bidirectional association. Individuals with PD appear to have a higher risk of RA development, whereas patients with RA demonstrate greater prevalence, severity, and progression of periodontal disease. Interventional studies suggest that nonsurgical periodontal therapy may reduce local periodontal inflammation, circulating inflammatory biomarkers, and RA disease activity indices, while effective pharmacological control of RA may also improve periodontal outcomes. This narrative review critically evaluates the PD–RA relationship across four interconnected domains: (i) epidemiological and clinical associations between PD and RA, (ii) key mechanisms underlying RA pathogenesis, (iii) shared biological pathways linking both diseases, and (iv) the extent to which treatment of one condition influences the other. Particular emphasis is placed on major sources of heterogeneity and confounding—including smoking, metabolic comorbidities, disease stage, therapeutic exposure, and variable diagnostic definitions—that may explain inconsistencies across the literature. By integrating current mechanistic and clinical evidence, this review provides a structured synthesis that extends beyond a descriptive overview of association studies. A clearer understanding of the periodontal–rheumatologic axis may facilitate risk stratification, identify novel therapeutic targets, and support integrated multidisciplinary care. Targeting both oral and systemic inflammation may improve outcomes in patients with coexisting PD and RA and may potentially reduce the risk or severity of one condition in individuals already affected by the other.

Background and Objectives: Presurgical infant orthopedics aims to reduce cleft severity and facilitate primary surgical repair during the early neonatal period, when increased tissue plasticity enhances molding. Nasoalveolar molding is widely used but requires intraoral appliances, laboratory support, specialized training, and frequent follow-up visits, which may limit accessibility and adherence. This case series reports the clinical application of presurgical lip–alveolus–nose approximation (PLANA), an extraoral technique for early presurgical cleft management, and describes the clinical changes observed during treatment in four infants. Materials and Methods: A prospective case series conducted in neonates with non-syndromic unilateral or bilateral cleft lip and/or palate referred within the first 10 days of life to the Alabama Cleft Center. Treatment consisted of a prefabricated silicone nasal aligner combined with hydrocolloid lip adhesive taping. No intraoral plates or dental impressions were used. Devices were worn 20 to 22 h daily. Follow up occurred every 2 to 4 weeks, with remote monitoring used when appropriate. Qualitative clinical observations focused on apparent changes in nasal symmetry, columellar length, septal alignment, nasal tip projection, premaxillary position, nostril dimensions, alar base width, cleft width, and lip approximation, as well as feeding tolerance, skin tolerance, and treatment adherence. These observations were assessed qualitatively through serial clinical examinations and clinical photographs; no standardized quantitative morphometric measurements were performed. Results: Four infants with complete unilateral or bilateral cleft lip and palate received PLANA treatment. Serial clinical examinations and photographs documented qualitative changes in nasolabial morphology over the course of treatment in all four patients. Qualitative clinical assessment of serial photographs and examinations suggested greater apparent nasal symmetry, apparent columellar elongation, more central-appearing nasal alignment, increased apparent nasal tip projection, apparent cleft-width reduction, and progressive lip approximation. In unilateral clefts, changes were observed in both the cleft and non-cleft nasal sides, while bilateral clefts demonstrated changes in nasal morphology bilaterally. No device-related complications or clinically significant skin intolerance were documented during the reported treatment periods. Parent-reported device wear was approximately 20–22 h per day. Conclusions: In this four-patient prospective descriptive case series, PLANA was applied clinically, with no clinically significant treatment-related complications documented during the reported treatment periods. Serial clinical observations suggested changes in nasolabial morphology during treatment. Given the small sample size, absence of a contemporaneous control group, and qualitative nature of the assessments, these findings should be interpreted as preliminary and hypothesis-generating rather than as evidence of treatment efficacy or comparative effectiveness. Larger prospective, multicenter comparative studies incorporating standardized quantitative measurements, objective adherence assessment, and long-term surgical and aesthetic outcomes are needed to evaluate the effectiveness, reproducibility, and clinical applicability of the PLANA approach.

Background: At present, there are very limited studies evaluating autonomous artificial intelligence (AI) agents in oral oncology or healthcare education, and no studies have directly compared traditional frontier large language models (LLMs) with autonomous AI agents in the field of pediatric oral oncologic pathology. This study evaluated the performance of AI LLMs and an autonomous AI scientific agent in generating engaging and accessible patient information sheets for common pediatric oral pathologic conditions and rare head and neck tumors. The development of high-quality patient education materials is particularly important in pediatric pathology because parents must often navigate complex and emotionally sensitive diagnoses, including rare tumors and developmental lesions, for which accessible, patient-friendly educational resources are frequently unavailable. AI-generated patient information sheets therefore represent a potential strategy to improve communication, understanding, and shared decision-making for families facing these uncommon conditions. Methods: AI-generated patient information sheets from popular frontier chatbots on various pediatric pathological conditions and rare tumors were evaluated by five platforms (Eli5a v2.0, ChatGPT-5.4, Claude Sonnet 4.6, Perplexity and Doximity), in a blinded fashion, by three expert evaluators using the Global Quality Score (GQS), DISCERN score, understandability score and actionability score using PEMAT, and the Flesch-Kincaid Grade Level. Because the same 20 conditions were assessed on every platform, observations were paired; platforms were compared using Friedman tests with paired Wilcoxon signed-rank post hoc tests and Holm correction, and interrater reliability was quantified using an absolute-agreement intraclass correlation coefficient (ICC). Results: Platform differences were significant for all five outcomes (all p < 0.001). Claude Sonnet 4.6 obtained the best overall information quality (GQS 4.25 ± 0.39), scoring significantly higher than all other platforms, while Perplexity, Eli5a v2.0 and ChatGPT-5.4 performed similarly to one another and better than Doximity. For information reliability, Doximity (DISCERN 70.50 ± 3.20) and Claude Sonnet 4.6 (70.25 ± 3.02) performed best, while Eli5a v2.0 recorded the lowest DISCERN score (54.50 ± 4.26). Eli5a v2.0 obtained the best results for patient-centered communication, with the highest understandability (PEMAT-U 95.05 ± 1.23) and readability (FKGL 5.45 ± 0.51) and an actionability score among the highest of the five platforms (PEMAT-A 89.00 ± 2.62, not significantly different from Perplexity or Doximity). Interrater absolute agreement for GQS was poor to moderate (ICC(2,1) = 0.236; ICC(2,3) = 0.481). Conclusion: No single platform was superior across all evaluated domains. Claude Sonnet 4.6 led in overall quality whereas Eli5a v2.0 achieved the highest understandability and the most appropriatereading grade level. Eli5a’s actionability was high but did not differ significantly from Perplexity or Doximity. These findings indicate a trade-off between information quality and reliability on one hand and lay accessibility on the other. Platform selection should therefore be matched to the communication task, and all AI-generated patient materials require clinician review before use.