The term necrotizing fasciitis (NF) was first used by Wilson in 1952, who described this rare, however, progressive infection that primarily affects the fascia and subcutaneous tissues. Necrotizing fasciitis may affect any part of the body; however, it usually appears on the extremities. The most common microorganisms isolated in NF are Staphylococcus aureus, group A Streptococci, and Escherichia Coli. We are presenting the case of a sixty-seven-year old woman, who was admitted for the perforation of painful edema of the left cheek. Clinical examination of the anterior two-thirds of the left cheek revealed a defect of the full thickness of the skin, 3×4 cm in size. During the patient’s hospitalization she was treated by parenterally administered broad-spectrum antibiotics, necrotomy, fasciotomy of the cheek and the extraction of the remaining roots in the 3^rd and 4^th quadrant. Necrotic fasciitis is a rare, rapidly progressive infection of soft tissues, which, if untimely diagnosed and treated, may be life-threatening. The prognosis of treatment depends on the early recognition of the disease. It is treated with aggressive surgical debridement followed by antibiotic therapy.

Background: This randomized parallel-group clinical study evaluated salivary cortisol as a biomarker of perioperative stress response during surgical extraction of impacted mandibular third molars performed under local anesthesia administration of ropivacaine and dexamethasone. Methods: The trial was registered in the ISRCTN registry (ISRCTN87752106). Ninety patients undergoing impacted mandibular third molar surgery were randomly assigned (1:1:1; n = 30/group) to receive inferior alveolar nerve block with 0.5% ropivacaine plus dexamethasone (R+D group), 0.5% ropivacaine (R group), or 0.5% bupivacaine (B group). Salivary cortisol as the primary outcome was measured at 15 min before anesthesia, and 15 min and 24 h postoperatively. Preoperative psychological stress was assessed using the Revised Norman Corah Dental Anxiety Scale. Results: No significant differences were observed between groups in preoperative anxiety (p = 0.890) or baseline salivary cortisol levels (p = 0.984). Significant intergroup differences in cortisol levels were observed at 15 min (p = 0.002) and 24 h postoperatively (p = 0.001). Cortisol levels at 15 min postoperatively were significantly lower in the R+D group compared to the R (p = 0.001) and B groups (p = 0.004) and after 24 h (R+D vs. R: p = 0.005; R+D vs. B: p < 0.001). Conclusions: The ropivacaine–dexamethasone administration significantly reduced perioperative salivary cortisol levels compared to ropivacaine alone or bupivacaine alone during impacted mandibular third molar surgery. This modulation of the neuroendocrine response likely results from dexamethasone-induced suppression of hypothalamic–pituitary–adrenal axis and the improved analgesic effects of this combination. The observed results may contribute to improved physiological stability, postoperative recovery and the clinical benefit of this anesthetic approach in oral surgery.

Introduction: Carcinoma of the stratified squamous epithelium of the oral cavity - oral squamous cell carcinoma (OSCC) is an invasive pathological lesion of the epithelium with varying degrees of squamous differentiation. It is characterized by early and extensive metastases, infiltration of adjacent anatomical structures, frequent recurrences, and a relatively low five-year survival rate of less than 50%. The aim of the study to determine the correlation between the analysis of the lymphocytic infiltrate of biopsy specimens with pathohistologically proven metastases of oral squamous cellular carcinoma on postoperative neck dissection specimens. Material and methods: The study included 42 patients with pathohistologically verified oral squamous cellular carcinoma who underwent surgery at the Department of Maxillofacial Surgery of the Clinic of Dental medicine in Niš in the period from 2018 to 2022. The histopathological analysis included the depth of tumor invasion, histopathological analysis of the lymph nodes of neck dissections, analysis of lymphocytic infiltration, and presence of lymphovascularand perineural invasion. Results: It was determined that the depth of invasion is statistically significantly different regarding the degree of lymphocytic infiltration (p=0.004). Invasion of over 4mm was present in 20% of patients with high infiltration, 44.4% of patients with medium infiltration, and 85.7% of patients with low infiltration. Conclusion: Given that the results of the study indicate that the analysis of the lymphocytic infiltrate can be a reliable predictive factor of the appearance of metastases in the lymph nodes of the neck, further research should be directed toward as sociating lymphocytic infiltration with certain biochemical and genetic parameters based on which a plan can be created for neck treatment in the N0 stage of oral squamous cellular carcinoma.

Background/Objectives: Oral leukoplakia (OL) is a common oral potentially malignant disorder, but prediction of malignant progression remains challenging. This study investigated miR-21-5p and miR-21-3p expression in healthy oral mucosa, OL with epithelial dysplasia, and early oral squamous cell carcinoma (OSCC), together with clinicopathological associations. Methods: Sixty participants were divided into three groups: exposure-free healthy controls (n = 20), histopathologically confirmed OL with epithelial dysplasia (n = 20), and early OSCC (pT1–2N0M0; n = 20). Expression was quantified by RT-qPCR and evaluated using exploratory correlation, regression, Welch’s ANOVA, and Games–Howell comparisons. Results: miR-21-5p differed significantly among groups (p < 0.001). Expression was lower in OL than in healthy controls and early OSCC (both p < 0.001), whereas early OSCC and controls did not differ (p = 0.997). miR-21-5p was inversely associated with dysplasia grade (Spearman’s ρ = −0.54, p = 0.013; unstandardized regression coefficient B = −0.646, p = 0.017). miR-21-3p was numerically higher in early OSCC, but its overall group difference was not significant (p = 0.051). Conclusions: The two mature miR-21 strands showed distinct, non-linear expression patterns across the three groups. These findings are preliminary and hypothesis-generating; the cross-sectional design does not establish predictive or prognostic value, and validation in larger longitudinal cohorts is required. The unexpected miR-21-5p pattern remains unexplained and requires independent validation.