Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 3 appraisals
Clinical oral investigations
Temporal dynamics of human biomarkers of orthodontically-induced root resorption: A systematic review
OBJECTIVE: To summarize time-related biomarker changes in orthodontically-induced root resorption (OIRR), classify biomarkers by function, and examine trajectories across OIRR stages. MATERIALS AND METHODS: PubMed/MEDLINE, Embase, Scopus, Web of Science, CENTRAL, CINAHL and grey literature, were searched from inception to October 1, 2025. Reference lists were manually searched. The risk of bias was assessed using the Cochrane RoB 2 for RCTs and ROBINS-I for non-RCTs. The certainty of evidence was evaluated via GRADE. Because of heterogeneity, findings were synthesized narratively. RESULTS: From 11,434 records, 14 studies (225 participants) were included. Gingival crevicular fluid, saliva and serum were analyzed, mainly using enzyme-linked immunosorbent assay. RoB was 'moderate'- 'serious' (non-RCTs) or 'some concerns' (RCTs). Studies reported a rise of pro-inflammatory cytokines right after force application. Subsequent force application phases showed signals of osteoclastic activity and regulation, followed by detection of root hard tissue degradation products that correlated with OIRR volume. Higher baseline salivary secretory IgA and anti-dentin humoral responses and lower baseline mineralized-tissue regulators were associated with greater OIRR severity. CONCLUSION: Evidence suggests time-related changes involving early inflammatory activation and later matrix degradation, which may be shaped by interaction between orthodontic force and patients' biological responses. Standardized multicenter prospective cohorts are needed for validation. CLINICAL RELEVANCE: Early cytokines changes and later signals of osteoclast regulation and root hard tissue degradation may help define candidate monitoring method for OIRR during treatment. Baseline immune profiles could inform future risk stratification, while bone turnover biomarkers may reflect tooth movement rather than resorption.
26 June 2026
Read appraisal →Clinical oral investigations
Exploring orofacial myofunctional therapy and its core components in mixed-dentition anterior open bite: the ombit study
OBJECTIVES: To explore the therapeutic effects of OMT in children with AOB in the mixed dentition phase, including a reduced form of OMT (focusing exclusively on breathing pattern and resting postures; OMTBPO) and traditional OMT (also including strength training and correction of swallowing; OMTBPSS). MATERIALS AND METHODS: In this double-baseline, longitudinal study, eight children with AOB (mean age 8.1 years old) were randomly allocated to the OMTBPO (n = 4) or OMTBPSS group (n = 4). Each participant received 7.5 h of OMT across 10 sessions. Outcomes included occlusal parameters, Photographic Open bite Severity Index (POSI) and Peer Assessment Rating (PAR) using 3D intraoral scans, orofacial function based on clinical and standardized assessment (Orofacial Myofunctional Evaluation with Scores; OMES), strength and endurance measurements, and oral health-related quality of life (child oral health impact profile - ortho; COHIP-ortho). RESULTS: Immediately post-therapy, anterior tongue strength had significantly increased in the full sample. At three-month follow-up, palatal volume, lateral lip endurance, and OMES function and deglutition scores had significantly increased, and vertical overbite had decreased. The PAR index showed a significant proportional reduction of 35% from baseline to the last follow-up moment (on average 6 months after therapy). The OMTBPO group showed significantly lower rates of atypical tongue posture and interdental articulation at six-month follow-up. CONCLUSION AND CLINICAL RELEVANCE: This study took a first step in exploring the effectiveness of OMT components in mixed-dentition AOB. Measurable short- to mid-term functional and occlusal improvements were found, and comparable outcomes between protocols suggest that posture-focused OMT may be an efficient interceptive approach. Further research including randomized controlled trials with larger sample sizes is required to provide evidence on efficacy and long-term stability.
1 June 2026
Read appraisal →Molecular biology reports
Oral mucosal microbiome alterations in recurrent aphthous stomatitis: a systematic review of 16 S rRNA gene sequencing studies
Recurrent aphthous stomatitis (RAS) is a prevalent inflammatory disorder of the oral mucosa characterized by recurrent painful ulcerations in otherwise healthy individuals. This systematic review aimed to evaluate alterations in the oral mucosal microbiome of patients with RAS based on studies using 16 S rRNA sequencing. A systematic search of PubMed, Scopus, and Web of Science was conducted on April 14, 2026. Eligible studies included human case-control investigations evaluating oral mucosal swab samples from patients with clinically diagnosed RAS and healthy controls using 16 S rRNA sequencing. Studies based solely on saliva, culture methods, PCR-only analyses, or lacking controls were excluded. Joanna Briggs Institute Critical Appraisal Checklist for Case-Control Studies was used for the evaluation of selected articles. Six studies met the inclusion criteria. Considerable heterogeneity was observed in alpha and beta diversity outcomes. Most studies reported reduced microbial richness in RAS lesions, whereas others found increased or unchanged diversity. Ulcerated sites frequently demonstrated reduced abundance of health-associated taxa such as Streptococcus and Firmicutes, with increased levels of Proteobacteria and inflammation-associated genera including Neisseria, Haemophilus, Prevotella, and Fusobacterium. Microbial alterations were most pronounced at active ulcer sites, while non-ulcerated or healed mucosa more closely resembled healthy controls. Current evidence suggests that RAS is associated with localized, site-specific microbial dysbiosis rather than generalized oral microbiome disruption. However, methodological heterogeneity and small sample sizes limit definitive conclusions. Future standardized longitudinal studies integrating functional metagenomics are warranted to clarify the role of the microbiome in RAS pathogenesis.
16 May 2026
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