Search Results (114)

Alopecia areata (AA) is a chronic autoimmune disorder characterized by non-scarring hair loss, with subtypes ranging from patchy alopecia (AAP) to alopecia totalis and universalis (AT/AU). The aim of this research is to investigate molecular features across AA severity by performing an integrated analysis of scalp transcriptomic datasets (GSE148346, GSE68801, GSE45512, GSE111061) and matched serum proteomic data from GSE148346. Differential expression analysis indicated that, relative to normal scalp, non-lesional AA tissue shows early immune activation—including Type 1 (C-X-C motif chemokine ligand 9 (CXCL9), CXCL10, CD8a molecule (CD8A), C-C motif chemokine ligand 5 (CCL5)) and Type 2 (CCL13, CCL18) signatures—together with reduced expression of hair-follicle structural genes (keratin 32(KRT32)–35, homeobox C13 (HOXC13)) (FDR < 0.05, |fold change| > 1.5). Lesional AAP and AT/AU scalp showed stronger pro-inflammatory upregulation and greater loss of keratins and keratin-associated proteins (KRT81, KRT83, desmoglein 4 (DSG4), KRTAP12/15) compared with non-lesional scalp (FDR < 0.05, |fold change| > 1.5). Ferroptosis-associated genes (cAMP responsive element binding protein 5 (CREB5), solute carrier family 40 member 1 (SLC40A1), (lipocalin 2) LCN2, SLC7A11) and IRS (inner root sheath) differentiation genes (KRT25, KRT27, KRT28, KRT71–KRT75, KRT81, KRT83, KRT85–86, trichohyalin (TCHH)) were consistently repressed across subtypes, with the strongest reductions in AT/AU lesions versus AAP lesions, suggesting that oxidative-stress pathways and follicular structural integrity may contribute to subtype-specific pathology. Pathway analysis of lesional versus non-lesional scalp highlighted enrichment of IFN-α/γ, cytotoxic, and IL-15 signaling. Serum proteomic profiling, contrasting AA vs. healthy controls, corroborated scalp findings, revealing parallel alterations in immune-related proteins (CXCL9–CXCL10, CD163, interleukin-16 (IL16)) and structural markers (angiopoietin 1 (ANGPT1), decorin (DCN), chitinase-3-like protein 1 (CHI3L1)) across AA subtypes. Together, these data offer an integrated view of immune, oxidative, and structural changes in AA and found ferroptosis-related and IRS genes, along with immune signatures, as potential molecular indicators to support future studies on disease subtypes and therapeutic strategies. Full article

Background: Chestnuts are keratinized skin structures found on equine limbs, but their characteristics in donkeys remain poorly understood. This study aimed to characterize chestnut morphology and histology in Dezhou donkeys and examine correlations with phenotypic traits. Methods: A cross-sectional study was conducted on 347 Dezhou donkeys (0.3–15 years, 79–419 kg). Chestnut dimensions were measured using precision calipers, and correlations were analyzed with age, body weight, limb measurements, and thoracolumbar vertebral counts. Histological analysis compared chestnut tissue with adjacent normal skin using standard H&E staining protocols. Results: Donkeys exclusively possessed chestnuts on forelimbs, predominantly showing regular geometric configurations. Histologically, chestnut tissue exhibited marked hyperkeratosis (>30 cellular layers vs. 4–6 in normal skin), widespread melanocyte distribution throughout the epidermis, and complete absence of cutaneous appendages. In group A, strong positive correlations were observed between chestnut width and age (r = +0.527, p < 0.01), body weight (r = +0.538, p < 0.01), and limb measurements (r > +0.589 p < 0.01). No significant correlations existed with vertebral numbers. In group B Dezhou donkeys older than 2 years, the length and width of the forelimb chestnuts showed the strongest significant correlation with right forelimb measurements, while no significant correlations were observed with other variables (age, body weight, and hindlimb measurements). Conclusions: Chestnuts in Dezhou donkeys represent specialized integumentary structures with unique histological features and strong correlations with somatic development. These findings support their potential utility as biometric markers for individual identification and indicate coordinated developmental regulation with overall growth patterns. Full article

Background and Clinical Significance: As a common inflammatory skin disorder, acne vulgaris is classically associated with sebum overproduction, follicular hyper keratinization, and Cutibacterium acnes proliferation. Emerging evidence suggests a link between severe or treatment-resistant acne and metabolic syndrome, characterized by central obesity, insulin resistance, dyslipidemia, and hypertension. This case series aims to explore the clinical overlap between acne and metabolic dysfunction and highlight the relevance of multidisciplinary evaluation. Case Presentation: Three patients with severe acne vulgaris and coexisting metabolic abnormalities were evaluated at a dermatology clinic in Oradea, Romania, between 2023 and 2024. Each patient underwent dermatologic examination, laboratory testing for metabolic and hormonal parameters, and individualized treatment. Management strategies included topical/systemic acne therapies combined with metabolic interventions (lifestyle modifications, metformin (in two cases), and lipid-lowering agents). Case 1 (female, 23) had obesity, insulin resistance, dyslipidemia, and polycystic ovary syndrome (PCOS). Case 2 (male, 19) presented with central obesity and atherogenic dyslipidemia. Case 3 (male, 18) showed insulin resistance, overweight status, and elevated inflammatory markers. All three showed suboptimal response to standard acne treatment. Adjunct metabolic management resulted in partial improvement within 3 months. One patient required isotretinoin after metabolic stabilization. Conclusions: These cases underscore the interplay between acne and metabolic dysfunction. Insulin resistance and systemic inflammation may contribute to therapeutic resistance in acne. Early recognition of metabolic syndrome features in patients with severe acne may improve treatment outcomes. Dermatologists should consider metabolic screening to guide comprehensive, multidisciplinary care. Full article

With the growing interest in natural strategies for preventing skin aging, plant-derived compounds are being actively investigated for their potential protective effects against skin inflammation and extracellular matrix (ECM) degradation. In this study, we explored the anti-aging and anti-inflammatory effects of harringtonine, an alkaloid isolated from Cephalotaxus harringtonia, in normal human epidermal keratinocytes (NHEKs) under inflammatory stress induced by tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ). Harringtonine significantly suppressed the expression of matrix metalloproteinases (MMP)-1, MMP-2, and MMP-9 and restored the expression of collagen synthesis-related genes [collagen type I alpha 1 chain (COL1A1), collagen type I alpha 2 chain (COL1A2), and collagen type IV alpha 1 chain COL4A1)], indicating its protective role in ECM degradation. Additionally, harringtonine improved the expression of skin barrier-related genes, such as serine peptidase inhibitor kazal type 5 (SPINK5), loricrin (LOR), quaporin-3 (AQP3), filaggrin (FLG), and keratin 1 (KRT1) although it had no significant effect on involucrin (IVL). Harringtonine also markedly reduced the production of pro-inflammatory cytokines [interleukin (IL)-1β, IL-6, and IL-8] and inflammatory mediators, including prostaglandin E₂ (PGE₂), cyclooxygenase-2 (COX-2), and nitric oxide (NO). Our findings suggest that harringtonine may serve as a promising natural compound for mitigating skin aging and inflammation through multi-targeted modulation of ECM remodeling, skin barrier function, and inflammatory response. Full article

Vitamin A deficiency (VAD) remains a significant cause of preventable blindness worldwide, with ocular surface changes representing early manifestations that require prompt recognition and treatment. Conventional examination methods are capable of detecting advanced changes; however, subtle conjunctival abnormalities may be overlooked, potentially delaying the administration of appropriate interventions. We herein present the case of a 5-year-old Japanese boy with severe VAD due to selective eating patterns. This case demonstrates the utility of infrared photography as a novel diagnostic approach for detecting and monitoring conjunctival surface abnormalities. The patient exhibited symptoms including corneal ulcers, night blindness, and reduced visual acuity. Furthermore, blood tests revealed undetectable levels of vitamin A (5 IU/dL), despite relatively normal physical growth parameters. Conventional slit-lamp examination revealed characteristic sandpaper-like conjunctival changes. However, infrared photography (700–900 nm wavelength) revealed distinct abnormal patterns of conjunctival surface folds and keratinization that were not fully appreciated on a routine examination. Following high-dose vitamin A supplementation (4000 IU/day), complete resolution of ocular abnormalities was achieved within 2 months, with infrared imaging objectively documenting treatment response and normalization of conjunctival surface patterns. This case underscores the potential for severe VAD in developed countries, particularly in the context of dietary restrictions, thereby underscoring the significance of a comprehensive dietary history and a meticulous ocular examination. Infrared photography provides a number of advantages, including the capacity for non-invasive assessment, enhanced visualization of subtle changes, objective monitoring of treatment response, and cost-effectiveness due to the use of readily available equipment. This technique represents an underutilized diagnostic modality with particular promise for screening programs and clinical monitoring of VAD-related ocular manifestations, potentially preventing irreversible visual loss through early detection and intervention. Full article

Dermatophytosis is a fungal infection that affects the skin, hair, and nails, impacting approximately 25% of the global population. Nannizzia gypsea is a geophilic fungus that can cause infections in humans and animals. Several studies have been conducted regarding its virulence, or ability to cause disease. This species may produce keratinolytic enzymes and form biofilms, which can increase resistance to treatment. Thus, this study focuses on investigating the biofilm formation of N. gypsea isolated from canine dermatophytosis using an ex vivo hair model, its biofilm extracellular matrix macromolecular contents, and the expression of genes involved in the colonization of keratinized surfaces. The biofilm was analyzed for metabolic activity using the XTT reduction assay, crystal violet staining to measure biofilm biomass, scanning electron microscopy (SEM), and the presence of polysaccharides, proteins, and extracellular DNA in the biofilm extracellular matrix. The virulence genes subtilisin 7, fungalysin (extracellular metalloproteinase), and efflux pump (Multidrug and Toxin Extrusion Protein 2) were evaluated by qPCR, comparing the planktonic and biofilm phenotypes. N. gypsea formed a robust biofilm, which matured after 5 days. Scanning electron microscopy (SEM) revealed the presence of an extensive extracellular matrix. In the hair model, the characteristic ectothrix parasitism of the species is observable. The gene expression analysis revealed a higher expression of all evaluated genes in the biofilm form compared to the planktonic form. Thus, N. gypsea exhibits a biofilm characterized by a robust extracellular matrix and high gene expression of factors related to pathogenesis and resistance. Full article

(1) Background: The IL-36 cytokines have been identified as key contributors to pustular psoriasis, and their inhibitor is already in clinical use. However, few studies have explored them in atopic dermatitis. (2) Methods: The role of IL-36α was investigated in various atopic dermatitis models using wild-type, keratin 14-specific IL-33 transgenic, IL-18 transgenic, caspase-1 transgenic, and caspase-1 transgenic mice with IL-17AF deletion, reflecting diverse aspects of human skin inflammation. IL-36α was administered subcutaneously in five doses on alternate days across the five strains to examine cellular infiltration patterns and cytokine expression levels. (3) Results: The skin phenotype was exacerbated, accompanied by worsening edema and skin thickness in all mouse groups upon IL-36α administration. An increase in infiltrating cells was observed among innate immune cells, while lymphocyte counts, including T cells and innate lymphoid cells, did not rise. Additionally, anti-inflammatory cytokines were induced simultaneously with inflammatory cytokines and downstream cytokines of IL-36α as well. Infiltrating lymphocytes in the skin displayed a distinct Type 2 cytokine-dominant profile for innate lymphoid cells and a Type 3 cytokine-dominant profile for T helper cells and γδ T cells, contrasting with the Type 1-dominant cell profile in draining lymph nodes. Type 1, Type 2, and Type 3 cytokine dominance patterns were not affected by the administration of IL-36α. (4) Conclusions: IL-36α triggers inflammatory responses in atopic dermatitis by activating innate immunity. The infiltrating lymphocytes in the skin have different cytokine production profiles between innate lymphoid cells and T cells, as well as different patterns of cytokine production in their draining lymph nodes. Full article

Background: A previous published Phase 2 trial using 2–4 doses of neoadjuvant cemiplimab in stage II–IV resectable cutaneous squamous cell carcinoma (CSCC) demonstrated that a complete pathological (pCR) rate of 51% and major pathological response (mPR) rate of 13% could be achieved with durable disease control. Methods: In this open-label, single-institution phase II trial (NCT05878288), patients with stage II–IV resectable CSCC received up to four doses of neoadjuvant cemiplimab prior to surgery. The primary endpoint of the study was to perform comprehensive molecular profiling. The focus of this report are the secondary clinical endpoints of pCR rate, mPR (defined as <10% viable tumour) rate, overall response rate (ORR) using Response Evaluation Criteria in Solid Tumours (RECIST) 1.1, immune-modified RECIST (imRECIST) and Immune PET Response Criteria in Solid Tumours (iPERCIST), disease-free survival (DFS), overall survival (OS), safety, and to describe changes in planned surgery. Results: Eleven patients were enrolled, with all proceeding with surgery. An ORR and pCR rate of 73% (8/11; 95% CI 0.39–0.93) was achieved, whilst 3/11 patients progressed on treatment. On pre-operative imaging, all 8/11 pCR patients demonstrated a partial response (RECIST 1.1), whilst 6/8 achieved a complete metabolic response and 2/8 a partial metabolic response (iPERCIST). Median follow-up was 10.2 (IQR 6.7–16.4) months. DFS was 91% (95% CI 0.57–1) and OS was 100% (95% CI 0.68–1), with one non-responder patient who developed recurrent locoregional and distant metastatic disease. There were no unexpected safety signals. Pathological features of response to neoadjuvant immunotherapy most commonly were granulomatous inflammation with keratin, fibrosis and inflammation. No cases with a dense inflammatory infiltrate were observed. Neoadjuvant immunotherapy did not impact the intra-operative planning and execution of surgery, but in the eight pCR cases, it reduced the extent of required surgery, whilst in the three non-responder cases, surgery was more extensive than originally planned. Conclusions: The DISCERN trial confirms that an excellent complete response rate can be achieved with four doses of neoadjuvant immunotherapy in stage II–IV CSCC. Proposed refinements to the pathological assessment of response and metabolic response criteria in CSCC for the neoadjuvant context are provided. Full article

The transcription and replication of the genome of influenza A virus (IAV) take place in the nucleus of infected cells, which is catalyzed by the viral ribonucleoprotein (vRNP) complex. The nuclear import of the vRNP complex and its component proteins is essential for the efficient replication of IAV and is therefore prone to be targeted by host restriction factors. Herein, we found that host cellular protein keratin 6A (KRT6A) is a negative regulator of IAV replication because siRNA-mediated knockdown of KRT6A expression increased the growth titers of IAV, whereas exogenous overexpression of KRT6A reduced viral yields. The nuclear import of incoming vRNP complexes and newly synthesized nucleoprotein (NP) was significantly impaired when KRT6A was overexpressed. Further studies showed that KRT6A interacts with the four vRNP complex proteins—polymerase basic protein 1 (PB1), polymerase basic protein 2 (PB2), polymerase acidic protein (PA), and NP. Notably, the interaction between KRT6A and vRNP complex proteins had no effect on the nuclear import of PB2 or the PB1-PA heterodimer but impaired the interaction between NP and the nuclear import adaptor importin α3, thereby inhibiting the nuclear import of incoming vRNP complexes and newly synthesized NP. Moreover, KRT6A was further shown to suppress the assembly of the vRNP complex and consequently reduce viral polymerase activity. Together, our data uncover a novel role of KRT6A in counteracting the nuclear import and functions of the vRNP complex, thereby restricting the replication of IAV. Full article

As far as history tells, people have set efforts both to improve the conditions and to change the visual outfit of the skin, nails, and hair. The first information on nail cosmetics is found in ancient China and Egypt, where various nature-derived compositions were used for changing the colour of the nails. Nowadays more mechanically and chemically durable systems for nail polishes are elaborated. This review focuses on the latest achievements in the field of UV-curable nail polishes. Herein, the polymerization mechanisms of various systems (acrylates, as well as epoxides and thiols) occurring in nail polishes are described. Besides plausible side reactions of the polymerization process are characterized. Thus, the main drawbacks for forming a uniform, perfect layer are illuminated. For effective curing, the choice of photoinitiators may be crucial; thus, various types of photoinitiators as well as their main advantages and disadvantages are characterized. Ensuring effective adhesion between the substrate (human nail) and the polymer film is one of the challenges for the nail polish industry—thus the plausible interactions between the adhesion promoters and the keratin are described. Regarding the film-forming agents, a comprehensive overview of the composition of the traditional UV-curing nail polishes is provided, but the main emphasis is devoted to alternative, nature-derived film-forming agents that could introduce renewable resources into nail cosmetics. Additionally, this review gives short insight into the latest innovations in UV-curing nail cosmetics, like (1) nail polishes with improved pealability, (2) covalently polymer-bonded dyes and photoinitiators, thus reducing the release of the low-molecular compounds or their degradation products, and (3) UV-curing nail polishes as delivery systems for nail treatment medicine. Full article

Background: Ensuring a minimum peri-implant keratinized mucosa width (PIKM-W) is critical for maintaining dental implant health, as inadequate PIKM-W is associated with increased risks of plaque accumulation, mucosal inflammation, and peri-implantitis. While epithelialized connective tissue grafts (ECTGs) are considered the gold standard for soft tissue augmentation, they often lead to significant patient morbidity. Xenogeneic dermal matrices (XDMs) offer a less invasive alternative, but are prone to shrinkage, particularly in the mandible. The aim of this study was to evaluate a new surgical method to overcome these limitations with the combination of a narrow band of ECTG (autogenous strip graft, ASG) and an XDM to augment the PIKM-W in the posterior mandible. Methods: Twelve patients with a PIKM-W of less than 2 mm in the mandible underwent peri-implant soft tissue augmentation using this combined approach. Changes in the PIKM-W were measured preoperatively; immediately postoperatively; and at 1, 3, 6, 9, and 12 months. Graft remodeling (shrinkage or contraction) and PIKM thickness (PIKM-T) were also evaluated over time. Results: Preoperatively, the mean PIKM-W was 0.39 ± 0.40 mm and the PIKM-T was 1.36 ± 0.43 mm. At 6 months, the mean PIKM-W was 4.93 ± 0.98 mm and the PIKM-T was 2.88 ± 0.80 mm, with shrinkage of 39.2 ± 14.1%. By 12 months, the mean PIKM-W stabilized at 4.58 ± 1.28 mm and the PIKM-T stabilized at 2.83 ± 0.65 mm, with shrinkage of 42.2% ± 16.8%. Conclusions: There were statistically significant differences in clinical parameters between the baseline and 6 and 12 months (p < 0.05). This technique demonstrated the potential for stable augmentation of PIKM-W and PIKM-T over time, with manageable shrinkage. However, further studies with larger sample sizes are needed to confirm its clinical efficacy as an alternative for mandibular keratinized mucosa augmentation around implants. Full article

This study evaluated the clinical and tomographic outcomes of socket healing. Immediate implants were placed in the molar area, and the gap was filled with either deproteinized bovine bone mineral (B) or collagen matrix (BM), n = 14/group. Scores of epithelization healing, immunoassay for VEGF, IL-1β, and FGF from wound exudate, keratinized mucosa variation (ΔKM), and bone levels were evaluated. The B group had slower tissue maturation than BM (p < 0.05), but gingival epithelialization was similar (p > 0.05). At the restorative phase, the B group exhibited greater ΔKM at prosthesis installation—1 to 2 months of postoperative (increase of 0.29 mm) compared to the BM group (reduction of −1.5 mm) (p < 0.05). Inflammatory tissue responses as well as vertical and horizontal bone remodeling were similar (p > 0.05). Crestal bone remodeling was limited to less than 0.8 mm for both groups. Taken together, the B and BM groups behaved similarly and promoted stable conditions for biomaterial incorporation in the socket healing after immediate implant placement in molar areas. Full article

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease characterized by repetitive alveolar injuries with excessive deposition of extracellular matrix (ECM) proteins. A crucial need in understanding IPF pathogenesis is identifying cell types associated with histopathological regions, particularly local fibrosis centers known as fibroblast foci. To address this, we integrated published spatial transcriptomics and single-cell RNA sequencing (scRNA-seq) transcriptomics and adopted the Query method and the Overlap method to determine cell type enrichments in histopathological regions. Distinct fibroblast cell types are highly associated with fibroblast foci, and transitional alveolar type 2 and aberrant KRT5-/KRT17+ (KRT: keratin) epithelial cells are associated with morphologically normal alveoli in human IPF lungs. Furthermore, we employed laser capture microdissection-directed mass spectrometry to profile proteins. By comparing with another published similar dataset, common differentially expressed proteins and enriched pathways related to ECM structure organization and collagen processing were identified in fibroblast foci. Importantly, cell type enrichment results from innovative spatial proteomics and scRNA-seq data integration accord with those from spatial transcriptomics and scRNA-seq data integration, supporting the capability and versatility of the entire approach. In summary, we integrated spatial multi-omics with scRNA-seq data to identify disease-associated cell types and potential targets for novel therapies in IPF intervention. The approach can be further applied to other disease areas characterized by spatial heterogeneity. Full article

The red panda (Ailurus), a rare and endangered mammal native to the Himalayan–Hengduan Mountains, has a specialized bamboo diet. Combining morphological and genomic evidence, red pandas have been classified as Ailurus fulgens and Ailurus styani. However, previous studies focused on ecological aspects such as foraging behaviors, habitat use and threats within specific distributions; hence, there is still a gap in quantitative comparative studies on the trophic niches of these two species. In this study, we calculated and compared the isotopic trophic niche widths of A. styani and A. fulgens by measuring carbon and nitrogen stable isotopes in hair keratin of 102 red pandas, then conducting a fecal analysis to explore the diet of a population. The results showed that (1) there was no significant difference in δ¹³C values between A. styani (−24.73 ± 1.26‰, N = 86) and A. fulgens (−24.43 ± 1.20‰, N = 16); however, A. styani had 1.4‰ higher average δ¹⁵N value than that of A. fulgens, and the isotopic niche widths converted by Bayesian ellipse model were A. styani SEA_C = 4.40‰², A. fulgens SEA_C = 4.70‰², which might be caused by their lower and narrower altitude distribution. (2) Niche widths of three genetic populations in A. styani were XXL-LS (5.16‰²), EH-GLG (3.40‰²), QL (2.31‰²), and the comparison of the fecal composition suggested their diet diversity, which might imply a degree of competitive pressure with sympatric animals. (3) Sichuan red pandas occupied a lower trophic position compared to other herbivores but higher than giant pandas in the same ecosystem, and the niche width of red pandas was two times larger than that of sympatric giant pandas, which was related to the foraging strategies and microhabitat selection of the giant and red panda. This research provides basic stable isotopic data for red pandas, offers scientific support for the differentiated and refined conservation and management of the red panda and its habitat, and develops the application of stable isotope analysis in the ecological studies of endangered species. Full article

(1) Background: A free gingival graft (FGG) is a common technique used to reconstruct or enhance the area of keratinized mucosa, while a connective tissue graft (CTG) is utilized to boost soft tissue thickness, thereby promoting stability in interproximal marginal bone levels. Most reported complications following FGG procedure are associated with the donor site. In addition to a painful, open wound in the palate, the most frequent complications linked to FGG harvesting include excessive bleeding, postoperative bone exposure, and recurrent herpes lesions. Numerous methods for securing the donor site after a free gingival graft surgery have been documented in research publications. The main objective of this systematic review was to assess various techniques for protecting the palate after graft harvesting and their impact on patient experience, with a focus on pain management. The secondary objective was to evaluate these techniques in relation to donor site wound healing. (2) Methods: The search was performed across four databases: Medline (PubMed Central), Scopus, Web of Science, and Embase, in accordance with PRISMA guidelines and the recommendations set forth in the Cochrane Handbook for Systematic Reviews of Interventions. The initial search took place on 9 October 2023, followed by an update on 28 June 2024. The search utilized the following keywords: (“wound” OR “injury”) AND (“graft” OR “free gingival graft” OR “graft harvesting”) AND (“healing” OR “recovery”) AND “palate”. (3) Results: After conducting the follow-up search, a total of 958 papers were identified: 193 from PubMed, 314 from Scopus, 101 from Web of Science, and 350 from Embase. Ultimately, of the 49 papers that remained, 11 were excluded due to not fulfilling the inclusion criteria, leaving 38 full-text papers on free gingival grafts (FGG) for qualitative analysis. (4) Conclusions: Various methods for palatal protection after free gingival grafts (FGG) are described in the literature, stemming from biological, physical, or chemical sources. Most studies in this review examined platelet-rich fibrin and suggested that it provides no benefits for patients’ subjective experiences or wound healing outcomes. While photobiomodulation appears to support wound epithelialization, it does not influence pain perception. Alternatives such as propolis, hyaluronic acid, and medicinal plant extracts show potential for palatal protection; however, further research is needed to thoroughly evaluate their effectiveness. Full article