{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:10:44Z","timestamp":1775146244502,"version":"3.50.1"},"reference-count":68,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This study aimed to evaluate associations between dental caries, periodontal pockets, and radiologically detected periapical lesions in relation to serum levels of Dickkopf-1 (Dkk-1) and tartrate-resistant acid phosphatase 5B (TRAP-5B) in oncologic patients with ear, nose, and throat (ENT) cancer compared with healthy controls. Materials and Methods: The study included 63 subjects divided into a study group of 33 patients diagnosed with ENT cancer and a control group of 30 healthy individuals. Blood samples were collected to assess serum Dkk-1 levels using a sandwich enzyme immunoassay and TRAP-5B levels. Radiological dental evaluation included orthopantomography (OPT) and cone beam computed tomography (CBCT) to assess the number and depth of dental caries and the presence of periapical lesions. Periodontal pockets were recorded through clinical examination. Results: Serum biomarker analysis demonstrated significant differences between groups: TRAP-5B levels were significantly higher in patients with ENT cancer, whereas Dkk-1 concentrations were significantly lower compared with healthy controls (p &lt; 0.001). OPT revealed up to eight carious lesions in both groups. The mean number of carious lesions was higher in healthy subjects (2.97 \u00b1 2.48) than in patients with ENT cancer (2.06 \u00b1 2.29). CBCT evaluation revealed 0\u20138 carious lesions in healthy individuals and 0\u20136 lesions in patients with ENT cancer, with a significantly higher mean number of lesions in the control group (2.97 \u00b1 2.48 vs. 1.85 \u00b1 1.89). Periodontal pockets were more frequent in patients with ENT cancer (0.67 \u00b1 1.32) than in controls (0.37 \u00b1 0.81). OPT evaluation also showed a higher mean number of periapical lesions in patients with ENT cancer (0.82 \u00b1 1.29) compared with controls (0.37 \u00b1 0.67). CBCT examination demonstrated that the mean number of periapical lesions in patients with ENT cancer was more than twice that of the control group, although this difference did not reach statistical significance. Conclusions: Patients with ENT cancer exhibited significantly altered systemic bone turnover biomarker profiles, characterized by increased TRAP-5B and decreased Dkk-1 levels. Clinically, these patients also presented a higher prevalence of periodontal pockets and periapical lesions, whereas carious lesions were more frequently detected in healthy individuals. The combined radiological and biochemical findings contribute to a better understanding of oral\u2013systemic interactions in oncologic patients and highlight the importance of comprehensive dental evaluation prior to oncologic therapy.<\/jats:p>","DOI":"10.3390\/medicina62040669","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:14:43Z","timestamp":1775142883000},"page":"669","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral Inflammatory Lesions and Bone Turnover Biomarkers (Dkk-1 and TRAP-5B) in Patients with ENT Cancer: A Radiological and Clinical Case\u2013Control Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3384-5857","authenticated-orcid":false,"given":"Cristina","family":"Antohi","sequence":"first","affiliation":[{"name":"Department of Odontology-Periodontology-Fixed Prosthetics, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0218-7376","authenticated-orcid":false,"given":"Eduard Radu","family":"Cernei","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9588-6910","authenticated-orcid":false,"given":"Sorina","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Odontology-Periodontology-Fixed Prosthetics, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8714-7713","authenticated-orcid":false,"given":"Alexandra Corina","family":"Concita","sequence":"additional","affiliation":[{"name":"Department of Odontology-Periodontology-Fixed Prosthetics, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1505-7567","authenticated-orcid":false,"given":"Roxana Mihaela","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4563-3794","authenticated-orcid":false,"given":"Mihaela","family":"Salceanu","sequence":"additional","affiliation":[{"name":"Department of Odontology-Periodontology-Fixed Prosthetics, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1600-0528.1997.tb00894.x","article-title":"Concepts of dental caries and their consequences for understanding the disease","volume":"25","author":"Fejerskov","year":"1997","journal-title":"Community Dent. 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