Search Results (3,951)

The aim of this study was to compare the efficacy of the guided tissue regeneration (GTR) of periodontal infrabony defects using the frozen radiation-sterilized allogenic bone graft (FRSABG) versus deproteinized bovine bone mineral (DBBM) 5 years after treatment. The association between patients’ compliance and periodontitis recurrence with 5-year outcomes was also evaluated. Thirty infrabony defects in 15 stage III/IV periodontitis patients were randomly allocated to the FRSBAG group (tests) or the DBBM group (controls). Between 1 and 5 years, one patient was lost to follow-up and one tooth was extracted due to root fracture. No tooth was extracted for periodontal reasons. Consequently, 13 teeth in test sites and 14 teeth in control sites were available for the 5-year analysis. The clinical attachment level gain (CAL-G, primary outcome), probing pocket depth (PPD), radiographic defect depth (DD), and linear defect fill (LDF) were examined at baseline and 5 years post-surgically. Both groups showed statistically significant improvements in all evaluated clinical and radiographic parameters at 5 years, with insignificant intergroup differences. CAL-Gs were 4.46 ± 2.07 mm in the FRSBAG group, and 3.86 ± 1.88 mm in the DBBM group (p = 0.5442). In six (43%) patients, we observed periodontitis recurrence, among whom two (33.33%) participated regularly in supportive periodontal care (SPC) and the other four (66.7%) did not take part in SPC. A regression analysis revealed that periodontitis recurrence was a significant predictor of CAL loss and DD increase. FRSBAG and DBBM were both equally effective 5 years after the GTR of infrabony defects. Within the limitations of the present study, its outcomes advocate that both grafts may be considered as a viable option based on patient preferences and clinical considerations. Full article

The literature has identified several common acute and chronic complications associated with periodontal health during pregnancy, such as gingivitis, recession, periodontitis, and changes in systemic health, such as gestational diabetes, which may act as additional risk factors for chronic periodontal disease. Are the general public and health care providers aware of the potential risks of systemic and intrauterine inflammation caused by bacteria from the oral microbiota entering the bloodstream through inflamed gingival tissue and affecting the fetoplacental unit, leading to complications, such as preterm birth and reduced prenatal growth? A questionnaire-based survey, conducted between January 2023 and June 2023, aimed to assess patients’ personal oral hygiene practices and their understanding of the link between pregnancy and periodontal health. A total of 826 people completed a questionnaire for this study. The majority of women surveyed (86.9%) were not pregnant, but 77.7% had at least one child. The majority of women believed in good oral hygiene during pregnancy but lacked knowledge about how oral care can affect pregnancy outcomes. Full article

Background/Objectives: The rising popularity of e-cigarette use is creating new challenges for oral healthcare. Factors such as targeted marketing, appealing flavors, and the perception that e-cigarettes are a safer alternative to traditional smoking have contributed to their widespread adoption. This trend is particularly prevalent among young adults and teenagers, many of whom turn to e-cigarettes despite having no prior history of regular cigarette use. This study aimed to evaluate dentists’ knowledge and perceptions regarding e-cigarettes, focusing on their health effects, regulatory status, and potential risks to oral health. Assessing dentists’ knowledge of e-cigarette risks is important, as they guide patients on the potential oral health dangers of vaping. E-cigarette use has been linked to several oral health problems. Methods: A cross-sectional survey was conducted among 189 dentists in Kosovo, comprising both general dentists and specialists. The questionnaire assessed participants’ awareness of e-cigarettes’ FDA approval status, their perceptions of health impacts, and their understanding of e-cigarettes’ association with oral conditions such as caries, periodontal disease, and oral cancer. Data were analyzed using SPSS 22, with significance set at p < 0.05. Results: The findings revealed significant knowledge gaps, with 74.1% of respondents being uncertain about the FDA approval status of e-cigarettes and 82.0% recognizing their harmful effects on general and oral health. Nearly half (49.7%) of the participants identified e-cigarettes as a potential risk factor for caries, while 66.1% and 64.6% associated their use with oral cancer and periodontal disease, respectively. Gender and professional specialization did not significantly influence these perceptions. Conclusions: Dentists need better education on the risks of e-cigarette use, including their harmful effects on oral health. Incorporating this knowledge into dental curricula and professional training is essential to give dentists the information needed to advise patients effectively. Raising public awareness through dental health professionals can help mitigate the oral health risks associated with e-cigarettes. Full article

Periodontitis is accompanied by inflammation that causes dysregulation of the Wnt/β-catenin and TGF-β signaling pathways. This leads to a violation of the homeostasis of periodontal tissues. Components of the extracellular matrix (ECM) are an important part of biomaterials used for the repair of periodontal tissue. The purpose of this study was to evaluate the components of the effect of ECM (hyaluronic acid (HA), fibronectin (Fn), and laminin (Lam)) on the osteogenic and odontogenic differentiation of periodontal ligament stem cells (PDLSCs) in the collagen I hydrogel under conditions of disruption of the Wnt/β-catenin and TGF-β signaling pathways. The study showed that the addition of components of the ECM restored the expression of odontogenic markers in PDLSCs, which was absent during inhibition of the canonical Wnt signaling pathway, and their multidirectional effect on the secretion of transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein 2 (BMP-2). Fn and Lam suppressed the expression of odontogenic markers in PDLSCs against the background of inhibition of the TGF-β signaling pathway. The addition of HA under the conditions of the TGF-β signaling pathway improved BMP-2 secretion, preserving odontogenic differentiation. Thus, our results demonstrated that disruption of the Wnt/β-catenin and TGF-β signaling pathways causes disorders in the differentiation of PDLSCs, preventing the regeneration of periodontal tissues. This should be taken into account when developing multicomponent scaffolds that recapitulate the ECM microenvironment at endogenic regeneration of the periodontium. Inclusion of hyaluronic acid as one of these components may enhance the therapeutic effect of such biomaterials. Full article

Background/Objectives: Vital pulpotomy involves the partial removal of the coronal pulp tissue in cases of vital pulp exposure, aiming to maintain the health and function of the remaining radicular pulp. The first aim of this study was to compare the effects of two different methodological approaches towards vital pulpotomy of the primary teeth—conventional and laser pulpotomy; thereafter, the aim was to perform a comparison of the effects of the application of calcium hydroxide (Ca(OH)₂) versus mineral trioxide aggregate (MTA); then, we analyzed and compared clinical and radiographic changes in pulpotomized teeth over a defined time period; finally, we determined the degree of efficiency of different methods of vital pulpotomy of the primary teeth. Methods: This study analyzed 40 primary molars, 20 teeth treated with conventional pulpotomy and 20 teeth submitted to laser pulpotomy. Additionally, two pulpotomy agents—Ca(OH)₂ and MTA—were used. The following clinical parameters were examined: pain, percussion sensitivity, swelling, sinus tract presence and pathological mobility. Absence of apical radiolucency, external and internal root resorption, and periodontal ligament widening were key radiographic parameters of the success of the endodontic therapy. Results: The results showed that there was no statistically significant difference between the two pulpotomy agents—Ca(OH)₂ and MTA—and therefore both can be used as alternative pulpotomy agents in the primary teeth. Conclusions: The success rate of pulpotomy with Ca(OH)₂ is similar to that of pulpotomy with MTA. The combination of laser pulpotomy and the use of MTA gave the best results according to all clinical and radiographic criteria examined and in all analyzed periods. Full article

Background and Objectives: AI is considered one of the most innovative technologies of this century. Its introduction into healthcare has transformed the industry, significantly impacting various aspects such as education, teaching, diagnosis, treatment planning, and patient care. Researchers have tested the accuracy of various generations of AI models for detecting peri-implant bone loss using radiographic images. While studies have reported promising outcomes, there remains significant potential for improving these models. This systematic review aims to critically analyze the existing published literature on the accuracy of AI models in detecting peri-implant bone loss and to evaluate the current state of knowledge in this area. Methods: The guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were pivotal and provided a framework for preparing, implementing, and recording this systematic review. The protocol for this review was registered in PROSPERO. Four electronic databases (PubMed, Scopus, Web of Science, and Cochrane) were diligently searched on 5–6 January 2025, targeting articles published between January 2000 and December 2024. The PIRD elements (population, index test, reference test, diagnosis of interest) that helped in structuring the protocol of the present review were: P: X-ray images of humans demonstrating the bone loss around the dental implant; I: Artificial intelligence models used for detecting radiographic peri-implant bone loss; R: Expert opinions and reference standards; D: Radiographic peri-implant bone loss. The Quality Assessment and Diagnostic Accuracy Tool (QUADAS-2) was used to assess the quality of each included study. Results: Seven studies met the selection criteria and were included in the qualitative analysis. A self-designed table was used to tabulate all the relevant study characteristics. The included studies were reported to have a moderate level of certainty of evidence as assessed by the GRADE assessment. In general, all studies included in this review demonstrated a low risk of bias. Overall accuracy of the AI models varied and ranged between 61% and 94.74%. The precision values ranged from 0.63% to 100%. Whereas sensitivity and specificity values range between 67% and 94.44%, and 87% and 100%, respectively. Conclusions: The present systematic review highlights that AI models demonstrate high accuracy in detecting peri-implant bone loss using dento-maxillofacial radiographic images. Thus, AI models can serve as effective tools for the practicing dentist in confirming the diagnosis of peri-implant bone loss, ultimately aiding in accurate treatment planning and improving treatment outcomes. Full article

Background/Objectives: Lactoferrin, a protein involved in the immune response, plays a significant role in the etiopathogenesis of periodontitis in the general population. This cross-sectional study aims to determine the salivary concentration of lactoferrin in Down syndrome individuals with periodontitis. Methods: A convenience cohort of 76 Down syndrome individuals was established, including 34 with periodontitis, 29 with gingivitis, and 13 with healthy gums. Unstimulated saliva samples were collected and processed to quantify the lactoferrin concentration using the Human Lactoferrin ELISA kit, the total protein concentration (bicinchoninic acid assay [BCA]) using the BCA Protein Assay Kit (Pierce, Rockford, IL, USA), and the lactoferrin/BCA ratio. Additionally, the Lf rs1126478 (140A/G in exon 2, Lys/Arg) genotypes were determined via PCR with restriction fragment length polymorphism (RFLP) analysis using the Earl enzyme. Results: The lactoferrin levels were comparable across patients with periodontitis, gingivitis, and healthy gums (median = 8.20, 6.57, and 7.61 µg/mL, respectively). There were no differences in the BCA levels between the three groups (median = 2.21, 3.17, and 2.08 µg/µL, respectively) nor in the lactoferrin/BCA ratios. The distribution of the Lf 140A/G polymorphism did not show differences concerning periodontal health status. Conclusions: In Down syndrome individuals, salivary lactoferrin and BCA levels are not influenced by the periodontal health condition. Additionally, no significant genetic associations were found with the rs1126478 polymorphism in Down syndrome individuals with and without periodontitis. Lactoferrin production in Down syndrome may not be upregulated in response to periodontal pathogens, which could be indicative of an immune system dysregulation contributing to the early onset and severity of periodontitis in this population. Full article

Oral cavity dysbiosis is associated with numerous inflammatory diseases, including diabetes, inflammatory bowel diseases, and periodontal disease. Changes in the oral microenvironment lead to bidirectional interactions between pathogens and individual host systems, which may induce systemic inflammation. There is increasing evidence linking the condition of the oral cavity with the most common causes of female infertility, such as polycystic ovary syndrome and endometriosis, as well as gestational complications, e.g., low birth weight, preterm delivery, and miscarriages. This review highlights the composition of the female oral microbiome in relation to infertility-related disorders, such as endometriosis and polycystic ovary syndrome, and provides a comprehensive overview of the current state of knowledge on the relationship between a dysbiotic oral microbiome, pregnancy, and its impact on the female reproductive tract. Full article

Neurodegenerative diseases (NDDs) represent a considerable global health burden with no definitive treatments. Emerging evidence suggests that periodontitis may contribute to NDD through shared inflammatory, microbial, and genetic pathways. A retrospective cohort design was applied to analyze hospital records from 2012–2022 and to determine whether periodontitis independently increases NDD risk when accounting for major cardiovascular, cerebrovascular, metabolic, and inflammatory confounders. Likelihood ratio-based Cox regression tests and Weibull survival models were applied to assess the association between periodontitis and NDD risk. Model selection was guided by Akaike and Bayesian information criteria, while Harrell’s C-index and receiver operating characteristic curves evaluated predictive performance. Periodontitis demonstrated an independent association with neurodegenerative disease risk (HR 1.43, 95% CI 1.02–1.99). Cerebral infarction conferred the highest hazard (HR 4.81, 95% CI 2.90–7.96), while pneumonia (HR 1.96, 95% CI 1.05–3.64) and gastroesophageal reflux disease (HR 2.82, 95% CI 1.77–4.51) also showed significant increases in risk. Older individuals with periodontitis are at heightened risk of neurodegenerative disease, an effect further intensified by cerebrovascular, cardiometabolic, and gastroesophageal conditions. Pneumonia also emerged as an independent pathophysiological factor that may accelerate disease onset or progression. Attention to oral and systemic factors through coordinated clinical management may mitigate the onset and severity of neurodegeneration. Full article

Background and Objectives: Nowadays, dental anxiety is one of the most common problems among the masses globally, causing individuals to avoid seeking dental treatment, which in turn leads to deterioration of quality of life related to oral health. Despite the technological advances in dentistry such that less pain is felt and high comfort performance is maintained, dental anxiety is still seen in individuals. Non-surgical periodontal therapy can be the cause of tension, anxiety, and stress. The aim of this study is to evaluate the possible relationships between pain perception and dental anxiety in individuals who underwent supragingival scaling. Materials and Methods: In our study, 226 individuals (114 female and 112 male) who were referred to the Dicle University Faculty of Dentistry, Department of Periodontology and who underwent supragingival scaling treatment were included. Participants were asked to complete the Modified Dental Anxiety Scale (M-DAS) and the Visual Analog Scale (VAS) to determine anxiety and pain levels and questionnaires containing information on gender, age, education level, previous dental visits, and complications. Results: The M-DAS score for females was significantly higher compared to males (p < 0.05). However, there was no statistically significant difference between genders regarding VAS scores. No statistically significant difference existed between M-DAS and VAS scores and education levels. There was a statistically significant relationship between M-DAS and VAS scores in females (p < 0.05). Conclusions: M-DAS and VAS scores in male patients did not show any statistically significant difference. Female patients exhibited higher levels of dental anxiety, and VAS scores were increased in females; M-DAS scores were also increased. Full article

Background/Objectives: Initiation and progression of periodontal disease include oxidative stress. Systemic application of antioxidants may provide clinical benefits against periodontal disease including gingivitis. Recently, a jelly containing a high concentration of hydrogen (40 ppm) was developed. We hypothesized that oral intake of this hydrogen-rich jelly may be safe and effective on gingivitis. This clinical trial was designed to investigate the safety and efficacy of oral intake of hydrogen-rich jelly against gingival inflammation. Methods: Participants with gingivitis were instructed to orally ingest 30 g of hydrogen-rich jelly (experimental group) or placebo jelly (control group) three times a day for 14 consecutive days. The primary outcome of this trial was the percentage of bleeding on probing (BOP) sites. Secondary outcomes were oral parameters, serum reactive oxygen metabolites, antioxidant capacity, oxidative index, concentrations of cytokine (interleukin [IL]-1β, IL-6, IL-10, IL-17, and tumor necrosis factor-alpha) in gingival crevicular fluid, and adverse events. For all parameters, Mann–Whitney U test was used for comparison between experimental and control groups. Analysis of covariance, controlling for baseline periodontal inflamed surface area, was performed to evaluate the association between the effect of the hydrogen-rich jelly and gingival inflammation. Results: In the experiment and control groups, the percentage of sites with BOP and PISA significantly decreased at the end of the experiment compared to the baseline. However, no significant differences were found between groups (p > 0.05). Conclusions: Administration of hydrogen-rich jelly for 14 days decreased gingival inflammation. However, no significant differences were identified compared to the control group. Full article

Background: Dental impaction requires careful consideration prior to extraction. Factors influencing the decision to extract an impacted tooth include the depth of impaction, proximity to vital structures, patient age, systemic conditions, and compliance. The eruption of third molars often presents periodontal challenges for adjacent second molars, with studies identifying a link between third molar presence and periodontal defects. Orthopantomography (OPG) is the primary diagnostic tool, providing a low-radiation, quick, and comprehensive view of the dental arches. Computed tomography (CT) offers additional three-dimensional information for a more accurate anatomical evaluation. Objective: This study aimed to evaluate the periodontal status of the lower second molar after lower third molar extraction, considering both periodontal and orthodontic perspectives. Methods: Conducted at the University of Modena and Reggio Emilia, this study evaluated changes in the periodontal status of the lower second molar at least 12 months after lower third molar extraction. A total of 53 patients meeting the inclusion criteria underwent surgical extraction. Clinical and radiographic evaluations were performed, analyzing parameters such as impaction type, angulation, and preoperative conditions. Results: The results suggest reduced healing in cases involving horizontal impacted third molars, although the small sample size limits statistical significance. These results align with the existing literature emphasizing better healing outcomes in young individuals undergoing early extraction. Conclusions: This pilot study highlights the periodontal implications of lower third molar extraction and underscore the potential benefits of early intervention for certain impaction types. Future research with larger sample sizes and a more detailed analysis of complications could provide deeper insights into the periodontal and orthodontic consequences of third molar management. Full article

Background/Objectives: The present study evaluated the effectiveness of a prevention protocol involving oral hygiene, instructions, and motivation in patients eligible for hematopoietic stem cell transplantation (HSCT). Methods: Consecutive patients scheduled for HSCT were enrolled. All patients received a complete dental examination aimed at assessing periodontal health status through periodontal charting and registration of the levels of plaque and inflammation. Subsequently, patients received professional oral hygiene care and were instructed on and motivated toward oral prophylaxis prior to HSCT. Upon engraftment, patients received dedicated instructions to improve oral hygiene maneuvers. After HSCT, patients were re-evaluated for periodontal clinical parameters. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was also administered to evaluate perceived oral health status. Results: Thirty-five patients (18 males and 17 females, with a mean age of 43.28 ± 11.73 years) were enrolled. An overall improvement was noted in periodontal parameters. However, despite plaque reduction, inflammation was still present because of the treatment. The OHIP-14 score slightly worsened after HSCT. Conclusions: Professional oral hygiene and prophylaxis proved effective in improving the oral health status of patients undergoing HSCT, potentially impacting post-treatment outcomes. Further assessment is needed to validate these results. Full article

Objectives: The aim of this study was to describe the structure and assess the efficacy of a patient-centered framework for managing periodontitis, utilizing the Bioperio^® protocol, a standardized treatment approach incorporating both clinical and extra-clinical phases. Methods: Patients diagnosed with periodontitis were included in this multicenter, single-arm, clinical observational study with a 3-month follow-up. All patients were treated following the Bioperio^® protocol, involving professional supra-gingival scaling, oral hygiene instructions, and scaling and root planing following a full-mouth approach. In Stage III/IV periodontitis cases, enamel matrix derivatives (EMD) were applied in periodontal pockets > 5 mm. Monthly recalls were performed until the 3-month follow-up. Results: In total, 663 patients were enrolled, with 76.4% being diagnosed with Stage II/III periodontitis. At 3 months, all clinical periodontal parameters improved regardless of the initial stage of periodontitis, achieving pocket closure in 75.4% of cases and patient resolution in 91.3% of the sample. Stages I/II showed significantly improved outcomes compared to Stage IV. The adjunct of EMDproved beneficial, especially in stage III patients, increasing pocket closure by 15% and doubling the odds of patient resolution. No adverse effects of the treatment protocol were observed throughout the study. Conclusions: The Bioperio^® protocol appears to be a safe and effective therapeutic approach for the management of patients affected by periodontitis. Combining a stepwise approach for clinical phases with tailored oral hygiene instructions and motivational sessions offers a comprehensive strategy that may enhance outcomes for patients with periodontitis. Full article

Head and neck cancers (HNCs) are often diagnosed late, leading to poor prognosis. Chronic inflammation, particularly periodontitis, has been linked to carcinogenesis, but systemic inflammatory markers remain underexplored. This study was the first to examine whether elevated C-reactive protein (CRP) can serve as a cost-effective adjunct in HNC risk assessment, alongside oral health indicators. A retrospective cohort study analysed 23,742 hospital records (4833 patients, 2015–2022) from the University Hospital of Debrecen. HNC cases were identified using ICD-10 codes, with CRP and periodontitis as key predictors. Kaplan–Meier survival analysis, log-rank tests, and Weibull regression were used to assess risk, with model performance evaluated via AIC/BIC and ROC curves. Periodontitis was significantly associated with HNC (HR 5.99 [1.96–18.30]), while elevated CRP (>15 mg/L) independently increased risk (HR 4.16 [1.45–12.00]). Females had a significantly lower risk than males (HR 0.06 [0.01–0.50]). CRP may serve as a cost-effective, easily accessible biomarker for early HNC detection when combined with oral health screening. Integrating systemic inflammation markers into HNC risk assessment models could potentially improve early diagnosis in high-risk populations. Full article