Search Results (151)

Alveolar bone loss is a defining feature of periodontitis and a principal cause of tooth loss worldwide. Driven by a dysregulated host immune response to chronic bacterial infection, periodontitis initiates a cascade of inflammatory events that lead to an imbalance in bone remodeling, favoring osteoclastic activity. While conventional periodontal therapies aim to control infection and inflammation, they often fall short in preserving bone integrity. As a result, interest has grown in adjunctive strategies targeting molecular pathways involved in bone metabolism. Among potential candidates, coffee, a globally consumed beverage often perceived as detrimental to health, has gained attention for its complex array of bioactive compounds, including caffeine, chlorogenic acids, and polyphenols. These compounds have demonstrated anti-inflammatory, antioxidant, and osteo-modulatory effects in various biological contexts. Despite coffee’s reputation as a potential health risk, its complex composition presents a paradox, necessitating an investigation into how its bioactive constituents may mitigate periodontal tissue destruction. The novelty of this short review lies in its integration of in vitro, animal, and epidemiologic evidence to delineate the dose- and context-dependent effects of coffee polyphenols, particularly chlorogenic and ferulic acids, on periodontal inflammation and alveolar bone remodeling, with special emphasis on osteoclast-related mechanisms that have not been synthesized previously. Caffeine can influence osteoblast and osteoclast activity in a dose-dependent manner, while chlorogenic acids (CGA) and polyphenols exert radical-scavenging and cytokine-suppressing activity that may reduce inflammatory bone loss. However, their efficacy is influenced by coffee species, cultivation, roasting, and extraction methods. This review evaluates current evidence and proposes directions for optimizing coffee-based formulations to support alveolar bone preservation in periodontitis. Full article

For decades, regeneration of alveolar bone defects has depended on traditional grafting options, such as autogenous/allogenic grafts or allografts. Recently, extracted teeth was introduced as an alternative graft source. Tooth autografts are being used and have gained significant attention due to their biocompatibility, osteoconductivity, osteoinductivity, and osteogenic properties. Furthermore, tooth allografts have potential to act as natural biocomposites for oral regeneration procedures and might be advantageous options in near future. Recent advances in tooth banking, including cryopreservation, can serve to maintain bioactivity and to improve the safety, viability, and regenerative potential of teeth. They might be revolutionary in oral surgery, offering a more sustainable solution to the growing demand for bone regeneration procedures. Nevertheless, challenges such as immunogenic responses, ethical issues, and regulatory constraints persist. Ongoing research and technological innovation continue to address these problems. To date, the success rates of tooth autografts are promising, and they are regarded as a reliable option in clinical practice, with predictable outcomes in alveolar ridge preservation, sinus augmentation, periodontal regeneration, guided bone regeneration (GBR), and endodontic surgery by providing natural scaffolds for cell integration and bone remodeling. However, the scientific literature on tooth allografts is lacking. Therefore, this review aimed to comprehensively evaluate the scientific literature for comparing the properties of tooth grafts with other grafting options, in terms of processing techniques, and various clinical applications, positioning them as versatile biocomposites for the future, bridging material science and regenerative dentistry. Furthermore, possible applications of allogenic tooth grafts and overcoming current limitations are also discussed. Full article

Background: Autologous tooth-derived grafts have recently gained attention as an innovative alternative to conventional biomaterials for alveolar ridge preservation (ARP) and augmentation (ARA). Their structural similarity to bone and osteoinductive potential support clinical use. Methods: This systematic review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420251108128). A comprehensive search was performed in PubMed, Scopus, and Web of Science (2010–2025). Randomized controlled trials (RCTs), split-mouth, and prospective clinical studies evaluating autologous dentin-derived grafts were included. Two reviewers independently extracted data and assessed risk of bias using Cochrane RoB 2.0 (for RCTs) and ROBINS-I (for non-randomized studies). Results: Nine studies involving 321 patients were included. Autologous dentin grafts effectively preserved ridge dimensions, with horizontal and vertical bone loss significantly reduced compared to controls. Histomorphometric analyses reported 42–56% new bone formation within 4–6 months, with minimal residual graft particles and favorable vascularization. Implant survival ranged from 96–100%, with stable marginal bone levels and no major complications. Conclusions: Autologous tooth-derived biomaterials represent a safe, biologically active, and cost-effective option for alveolar bone regeneration, showing comparable or superior results to xenografts and autologous bone. Further standardized, long-term RCTs are warranted to confirm their role in clinical practice. Full article

Background and Objectives: Immediate implant placement in the esthetic zone presents challenges in maintaining peri-implant tissues due to post-extraction remodeling. Bone grafting has been proposed to support tissue preservation and improve esthetic outcomes. This article reviews the role of grafting in clinical studies and case reports. Materials and Methods: A literature search on PubMed and Google Scholar identified studies focusing on immediate implant placement with grafting. The search strategy included articles from 2012 to 2025, in English, from peer-reviewed journals. Results: Implant survival is possible without grafting in ideal cases, but grafting is often essential in patients with thin biotypes or esthetic demands. Technique and material selection are critical. The socket shield technique shows promise in preserving buccal tissues despite its complexity. Case reports demonstrated stable soft tissues and favorable esthetic outcomes. Conclusions: Grafting should be tailored to the clinical situation. While not always necessary, it is often crucial in compromised sites to ensure long-term esthetic success. Current literature supports predictable outcomes with appropriate grafting protocols. Full article

Zanthoxyli Pericarpium (ZP), the dried pericarp of mature fruits of Zanthoxylum schinifolium Siebold and Zucc., has traditionally been used in East Asian medicine for its medicinal properties, but its therapeutic potential in periodontitis has not been elucidated. In the present study, we investigated the effects of ZP on ligature-induced experimental periodontitis (EPD) in male Sprague Dawley rats. Animals were assigned to vehicle control, ligature control, ZP-treated (25, 50, and 100 mg/kg), or indomethacin-treated (5 mg/kg) groups (n = 10 per group) and orally administered the respective treatments daily for 10 days after ligature placement. ZP significantly reduced anaerobic bacterial proliferation and inflammatory cell infiltration in gingival tissue. ZP suppressed the production of inflammatory mediators, such as tumor necrosis factor-α and interleukin-1β, in both gingival tissues and lipopolysaccharide-stimulated RAW 264.7 macrophages, through inhibition of the mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) signaling pathways. In addition, ZP decreased myeloperoxidase activity and reduced matrix metalloproteinase-8 expression, thereby preserving collagen areas. ZP also restored the receptor activator of NF-κB ligand/osteoprotegerin (RANKL/OPG) balance, leading to a reduction in osteoclast numbers and their occupancy on the alveolar surface, and it effectively ameliorated horizontal alveolar bone loss. Furthermore, ZP exhibited antioxidant effects by lowering malondialdehyde levels and inducible nitric oxide synthase activity in gingival tissues. Statistical analysis was performed using ANOVA followed by a post hoc test, with significance set at p < 0.05. These findings indicate that ZP mitigates periodontitis through combined antimicrobial, anti-inflammatory, antioxidant, and anti-resorptive actions, supporting its potential as a therapeutic candidate for periodontitis. Full article

Objectives: This study aimed to evaluate the available evidence on the use of orthodontic mini-implants (MIs) as temporary anchorage devices (TADs), with particular focus on how insertion angulation may influence clinical outcomes. A clinical case report was also included to complement the review findings. Methods: A systematic review was performed following PRISMA guidelines and a focused PICO question. Searches in PubMed, Web of Science, and Scopus, supplemented by manual screening of reference lists. Duplicates, systematic reviews, and studies outside the PICO scope were excluded. An observational analysis of CBCT and intraoral images, and a clinical case report, were evaluated with a standardized protocol for angulation classification based on anatomical landmarks and angular measurements. Results: Ten studies met the eligibility criteria. Most reported high survival rates, with stability defined by the absence of TAD mobility or loss. CBCT-derived data from two studies, together with one clinical case, demonstrated maintenance of alveolar bone. Improved outcomes were occasionally associated with changes in insertion angulation. Vertical positioning was more frequently linked to complications in shorter TADs, while horizontal placement preserved bone but introduced hygiene-related difficulties. Conclusions: TAD success and bone preservation may depend on insertion angulation, TAD size, and soft tissue conditions. Further standardized prospective studies are needed to validate these findings, particularly regarding intermediate diagonal insertion angles (between vertical and horizontal) extending from palatal to buccal, as observed in our clinical case, which is not yet reported in the literature. Full article

Although ridge preservation procedures have been shown to prevent post-extraction bone loss, the effectiveness of using a flap or flapless surgical approach remains unclear. The aim of the study was to compare the mentioned above alveolar ridge preservation procedures in the esthetic region of maxilla. Twenty-nine patients were randomly assigned to receive flap (n = 14) or flapless (n = 15) alveolar ridge preservation procedure. Sockets were grafted with alloplastic biomaterial, then covered with a collagen membrane in both groups. Clinical examinations were performed over a 6-month observation period and radiological (CBCT) examination was conducted before and 6 months after treatment. For both after flap and flapless procedures, there was a reduction in interdental papillae height and keratinized tissue width, increase in buccal soft tissues thickness with a decrease in radiological buccal bone plate width, decrease in radiological buccal and lingual plate height (significantly for the flapless group) and radiological alveolar process width reduction (significantly in flapless group at the height of 5 mm and 7 mm from the bottom of the socket). A decrease in the radiological buccal bone plate width was observed, where the further measuring point was from the bottom of the alveolus. In the mucoperiosteal flap preparation, group buccal bone plate width reduction at the height 3 mm, 5 mm and 7 mm was significant and in the flapless group a significant decrease was observed from 5 to 9 mm from the bottom of the socket. Despite ridge preservation, there is soft tissue thickening and a decrease in bone height and width regardless of the flap/flapless method used. Full article

Background/Objectives: Tooth autotransplantation is a natural tooth replacement method that preserves the periodontal ligament, supporting root development and alveolar bone remodeling. Unlike dental implants, autotransplanted teeth maintain sensory function and adapt better to the mouth. Although once overlooked, new surgical, imaging, and regenerative advances have revived interest in this technique. This narrative review explores the renewed interest in tooth autotransplantation by assessing its benefits, success rates, technological advancements, and role in modern dentistry while evaluating its advantages, limitations, and potential impact on dental care. Methods: A narrative approach was used to provide a comprehensive and descriptive overview of current knowledge on tooth autotransplantation. A literature search was conducted in PubMed, Scopus, and Google Scholar using keywords such as “tooth autotransplantation”, “biological tooth replacement”, “periodontal ligament”, and “dental implants alternative”. English-language articles published between 2000 and 2025 were included, covering clinical trials, reviews, and relevant case reports. Selection focused on studies discussing biological mechanisms, clinical techniques, technological advances, and treatment outcomes. Results: Success rates range from 80% to 95%, with better predictability in younger patients with immature donor teeth. Long-term viability depends on preserving the PDL and performing atraumatic extractions. However, challenges such as root resorption, ankylosis, and appropriate case selection remain significant considerations. Technological advancements, including CBCT, 3D-printed surgical guides, and biomimetic storage media, have improved surgical precision and clinical outcomes. Conclusions: Tooth autotransplantation is an effective and cost-effective alternative to dental implants, particularly for growing patients or when implants are not suitable. While success depends on surgical skill and proper case selection, improvements in imaging and regenerative techniques have made outcomes more predictable. Future advances in bioengineering, AI-based planning, and regenerative therapies are likely to expand their use in modern dentistry. Full article

Background. Orthodontic extrusion (OE), or forced eruption, is a conservative technique used to recover teeth affected by coronal fractures, traumatic intrusions, or severe caries. It involves applying light, continuous forces to induce vertical tooth movement, promoting tissue remodeling through periodontal ligament stimulation. Materials and Methods. This narrative review included studies investigating OE as a therapeutic approach for the management of deep or subgingival carious lesions, traumatic dental injuries (such as intrusion or fracture), or for alveolar ridge augmentation in implant site development. OE is typically performed using fixed appliances such as the straight-wire system or, in selected cases, clear aligners. Forces between 30 and 100 g per tooth are applied, depending on the clinical situation. In some protocols, OE is combined with fiberotomy to minimize gingival and bone migration. Results. Studies show that OE leads to significant vertical movement and increases in buccal bone height and interproximal septa. It enhances bone volume in targeted sites, making it valuable in implant site development. Compared to surgical crown lengthening, OE better preserves periodontal tissues and improves esthetics. Conclusions. In this narrative review is analized how OE is effective for managing traumatic intrusions and compromised periodontal sites, particularly when paired with early endodontic treatment. It reduces the risks of ankylosis and root resorption while avoiding invasive procedures like grafting. Although clear aligners may limit axial tooth movement, OE remains a minimally invasive, cost-effective alternative in both restorative and implant dentistry. Full article

Adenosine signaling plays protective roles in gingival mitochondrial health and inflammation control, with the ectoenzyme CD73 implicated in periodontitis. Here, we investigated the effects of selective adenosine A2a receptor (A2aR) stimulation using the agonist CGS21680 in a mouse model of ligature-induced periodontitis (LIP) and in gingival fibroblast mitochondrial function. Mature C57Bl/6 mice underwent LIP and received daily intraperitoneal injections of CGS21680 (0.1 mg/Kg) or saline. After 8 days, gingival tissues and maxillae were analyzed for alveolar bone loss and Il-1β levels. In parallel, murine gingival fibroblasts (mGFs) were treated with Tnf-α (5 ng/mL) ± CGS21680 (10 µM) to assess mitochondrial function, morphology, and quality control. A2aR activation significantly reduced alveolar bone loss and Il-1β expression in vivo. In vitro, CGS21680 suppressed Tnf-α-induced Cxcl10 and Cxcl12 expressions and enhanced Vegf production. Mitochondrial analysis revealed increased mitochondrial complex levels, membrane potential, and mass, alongside reduced reactive oxygen species (ROS), proton leak, and mitochondrial stress. Ultrastructural studies showed elongated, healthier mitochondria and increased pro-fusion markers, indicating enhanced mitochondrial quality control. Overall, A2aR stimulation attenuates periodontal inflammation and confers mitoprotective effects on gingival fibroblasts, supporting its potential as a therapeutic strategy to both mitigate periodontitis progression and preserve tissue bioenergetics supporting cellular resilience. Full article

Background: The purpose of alveolar ridge preservation (ARP) is to minimise the physiological alveolar ridge reduction occurring after dental extraction, which can prevent the need for future alveolar ridge augmentation. Biologic materials (biologics) promote tissue regeneration based on their effect on wound healing at a cellular level. By integrating biologics into ARP biomaterials, there is a potential to enhance the regeneration of both hard and soft tissues with greater efficacy. Aim: This narrative review aims to evaluate the clinical efficacy of the addition of biologics to existing ARP materials on the physiological changes following ARP of an extraction site. Methods: A search of the PubMed electronic database was conducted, and relevant articles were examined. Sixty-three articles met the inclusion and exclusion criteria and were included in this review. Results and Conclusions: A review of the existing literature found that the combination of biologics with ARP materials resulted in similar dimensional changes when compared to using ARP materials alone. Existing research has identified an enhancement in bone density, increased wound healing capacity of soft and hard tissue, and a reduction in post-operative pain. Whilst the addition of biologics to ARP materials has shown an increase in bone density, its effectiveness in improving implant outcomes and reducing the need for future alveolar ridge augmentation is unclear. Recognising the limitations within the existing literature, along with the risk of bias and heterogeneity, renders it unwise to make definite conclusions about the benefits of integrating biologics with ARP materials. This narrative review found possible benefits in the use of biologics in ARP to optimise patient-related and treatment outcomes, indicating the need for additional research. Full article

(1) Background: This study aimed to compare alveolar bone preservation and early healing outcomes following a comprehensive laser-assisted post-extraction protocol compared to conventional extraction alone. In addition, the potential influence of serum vitamin D levels on bone regeneration was assessed. (2) Methods: Thirty tooth extractions were performed and randomized into two groups: a test group (G1, n =15) and a control group (G2, n = 15). G1 received a laser-assisted protocol using Er:YAG and Nd:YAG lasers for granulation tissue removal, socket disinfection, clot stabilization, de-epithelialization, and photobiomodulation (PBM) with the Genova handpiece (LightWalker, Fotona, Slovenia). G2 underwent standard mechanical extractions and socket debridement without laser. (3) Results: Procedures in G1 were on average 8.7 min longer, but patients in this group reported significantly lower postoperative pain during the first three days (p < 0.05). A statistically significant difference in alveolar height was observed at the distal lingual site (25.4 mm vs. 21.7 mm; p = 0.046), with other sites showing a trend toward significance. Cumulative bone preservation, measured by Bone Loss Index (BLI4), was significantly better in the laser group. Notably, a positive correlation was found between serum vitamin D levels and bone preservation: each 1 ng/mL increase in vitamin D corresponded to a 0.18 mm gain in alveolar height (p = 0.021). (4) Conclusions: The comprehensive laser-assisted post-extraction protocol reduced postoperative pain and improved alveolar bone preservation, particularly at the lingual distal site. Serum vitamin D levels positively correlated with healing outcomes, suggesting a potential synergistic role of systemic and local regenerative factors. Full article

This study aimed to compare the performance of three hydroxyapatite–β-tricalcium phosphate (HA–β-TCP) collagen composite grafts in a canine model for extraction socket preservation. Eight mongrel dogs underwent atraumatic bilateral mandibular premolar extraction, and sockets were randomly grafted with HBC28 (20% high-crystalline HA, 80% β-TCP bovine collagen), HBC37 (30% HA, 70% β-TCP, bovine collagen), or HPC64 (60% HA, 40% β-TCP, porcine collagen). Grafts differed in their HA–β-TCP ratio and collagen origin and content. Animals were sacrificed at 4 and 12 weeks, and the healing sites were evaluated using micro-computed tomography (micro-CT) and histological analysis. At 12 weeks, all groups showed good socket maintenance with comparable new bone formation. However, histological analysis revealed that HBC28 had significantly higher residual graft volume, while HPC64 demonstrated more extensive graft resorption. Histomorphometric analysis confirmed these findings, with statistically significant differences in residual graft area and bone volume fraction. No inflammatory response or adverse tissue reactions were observed in any group. These results suggest that all three HA–β-TCP collagen composites are biocompatible and suitable for socket preservation, with varying resorption kinetics influenced by graft composition. Selection of graft material may thus be guided by the desired rate of replacement by new bone. Full article

Evaluating the implant site immediately after implant removal is crucial for assessing its condition and ensuring morphological stability. Immediate reconstruction at the time of implant removal has been proposed as a strategy to preserve alveolar ridge width. This study aims to evaluate whether immediate alveolar bone reconstruction at the time of implant removal provides comparable or superior dimensional stability of the alveolar ridge compared to staged reconstruction approaches. The null hypothesis of this study is that there is no significant difference in alveolar bone dimensions between immediate and staged reconstructions following implant removal. This retrospective study included seven participants, consisting of six males and one female. The participants were categorized into three groups based on the treatment approach following implant removal. In Group 1, no bone grafting was performed after implant removal. In Group 2, bone grafting was conducted following implant removal, with an adequate healing period before implant placement. In Group 3, bone grafting was performed simultaneously with implant removal. Cone-beam computed tomography (CBCT) imaging was conducted before implant removal (T0), after implant removal or bone grafting (T1), and after implant placement (T2). All removed implants were successfully replaced with new ones, regardless of bone grafting. In terms of alveolar ridge width at 1 mm below the crest, Group 1 exhibited the greatest reduction (ΔT1 − T0 = −5.1 ± 3.7 mm), while Group 2 showed a mild increase (+1.1 ± 2.6 mm), and Group 3 had a moderate decrease (−1.3 ± 1.0 mm). This suggests that delayed bone grafting can better preserve or enhance bone volume during healing. A reduction in buccal ridge height between T1 and T0 (ΔT1 − T0) was observed, particularly in Group 1. In contrast, an increase in buccal ridge height was most pronounced in Group 2. Although immediate reconstruction (Group 3) did not result in statistically significant gains, it achieved successful implant placement without complications and reduced the total treatment duration, which might be beneficial from a clinical efficiency and patient satisfaction standpoint. Therefore, staged bone grafting (Group 2) appears to offer greater dimensional stability, particularly in maintaining ridge height, whereas immediate reconstruction (Group 3) remains a clinically viable alternative for stable healing in select cases, especially when shorter treatment timelines are prioritized. Full article

Background: Tooth agenesis, particularly hypodontia, poses a clinical and esthetic challenge in growing patients due to limitations in definitive implant placement before skeletal maturity. Traditional solutions such as removable prostheses or orthodontic space closure often fail to provide adequate long-term stability, function, and tissue preservation. In recent years, orthodontic mini-implants have emerged as a promising interim solution. This narrative review aims to synthesize current clinical evidence on the use of orthodontic mini-implants as temporary prosthetic abutments in children and adolescents with hypodontia or post-traumatic tooth loss. Methods: A literature search was conducted using PubMed and Google Scholar databases, covering studies published between January 2004 and March 2025. Inclusion criteria were clinical reports involving skeletally immature patients with congenital or traumatic tooth loss treated with mini-implants, with mandatory radiographic diagnostics and outcome data. Data extracted included patient demographics, etiology, implant site, imaging, follow-up, complications, and outcomes. A total of 17 studies comprising 42 cases were analyzed and summarized in tabular form. Results: Patients aged 6 to 16 years were treated primarily for agenesis of maxillary lateral or central incisors. The mean follow-up duration was 36.9 months. CBCT was used in 28.6% of cases. Mini-implants demonstrated high clinical success with stable soft tissue contours and preservation of alveolar volume. Complications were reported in 21.4% of cases and included crown debonding, minor infraocclusion, soft tissue irritation, and rare instances of osseointegration. Conclusions: Orthodontic mini-implants may provide a minimally invasive and reversible approach to interim tooth replacement in growing patients. Preliminary evidence suggests favorable outcomes in terms of stability, esthetics, and tissue preservation, but further prospective research is needed to validate their long-term effectiveness and standardize clinical application. Full article