Search Results (289)

Background/Objectives: This retrospective observational study evaluated associations among dentition type, age, systemic conditions, and oral pathology in pediatric patients. Methods: A six-month retrospective analysis was conducted in a specialized pediatric hospital. Patients (n = 155; 0–18 years) were grouped as clinically healthy with oro-maxillofacial diseases or with systemic diseases. Data included dental/periodontal status, anomalies, gingival bleeding index, IOTN score and oral mucosal conditions. Statistical tests (chi-square, ANOVA, and correlations) were applied. Results: Chronic gingivitis was most frequently associated with primary dentition. Caries and root debris were more frequent in ages 4–6, while acute gingivitis appeared in younger children. Orthodontic treatment need increased with age, especially in mixed dentition. Periodontal diseases were most often linked to digestive pathologies. Conclusions: Oral health in children showed associations with age, dentition type, and systemic conditions. Findings highlight associations rather than causation, underscoring the importance of prevention, early monitoring, and age-appropriate interdisciplinary management. Full article

Background/Objectives: Plasma cell gingivitis (PCG) is a rare, benign, non-dental-plaque-induced inflammatory condition characterized by dense subepithelial infiltration of polyclonal plasma cells. Due to its nonspecific clinical presentation, PCG represents a diagnostic challenge. This case report aims to describe a clinical case of PCG, highlighting the diagnostic process, histopathological correlation, and therapeutic approach. Methods: A 57-year-old male presented with a polypoid, erythematous, and edematous gingival lesion in the anterior maxillary region, with spontaneous bleeding on probing. Following clinic assessment, an incisional biopsy was performed, alongside complete hematological and inflammatory profiling. Histological and immunohistochemical analyses revealed the presence of an inflammatory infiltrate. Results: Histological evaluation revealed spongiotic squamous epithelium characterized by a dense plasma cell infiltrate with a liquenoid pattern of CD3-positive T and CD20-positive B lymphocytes. A polytypic expression of kappa and lambda light chains was also detected. The patient underwent topical corticosteroid therapy, showing progressive clinical improvement and resolution of symptoms, although minor mucosal involvement persisted. Conclusions: PCG remains a rare and underdiagnosed condition requiring integration of clinical, hematological, and histopathological data for accurate diagnosis. While corticosteroids remain the first-line therapy, emerging treatments, including photobiomodulation, may offer future adjunctive strategies to improve outcomes and reduce recurrence. Full article

Background: The asymptomatic progression of initial gingival inflammation in children often remains unnoticed or undiagnosed. Although full-mouth periodontal examination is considered the gold standard in diagnosing periodontal diseases, it is usually time-consuming and expensive. Therefore, the aim of this study was to assess gingival status using partial-mouth examination with the Community Periodontal Index of Treatment Needs (CPITN) and full-mouth examination with Bleeding on Probing (BOP) in the periodontal diagnosis of adolescents. Methods: This cross-sectional study was conducted in a sample of 457 Bulgarian children aged 11 to 14 years. Full-mouth examination was performed with the BOP index on all fully erupted permanent teeth, probing four gingival sites—three buccal and one oral. Partial-mouth examination was performed with CPITN, probing six representative teeth at six sites. Statistical analysis was conducted using Pearson’s chi-square test (χ²) and t-tests to compare relative proportions. Results: The BOP index identified significantly more healthy children compared to the CPITN (t = 1.90, p < 0.05). The CPITN has limitations in distinguishing between initial (BOP 10–30%) and advanced (BOP 30–60%) gingival inflammation. The comparative evaluation of the two indices by sextant showed that a healthy periodontium is most commonly observed in the posterior segments of both jaws in children, while gingival inflammation is localized predominantly in frontal areas. Conclusions: The CPITN has the advantage of providing a quick and easy method for recording gingival status in children, but it does not allow for the determination of the severity of gingival inflammation. Clinical Significance: Full-mouth examination using the BOP index is a more appropriate method for periodontal diagnosis in children, as it provides a detailed and comprehensive picture of the condition of the gingival tissues, especially when a clinical diagnosis is required to guide further treatment planning. Full article

Background/Objectives: Soft tissues are essential for maintaining the function and long-term success of dental implants. In many cases, implant placement necessitates soft tissue augmentation procedures such as free gingival grafts (FGGs) or connective tissue grafts (CTGs) to restore lost gingival architecture. Nevertheless, a significant challenge associated with FGG and CTG is postoperative pain, largely due to morbidity at the palatal donor site. To address this issue, various approaches have been proposed to reduce patient discomfort and promote improved wound healing at the donor site. This study aimed to compare the effectiveness of four different methods for protecting the palatal donor site following free gingival graft harvesting. Methods: A total of 76 patients undergoing implant therapy with an indication for free gingival grafting were selected and divided into four groups based on the method used to protect the palatal donor site: an absorbable gelatin sponge secured with sutures (GS); an absorbable gelatin sponge with sutures and cyanoacrylate tissue adhesive (GS+CTA); oxidized regenerated cellulose combined with cyanoacrylate tissue adhesive (ORC+CTA); and an absorbable gelatin sponge covered with a flowable resin composite and stabilized with sutures (GS+FRC). The effectiveness of each method was evaluated in terms of postoperative pain, bleeding, and wound healing. Results: Although the differences in pain intensity among the groups were not statistically significant throughout the observation period (p > 0.05), the GS+FRC group consistently exhibited the lowest mean pain scores. No statistically significant differences were observed between the groups regarding the incidence of secondary bleeding. The highest mean wound healing rate was recorded in the GS+FRC group (75.95 ± 18.75%), whereas the ORC+CTA group demonstrated the lowest rate (43.66 ± 25.74%). Conclusions: The use of an absorbable gelatin sponge covered with a flowable resin composite and secured with sutures, despite the presented limitations, appears to be a promising approach for palatal wound protection. While this group consistently demonstrated the lowest mean pain scores, differences in pain intensity among the groups were not statistically significant. Nonetheless, it achieved the most favorable outcomes in terms of wound epithelialization. Full article

Objective: To evaluate the short-term clinical impact of daily use of calibrated interdental brushes (IDBs) on gingival bleeding among dental and dental hygiene students within academic curricula. Methods: A prospective cohort of 117 students from three Italian universities was followed over three months. All participants received personalized training and calibrated interdental brushes matched to their interdental spaces. The primary outcome was the percentage of interdental sites exhibiting bleeding on interdental brushing (BOIB), assessed at baseline (T0), one month (T1), and three months (T2). Adherence was self-reported. Statistical analyses included Wilcoxon tests, multivariate regression, and adjusted ANCOVA models. Results: Median bleeding scores decreased from 50.0% [IQR: 26.9–69.2] at baseline to 15.4% [IQR: 3.8–30.8] at one month and further to 11.5% [IQR: 0.0–26.9] at three months (p < 0.001). Regular interdental brush users showed a 15 to 16 percentage point greater reduction in bleeding compared to occasional users (p < 0.001). Dental hygiene students had significantly lower baseline bleeding scores than dental students, but both groups experienced comparable benefits from the intervention. Adjusted analyses confirmed a sustained beneficial effect of regular interdental brushing. Initial weak and transient correlations between behavioral factors and bleeding likely reflect multifactorial influences and variable adherence. Conclusions: Daily use of calibrated interdental brushes produces a rapid, significant, and sustained reduction in gingival bleeding among dental students. Systematic integration of this protocol within dental education programs is feasible and effective, promoting early adoption and maintenance of essential preventive oral health behaviors. Full article

Objective: With a global prevalence ranging from 50% to 100%, gingivitis is considered the most common oral disease in adults worldwide. It is characterized by clinical signs of inflammation, such as redness, swelling and bleeding, on gentle probing. Although it is considered a milder form of periodontal disease, gingivitis plays an important role in overall oral health. Early detection and treatment are essential to prevent progression to more severe conditions. Typically, diagnosis is performed by dental professionals, as individuals are often unable to accurately assess whether they are affected. Therefore, the aim of the present study was to determine to what degree gingivitis is visually detectable by an easy-to-use camera-based application. Materials and methods: Standardized intraoral photographs were taken using a specialized intraoral camera and processed using a custom-developed filter based on a machine-learning algorithm. The latter was trained to highlight areas suggestive of gingivitis. A total of 110 participants were enrolled through ad hoc sampling, resulting in 320 assessable test sites. A dentist provided two reference standards: the clinical diagnosis based on bleeding on probing of the periodontal sulcus (BOP) and an independent visual assessment of the same images. Agreement between diagnostic methods was measured using Cohen’s kappa statistic. Results: The agreement between the application’s output and the BOP-based clinical diagnosis was low, with a kappa value of 0.055 [p = 0.010]. Similarly, the dentist’s visual assessment of clinical photos showed low agreement with BOP, with a kappa value of 0.087 [p < 0.001]. In contrast, the agreement between the application and the dentist’s photo-based evaluations was higher, with a kappa value of 0.280 [p < 0.001]. Conclusions: In its current form, the camera-based application is not able to reliably detect gingivitis. The low level of agreement between dentists’ visual assessments and the clinical gold standard highlights that gingivitis is difficult to identify merely visually. These results underscore the need to refine visual diagnostic approaches further, which could support future self-assessment or remote screening applications. Full article

Background and Objectives: Periodontitis is a chronic inflammatory disease that leads to progressive destruction of periodontal tissues and remains a significant global health burden. While conventional therapies such as scaling and root planning offer short-term improvements, they often fall short in maintaining long-term microbial control, underscoring the need for adjunctive strategies. This study evaluated the clinical and microbiological effects of a novel essential oil (EO)-based gel—SmartGel OV—formulated with Origanum vulgare. Materials and Methods: Thirty adults with periodontitis were enrolled in a 4-month observational study, during which SmartGel OV was applied daily via gingival massage. Clinical outcomes and bacterial profiles were assessed through probing measurements and real-time PCR analysis. Additionally, a pilot AI-based tool was explored as a supplemental method to monitor inflammation progression through intraoral images. Results: Significant reductions were observed in Fusobacterium nucleatum and Capnocytophaga spp., accompanied by improvements in clinical markers, including probing depth, bleeding on probing, and plaque index. The AI framework successfully identified visual inflammation changes and supported early detection of non-responsiveness. Conclusions: SmartGel OV demonstrates promise as a natural adjunctive treatment for periodontitis and AI monitoring was included as an exploratory secondary tool to assess feasibility for future remote tracking. Full article

Background/Objectives: Schoolteachers play a central role in shaping their students’ beliefs and attitudes towards oral health. Our aim was to investigate the oral and periodontal health knowledge of schoolteachers in Riyadh and factors affecting this knowledge. Methods: Government schoolteachers from representative areas of Riyadh (n = 895) responded to a structured questionnaire. Descriptive statistics, t-tests, one-way analysis of variance, and multiple linear regression (p ≤ 0.05). Results: Teachers demonstrated good basic oral/periodontal health knowledge (mean score = 60.21 ± 10.68). Most knew that toothbrushing is necessary to preserve dental (78.66%) and periodontal (57.88%) health; that gingival bleeding (74.41%), swelling (64.25%), and abscess formation (52.96%) are signs of periodontal disease; about 63% identified dental biofilm as an etiologic factor, and 58% knew that periodontitis may cause gingival recession and influence systemic health (74.07%). However, only 38% knew that dental flossing is necessary to preserve periodontal health, and 66.03% believed that gingival health can be restored with a special toothpaste. Teachers who were female, older in age, worked in north Riyadh, and taught the intermediate stage demonstrated statistically significantly better knowledge than the other categories. Conclusions: The studied sample of schoolteachers possesses acceptable basic oral health knowledge but has inadequate knowledge of periodontal health. Factors influencing teachers’ knowledge were age, gender, region of work, and teaching stage. Full article

Background/Objectives: Periodontitis is a chronic inflammation of the periodontium that induces damage in the periodontal ligaments and the surrounding alveolar bone. This study aimed to comparatively evaluate the clinical outcomes of two therapies used in the management of periodontal conditions, represented by scaling and root planing (SRP) alone and laser-assisted new attachment procedure (LANAP). Methods: Two quadrants of the oral cavity from each selected patient were randomly allocated to one of the treatment groups, SRP or LANAP. The periodontal status was documented in a periodontal chart at baseline, six weeks, and one year after treatment. SRP was performed in the first group of patients. The LANAP protocol was carried out on the patients belonging to the second group. Results: The outcomes of the study highlighted that LANAP leads to a reduction in periodontal disease signs (pocket depth, bleeding on probing, and gingival recession), contributing to the formation of new attachment tissues. LANAP shows more stability in maintaining the improvements achieved during six weeks, while SRP shows a slight deterioration in several parameters, particularly attachment loss, between six weeks and one year. The collected data at six-week and one-year follow-ups show improvements in periodontal health, thus improving oral health. Conclusions: Both minimally invasive periodontal procedures were effective, with LANAP demonstrating greater efficiency in patients with chronic periodontal disease, a greater reduction in pocket depth, and improved clinical outcomes compared to SRP alone. Full article

Objectives: We aimed to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) in promoting wound healing after the surgical removal of inferior third molars. Methods: Patients in need of unilateral mandibular third molar extraction were randomly assigned to either a test or control group before surgery. During the test, a photoactive substance activated with laser light (20 mW, 660 nm) was applied to the post-extraction site for 60 s before suturing to promote healing and disinfection. The control group did not receive any laser applications after tooth removal. The probing pocket depth (PPD), bleeding on probing (BOP), plaque index (PI), gingival recession (REC), and levels of clinical attachment loss (CAL) before surgery (T0), 14 days after surgery (T1), and after 3 months after surgery (T2) were evaluated for the adjacent second molar. Post-operative swelling, pain (VAS index), the number of painkillers taken, alveolar probing, and Landry’s healing index were recorded at T1. Results: Sixty-five patients, aged between 14 and 39 years, were assigned randomly to test (n = 32) or control (n = 33) groups. Five dropouts occurred. Post-operative swelling and the VAS index were significantly lower in the test group compared to the control (p = 0.002 and p = 0.04, respectively). All periodontal indexes except recession significantly worsened at T1 in both groups. After three months, a significant improvement for PPD, CAL, and PI was recorded in the test group compared to the control (p = 0.001). Conclusions: According to the results of this study, the use of aPDT seems to have a beneficial effect on post-operative swelling and pain, as well as the plaque index, in the short-term follow-up. Full article

The subgingival microbiome is a critical component of the oral microbiota and plays a central role in pediatric periodontology. This study investigated differences in periodontopathogen profiles in children with gingival inflammation compared to healthy controls using real-time PCR, with a focus on the microbial complexes defined by Socransky. A total of 73 children (ages 10–14) underwent comprehensive periodontal assessment, including assessments of general health status, the O’Leary hygiene index (HI), gingival condition, and the papillary bleeding index (PBI). Subgingival plaque samples were analyzed using real-time PCR to identify key bacterial species associated with gingival health and disease. Highly pathogenic periodontopathogens such as Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Eubacterium nodatum were absent in healthy subjects. In contrast, Tannerella forsythia was significantly more frequently detected in children with gingival inflammation (p < 0.05). The most abundant species in the inflammation group were Prevotella intermedia and Capnocytophaga gingivalis. Children with gingival inflammation exhibit a distinct subgingival microbiome profile characterized by an increased presence of specific periodontopathogens, including a higher prevalence of red complex species as defined by Socransky. However, the cross-sectional nature of this study limits the ability to establish causal relationships. Full article

Background/Objectives: Diabetes mellitus is defined as a group of metabolic diseases characterized by chronically elevated blood glucose levels. This condition influences the course of orthodontic treatment, as it affects various clinical aspects of the patient that must be taken into consideration prior to initiation. Therefore, achieving adequate control and management of diabetic patients undergoing orthodontic therapy is essential. This article presents a qualitative synthesis of studies addressing how diabetes affects orthodontic treatments, emphasizing the importance of understanding the necessary considerations prior to initiating treatment and how to manage potential complications. Methods: This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A database search was performed on 5 May 2025, in PubMed, Scopus, Scielo, and The Cochrane Library, using terms related to “diabetes mellitus” and “orthodontic treatments”. Studies meeting the search criteria were included, particularly those that were published in the past ten years and reported on the influence of diabetes on orthodontic treatment. The quality of the case–control studies was assessed using the Newcastle–Ottawa Scale (NOS); for cross-sectional studies, the Joanna Briggs Institute (JBI) critical appraisal checklist was used; and for experimental studies, the SYRCLE’s Risk of Bias Tool was applied. Results: Fourteen studies ultimately met the inclusion criteria. The evidence showed that diabetes increases gingival bleeding due to elevated levels of advanced glycation end-products (AGEs) and pro-inflammatory cytokines; reduces the efficiency of tooth movement; increases root resorption and affects bone remodeling; and compromises both periodontal and pulpal responses, thereby hindering tissue regeneration. It was also observed that the use of insulin or antidiabetic agents such as metformin may partially mitigate these adverse effects. Conclusions: This systematic review reveals a clear relationship between diabetes and various clinical aspects that influence the progression of orthodontic treatments. Nonetheless, further studies are needed to better understand the impact of this systemic condition on dental treatment outcomes. Full article

Objectives: To evaluate and compare the plaque-reducing efficacy of sesame-based oil pulling versus distilled water in a randomized controlled, examiner-blinded parallel-group study. Materials and Methods: Forty participants with gingivitis (community periodontal index of treatment needs grade 1 or 2) were randomly assigned to either the test group (sesame-based oil) or the control group (distilled water). Participants were instructed to perform oil pulling daily in the morning for 15 min over an eight-week period. The Rustogi Modified Navy Plaque Index (RMNPI) and gingival bleeding index (GBI) were evaluated at the baseline, as well as after four and eight weeks. Additionally, biofilm samples were collected for microbiological analysis. Results: The RMNPI was statistically significantly reduced after eight weeks of pulling with sesame-based oil (p < 0.001), as well as with distilled water (p < 0.001), without a significant difference between the groups. The GBI was statistically significantly reduced after eight weeks of pulling with sesame-based oil (p < 0.002), as well as with distilled water (p < 0.002), without a significant difference between the groups. No significant microbiological changes were detected in biofilm samples. Conclusions: Both plaque and gingival indices significantly decreased with oil pulling after eight weeks of intervention. Preclinical studies are necessary to clarify the mechanism of plaque reduction by oil pulling. Full article

Background and Objectives: Periodontitis is an inflammatory disease that compromises the supporting structures of the teeth, leading to irreversible tissue damage and tooth loss. While subgingival professional mechanical plaque removal (PMPR) remains the gold standard treatment, there is increasing interest in adjunctive therapies. Platelet-rich fibrin (PRF) has gained attention as a promising biomaterial to enhance periodontal healing and regeneration. This study aimed to evaluate the clinical and immunological effectiveness of PRF as an adjunct to PMPR. Materials and Methods: Clinical studies published between January 2019 and August 2024 were included from the ProQuest, PubMed, PMC, ScienceDirect, Scopus, and EBSCO databases. Seven studies met the inclusion criteria, focusing on adults with periodontitis treated with PRF + PMPR compared to PMPR alone. Primary outcomes included changes in clinical and immunological parameters. Risk of bias was assessed using the Cochrane ROB2 tool. Meta-analysis was conducted using both fixed-effect and random-effects models, depending on heterogeneity. Results: The meta-analysis demonstrated significant improvements in clinical outcomes in the PRF + PMPR group, with reductions in probing pocket depth (SMD: −1.43 mm; 95% CI: −2.05 to −0.81; p < 0.00001), clinical attachment level (SMD: −1.34 mm; 95% CI: −1.95 to −0.73; p < 0.0001), bleeding on probing (SMD: −0.75 mm; 95% CI: −1.11 to −0.39; p < 0.00001), gingival recession (SMD: −0.79 mm; 95% CI: −1.33 to −0.25; p = 0.004), and gingival index (SMD: −0.82 mm; 95% CI: −1.37 to −0.28; p = 0.003). Favorable trends were also observed in IL-10, TGF-β, VEGF, PDGF-BB, periostin, and type I collagen levels. Conclusions: PRF enhances clinical and immunological outcomes and supports periodontal tissue stability when used as an adjunct to non-surgical therapy. Full article

Background/Objectives: Children with Autism Spectrum Disorder (ASD) often exhibit similar food-related behaviors, such as excessive sugar consumption, and sensory processing difficulties, which can hinder oral hygiene routines like toothbrushing and increase the risk of cavities or gum problems. Therefore, caregiver involvement in maintaining oral health is crucial. The aim of this study was to assess the knowledge, attitudes, and practices reported by caregivers in terms of oral care provided to children diagnosed with ASD between the ages of 5 and 12 years. Methods: A cross-sectional study was conducted, and the participants comprised 72 caregivers of children with ASD enrolled in four therapeutic centers in SLP, Mexico. Data on caregivers’ knowledge, attitudes, and care in terms of oral health, as well as sociodemographic characteristics, were collected through a structured and self-administered questionnaire. Results: Among the caregivers, 85% were women, and 86% recognized sugar as a cariogenic and gingival bleeding as a sign of inflammation. Despite this, over 60% reported frequent sugar consumption, 65.4% supervised toothbrushing, and floss use was minimal. More than half showed high self-efficacy, which correlated with more frequent supervised or autonomous toothbrushing. Caregivers involved in homecare brushed their children’s teeth more often. Correct knowledge of brushing frequency was associated with actual toothbrushing practices (p < 0.05). Conclusions: This study highlights a notable gap between caregivers’ knowledge and oral care practices in terms of children with ASD. Full article